Fieldset
“We call them survivors”: Treating the trauma of sexual violence

Working on a project to treat survivors of sexual violence in Nigeria, US administrator Russ answers the difficult question of “What’s the work like?”

How to answer the question of what’s the work like? 

I’m at the beginning of my second assignment with MSF, this time in Port Harcourt, Nigeria

MSF runs two sexual-based violence clinics here, providing critical medical and psychosocial care primarily to victims of rape. 

Port Harcourt is a post-boom town. Lots of wealth (oil money) and poverty side by side. Lots of street crime. Kidnap and ransom is a minor industry here, targeted at the wealthy. We take extra precautions in our movements around the city.

The times of “Teme”

MSF has a great reputation here. Riding in the car in town people will frequently call out: “Teme, Teme!” and wave. I quickly learned that “Teme” was the name of the hospital where MSF previously ran a trauma unit.

In a trauma unit, time is life; and MSF would treat anyone. However, with the civil unrest at that time, if you came to the hospital with a gunshot wound the medical team first had to get police clearance before treating you.

The story is not like the gunshot wound that heals up neatly. It is messy. Complex.

The people waving at the MSF car were remembering that difficult time, when MSF was there impartially providing critical care to a friend, loved one, or themselves, and still thankful. 

The civil unrest subsided, and MSF found the patient load turned primarily to road traffic accident victims, usually involving a car hitting a bicycle. Then, with the passage of a law saying, “no bicycles on the roads”, the accident rate dropped dramatically. 

MSF scaled down to handle the cases that were still coming in the door, as well as a significant number of victims of sexual violence. 

A photograph

In the times of “Teme”, you could take a picture of someone patched up from a gunshot wound and it would help you tell the story of why you were working there.

In fact, it would put a smile on the face of the hundreds of people who we helped. Years later, it’s this same reason why they still call out “Teme!”.

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Russ Filby outside of the MSF Orugbum clinic, Nigeria
Russ Filby outside of the MSF Orugbum clinic, Nigeria

However, the work MSF is doing now in Port Harcourt is different. The stories are very personal, sometimes horrific, and mostly distressing.

Once again, if you were to take a photograph – the picture would tell a thousand words that the person in it would not want to hear ever again. It would represent the thousands of stories like it, traumatic and individual in their own way.

Survivors

So, what are we doing?

As mentioned above, MSF runs two clinics. One open 24 hours a day, staffed with doctors, nurses, psychologists and social workers. The patients themselves, we call them “survivors” because they have taken steps to get help.

And our two clinics operating in Port Harcourt are taking in survivors, treating them, listening to their stories and healing what can be healed.

It is difficult work, and the anonymous stories are “messy” in that there is no “clean” ending:

For example, a mentally disabled rape victim. Her mother decides they will keep the baby and they don’t show up for follow-up visits… 

The story is not like the gunshot wound that heals up neatly. It is messy. Complex. 

Hoping for change

We see roughly 1,400 new cases a year and think this is just a fraction of the people in the area who experience sexual violence.

We also have community outreach activities where we are working with other NGOs to raise awareness of sexual violence. 

At a national level, there seems to be an awareness that this is an issue that needs to be addressed.  One can be hopeful that there will be change.

In the meantime, we are here. And our two clinics operating in Port Harcourt are taking in survivors, treating them, listening to their stories and healing what can be healed.

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