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Abstract
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Lindsay Stark and colleagues1 make some useful recommendations for addressing the impacts of conflict-related sexual violence in humanitarian contexts, and recognise partnering with local practitioners, organising mobile clinics, and incorporating health-service provision into non-medical interventions within acute humanitarian settings as effective practices to improve outcomes in survivors. However, as a British clinician working with local practitioners to deliver mobile primary health-care clinics in Trostyanets and its surrounding villages in eastern Ukraine, which were occupied by Russian troops for 30 days around March, 20222—my insight from the field identifies an inherent challenge to the practical implementation of this academic idea in a real-world context.
As humanitarian actors, identifying, recruiting, and partnering with locally influential, socially connected, and well recognised practitioners is paramount to gaining both the trust and acceptance of the local communities that my colleagues and I wish to serve, and essential to overcoming substantial language barriers. However, with regard to highly sensitive personal matters that are often associated with social stigmatisation, such as conflict-related sexual violence,3 the public status of such local partners that facilitate access to beneficiary communities might inadvertently prevent disclosure of such atrocities and subsequent access to appropriate services.
Inhabitants of the isolated and enclosed rural villages surrounding Trostyanets (which rarely exceed 150 people) are strongly acquainted with their fellow villagers, making social anonymity and personal privacy difficult to achieve. Simultaneously, senior teachers, community leaders, and other public figures regularly travel between these villages and are strongly connected to and interpersonally influential with large numbers of citizens across this network. These individuals might not have medical training and might lack the non-judgemental professional standards aspired to by the partnering humanitarians; instead, they might harbour locally prevalent prejudice and stigmatising views. As such, survivors of conflict-related sexual violence might be deterred from sharing such sensitive information in mobile clinics for fear of confidentiality breaches and social stigmatisation. As a result, an intrinsic trade-off exists between the access to beneficiaries facilitated by influential local partners and the divulgence of information required to optimise care ...
Language: en |