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ZAMBIA

NATIONAL GENDER BASED VIOLENCE AND VIOLENCE AGAINST CHILDREN MULTI-SECTORAL TRAINING MANUAL

Copyright MCDMCH 2013. All rights reserved National Gender Based Violence and Violence Against Children Multi-Sectoral Training Manual Training Manual Developed and edited by: Mrs. Rosemary Kasonde Kakompe with technical support from Dr. Chipepo Kankasa and Ms Annie Sampa for the Ministry of Community Development, Mother and Child Health through the Paediatrics Centre of Excellence, University Teaching Hospital

Foreword

Gender Based Violence (GBV) is a scourge that is prevalent worldwide. However, it is more common in underprivileged societies where recognition and management of GBV is either minimal or none existent. The Zambian government has prioritised the fight against GBV by formulating Policies and establishing mechanisms from Cabinet down to community levels to mitigate against GBV. The production of a National GBV Manual will ensure that those who manage cases of GBV are well trained in order to provide quality service. This manual will also go a long way in the prevention of GBV as early recognition of signs and effects of GBV will help community health workers to take preventative steps before it takes place or becomes accepted as the norm. This manual is an important tool for it has adopted as a strategy, a multidisciplinary and integrated approach which is an effective way to holistically manage GBV. This manual is for Policy makers who formulate laws against GBV, the professionals who manage cases of GBV the civil societies who advocate against GBV and families and communities who are the first defence against GBV.

Professor Elwyn M. Chomba Permanent Secretary MINISTRY OF COMMUNITY DEVELOPMENT, MOTHER AND CHILD HEALTH

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Acknowledgement This National GBV Training Manual was produced in close coordination with the Ministry of Community Development, Mother and Child Health and the Paediatrics Centre of Excellence. The Ministry of Community Development, Mother and Child Health wishes to express its gratitude to all GBV stakeholders who participated in the development of the training manuals; for their valuable input and tireless efforts towards the development and finalization of the National GBV training manuals. Special tribute goes to UNICEF for their technical support and for facilitating the engagement of the consultants. MDCDMH would also like to thank the Ministry of Health through the University Teaching Hospital HIV/AIDS Programme (UTHHAP) for their technical support and for coordinating the process. The government acknowledges all the members of the technical committees for their tireless work in producing this document who comprised the following: Dr. Chipepo Kankasa (UTHPaediatrics Centre of Excellence), Dr Eugine Kaunda and Dr Alexander Kawimbe (UTH OBS & Gyn), Dr Sam Miti (UTH Paediatrics), Senior Superindent. Tresford Kasale (Ministry of Home Affairs-VSU), Annie J. Sampa (UNICEF), Mrs Christine Munalula (World Vision), Ms Martha Kyakilika (Save the Children) Mr Augustine Mukuka (FBI Business Investment Limited) Mrs Chibesa Maimbo (Human Rights Commission), Mrs Mary Zama (Population Council), Mrs Florence Nkhuwa (Lifeline Zambia), Mr Wallace Ngulube (Ministry of Gender and Child Development), Mr. Simmy Chapula (Ministry of Community Development, Mother and Child Health and Mrs Fadillah Kankasa-Chohan (Paediatrics Centre of Excellence) Finally, gratitude is extended to all individuals and organisations that helped in one way or another in the production of this document.

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Glossary/Acronyms AIDS ARV AGBV CEDAW Acquired Immune Deficiency Syndrome Antiretroviral drug Anti-Gender Based Violence Act The Convention on the Elimination of all Forms of Discrimination against women Diphtheria and Tetanus Toxoids and Pertussis Diphtheria and Tetanus Toxoid Emergency Contraceptive Pills Enzyme-linked Immunosorbent Assay Gender Based violence Gender-based violence is an umbrella term referring to all forms of abuse inflicted on a person as a result of a power imbalance between men and women and may be perpetrated by a family member, a member of the community or by one or more people who as in the name of cultural, religious or state institutions. Hepatitis B Virus Human Immuno deficiency Virus International Covenant on Civil and Political Rights Intrauterine Device Penal Code Post-Traumatic Stress Disorder Post-Exposure Prophylaxis Rapid Plasma Reagin Sexual and Gender Based Violence Sexually Transmitted Infections Tetanus toxoid and reduced diphtheria toxoid
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DPT DT ECP ELISA GBV GBV

