Survivors of sexual violence in South Sudan struggle to access health care

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GENEVA (19 MAY 2020) - Survivors of conflict-related sexual violence continue to struggle to access adequate medical and mental health care, according to a new report issued by the United Nations Mission in South Sudan and the UN Human Rights Office.

"The COVID-19 pandemic has made it clear, if there was ever any doubt, just how important it is for everyone to have immediate and adequate access to health care," said UN High Commissioner for Human Rights Michelle Bachelet. "For the survivors of conflict-related sexual violence, it goes beyond treating their physical injuries and psychological trauma. It is quite simply a crucial step in giving them a chance to rebuild their lives and the lives of their families."

The report, titled "Access to Health for Survivors of Conflict-Related Sexual Violence in South Sudan," takes an in-depth look at the adequacy of health care available in Unity and the Central and Western Equatorian regions, which account for 85 percent of conflict-related sexual violence cases documented between January 2018 and January 2020.

It found that funding for public health care in South Sudan has not been prioritized, with just 1.2 percent (USD 14 million) of the national budget allocated for this purpose. This has resulted in international organizations using donor funding to try to fill the gap. Despite the enormous financial investment, the medical response for survivors of sexual violence remains weak.

In its response to the findings, the Ministry of Gender, Child and Social Welfare said the report was "timely" and provided "a true picture" of the challenges faced by CRSV survivors, including access to health services. The Ministry also highlighted actions already taken by the Republic of South Sudan to tackle sexual violence across the country.

"It is really encouraging to see the Government acknowledging the concerns raised in the report and being prepared to work together with the United Nations to combat sexual violence in South Sudan," said the Special Representative of the Secretary-General and Head of UNMISS, David Shearer. "Women in this country have suffered immensely from sexual violence. We must do everything we can to make sure survivors get the health care and support they so desperately need."

The report found that there is, on average, only one health facility per 10,000 people and an estimated 72 percent of the population live more than 5 km away from their closest clinic. Many of these facilities are not capable of providing specialized care and there are not enough qualified doctors, nurses or midwives to treat sexual violence survivors.

These factors have resulted in many victims not seeking assistance until they develop complications, such as sexually transmitted infections, unwanted pregnancies, and problems from unsafe abortions. Stigmatization, coupled with the risk of being labelled a sexual violence survivor if they seek health care, has also forced many to suffer in silence.

One 47-year-old victim told human rights officers how she felt lucky to even be alive after being gang-raped by armed men in 2018.

"I am lucky because I am healthy now," she said. "Last year, two women and one girl were gang-raped by armed men. One of the women and the girl returned to the village after the incident. The other woman…never visited the hospital because of shame. She became very ill and passed away last month. Her relatives told me she died of an illness that was caused by the rape. The other two survivors have also passed away."

The report documents 356 incidents of conflict-related sexual violence, including rape, that took place between January 2018 and January 2020. These incidents involved at least 1423 victims, including 302 children. Those responsible for the violence included government and opposition forces, as well as youth militia used by the parties to the conflict.

Sexual violence has been endemic and used as a weapon of war in South Sudan since armed conflict erupted in 2013. There has been a significant decrease since the signing of a peace deal in 2018. However, it remains a serious problem with victims continuing to suffer appalling acts of sexual violence that often result in long-term physical harm and mental health consequences.

In 2019 and 2020, the army and police forces as well as the pro-Riek Machar Sudan People's Liberation Army-In Opposition and the National Salvation Front endorsed dedicated action plans and/or issued command orders committing to take concrete measures to prevent and respond to conflict-related sexual violence.

The report makes a series of recommendations, including:

• Substantially increasing Government funding for the public health sector, strengthening the capabilities of facilities and health workers, and improving access to sexual and reproductive care.
• Investigating and prosecuting offenders responsible for sexual violence, including those in positions of military command and control.
• Strengthening links between donor-funded projects providing medical care to survivors and programmes designed to build the capability of the existing health care system.
• Educating parties about CRSV and ensuring Action Plans and command orders to prevent it are implemented by defence and security forces.
• Increasing efforts to overcome social barriers by educating communities about CRSV and its impact on survivors.

For more information and media requests, please contact:

In Geneva: Liz Throssell - + 41 22 917 9296 / ethrossell@ohchr.org

In Juba: Francesca Mold / mold2@un.org

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