Healthcare workers in Baringo, Kenya, require continuous training to detect mental illness and holistically respond to cases of sexual and gender-based violence (SGBV).
Following the escalation of inter-community conflict early this year, Mary* was forced to flee her home in search of safety. Unlike her neighbours who headed straight for an Internally Displaced People (IDP) camp miles away, Mary, who had a school-going teenage daughter, decided to seek refuge at a distant relative's home. This is because the camp was far from where her daughter went to school, and she wanted to allow her daughter to continue with her education. This is a common practice in the area as some internally displaced people choose to integrate into the community instead of going to stay in the camps.
Mary and her daughter were hosted at a relative's home and set up a temporary shelter inside the compound. Initially, everything seemed to be going well for them. This, however, was before Mary’s daughter told her about the awkward propositions she was getting from the relative’s eldest son.
Coming from a community that rarely addresses sexual and gender-based violence (SGBV) issues, Mary decided to turn a blind eye to the matter, asking her daughter not to cause trouble with a family that had graciously hosted them. This, unfortunately, made the situation even worse, with the relative’s son, who was over 18 years old, becoming more aggressive in his advances towards Mary’s teenage daughter.
One night, after a drinking spree, the relative's son came home and attempted to defile Mary’s daughter. “Were it not for her loud screams, he would have been successful!” says Mary. “I said enough is enough!” That night, Mary and her daughter packed their bags and left for the camp. This, unfortunately, is the story of many internally displaced persons in Baringo County.
“A needs assessment by MSF showed significant gaps in case detection and management of SGBV cases in the displaced persons camps in Baringo county. On 29 April, MSF initiated an emergency intervention focused on supporting the displaced persons on mental health and specifically SGBV.” Jonah Ngugi, Nursing Activity Manager, says. MSF appointed a clinician with SGBV experience to be part of the medical outreach activities and medical services offered at IDP camps to support the detection of SGBV cases in the community.
“We had two entry points for SGBV case detection and management, one was during therapy sessions with our psychologists, and another was during medical consultations through the clinician with experience in SGBV case detection,” he says.
Nancy Mutai, an MSF psychologist, says it is likely underreported. “We received cases of attempted rape and gender-based violence, and we have been able to manage them and link them to care, but this is not the true picture,” she says.
Further analysis by MSF teams on the ground shows that the SGBV cases are mainly in integrated settings compared to the camps. “In the camps, there is a clear separation between where men and women sleep, the internally displaced persons also get up to two meals a day, and mothers are more aware of their children’s whereabouts. In the integrated settings, however, the situation is much more complicated; girls tend to walk long distances in search of water and firewood, which puts them at risk. The IDPs are also at the mercy of their hosts and can easily be taken advantage of,” says Nancy.
MSF noted with concern the lack of awareness of SGBV issues and cultural hindrances blocking the early detection and management of SGBV cases in these communities. In response to this and to promote sustainability even as it concluded its emergency intervention in Baringo county, MSF, in partnership with the Ministry of Health, conducted capacity building for 187 community health promoters and 60 health care workers on sexual and gender-based violence response and mental health and psychosocial support between 12 and 28 June.
*Not her real name; the name has been changed to protect her identity.
