Gender-based violence contributes significantly to mental health challenges among refugees. Sexual violence is used as a tool of war and has long-lasting physical, psychological, and social effects. Jane, a refugee from the DRC, experienced sexual abuse in both her home country and as a refugee in Uganda. As a result, she contracted HIV, became pregnant, and developed a uterine prolapse. She has given up on life and the hospital is ill-equipped to support her. International guidelines emphasize helping survivors cope with injuries, accessing social support and security, and preventing future violence, but comprehensive support for victims remains a challenge. Left unaddressed, gender-based violence can lead to mental health issues like PTSD, depression, and

1. Gender Based Violence as a
Contributor to Mental
Health Challenges among
refugees.
Vivian Olgah Kudda
Clinical Psychologist at Minders Wellness and Psychological Center

2. Introduction
• Sexual and Gender-Based Violence (SGBV) refers to any act
that is perpetrated against a person’s will and is based on
gender norms and unequal power relationships (UNHCR, 2016)
• Mental health: “a state of well-being in which the individual
realizes his or her own abilities, can cope with the normal
stresses of life, can work productively and fruitfully, and is able
to make a contribution to his or her community” (WHO, 2004)

3. Back ground
• Sexual Violence: affects millions of people in conflict worldwide,
used as a tool to weaken political, economic and military
strength.
• It is “cheap and effective” but effects are long lasting with a
huge ripple effects-physical, psychological and otherwise.

4. Jane
• Jane, is a 34 year old female from DRC. She holds a Bachelor’s
degree in Economics. In 2016, she was sexually abused in
DRC. She came with one child to Uganda and a husband. He
was supportive then until she sexually abused in the host
country again!
• Jane contracted HIV, lost several pounds of weight and later got
a uterus prolapse. She would later discover that she was
pregnant. Her husband even after leaving her, has told most of
the community members.
• The hospital is not well equipped to support Jane. Jane has
given up on life!

5. IASC and GBV
• Guidelines for Gender based violence interventions in Gender
based Humanitarian Settings-IASC, 2005.
• Emphasis directed towards;
1. Helping survivors to cope with immediate physical injuries
2. Access to social support
3. Access to security and legal redress.
At the same time, prevention programmes to address the causes of GBV
and factors that contribute to it.

6. Trauma and GBV
Exaggerated
startle response
Feeling dirty-which often
leads to compulsive
washing
Extreme shock
reactions-
Agitation
Feelings of shame,
self-blame and guilt
Increased
arousal
Intense intrusive re-
experiencing of the
original trauma

7. Mental Health Disorders associated with SGBV
• Post Traumatic Stress Disorder
• Anxiety disorders
• Mood disorders: depression is, more often than not, comorbid with
PTSD in cases of GBV
• Sexual disorders
• Attachment difficulties (mother and child), associated with
pregnancies out of rape, defilement
• Stigma
• Substance use disorders

8. Psychosocial outcomes arising out of GBV
• Stigma and discrimination
• Unwanted pregnancies
• Sexually transmitted infections

9. Child Survivors
Apart from Behavioral challenges, poor school performance,
pregnancies and poor physical health.
Cases not adequately followed up because focus is on
HIV/Pregnancy-shame.

10. Men and GBV
response/Prevention

11. Safe places
Are safe places/spaces adequately available and accessible by different
groups including people with disabilities?

12. Best Practices-from ARC
• Client centered approach.
• Provide consistent sessions
• Group sessions
• Awareness sessions that link MHPSS and GBV
• Provide spaces for men and children
• Openly ask about and talk about GBV
• Advocate for survivors-medical, legal, protection.
• High level coordination with partners

13. Food for thought……
• Are GBV services more responsive than preventive?
• Are GBV victims comprehensively supported?
• How best can MHPSS be streamlined into GBV services?
• Who takes care of GBV workers’ psychological wellbeing?
• Are GBV workers sufficiently equipped with knowledge to
identify, respond and refer cases to MHPSS providers?
• Is the knowledge/skills used?

14. References
• Promoting mental health: concepts, emerging evidence,
practice (Summary Report) Geneva: World Health Organization;
2004
• Mental health and gender-based violence Helping survivors of
sexual violence in conflict – a training manual: Health and
Human Rights, 2014
• SGBV Prevention and Response training package, UNHCR;
2016.