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Saturday, November 18, 2017
HomeHealthCeteraInternational Forensic Nurse addressing sexual violence in conflict zones in central & east Africa

International Forensic Nurse addressing sexual violence in conflict zones in central & east Africa

Senior Fellow, Nancy Cabelus, DNP, MSN, RN, is an international forensic nurse consultant currently working with Physicians for Human Rights on a program addressing sexual violence in conflict zones in central and east Africa.


Nancy Cabelus

In recent weeks I visited impoverished areas in Kenya to specifically meet with women and talk with them about sexual violence.  In Kibera slum, the largest and most renowned slum on the African continent, I spoke one morning with 16 women.  The women I met with are HIV positive and receive antiretroviral (ARV) treatment.  I asked the women to whom they would turn if they or someone close to them were raped. All said that they would seek care from a doctor but most were not aware of places they could go where medical treatment was free. Only two reported that they would seek help from the police. Police are perceived as rude, accusatory, and often ask for bribes from women seeking help.  Two women stated they would speak to the tribal chief in the slum and eleven others said they would tell a trusted friend. None would tell a family member and would prefer to suffer in silence rather than deal with the stigma and family outcast attached to rape.

New awareness of hospitals and clinics offering free medical attention gave encouragement to the women but reporting to the police is something that they are reluctant to do. They talked about an incident concerning the rape of a child by a man who dwells in Kibera. Two weeks after the assault, the man returned, this time killing the child. The women are terrified to report the crime and yet continue to live in fear knowing the perpetrator may be nearby. The women also said they were not aware of the Child Help Line  where they could place a confidential call from their mobile phones to report matters involving abuse or neglect of a child.

On another day I spoke with a group of approximately 43 women and two men at Ngong, a small town located southwest of Nairobi. I asked a similar set of questions about whom they would tell if they or someone they knew were raped. The results were interesting: 20 said they would go to the police and some felt that the police could be trusted; 25 replied that they would go to the hospital, 22 to a community health worker, 11 to the pastor, 10 would tell a friend, and 2 would keep it a secret. Reasons not to report the crime of rape are: threats by the perpetrator, people would talk about you, fear, blame, rejection, and bribery. For some, it is a waste of time to report the incident because it takes too long to get anyone to help you.  Other concerns and complaints are about the deep-rooted cultural practices in Africa such as wife inheritance, widow cleansing, and female circumcision.

Wife inheritance is when the brother of a deceased man inherits his wife’s inheritance. If he is expected to provide for her, she is in turn required to have sexual intercourse with this man in the presence of family elders. Failure to comply could mean that the woman is forced off the property and is left with no means of survival. In cases of widow cleansing, a woman must have sex with her deceased husband’s brother, cousin or sometimes all of her husband’s male family members.

While these practices may greatly contribute to spreading of the HIV/AIDS epidemic, a woman in the Ngong discussion group announced that female genital mutilation (also called female circumcision or cutting) is done to prevent AIDS! Voices shouted in protest, “No, No! That is not true!” A Kisii woman disclosed that her parents support the practice of female circumcision. To protect her own daughters, she does not allow her children to visit the grandparents in their Kisii village.

Lastly, the group talked up the topic of male rape. Some did not believe that men could be raped while others covered up giggles with their hands. Male rape and homosexuality are unspeakable topics for most Kenyan people. A man in the group disclosed that if he were raped he would not be able to tell anyone because he would be ashamed and laughed at.

In recent years I have been holding informal discussion groups on sexual violence in Kenya as part of my work. My mission is to provide a forum where people can speak freely in a safe environment about a subject that is typically taboo. To get people talking, I offer sweet treats and other simple prizes. Afterward, when I ask what they learned today, I am always amazed. Before I know it, a sea of hands and voices are raised. Everyone is empowered. Everyone has a story.

Sometimes, women have disclosed personal accounts of childhood sexual abuse that they had never before been able to talk about.  I am stricken by the courage of these women survivors as I witness them take their first steps into the healing process. I wonder how many have harbored the violence in their lives and for how many years would they have locked away their secrets had they not had this chance to speak out.

The meetings end in song and prayer.  Most graciously, I am always invited to come back.

God’s peace,


Rise Up!

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