HBV HIV ICCPR IUD PC PTSD PEP RPR SGBV STI Td

TIG TT UDHR UNICEF UTH VCT VSU ZDHS

Tetanus Immunoglobulin Tetanus Toxoid Universal Declaration of Human Rights United Nations Childrens Emergency Fund University Teaching Hospital Voluntary Counselling and Testing Victim Support Unit Zambia Demographic Health Survey

Table of Contents
Foreword ....................................................................................................................................................... i Acknowledgement .......................................................................................................................................ii Glossary/Acronyms ................................................................................................................................... iii Table of Contents.iv Introduction ................................................................................................................................................. 1 MODULE 1: COMMUNITY RESPONSE TO GBV............................................................................... 4 Module Description ..................................................................................................................................... 4 Module Objective: ....................................................................................................................................... 4 1.1 Gender ..................................................................................................................................................... 4 1.2 How Gender is constructed ..................................................................................................................... 7 1.3 Abuse ...................................................................................................................................................... 9 1.4 Types of Abuse ..................................................................................................................................... 10 1.4.1 Physical abuse .................................................................................................................................... 11 1.4.2 Child Abuse........................................................................................................................................ 13 1.4.3 Sexual abuse ....................................................................................................................................... 15 1.4.4 Emotional Abuse ................................................................................................................................ 19 1.4.5 Social-economic Abuse ...................................................................................................................... 23 1.5 Gender Based Violence ......................................................................................................................... 25 1.6 Consequences of GBV .......................................................................................................................... 28 1.7 Causes of gender based violence ........................................................................................................... 31 1.8 History taking ........................................................................................................................................ 34 1.9 Reporting Procedures of gender based violence ................................................................................... 36 1.10 Referrals for further Management of GBV ......................................................................................... 40 1.11 Safe Record Keeping........................................................................................................................... 42 MODULE 2: POLICE, LEGAL/PARALEGAL RESPONSE .............................................................. 94 Module Description ................................................................................................................................... 94 Module Objectives..................................................................................................................................... 94

2.1 What is gender? .................................................................................................................................... 95 2.2 What is GBV?....................................................................................................................................... 97 2.3 Factors that contribute to GBV ............................................................................................................. 99 2.4 Prevalence of GBV in Zambia............................................................................................................ 101 2.5 Human Rights ..................................................................................................................................... 102 2.6 GBV and the law (National Legal Framework) ................................................................................. 105 2.7 Dealing with victims/survivors of GBV- Police perspective.............................................................. 109 MODULE 3: MEDICAL MULTIDISCIPLINARY MANAGEMENT OF GBV ............................ 116 Module Description ................................................................................................................................ 116 Module Objective.................................................................................................................................... 116 3.1 Gender Based Violence ...................................................................................................................... 116 3.2 Clinical assessment (history taking) ................................................................................................... 119 3.3 Laboratory investigations ................................................................................................................... 123 3.4 The Physical Examination and Evidence Collection .......................................................................... 125 3.5 Multidisciplinary medical treatment of GBV ..................................................................................... 128 3.6 Prevention of HIV Transmission, Other Infections and Pregnancy ................................................... 130 3.7 Monitoring and Evaluation for GBV Service Provision..................................................................... 132 3.8 Setting up One stop centers ................................................................................................................ 136 3.9 Answers - Scenarios ........................................................................................................................... 137 MODULE 4: PSYCHOSOCIAL CARE AND SUPPORT TRAINING MANUAL FOR SEXUAL AND GENDER BASED VIOLENCE (SGBV) .............................................................................................. 140 Module Description ................................................................................................................................ 140 Module Objective.................................................................................................................................... 141 4.1What is Psychosocial Care and Support? ............................................................................................ 141 4.2 What is counselling?........................................................................................................................... 143 4.3 Initial psychosocial assessment .......................................................................................................... 146 4.4 Types of Counselling .......................................................................................................................... 149

4.5 Group, Peer and Family Counselling.................................................................................................. 151 4.6 Preparing the survivor for medical examination and court proceedings ............................................ 155 4.7 Special considerations for children ..................................................................................................... 158 4.8 Support for child survivors of GBV and their families ...................................................................... 165 4.9 Co-joint child-parent sessions............................................................................................................. 167 4.10 When to terminate a counselling session .......................................................................................... 169 4.11 Safe Record Keeping ........................................................................................................................ 172 MODULE 5: MEDIA AND ADVOCACY ........................................................................................... 202 Module Description ................................................................................................................................ 202 Module objectives ................................................................................................................................... 202 5.1 Examining current media coverage of gender-based violence ........................................................... 203 5.2 Tips for covering gender-based violence ............................................................................................ 206 5.3 Considering the interests of survivors of gender-based violence ....................................................... 207 5.4 Preparing sample questions to ask a GBV survivor ........................................................................... 209 5.5 Summary and closing ......................................................................................................................... 212 5.6 Questions and comments .................................................................................................................... 212 5.7 Media and advocacy ........................................................................................................................... 213 5.7.1 Situation Analysis ............................................................................................................................ 213 5.7.2 State and Power Structure ................................................................................................................ 215 5.7.3 Community and Social Mobilization ............................................................................................... 217 5.7.4 Advocacy ......................................................................................................................................... 219 5.7.5 Why Advocacy ................................................................................................................................ 222

