Calderón-Jaramillo Mariana, Parra-Romero Diana, Forero-Martínez Luz Janeth, Royo Marta, Rivillas-García Juan Carlos
Asociación Profamilia, Calle 34 No. 14 - 52, Teusaquillo, Bogotá, DC, Colombia.
Bogotá Mayoralty, Bogotá, DC, Colombia.
J Migr Health. 2020 Sep 29;1-2:100003. doi: 10.1016/j.jmh.2020.100003. eCollection 2020.
Sexual and Gender-Based Violence (SGBV) affects women and girls in multiple ways. During migration and within humanitarian settings, migrant women and girls are exposed to different forms of SGBV and to higher vulnerabilities compared with those men encounter. Survivors of this kind of violence face challenges in accessing healthcare for reasons that not only include legal status, language barriers, discrimination, misinformation on the availability of healthcare services, but also the growing spread of conservative views regarding sexual and reproductive health which pose a considerable threat to human rights. This study was guided by the question of how humanitarian emergency preparedness and response initiatives within four cities at the Colombo-Venezuelan border are addressing SGBV. The goal of this research was threefold: first, to explain the level of implementation of the second goal of the MISP, which is to prevent and respond to the consequences of sexual violence; second, to assess the availability of services for migrants who have experienced some type of sexual violence; and third, to understand the perceptions of migrants regarding sexual and gender-based violence.
This study assessed the degree of implementation of the Minimal Initial Service Package (MISP) using a set of tools developed by the Inter-Agency Working Group on Reproductive Health in Crises. This study combined the use of different qualitative methods: i) a literature review; ii) 23 interviews with key informants on sexual and reproductive health; iii) an assessment of 21 health institutions which provide services to migrants; and iv) 24 focus groups with migrants between the ages of 14 to 49 years old (241 participants, of which 121 were women and 120 were men). This research was conducted in four cities at the Colombo-Venezuelan border where there was the highest concentration of migrants. Ethical approval was granted by Profamilia´s Advisory Committee on Research Ethics. Although preventing and managing the consequences of sexual violence is the second objective of the MISP, this study found several barriers for the guarantee of comprehensive healthcare for survivors: Venezuelan migrants do not usually consider that healthcare is a need for them after they have survived sexual violence; SGBV during migration is a common occurrence according to key informants; in three out of four cities there were existing organizations working on SGBV, but not all of them could offer comprehensive healthcare services in response to sexual violence.
In this study, we observed that migrants tend to be more exposed to Sexual and Gender-Based Violence due to the normalization of such forms of violence in the Colombian and Venezuelan cultures. Findings suggest that Venezuelan migrants are facing complex SGBV issues during the humanitarian emergency at the Colombia-Venezuela border. Recommendations include local health systems response teams, governments and host communities working together to address early access to prevention, healthcare, and protection services for the survivors of SGBV; eliminating barriers in access to essential and comprehensive equity-oriented healthcare services; developing the skills and capacities of healthcare services professionals around the proper management of SGBV; and countering misinformation, lowering the stigma associated with migrants in host communities, and broadening migrant´s perceptions of SGBV, gender roles, and xenophobia.
性暴力和基于性别的暴力(SGBV)对妇女和女孩有多种影响。在移民过程中和人道主义环境中,与男性相比,移民妇女和女孩面临不同形式的SGBV,且更容易受到伤害。这类暴力的幸存者在获得医疗保健方面面临挑战,原因不仅包括法律地位、语言障碍、歧视、关于医疗保健服务可及性的错误信息,还包括对性健康和生殖健康的保守观点日益盛行,这对人权构成了相当大的威胁。本研究的指导问题是科伦坡 - 委内瑞拉边境四个城市的人道主义应急准备和应对举措如何应对SGBV。本研究的目标有三个:第一,解释多部门综合应对计划(MISP)第二个目标的实施水平,该目标是预防和应对性暴力的后果;第二,评估为遭受某种性暴力的移民提供服务的可及性;第三,了解移民对性暴力和基于性别的暴力的看法。
本研究使用危机中生殖健康问题机构间工作组开发的一套工具评估了最低限度初始服务包(MISP)的实施程度。本研究结合使用了不同的定性方法:i)文献综述;ii)对23名性健康和生殖健康关键信息提供者的访谈;iii)对21家为移民提供服务的医疗机构的评估;iv)与14至49岁的移民进行24次焦点小组讨论(241名参与者,其中121名是女性,120名是男性)。本研究在科伦坡 - 委内瑞拉边境移民最集中的四个城市进行。Profamilia研究伦理咨询委员会批准了伦理许可。尽管预防和管理性暴力的后果是MISP的第二个目标,但本研究发现为幸存者提供全面医疗保健存在几个障碍:委内瑞拉移民在遭受性暴力后通常不认为医疗保健是他们的需求;关键信息提供者表示,移民过程中的SGBV很常见;在四个城市中的三个城市,有致力于SGBV的现有组织,但并非所有组织都能提供应对性暴力的全面医疗服务。
在本研究中,我们观察到由于此类暴力形式在哥伦比亚和委内瑞拉文化中常态化,移民往往更容易遭受性暴力和基于性别的暴力。研究结果表明,在哥伦比亚 - 委内瑞拉边境的人道主义紧急情况下,委内瑞拉移民面临复杂的SGBV问题。建议包括地方卫生系统应对团队、政府和东道社区共同努力,为SGBV幸存者尽早提供预防、医疗保健和保护服务;消除获得基本和全面的公平导向医疗服务的障碍;培养医疗服务专业人员正确管理SGBV的技能和能力;反驳错误信息,降低东道社区对移民的污名化,并拓宽移民对SGBV、性别角色和仇外心理的认识。