Increased sexual violence raises HIV concerns

Escalating violence in Somalia is increasing the incidence of sexual attacks against women and girls and heightening their risk of HIV infection, say humanitarian workers based in the region.

"While we do not currently have accurate data on the extent of sexual violence across the country, reports from local and international actors on the ground say it is on the rise," Cecilia Kaijser, gender adviser for the UN Office for the Coordination of Humanitarian Affairs (OCHA)  in Somalia, told IRIN/PlusNews.

Fighting between the Ethiopian-backed Transitional Federal Government (TFG) and insurgents has intensified, especially in south-central Somalia, since the TFG ousted the Union of Islamic Courts in January. Tens of thousands of people have fled the capital, Mogadishu, for the relative safety of camps for internally displaced persons (IDP).

According to anecdotal reports from OCHA, adolescent girls and women have been abducted, harassed and raped, leaving them vulnerable to unwanted pregnancies and HIV infections. The agency has also reported that a curfew imposed by the government is preventing people in need of urgent medical care from reaching health facilities.

"We are convinced that sexual and gender-based violence, which is a symptom of the lowly status of women and their lack of negotiating power, is a driver of the Somali HIV epidemic," said Leo Kenny, country director of UNAIDS Somalia. "However, we need - and are in the process of gathering - accurate empirical data that will give us a better idea of HIV in the Somali context."

The UN and its local and international partners have embarked on a number of projects aimed at protecting women and girls from sexual violence and ensuring that they receive proper care after attacks.

The UN Children's Fund (UNICEF),  for instance, is providing water and sanitation facilities in the IDP camps to limit the risks women are exposed to when they go in search of water. 

Through its 'Caring for Survivors' programme, UNICEF is also providing training to 35 community health workers in Baidoa, a town 240km northwest of Mogadishu, where the situation is particularly hazardous.

According to Ulrike Gilbert, UNICEF's HIV/AIDS project officer in Somalia, "They learn basic interviewing and reporting skills, and refer the women to our partner, UNFPA [UN Population Fund], for medical care and trauma counselling."

UNFPA recently trained health workers across south-central Somalia to provide clinical and psycho-social care to the survivors of sexual and gender-based violence.

"There has been no system in place in Somalia where people could get PEP [post-exposure prophylaxis]," said Dr Penina Gathuri, sexual and gender-based violence (SBGV) coordinator for UNFPA in Somalia. "Rape survivors were given antibiotics or painkillers - whatever the health centre had - but no treatment for HIV."

UNFPA plans to start providing PEP kits and rape kits, and referring women who have been seriously injured to hospitals, such as the one in Baidoa, where the agency is supporting an obstetrician-gynaecologist.

"We have also started a media outreach programme in partnership with HornAfrik Radio, whereby they broadcast messages about SGBV," UNICEF's Gilbert said. "UNDP [UN Development Programme] is also involved in liaising with Somali religious leaders to ensure we are all on the same page."

According to UNAIDS, the HIV prevalence in Somalia is 0.9 percent, which is significantly lower than that of its neighbours. However, the prevailing insecurity means thousands of Somalis are crossing borders to higher prevalence countries such as Kenya, further increasing the threat of HIV.

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