Introduction In 2011, the Government of Zambia launched the National Guidelines for the Multidisciplinary Management of Survivors of Gender Based Violence (GBV) with special considerations for children. Acknowledging that this kind of work needs concerted efforts, these guidelines were developed through the collaboration of the Gender in Development Division currently Ministry of Gender and Child Development, Health, Home Affairs, Community Development and Social Services (now the Ministry of Community Development, Mother and Child Health) in consultation with civil society to provide a multi-disciplinary set of strategies for responding to the medical, legal, and psychosocial support needs of the GBV survivor. It was however, recognized that there was a need to also provide guidelines to serve as reference material for service delivery at community level for identified individuals and groups who come in contact with survivors of GBV. The community response chapter has therefore been developed to outline the procedures for a community level integrated, multidisciplinary response to GBV and violence against children in Zambia and it is expected that all community structures involved in this service provision will be trained to recognize and manage survivors of GBV. In addition, the government of Zambia realized that it was important that service providers are trained to understand the magnitude and the needs of survivors as well as perpetrators of GBV and violence against children in order to end these vices; hence the need to come up with a training manual for all service providers dealing with GBV and VAC. The National GBV Multi-sectoral Training Manual comprises five modules which individually outline a set of training standards and procedures for health care providers, police/legal, psychosocial care providers, community service providers and the media. The document presents a bold vision for integrated care and recovery services that unite the key organizations including government departments in the fight against GBV. The aim of the training manual is to set standards for the comprehensive care of survivors of GBV and ensure uniform procedures across the country amongst all GBV service providers (health, police and legal, psychosocial, community services and media) which will improve efficiency, accuracy and reporting thereby reducing trauma to individuals who report GBV. Psychosocial counselling allows the recovery from and healing of moral and psychological wounds created by prolonged periods of violence, humiliation, stress and denial of the most basic human rights. In addition to the psychological support given, counselling also assists survivors recovery in the social, cultural, medical and legal areas. Hence, psychosocial counseling becomes a vital methodology for a vast number of service providers such as police officers, lawyers, doctors and social workers who contribute to the multi-sectoral psychosocial support activities.

The media is one of the most important socializing influences in peoples lives and plays an enormous role in forming opinions on gender issues and womens rights as well as sensitizing the public towards such important topics as GBV. Negative and stereotype images of women in the media, and the ways in which the media reports on gender based violence (as a lesser crime or violation) contributes to the acceptance of gender-based violence as a norm. The dominant myth is that the media is neutral and objective. This is not always true. Each journalist brings to the newsroom his/her views opinion, beliefs and attitudes. These inform the way in which the journalist views a particular issue. Thus the media is not a passive transmitter of information to society but a source of information that comes with value judgments. Because the media informs our understanding of issues, it has a critical role to play in processes of transformation. Therefore its inclusion in the training manual will be pivotal in creating awareness and elimination of GBV. The manual is organized by sector, and contains the following modules: Module 1: for Community Support Module 2: for Police & Paralegal support Module 3: for Medical care Module 4: for Psychosocial Care and Support Module 5: for Media & Advocacy The basic principle of this training manual is that health, police & legal, community, and media should work together in responding to and tracking all cases of GBV.

