Henttonen Mirkka, Watts Charlotte, Roberts Bayard, Kaducu Felix, Borchert Matthias
Finnish HIV Foundation / AIDS Council, Helsinki, Finland.
Reprod Health Matters. 2008 May;16(31):122-31. doi: 10.1016/S0968-8080(08)31353-6.
The 20-year war in northern Uganda has resulted in up to 1.7 million people being internally displaced, and impoverishment and vulnerability to violence amongst the civilian population. This qualitative study examined the status of health services available for the survivors of gender-based violence in the Gulu district, northern Uganda. Semi-structured interviews were carried out in 2006 with 26 experts on gender-based violence and general health providers, and availability of medical supplies was reviewed. The Inter-Agency Standing Committee (IASC) guidelines on gender-based violence interventions in humanitarian settings were used to prepare the interview guides and analyse the findings. Some legislation and programmes do exist on gender-based violence. However, health facilities lacked sufficiently qualified staff and medical supplies to adequately detect and manage survivors, and confidential treatment and counselling could not be ensured. There was inter-sectoral collaboration, but greater resources are required to increase coverage and effectiveness of services. Intimate partner violence, sexual abuse of girls aged under 18, sexual harassment and early and forced marriage may be more common than rape by strangers. As the IASC guidelines focus on sexual violence by strangers and do not address other forms of gender-based violence, we suggest the need to explore this issue further to determine whether a broader concept of gender-based violence should be incorporated into the guidelines.
乌干达北部持续20年的战争导致多达170万人在国内流离失所，平民陷入贫困并易遭受暴力侵害。这项定性研究调查了乌干达北部古卢地区为基于性别的暴力幸存者提供的卫生服务状况。2006年，对26名基于性别的暴力问题专家和普通医疗服务提供者进行了半结构式访谈，并审查了医疗用品的供应情况。采用了机构间常设委员会（IASC）关于在人道主义环境中干预基于性别的暴力的准则来编写访谈指南并分析研究结果。关于基于性别的暴力确实存在一些立法和方案。然而，卫生设施缺乏足够合格的工作人员和医疗用品，无法充分检测和管理幸存者，也无法确保提供保密治疗和咨询服务。存在部门间合作，但需要更多资源来提高服务的覆盖范围和有效性。亲密伴侣暴力、对18岁以下女孩的性虐待、性骚扰以及早婚和逼婚可能比陌生人强奸更为常见。由于机构间常设委员会的准则侧重于陌生人实施的性暴力，未涉及其他形式的基于性别的暴力，我们建议有必要进一步探讨这个问题，以确定是否应将更广泛的基于性别的暴力概念纳入准则。
