Rebecca is not her real name. Changed for her safety, her story of gender-based violence is harrowing but, unfortunately, not unique. In fact, women in developing countries – including South Sudan, where we met – are often faced with an impossible choice: continue to endure the crushing blows of an abusive husband, or live with the crushing weight of poverty and marginalization by choosing to leave.
But that implies Rebecca has a choice. She doesn’t really.
“He’s depressed because he isn’t working,” Rebecca says of her husband’s current state. “So he drinks, and then he comes home and I ask him, ‘why aren’t you working to buy food?’ That’s when he starts beating me.”
A public health crisis
Here in Bor, violence has been part of the city’s story ever since the first kwaje set foot on the banks of the White Nile here in the 1860s to trade ivory and slaves. Given years of colonialism and, now, civil war, violence seems to have captured imaginations. “When I was young I remember children playing and pretending to be farmers,” one teacher-turned IMA World Health staff member told me. “Now they pretend to run around with guns and shoot one another.”
As desensitized as society here seems to be to violence, gender-based violence has created an issue so complex, and so pressing, that it has been raised by the local medical community as a public health concern. Under their leadership, the UN’s family planning agency and IMA World Health have supported the community to create a center focused exclusively on sexual and gender-based violence, or SGBV. It is the kind of justice and peace-making work to which faith-based organizations are drawn.
Creating a safe space
The facility is surrounded by Bor’s other state health facilities. A hospital, outpatient clinic and maternity clinic anchor the walled-in compound. The new SGBV center provides survivors immediate psyco-social, medical and legal support in a setting where it looks like they could be seeking medical services for any other common malady.
IMA staff joined community health workers to engage police as a partner in the problem, helping them to understand some of the challenges women face to seeking help, such as charging for filing a report. And, together, we’ve worked with police to create a special protection unit, which aims to keep survivors safe outside of the health facility.
“They come here and they haven’t shared their stories of abuse with anyone," IMA World Health SGBV officer Chandia Martin says. “So they are usually very tired once they tell us what’s going on. We can provide them a place to rest until dark but then they have to go somewhere else.
There is a lot of effort put in to determining if the person we’re treating is able to leave here and be safe at home.”
It is in this effort where the tidiness of the new four-room SGBV clinic meets the messiness of real life. In most anywhere else in the world, one might think sending a woman home to return to her abusive husband unconscionable. Yet in a country that has the among world’s highest maternal mortality rates and the highest rate of female illiteracy of anywhere in the world, the choices aren’t so clear - especially for women.
Rebecca thumbs a red and green rubber bracelet printed with MERRY CHRISTMAS as she tells me about her family. The bracelet is a gift from her daughter, which brings a smile to her face even though she may not seem to have much to smile about. Rebecca described for me the debilitating poverty she and her family endure. She wears a dress given to her by a missionary that is so worn thin daylight easily streams through its floral pattern. She wears pink sandals held together by tape that were given to her by a woman for whom she collects water, to try and earn a few pounds.
An examination kit used by doctors to help survivors of sexual and gender-based violence.
Treating the invisible wounds
Rebecca endured her last round of drunken beatings in July. She did what she had always done, seeking help at the local hospital for her wounds. Invisible wounds usually went unattended; that is, until the hospital doctor connected her to the drop-in center. Here, in this new office Rebecca was met by a social worker who listened to her story. Then she had a session with a counselor.
“I had never reported this to anyone,” Rebecca said. “If I had had this place, maybe I wouldn’t have been beaten for all those years.”
Rebecca’s counselor helped her to see the cycle brought on by her husband’s drinking. The counselor suggested that instead of confronting him while he was inebriated, Rebecca should wait to speak with her husband when sober.
She tried it. “So I asked him, ‘why do you do this to me? Come home from drinking and insult me and beat me. I am the mother of your children.”
Rebecca says this was a turning point. That her husband began to feel shame and remorse for his actions. “He has really promised not to fight any more.”
Moving forward
But pressures remain. The stress to earn money that would feed their family hangs over their home like a consuming cloud. She and her husband leave their seven children alone during the day while they look for work. They can’t afford the school fees for their children, around 1,200 South Sudan Pounds each (around US$9.22).
“I am worried if I don’t find work and put them in school they will become thieves,” she says.
Yet, Rebecca and her husband’s frank conversation since the July altercation has given light to the possibility of a new business collecting water for homes and other businesses in their area of Bor. Rebecca says this possibility gives her hope. Her husband has not beaten her since she confronted him in July. Caught between the assurance of safety and the risk of unimaginable depravity for her and her children, Rebecca left the one-stop center and made a choice that few have any right to judge.
“I have no one else,” Rebecca says. “We have each other. If it happens again I know I can come back to this center.”
Matt Hackworth is senior advisor for marketing and communications for IMA World Health and Lutheran World Relief.