Community services Community service providers are responsible for first line services: identifying, counselling, referral and follow up services including reintegration of survivors/perpetrators as well as community education on GBV. Social services: Social services place survivors in a place of safety where there is need. They also act as escorts, apply for committal order, provide transport, monitor and inspect places of safety and childrens homes and aftercare centres. They write social welfare reports regarding survivors The Ministry of Community Development and Social Services is mandated to coordinate effective provision of social services to survivors and their families. The ministry, where need be, could refer the survivor to relevant organisations available in the district.
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Police: Police are responsible for thoroughly investigating allegations of GBV and VAC to determine if reasonable grounds exist to lay charges. They also respond to the survivors needs through counselling, referral to health facilities and provision of emergency contraception, when applicable. Judiciary: The role of the judiciary is to adjudicate over all cases without bias and therefore deliver sound judgment. The judiciary is expected to create a conducive environment for the survivors including use of child friendly court rooms when they are addressing matters involving children. Para-Legal: They provide information to community members seeking legal advice, as well as survivors of abuse. They are non-lawyers who do legal work. Health services: Health care providers are responsible for identifying, delivering medical services, collecting forensic evidence and offering counselling services in cases of GBV and VAC. Media The media has the responsibility of creating awareness among both the community and policy makers about GBV, VAC and the importance of eliminating it. NOTE: This training manual deals with issues of gender based violence as well as violence against children. There should be special considerations all the time when dealing with violence against children.

MODULE 1: COMMUNITY RESPONSE FOR GBV Module Description The primary purpose of this module is to provide participants with a real opportunity to understand the intricacies of GBV and how the community can contribute to its multidisciplinary management. The module uses adult learning methods which enable participants to discuss factors contributing to GBV as well as the National and International Instruments related to GBV. The module is also intended to be interactive and to ensure that participants have a clear understanding of the key concepts. Module Objective To describe what gender and gender based violence are as per the Anti -GBV Act no.1 of 2011 and the standard management of survivors by the community. Although gender based violence is largely experienced by women and children, we recognise that victims can also be boys and men. It is important that participants are fully aware of this and that gender based violence is not discussed always in the context of the female sex. 1.1 Gender Gender knowledge is important as it affects our everyday activities, well-being, general development and existence. The roles that men and women perform are mainly defined and affected by their gender through their community classification. That is, the community determines what they do or are involved in on a day to day basis as males or females.

Key Messages 1. Sex roles of males and females are determined by ones biological make up. 2. Gender roles are socially defined 3. Gender roles allow individuals a broad range of behaviours. Gender roles are interchangeable for example, in most societies girls can be mechanics whiles boys can cook a meal at home for everyone. In other communities or societies it is unacceptable for a man to cook. 4. It is important to discuss and to discover beliefs about what roles girls and boys, women and men should have in society. 5. These gender roles are unevenly distributed between men and women.

Time: 45 Minutes

Content: Definitions Basic concepts

Learning Resources and Materials: Flip charts / Stand Stick stuff Marker pens Community Guidelines Hand out

Specific Objective To introduce participants to gender concepts. To give participants an understanding of the salient issues in the Anti-Gender Based Violence Act no.1 of 2011. To reinforce the meaning of gender and gender roles

Activity 1 The Gender Game: Establishing the difference between sex and gender

Methodology and learning activities 1. Ask the group if they understand the difference between sex and gender. 2. Divide participants into small groups and distribute the Gender hand-out to each group. 3. Ask the groups to quickly and simply discuss the difference between sex and gender (i.e. sex is a biological construct while gender is a social construct)(10 minutes) 4. Ask them to read the statements one by one in their groups, and to discuss among selves whether they think the statements refer to sex or to gender, writing a G they think refer to gender, and S for those they think refer to sex. If there ment or uncertainty among the group, they should take note of that. 5. The facilitator then reads the answers aloud and discusses them with the whole group. 5.1 Women give birth to babies, men do not. (S) 5.2 Little girls are gentle, boys are tough. (G) 5.3 Amongst agricultural workers, women are paid 40-60 per cent of the male wage. (G) themfor those

is disagree-

5.4 Women can breastfeed babies, men can bottle-feed babies. (S) 5.5 Most building site workers in Zambia are men. (G) 5.6 In Ancient Egypt, men stayed at home and did weaving. Women handled family business. Women inherited property and men did not. (G) 5.7 Mens voices break at puberty, womens do not. (S) 5.8 In one study of 224 cultures, there were 5 in which men did all the cooking, and 36 in which women did all the house-building. (G) 5.9 According to UN statistics, women do 67 per cent of the worlds work, yet their earnings for it amounts to only 10 per cent of the worlds income. (G) Focus on the following questions and key ideas: a. Did any statements surprise you? b. Do the statements indicate that gender is inborn or learned? c. Gender roles vary greatly in different societies, cultures and historical periods. d. Age, race and class are also major factors, which determine our gender roles. e. Women in every society experience both power and oppression differently.
(35 minutes)

Facilitators Notes The facilitator should explain to the participants the difference between gender and sex.

The facilitator should also emphasise that these gender roles can change from one society to another.

