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 Table of Contents  
COMMENTARY
Year : 2021  |  Volume : 5  |  Issue : 2  |  Page : 181-184

A pandemic worser than a pandemic – Sexual violence during COVID-19


1 Department of Anaesthesia and Critical Care, Level III UN Hospital, Goma, Democratic Republic of the Congo
2 Department of Psychiatry, Level III UN Hospital, Goma, Democratic Republic of the Congo

Date of Submission06-Mar-2021
Date of Decision01-Apr-2021
Date of Acceptance08-Apr-2021
Date of Web Publication28-Oct-2021

Correspondence Address:
Dr. Shibu Sasidharan
Department of Anaesthesia and Critical Care, Level III UN Hospital, Goma
Democratic Republic of the Congo
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/aip.aip_26_21

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  Abstract 


This article underscores the importance of making advance preparations for situations of disaster when anti-sexual violence work becomes more difficult and complex. It also highlights the painful price that disasters can exact, especially when society is ill-equipped or unwilling to respond effectively.

Keywords: COVID-19, pandemic, sex crimes, sexual violence


How to cite this article:
Sasidharan S, Dhillon HS. A pandemic worser than a pandemic – Sexual violence during COVID-19. Ann Indian Psychiatry 2021;5:181-4

How to cite this URL:
Sasidharan S, Dhillon HS. A pandemic worser than a pandemic – Sexual violence during COVID-19. Ann Indian Psychiatry [serial online] 2021 [cited 2021 Dec 6];5:181-4. Available from: https://www.anip.co.in/text.asp?2021/5/2/181/329430




  Introduction Top


It is indeed unfortunate when the term “safer-at-home” does not mean the same for everyone.

Unfortunately, sexual violence is a pandemic. It has consumed the world since the history of time. Although many countries around the world do not have statistical data on this sensitive issue, the data that are available submit that in some countries almost one in four women may experience sexual violence by an intimate partner,[1],[2] and a staggering one-third of adolescent girls report that their first sexual experience as being by force.[3],[4],[5]

The term sexual violence is defined as any sexual act, attempt to obtain a sexual act, unwanted sexual comments or advances, or acts to traffic, or otherwise directed, against a person's sexuality using coercion, by any person regardless of their relationship to the victim, in any setting, including but not limited to home and work.[6] Domestic violence includes emotional, physical, and/or sexual harm by a current or former intimate partner.[7] Since research is limited about the type of violence following or during a disaster, what we have is the sum of domestic and nondomestic sexual violence.

When we compare rape victims to others who have not experienced rape, the chances for them to develop major depression is three times more. Almost one-third (31%) of all rape victims developed posttraumatic stress disorder (PTSD) sometime during their lifetime; and more than one in ten rape victims (11%) still has PTSD today. Rape victims were 6.2 times more likely to develop PTSD than women who had never been victims of crime (31% vs. 5%).[8] The victims are 4.1 times likely to have seriously contemplated suicide and 13 times more likely to have actually made a suicide attempt.[9]

Victims having to cope with physical, mental, and emotional ramifications of sexual assault in the face of a pandemic are unacceptable. The probability that this “twofold victim” will be stung by hopelessness, depression, horror, or conceivably suicidal thoughts is glaring. Preventing sexual violence in disasters is about keeping people alive.[10]

For the major part of 2020 and till date, the world has been consumed with the consequences of the disease and the lockdowns caused by COVID-19. While there seems no visible end to the quarantines and the stay-at-home measures, the pandemic of sexual violence is not “silent” anymore. Statistics show us that sexual violence rates upsurge during states of emergency, such as health crises, war, and natural disasters. For example, in the weeks immediately following Hurricanes Katrina and Rita, reports indicate that sexual assault increased by 45%.[11] Risk factors for the enactment of violence against women tend to increase in the face of distress, anxiety, and sense of helplessness associated with emergencies.[12] The World Health Organization (WHO) report of 2005 states, “there is a pattern of gender differentiation at all levels of the disaster process: exposure to risk, risk perception, preparedness, response, physical impact, psychological impact, recovery, and reconstruction.”[13]

As governments throughout the world have failed dismally in curbing sexual violence as a result of COVID-19, examples of this upsurge in violence are appalling. Equality, a Beijing-based NGO dedicated to combating violence against women, reports a surge in the number of calls to its helpline since the government locked down cities in the outbreak's epicenter-Hubei Province. Spain, in the first 2 weeks of lockdown received 18% more calls on the emergency number for domestic violence than in the same period a month earlier. About 30% increase in domestic violence, including sexual violence, was reported in France since their lockdown began. In Sierra Leone, during the Ebola epidemic, community members responsible for implementing quarantine were accused of sexually assaulting girls.[13] Research found that >65% of female respondents reported manipulation and exploitation by guards; women and girls quarantined were financially and sexually exploited by guards in exchange for permission to leave the house for basic necessities such as water and firewood.

