Protecting reproductive health of refugees

One of the United Nations High Commissioner for Refugees' (UNHCR) first priorities in addressing the problem of sexual violence against refugees is to meet the needs of the victims. The devastating consequences of sexual violence for the victim's family and community must also be recognized and addressed. It is clear that both medical and appropriate psycho-social care and counselling are of critical importance for victims of rape and other forms of sexual violence. Special measures with respect to accommodation, documentation, recognition of refugee status and durable solutions may also be necessary, as is indicated in the UNHCR Guidelines. UNHCR uses the Guidelines in its People-Oriented Planning (POP) training with a view to ensuring that they are incorporated into the daily work of all those who may have an impact on the protection of refugee women and girls, including UNHCR field, programme and protection staff, as well as the staff of governmental and non-governmental agencies dealing with refugees.

One obstacle to providing appropriate care to victims of sexual violence is the desire of many of the victims themselves to remain silent about their experience, often owing at least in part to a wholly understandable concern about how they will be regarded and treated by others because of it. In several instances of rape, UNHCR was able to learn of the extent of the attacks only when the victims were obliged to seek medical care. Regardless of nationality and culture, rape is experienced by most victims as shameful and stigmatizing, and arouses fears, often justified, of rejection by a present or future partner. The problem is aggravated in the many societies where protection of a woman's chastity is considered a matter of family honour. Even under normal circumstances, sex generally is not a subject of open discussion in many cultural contexts, and the experience of the Office has confirmed that the victim of rape often prefers to hide her victimization to escape the shame and ostracism it could bring upon her, her family and her community. To avoid further stigmatization and respect their need for privacy, it has been found useful to provide care and treatment to victims of sexual abuse within the framework of programmes to meet the needs of women generally, so that they are not singled out or "labelled" as rape victims. The presence of women field, protection, medical and social services staff is also essential for victims of sexual violence to obtain the protection, treatment and counselling they require.

Finding the appropriate durable solution for refugee victims of sexual violence can pose special problems. For many, perhaps most, the support of family, friends and community will be essential to their recovery from the trauma they have suffered, and the appropriate durable solution will be the same as for the other members of their communities. For some, particularly unaccompanied or abandoned women who have been subjected to sexual abuse in or en route to the country of asylum, early voluntary repatriation to their own culture and society may be in their best interests, and in some cases provide an escape from an intolerable situation. For other women and girls, repatriation may represent return to a situation where the threat of sexual violence still exists or where the victim of rape will suffer ostracism or severe discrimination. For this and other reasons it is essential that women have the opportunity to make an individual decision with respect to repatriation.

Whether local integration is a desirable option for women who have suffered sexual abuse will depend on many factors, including the policies of the government concerned, facilities for reception, treatment and care, and the situation of similarly situated women in the local culture. When there are linguistic and cultural affinities with the country of origin, as well as adequate programmes of care, it may be better to remain in a country of first asylum than to be resettled in unfamiliar surroundings in another region. Resettlement is an important option, however, for victims of sexual violence for whom neither repatriation nor local integration is a viable solution. Urgent resettlement might provide the best chances for emotional recovery for victims of rape, and sometimes can be required for the security of both the victim and witnesses to the crime if their protection cannot be ensured in the country of asylum. Several states have special resettlement programmes for women-at-risk which have been extremely helpful in meeting this need. Care must always be taken, however, that rape accusations do not come to be seen as a means to obtaining rapid resettlement.