Sex refers to ones biological and physiological make up, i.e. male or female; whereas gender refers to the socially constructed roles, behaviours, activities, and attributes that a given society considers appropriate for men and women. Gender roles are assigned to men and women separately.

1.2 How Gender is constructed? Methodology and Learning Activities: Activity 1: Picture code 1. Facilitator to divide flipchart in three columns, the first column for Ages, second column for female and third column for male. 2. Facilitator then does the following as they appear in three columns: Age 0-5 511 1218 Young adult Middle age Elderly Female Draw a sad face Draw a girl doing Domestic work Draw a girl with low esteem Draw a girl with a statement I wish I could get married Draw a woman who is pregnant With the words Kids, work, kids Draw a woman with the words Very tired grand-mum Male Draw a happy face Draw a boy playing or going to school Draw a boy running Draw a boy with a statement I need a job Draw a man with the words work, work, work Draw a man with the words Very bored grand-dad

Note: Use match stick drawings. This is easier than trying to attempt to draw actual pictures. Facilitator then asks the participants using the flip charts to give a pictorial expression of the following: The girls story from birth to elderly life? The boys story from birth to elderly life? What could have caused the differences in the way their lives and future were shaped? What should be done to change this? (45 minutes)

Facilitators Notes: Adaptation: Alternatively, the facilitator can read out the statements one by one and ask participants to write down on a piece of paper, the letter G for those they think refer to gender and S for those they think refer to sex. The facilitator then distributes the Gender Game Hand out and reads aloud the answers to the participants and proceeds with the discussion. This is an activity to be used with participants, who have very little, or no understanding of the concepts of gender, or who feel that they need to go back to basics to be sure of their grasp of the concepts.

Activity 2 Gender Roles

Methodology and Learning Activities 1. Facilitator writes on flipchart the following questions: 1.1 List the roles men and boys perform in a household from morning to evening. 1.2 List the roles performed by women and girls in a household from morning to evening 2. Participants to form two groups of men and women. 3. Women to list womens roles and men to list mens roles on sheets of A4 paper.(20 minutes) 4. The two groups report back in plenary. 5. The trainer/facilitator and participants fill in gaps. 6. The facilitator asks participants to read hand out 10. Materials: Flipchart paper, Markers, A4 paper and pens, Flip chart stand and Masking tape. (15 minutes) (5 minutes)

1.3 Abuse In this unit you will be introduced to the concept of abuse as it relates to GBV and examine some of the strategies that you can use to reach members of the community for the purposes of prevention, support and advocacy.

Time: 50 Minutes

Content: Definition Magnitude of problem Significance

Learning Resources and Materials: Flip charts Stick stuff Marker pens Community guidelines Hand outs

Specific Objective To define abuse To identify the various types of abuse related to GBV To discuss consequences of abuse To demonstrate understanding of how to detect abuse To demonstrate history taking for GBV survivors

Methodology and Learning activities 1. In the large group ask participants to define abuse in their own words. Use a flip chart to take note of their answers for visual learning. 2. Facilitator gives participants the definition as given in the National Gender Based Violence Guidelines. 3. The facilitator divides participants into four groups and ask them to identify the four main types of abuse and their sub-themes (20 minutes) 4. The groups report back in plenary (20) minutes)

5. In the same groups participants are asked to role play the four main types of abuse (each group does only one of the four types of abuse) 6. In the large group participants discuss the various role plays 7. Participants are then asked to read Hand out 5 (10 minutes)

1.4 Types of Abuse

Time: 40 Minutes

Content: Definition Magnitude of problem Significance

Learning Resources Materials: Flip charts / stand Stick stuff Marker pens Hand outs

and

Specific Objective To discuss various forms of abuse To discuss consequences of abuse To create awareness on how to detect abuse

Methodology and learning activities 1. Divide participants into four groups and ask them to identify the four main types of abuse and their sub-themes. (20 minutes) 2. The groups report back in plenary 3. Ask participants to read Hand out 6 (15 minutes) (5 minutes)

Facilitators Notes The facilitator should ensure that the following types of abuse and their sub-themes come out: Physical: Battery, aggravated battery, physical abuse, forced abortion Child abuse Sexual Abuse: rape, sexual harassment, sexual abuse, incest, forced prostitution, engagement in phonography Mental/Emotional abuse: harassment, psychological Social or economic abuse: property grabbing