While in some parts of the world, rape crisis centers report a 40% increase in demand for their services since the outbreaks, there are a few centers in the world, such as Washington, where the number has dwindled.[12] The reason behind this is the fear of contracting the infection during the hospital visit. Moreover, this situation is not new with COVID-19. In an alarming statement, the National Sexual Violence Resource Center states that “the reporting of sexual violence in disasters is often considered a 'luxury issue–something that is further down on the hierarchy of needs' for disaster victims.[14]” This specifies that the surge in sexual violence during emergencies is essentially much greater than what we deliberate.

Studies show that financial crisis manifesting as lost jobs or major financial setbacks tend to make abusers more likely to murder their partners. With millions of people around the world jobless and shattered economies, its time enough to pay heed to this significant concern which could sow penalties even for the time subsequent to the pandemic.


  Populations at Increased Risk Top


In March, in the USA, half the calls to the hotline for the National Sexual Assault, comprised minors. This was for the first time ever. RAINN President Scott Berkowitz said that “Unfortunately for many, and especially for children experiencing sexual abuse, 'stay at home' does not mean 'safe at home.'”[15] Children living in foster care or with someone other than biological family were at a higher risk.

In addition to minors, individuals particularly vulnerable to all types of violence during emergencies are those with physical or mental disabilities, the homeless, and those suffering from substance misuse.


  Factors Increasing Women's Vulnerability Top


Studies state that the most common form of sexual violence is committed by an intimate partner. Thus being married or cohabiting with a partner was an individual risk factor. Other factors influencing the risk of sexual violence include:

  • Being young
  • Consuming alcohol or drugs
  • Having previously been raped or sexually abused
  • Having many sexual partners
  • Involvement in sex work
  • Becoming more educated and economically empowered, at least where sexual violence perpetrated by an intimate partner is concerned
  • Poverty.[16]



  Sexual Violence against Men and Boys Top


Sexual violence against men and boys is an underreported, neglected, yet significant problem. Sexual bullying or rape directed against men and boys take place in a variety of settings-home, streets, workplace, in military, during war, schools, prisons, and also in police custody. In prisons to establish hierarchies of respect and discipline, inmates are forced into sex. Sexual violence takes the form of “entertainment” or “punishment.” As is the case with female victims of sexual assault, research suggests that male victims are likely to suffer in the same way with similar consequences during periods such as the COVID-19 pandemic.


  Nowhere to Escape Top


Renowned trauma expert, Harvard Medical School's Judith Lewis Herman, has found that the intimidating methods used to control their partners and children by domestic abusers “bear an uncanny resemblance” to those kidnappers use to control hostages and repressive regimes use to break the will of political prisoners. “The methods which enable one human being to control another are remarkably consistent,” she wrote in a widely cited 1992 article published in the Journal of Traumatic Stress. Lewis writes that “common tools of abuse include isolation from friends, family and employment; constant surveillance; strict, detailed rules for behavior; and restrictions on access to basic necessities such as food, clothing, and sanitary facilities.” This strict control compounds the problems caused by stay-at-home orders and makes escaping or reporting the violence nearly impossible for victims.[8]


  Increased Demand and Meagre Supply Due to Fragile Systems Top


In the face of calamities, such as the COVID-19 pandemic, accessing resources has become increasingly difficult because the basic resources are not readily available. With most shelters working in limited capacity, many countries have started to use vacant hotel rooms as shelters and quarantine facilities. Service agencies and child advocacy centers are prioritizing in-person cases based on impending harm. In the hardest-hit areas by COVID-19, rape kits are limited or not available.

The need for emergency funding to keep afloat the survivors and those seeking medical attention has not taken this place of significance. Emergency funding for programs supporting the cause and rape crisis centers is needed to meet the requirements of victims of sexual injustice during the COVID-19 pandemic.[16]


  Acute Period Response Top


The WHO has outlined the following recommendations to help ensure the safety of the community and help preserve its ability to prevent and respond to violence:[17]

  1. Earmark funding for services that support women experiencing violence
  2. Adapt and strengthen existing services to the current situation of restricted mobility
  3. Build capacity to identify violence and prevent impunity
  4. Provide support for women who may be experiencing violence while working remotely
  5. Collect and use sex-disaggregated data on the impact of COVID-19 on sexual violence
  6. Raise awareness about sexual misconduct through social media, radio, and advertisements
  7. Put women at the center of policy change, solutions, and recovery.



  Conclusion Top


Sexual violence has commonly been a ignored area of research throughout the world, despite its effect on the public by substantial proportions. There is still so much more that can be done to understand this disturbing phenomenon, and equally more to prevent something like this. More research, determining effective responses, and greater attention to primary prevention are some of the recommendations to manage the situation. The pandemic has highlighted how much work needs to be done to ensure that people who experience abuse can continue to obtain access to support, refuge, and medical care when another public health disaster hits.[1] To reduce the prevalence of the issue, it is crucial to acknowledge the extent of gender-based violence, reimagine government policies, and support networks to make it easier for the victims to access them, and finally, create awareness about the issue as well as the resources available to tackle it.

