Consequences of gender-based violence
Stop reading for a moment and think about this from your own experience. Try to remember a girl in your community who experienced any form of GBV. What were the consequences for her?
GBV that involves physical violence could lead to a physical injury, from a simple wound to loss of body parts and even death. There are lots of reported cases of deaths due to GBV in Ethiopia so you may have thought about such a case from within your own community.
GBV also causes psychological trauma such as fear, anxiety, self-blame, depression and suicidal thoughts. It is not usually visible (unlike physical trauma) but girls/women suffer a great deal from it and the effects can be longer-lasting than a physical injury (see Figure 6.5) and affect behaviour and interpersonal relationships. For example, women who are sexually abused during their childhood tend to feel guilty about the abuse. They develop negative feelings about themselves and lose self-esteem. These bad feelings about themselves often causes them to engage in high-risk behaviours and practices. This makes them more vulnerable to STIs including HIV, unwanted pregnancies and infertility.
Sexual violence also contributes to the spread of STIs. For example, a girl or woman who is raped by an infected person can get infected. She could also have an unwanted pregnancy leading to a number of negative outcomes including unsafe abortion. Girls who have experience GBV (particularly when physical and sexual violence is involved) may make frequent visits to health facilities with various complaints which could include escalating pain, pelvic and back pain, gastrointestinal problems, and repetitive episodes of STIs or unintended pregnancies (Table 6.2). But they may not tell health workers of the sexual violence they have experienced and health workers fail to recognise that undiagnosed GBV is underlying all these complaints and problems, so they do not ask about violence. Thus, these girls and women do not get the help that they need from the health facilities.
Table 6.2 Effects of gender-based violence.
| Physical | Psychosocial/mental | Sexual and reproductive |
|---|---|---|
| Partial or permanent disability | Anger, anxiety, fear | Sexual disorders and risky behaviours |
| Poor nutrition | Shame, self-hate, self-blame | Early sexual experiences (for those who are victims of childhood sexual abuse) |
| Exacerbation of chronic illness | Post traumatic stress disorder (nightmares, recurrent distressing thoughts) | Unprotected sex |
| Chronic pain | Depression | Abortions |
| Gastrointestinal problems | Sleep disorders | Bad pregnancy outcomes, low birth weight, neonatal death |
| Organ damage | Suicidal thoughts | Maternal death |
| Substance abuse | Suicide | |
| Social stigma | STIs including HIV | |
| Social rejection and isolation | AIDS | |
| Infertility | ||
| Chronic pain |
GBV has various interrelated effects on health, so it seems strange that girls and young women do not report the GBV when they come to the health facility.