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1.4.1 Physical abuse Physical abuse includes hitting, slapping, punching, choking, pushing, burning and other types of contact that result in physical injury to the victim. Physical abuse can also include behaviours such as denying the victim of medical care when needed, depriving the victim of sleep or other functions necessary to live, or forcing the victim to engage in drug/alcohol use against his/her will. If a person is suffering from any physical harm then they are experiencing physical abuse. This pain can be experienced on any level. It can also include inflicting physical injury onto other targets, such as children or pets, in order to cause psychological harm to the victim

Time: 50 Minutes

Content: Define physical abuse Types of physical abuse

Learning Resources Materials: Flip charts / Stand

and

Masking tape/sticky stuff Marker pens

Specific Objective To define physical abuse To identify types of physical abuse

Methodology and Learning activities 1. Divide participants into 2 groups to do the following: 1.1 Define physical abuse 1.2 Identify types of physical abuse (30 minutes) 2. The groups report back in plenary. The facilitator clarifies any misconceptions (20 minutes)

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Facilitators Notes: Physical Abuse: means physical assault or use of physical force against another person, including the forcible confinement or detention of another person and the deprivation of another person of access to adequate food, water, clothing, shelter, rest, or subjecting another person to torture or other cruel, inhuman or degrading treatment or punishment;

Physical abuse may include the following:

Battery: The actual intentional striking of someone, with intent to harm, or in a " rude and insolent manner"even if the injury is slight. Negligent or careless unintentional contact is not battery no matter how great the harm. Battery is a crime and also the basis for a lawsuit as a civil wrong if there is damage. It is often coupled with " assault"(which does not require actual touching) in " assault and battery."

Harmful or Offensive Conduct: It is not necessary for the act to result in direct contact with the victim. It is sufficient if the act sets in motion a force that results in the contact. Aggravated Battery: When a battery is committed with intent to do serious harm or murder, or when it is done with a dangerous weapon, it is described as aggravated. Forced Abortion: Most abortions are carried out in private and therefore leave very little room for investigation. Victims of forced abortions are often afraid to report for fear of prosecution. Forced abortion is further perceived as embarrassing for the family therefore exposing the perpetrator is not even a consideration. However since 2003, gender-based violence (GBV) has been recognized and discussed as a public, rather than a private problem in Zambia. The victim may adversely suffer from one or more of these consequences; pregnancy complication, unwanted pregnancies, injury, disability, death, STIs and HIV and AIDS, Reproductive health disorders, Miscarriage, Unsafe abortions, Depression and chronic illness, Infection, Excessive bleeding.

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1.4.2 Child Abuse

Time: 1hr 40 Minutes

Content: Definition

Learning Resources and Materials: Flip charts / Stand Marker pens A4 plain paper Hand outs Cards Stick stuff Community guidelines

Different community structures for support of survivors of sexu al abuse Specific Objective

To define child abuse To identify and discuss the signs and symptoms of child abuse To discuss the various forms of child abuse To discuss the effects of abuse on children and adults To discuss identification and support services for survivors To discuss services available for perpetrators

Methodology and Learning Activity 1. Facilitator asks participants in the large group to define child abuse(15 minutes) 2. Facilitator writes on flip chart five types of abuse: 2.1 Neglect 2.2. physical injury 2.3 sexual abuse and incest 2.4 Commercial exploitation which includes: child prostitution, child labour, child traffick ing and child soldiers 2.5 emotional abuse (10 minutes)

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3. Participants form five small groups according to the five types of abuse listed above 4. Each group defines and discusses what actually happens under the type of child abuse they fall under and the impact of such abuse on the child (20 minutes) 5. On cards, each group writes only two results/actions of abuse e.g. physical injury such as hitting and starving. (5 minutes) 6. Each group paste/stick their cards on the flip chart under the appropriate type of abuse they are addressing 7. The larger group discuss all the presentations on the flip chart and see what they agree with and what they disagree with. (20 minutes) 8. Facilitator then using already written down definitions of abuse on a flip chart, on all five types and clarifies any misconceptions 9. The large group discusses services available in the community for survivors 10. The large group discusses services available in the community for perpetrators of child abuse. (30 minutes)

Facilitators Notes

It is the responsibility of the community care provider to identify abuse where the survivor tries to conceal it. During history taking, the community care provider should take note of inconsistencies in the survivors story and the indicators of abuse.