If sexual violence is happening in your relationship, talk to someone. The abuse will continue without help. Hence, making that first call to seek help is the most important and courageous step you need to take.[18]

Additional resources

Assessments of impact of COVID-19 on violence against women and girls:

  1. Majumdar S, Wood G. 2020. “UNTF EVAW Briefing Note on the Impact of COVID-19 on Violence against Women through the Lens of Civil Society and Women's Rights Organizations.” UN Trust Fund to End Violence against Women, New York[19]
  2. UN Women. 2020. “Impact of COVID-19 on Violence against Women and Girls and Service Provision: UN Women Rapid Assessment and Findings.” Issue Brief. UN Women, New York.[20]


Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

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Matasha E, Ntembelea T, Mayaud P, Saidi W, Todd J, Mujaya B, et al. Sexual and reproductive health among primary and secondary school pupils in Mwanza, Tanzania: Need for intervention. AIDS Care 1998;10:571-82.  Back to cited text no. 4
    
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Kelly L. The continuum of sexual violence. In: Women, Violence and Social Control. UK: Palgrave Macmillan; 1987. p. 46-60.  Back to cited text no. 6
    
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Kalokhe AS, Potdar RR, Stephenson R, Dunkle KL, Paranjape A, del Rio C, et al. How Well Does the World Health Organization Definition of Domestic Violence Work for India? PLoS One 2015;10:e0120909.  Back to cited text no. 7
    
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Mental Health Impact of Rape. Available from: https://mainweb-v.musc.edu/vawprevention/research/mentalimpact.shtml. [Last accessed on 2021 Mar 06].  Back to cited text no. 8
    
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Martin G, Bergen HA, Richardson AS, Roeger L, Allison S. Sexual abuse and suicidality: Gender differences in a large community sample of adolescents. Child Abuse Negl 2004;28:491-503.  Back to cited text no. 9
    
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The Responsibility to Prevent and Respond to Sexual and Gender-Based Violence in Disasters and Crises-World | ReliefWeb. Available from: https://reliefweb.int/report/world/responsibility-prevent-and-respond-sexual-and-gender-based-violence-disasters-and. [Last accessed on 2021 Mar 06].  Back to cited text no. 10
    
11.
Hurricanes Katrina/Rita and Sexual Violence: Report on Database of Sexual Violence Prevalence and Incidence Related to Hurricanes Katrina and Rita | National Sexual Violence Resource Center (NSVRC). Available from: https://www.nsvrc.org/publications/nsvrc-publications/hurricanes-katrinarita-and-sexual-violence-report-database-sexual-vi. [Last accessed on 2021 Mar 06].  Back to cited text no. 11
    
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A Second, Silent Pandemic: Sexual Violence in the Time of COVID-19. Available from: http://info.primarycare.hms.harvard.edu/blog/sexual-violence-and-covid. [Last accessed on 2021 Mar 06].  Back to cited text no. 12
    
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Sasidharan S, Singh DH, Vijay S, Manalikuzhiyil B. COVID-19: Pan (info) demic. Turkish Journal of Anaesthesiology and Reanimation. 2020;48:438.  Back to cited text no. 13
    
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Seager J. Disasters Are Gendered: What's New?. InReducing disaster: Early warning systems for climate change 2014:265-81. Springer, Dordrecht. [Last accessed on2021 Mar 06].  Back to cited text no. 14
    
15.
For the First Time Ever, Minors Make Up Half of Visitors to National Sexual Assault Hotline | RAINN. Available from: https://www.rainn.org/news/first-time-ever-minors-make-half-visitors-national-sexual-assault-hotline. [Last accessed on 2021 Mar 06].  Back to cited text no. 15
    
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Harvey A, Garcia-Moreno C, Butchart A. Primary prevention of intimate-partner violence and sexual violence: Background paper for WHO expert meeting May 2–3, 2007. Geneva: World Health Organization, Department of Violence and Injuy Prevention and Disability 2007:2.  Back to cited text no. 16
    
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Dhillon HS, Sasidharan S, Dhillon GK, Singh V, Babitha M. COVID-19: Neuropsychiatric manifestations and psychopharmacology. Annals of Indian Psychiatry. 2020;4:226.  Back to cited text no. 17
    
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Nations U. What Is Domestic Abuse? | United Nations. Available from: https://www.un.org/en/coronavirus/what-is-domestic-abuse. [Last accessed on 2021 Mar 06].  Back to cited text no. 18
    
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20.
Impact of COVID-19 on Violence against Women and Girls and Service Provision: UN Women Rapid Assessment and Findings | Digital Library: Publications | UN Women – Headquarters. Available from: https://www.unwomen.org/en/digital-library/publications/2020/05/impact-of-covid-19-on-violence-against-women-and-girls-and-service-provision. [Last accessed on 2021 Mar 06].  Back to cited text no. 20
    




 

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Abstract
Introduction
Populations at I...
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Sexual Violence ...
Nowhere to Escape
Increased Demand...
Acute Period Res...
Conclusion
References

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