Health Consequences of Sexual Violence

Health Consequences of Sexual Violence

 
Fistula
 
Traumatic fistula is an abnormal
opening between the reproductive
tract of a woman and one
or more body cavities or surfaces,
caused by sexual violence, usually
but not always in conflict and post-conflict settings. It is a result of direct gynaecological trauma, usually from violent rape, mass rape and/or forced insertion of objects into a woman’s vagina[1].
 
Due to the nature of conflict related sexual violence, women are often sexually assaulted using sticks, guns, branches of trees and bottles, causing disastrous physical injuries. Women’s genitals are deliberately destroyed and traumatic fistula is often the result[1]. Permanent damage to the uterus, ensuing incontinence, sexually transmitted infections like Syphilis, Gonorrhoea, Chlamydia, Trichomoniasis and even the transmission of HIV, are other reoccurring physical consequences that victims of sexual violence face[2]. Health clinics in Liberia reported in 2003 that all female patients, who said they had been raped by government soldiers, tested positive on at least one sexually transmitted infection[3]. Moreover, in Rwanda 67 percent of the genocide widows joining a field research in 2000 were found to be HIV-positive.
 
 
 
Physical consequences [5]


 Unwanted pregnancy


 Unsafe abortion


 Sexually transmitted infections (STI);   HIV/AIDS


 Infertility


  Pelvic inflammatory disease


  Urinary tract infections


  Fistula / Tears


  Anal / rectal trauma


It are not only physically mature women who are raped but also children whose bodies have not yet developed and who may sustain horrific internal injuries as result. In addition, in countries where most girls and women have undergone female genital mutilation, sexual violence can cause extensive tearing externally as well as internally and makes diagnosis of STI more difficult. Most often, female victims are left to heal without medication or surgical intervention causing inhuman suffering which eventually in many cases leads to death. Mortality might, besides as result from the violent act itself, also result from acts of retribution such as ’honour killings’ or from suicide[4]. Affected women that do survive are usually subsequently divorced, shunned by their communities and unable to work or care for their families because of cultural standards. The long-term medical complications of violent rape for survivors may include uterine prolapsed, miscarriages, infertility and AIDS.
 
  
[1] Peterman, A. & Johnson, K. (2009). Incontinence and trauma: Sexual violence, female genital cutting and proxy measures of gynaecological fistula. Social Science & Medicine, 68, p. 971-979.


[2] Russel, W. (2007). Sexual Violence Against Men and Boys. Forced Migration Review, 27, p. 22-23.


[3] UNFPA. (2006). Sexual Violence Against Women and Girls in War and Its Aftermath: Realities, Responses, and Required Resources. Retrieved on August 1, 2013 from: http://www.unfpa.org/emergencies/symposium06/docs/finalbrusselsbriefingpaper.pdf.


[4] WHO. (2003). Guidelines for medico-legal care for victims of sexual violence. Retrieved on August 2, 2013, from: http://whqlibdoc.who.int/publications/2004/924154628X.pdf.
 
[5] Lawn, J. E., Cousens, S. & Zupan, J. (2005). 4 Million Neonatal Deaths: When, Where, Why? Lances, 365, p. 891 – 900.

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