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1.4.3 Sexual abuse

Time: 1 hr

Content: Definition

Learning Resources and Materials: Flip charts / Stand Stick stuff Marker pens Hand outs

Different community struc- tures for support of survivors of sexual abuse

Specific Objective To define sexual abuse To discuss the various forms of sexual abuse To discuss identification and support services To discuss services available for perpetrators of sexual abuse

Methodology and Learning Activities: 1. Participants are divided into 5 groups, to discuss the following 1.1 Sexual abuse 1.2 Forms of sexual abuse 1.3 The process of identifying and providing support services 1.4 Community structures for perpetrators of GBV 1.5 Profile of a sex offender (particularly related to children, for example, process of grooming). (40 minutes) 2. All the groups report back in plenary. Facilitator fills in gaps by giving an illustrated presentation . (15 minutes) 3. Facilitator Asks participants to quickly read Hand out (5 minutes)

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Facilitators Notes The facilitator should give a lecture on child sexual abuse before participants get into activities. The facilitator should emphasize that sexual abuse of children often includes incest as a subset of this form of abuse. While there is a substantial amount of overlap in the two types of sexual abuse, there are different needs that victims of each type of abuse may have. Further the facilitator should explain how adults can be vulnerable to sexual abuse. Forms of child sexual abuse can Include: Fondling Obscene phone calls Exhibitionism Masturbation Intercourse Oral or anal sex Prostitution Pornography

Any other sexual conduct that is harmful to a child's mental, emotional, or physical welfare Additional Features May consist of a single incident or many acts over a long period of time. Abuse is more often perpetrated by someone known to the child.

Abuse may escalate over time, particularly if the abuser is a family member. Adult Reactions Many adults tend to overlook, minimize, explain away, or disbelieve allegations of abuse. This may be particularly true if the perpetrator is a family member. NOTE: The absence of force or coercion does not diminish the abusive nature of the conduct, but, sadly, it may cause the child to feel responsible for what has occurred.

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Warning Signs: Physical Signs Difficulty walking or sitting Bloody, torn, or stained underclothes Bleeding, bruises, or swelling in genital area Pain, itching, or burning in genital area Frequent urinary or yeast infections Sexually Transmitted Infections, especially if under 14 years old Pregnancy, especially if under 14 years old

Behavioral Signs Reports sexual abuse Inappropriate sexual knowledge Inappropriate sexual behavior Nightmares or bed-wetting Large weight changes/major changes in appetite Suicide attempts or self-harming, especially in adolescents Shrinks away or seems threatened by physical contact Runs away Overly protective and concerned for siblings, assumes a caretaker role Post-Traumatic Stress Disorder or Rape Trauma Syndrome symptoms

Common Reactions Withdrawal Sleeping & eating disorders Self-mutilation Phobias Psychosomatic symptoms (stomachaches, headaches) School problems (absences, drops in grades) Poor hygiene/excessive bathing Anxiety Guilt

Depression

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Regressive behaviors - thumb-sucking, etc.

Adult survivors of sexual abuse have a high incidence of being re-victimised as adults by battery, sexual assault or both. The following are some of the effects of sexual abuse on adults: Potential abusers Lack of assertiveness Aggressiveness Problem behavior Self-harm Drug use Prostitution Running away Relationship and sexual problems Social withdrawal Sexual promiscuity Re-victimization Learning disabilities Psychiatric disorders Eating disorders Somatisation disorders Post-traumatic stress disorder Borderline personality disorder

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1.4.4 Emotional Abuse Key messages If children do not have confidence in themselves, if children do not feel that they are worthwhile, then they cannot take initiative and make something of themselves. The childs emotional welfare is influenced by such factors as the family, school, neighbourhood, countrys economic conditions as well as the religion and culture in which the child lives. These factors can either put children at risk or build their resilience to emotionally survive. For instance the family can hurt the child emotionally if they destroy the childs confidence in themselves. They can strengthen the child in stressful times if they provide support and good communication.

Time: 1hr 20 minutes

Content: Risk factors Indicators of stress

Learning Resources and Materials: Flip charts / Stand Marker pens Hand outs Stick stuff

Specific Objective To discuss emotional abuse as it relates to GBV To discuss risk factors of emotional abuse To discuss indicators of emotional abuse

