"My 10 year old daughter decided to follow me when I visited a friend at the hospital. She managed to escape from my sister’s and got on a bus. But she never found me. Instead I got a call from the police: she had been taken by a stranger and raped. I could not stop crying. What had ruined my life when I was 21 had now happened to my child too.”

Betty* is amongst the patients seeking care at the Family Support Centre in Port Moresby General Hospital, the largest health facility in Papua New Guinea (PNG). Two months ago Médecins Sans Frontières (MSF) provided her daughter with the emergency care survivors need after such assault. Both now receive psychological counseling following rapes that occurred nearly 15 years apart.

Medical emergency nature of violence often overlooked

“The medical emergency nature of violence is often overlooked” said MSF Head of Mission Elisabeth Bijtelaar. “Treatment to prevent HIV transmission needs to start within 72 hours following a rape. Our primary objective is the immediate provision of 5 essential medical services: to treat wounds and acute injuries, psychological first aid, prevention of sexually transmitted diseases, vaccination against hepatitis B and tetanus and emergency contraception to avoid unwanted pregnancies.”

Violence is not a new problem in PNG. I saw my aunts and cousins facing it with no way to find help, physically or emotionally. Since we started community awareness, women know that they should go to the Family Support Centre.

Marilyn Yull, outreach worker

Family and sexual violence, particularly against women and children, is all too common in PNG. Last November MSF co-sponsored a conference, which, for the first time, brought together State and non-governmental actors working in the medical, law & justice and protection sectors. Its objective was to promote a comprehensive response in assisting survivors of family and sexual violence in Papua New Guinea. Among other topics, the participants discussed the ambition to improve existing services and expand the establishment of Family Support Centres to provinces where this service does not exist yet. MSF committed to continue supporting this process with on-the-job training and coaching of local nurses, which is already underway in Maprik and Port Moresby.

Family and sexual violence is common in PNG

In 2010, Health Program Manager Raymond Pohonai decided to establish a Family Support Centre in Maprik District Hospital: “It was very difficult. Most of our staff was unable to approach and assist survivors properly before MSF came to assist.” Nurse Elizabeth Baga concurs: “First I was working blindly and did not know what to do with the patients. Many specific medications were not available. Now I would feel more confident running the Centre autonomously if more resources were allocated by the Department of Health.”

MSF teams visit local markets to inform the population about the services provided, emphasizing the importance for the survivors of family & sexual violence to present early. “Violence is not a new problem in PNG” explains Marilyn Yull, one of the outreach workers. “I saw my aunts and cousins facing it with no way to find help, physically or emotionally. Since we started community awareness, women know that they should go to the Family Support Centre”. For her colleague Dixon Lay: “Melanesian culture states that men are superior to women and can decide anything for them. But things are changing. Myself I have a different attitude. I want to be a role model for the men and boys.”

MSF provides aid, but roots remain complex

With close to 20,000 survivors treated in Papua New Guinea since 2007, MSF provides a response that aims to mitigate the serious medical consequences usually associated with family and sexual violence. But the roots remain complex to address, and lie beyond medicine. “Many men want to marry at least 2 or 3 wives and still consider that women have to stay at home, looking after kids and pigs” explains Nerty, another victim. “I found out my husband got involved with another woman and I tried to stop him. He kicked me and gave me a black eye.”

Tessi Soy, head of the social work department at Port Moresby General Hospital, voices strong concerns: “What is really frightening me today is the young age of the sexual violence survivors. Girls need to hear that rape is never their fault, that they can be whoever they decide to be and stay safe. Parents also go through a very emotional time after their child was abused. Fathers often want to kill somebody, so we are trying to convince them to use the right legal system. We need aggressive awareness for the protection of our children.”

*The name has been modified