Sexual violence: an increasingly frequent reality in the migration crisis

Today, at international day for the elimination of violence against women, we need to talk about sexual violence, especially in the migrant crisis. At Médecins Sans Frontières, we have witnessed rape, sexual exploitation, forced service or labor, and practices that often resemble the slavery and exploitation of children and adults.

Since 2023, MSF has conducted 1,132 consultations on sexual violence. 550 cases in Mexico (January to October), 397 cases in Panama (January to October), 76 cases in Honduras (January to October), 61 cases in Guatemala (January to October), 37 cases in Brazil (January to September) and 11 cases in Peru (January to October). – October). – August). Of the 1,132 cases handled by MSF, 997 (88%) were cases of sexual violence against women, 115 (10%) cases of sexual violence against men, and 20 cases of sexual violence against LGBTQIA+ people (2 %).

These cases expose the surface of the problem, as under-registration is severe, largely due to numerous barriers for victims to seek and receive help. For example, in our project we found a lack of awareness that sexual violence is a medical emergency.

At the same time, many people believe that incidents of sexual violence are the norm in their communities or in the immigration process, and the most important thing is to get on with it. In other cases, intense threats from the abuser or family, as well as social pressure, lead the person not to seek medical assistance. A core factor is the fear of legal proceedings in a foreign country, which could slow progress on the route. Prioritizing reporting and legal proceedings over medical care is to prioritize perpetrators over survivors.

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Another common barrier is that many survivors of sexual violence do not receive preventive treatment against sexually transmitted diseases, and in many cases they do not receive HIV testing to know their serological status; they also do not receive syphilis testing, And access to psychological support after an incident of sexual violence is difficult.

In fact, in many cases post-exposure prophylaxis kits are not available because health agencies do not have the category to provide them. In general, when caring for immigrant populations, we found that institutional health staff had negative attitudes toward survivors (many times due to xenophobia or the criminalization of immigrants). Furthermore, migration situations exacerbate people’s vulnerabilities and expose them to greater risks.

We also show that in many places, Survivors re-victimized as they are forced to travel long distances to seek care; There were still 2 or 3 medical professionals who checked and confirmed that it was “rape”, which once again proved that the survivors’ words were not true.

Sexual violence: a public health issue

Current approaches to care for survivors of sexual violence in our region aim to be widespread, but in practice the government does not emphasize the need for those affected by sexual violence to seek immediate help from health facilities. We call for sexual violence to be considered a public health issue rather than a primarily criminal issue.the situation is further complicated when migrants do not receive documentation or institutional support.

It is worth emphasizing that comprehensive health care is the only service guaranteed to save the lives of victims of sexual violence. From a health perspective, sexual violence is a race against time; HIV/AIDS prevention medications and antibiotics are available within the first 72 hours of onset to help prevent infections such as chlamydia, gonorrhea, syphilis, and avoid unwanted pregnancies .

During the first 120 hours, treatment includes providing emergency contraceptive pills to avoid unwanted pregnancy and prevent infection. Hepatitis B and tetanus vaccinations are available in the first 6 months, but the opportunity to treat other diseases is lost.

Therefore, major impacts on physical health include unintended pregnancy, sexually transmitted infections, and fistulas. The main impacts on mental health are feelings of sadness, depression, suicidal ideation, feelings of fear or threat, irritability, anxiety, guilt, worry, sleep problems, etc., which can affect survivors for years or throughout their lives.

emergency procedures

Governments across the region must take urgent steps to reduce cases of sexual violence, which means opening safe routes and respecting migrants’ rights. also, The health status of the migrant population needs to be improved urgentlyexpands access to services for survivors of sexual violence and provides people with comprehensive care in less than 72 hours after an incident.

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In this sense, the message must be conveyed to the public and institutions that cases of sexual violence are first and foremost a medical emergency and must be treated as confidential public health issues, with priority given to medical and psychological care of those affected, Avoid their marginalization and the invisibility of this reality.

* Regional Advocacy Representative for Médecins Sans Frontières (MSF). MSF provides humanitarian responses in our region, including projects related to violence, access to health services, emergencies and, of course, migration crises. Along these migration routes, MSF has developed 10 projects with different focuses during 2023, covering some of the most difficult routes for migrating populations.