Methodology and learning activities The facilitator gives an interactive presentation on emotional abuse as it relates to GBV (15 minutes) 1. Thereafter, participants are put into groups of six people. 2. One person acts as a child, and should stand in the centre. 3. The remaining five people form a circle around the child. 4. The facilitator makes the following statements which illustrate how specific factors can hurt the child or protect them. For each statement, the groups should perform a brief three minute drama among themselves.
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a) This 12 year old attends a school where he or she is told daily by the teacher how stupid he or she is. The people who have formed the circle are the teachers at the school. The child is in the centre. The facilitator tells the teachers this: All teachers at the same time start telling the child that he/she is stupid. b) This child comes from a family where the mother is beaten up weekly and the father is often drunk. The child speaks openly to her/his friends of her/his misery. The friends are very supportive. The people who have formed the circle are the girls/boys friends. The child is in the centre. 5. Again the facilitator tells the participants in the circle this: All friends advice your friend on how well they should react and give her/him reassurance that all will be well. (45 minutes) 6. The facilitator leads a focused group discussion based on: a) Assess and compare the childs emotional experience in the first and second drama. b) What was the experience like for those in the outer circle (as teachers, as peers?) (20 minutes)

Facilitators Notes During the presentation and group discussions the facilitator should ensure that the following issues come out: How Risk Factors Can Hurt the Childs Emotional Development If the family and school focus upon the childs faults and make them feel worthless, then they will impair the childs healthy emotional development. If the economy is weak, then children, especially girls may be asked to earn additional income on the streets and leave school. Economic hardships cause early marriages, for instance the family may look forward to early receipt of lobola. This can be stressful for the child if they are not ready. And if faced with limited finances the family will educate the boy. Lack of proper shelter leads to overcrowding and sexual abuse; also lack of privacy makes studying difficult. In the social environment, lack of supervision leaves the child vulnerable to sexual abuse and key activities such as homework do not get supervised. Peer pressure may force the child to engage in negative actions, such as stealing to acquire material goods others have engaged in sex.

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In school, the environment may not be sensitive to the childs needs and cause them undue stress.

How these Factors Can Help For example, if the family or the school is supportive of the childs efforts and helps the child to believe in themselves and their abilities, the child will be better able to survive difficult times. If ones culture supports the efforts of the child, encourages them to go to school and when tragedies occur such as sexual abuse, the culture provides protection and consolation to the child, this will help the child through adversity. Certain cultural practices cause the child stress and interfere with their healthy development e.g. circumcision outside the hospital, sexual initiation ceremonies, inheritance where children maybe neglected or sent away. Girls and boys may be married off at puberty to avoid STD infection or polygamy (obtain further examples from the group).

Indicators of Stress in Children One can identify children experiencing stress by observation of physical, behavioural and emotional symptoms: Physical: Headaches Stomach-aches Increased illnesses Changes in sleep or hearing

Behavioural: Regression to wetting/soiling Stealing Nightmares Poor concentration/school performance Increased Aggression/Bullying

Emotional: Mood changes Anxiety Increased fearfulness

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If the family is experiencing stress, you need to identify children at risk of emotional disturbance. To do this, consider families experiencing any of the following: Financial Problems Marital Problems Chronic Illness Death/loss of a loved one Poverty Parents or siblings or the child with physical/mental disabilities. Drug or alcohol abuse by a family member Displacement from ones home

What Helps Children and Families to Survive We know what puts children at risk and characteristics of what makes them survive: a) Within the child good self-esteem positive relationships with peers and family members (popular), and ability to master difficult situations. b) Within the family and environment strong political or religious beliefs within the family or community, strong extended family and clan, positive model of parents dealing with adversity, community concern. c) Within the culture Close relationships between parents and same sex child (in families, positive relationships between children and any parent is important). Older girls teaching younger girls. Decision-making: family discusses issues together. Moral education by aunties, uncles and grandparents.

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1.4.5 Social-economic Abuse

Time: 1hr 20 minutes

Content:

Learning Resources and Materials: Types of social economic Flip charts / Stand abuse Sticky stuff Marker pens Community guidelines Hand outs

Specific Objective To identify types of social economic abuses To discuss social economic abuse as it relates to gender based violence

Methodology and learning activities 1. The facilitator makes a brief presentation on social economic abuse in relation to GBV 2. The facilitator divides participants into two groups to: 2.1 Identify social economic abuse as it relates to GBV 2.2 Which gender is more vulnerable to this type of abuse and why (15 minutes) 3. Groups report back in plenary (15 minutes) 4. Then the facilitator gives participants the scenario below and asks them to discuss in pairs whether this is happens in their area. We got married right after high-school, and I got pregnant at 19. I stayed at home for the next three years on maternity leave. He started to beat me regularly after our child was born, but he always took great care to hit me on places where it would not show: on my torso or where my head was covered with hair, so that our friends and family would not see it and ask questions. I would not have said anything to anyone because we are a middle-class family, and nobody would have believed that things like this happen outside poor ethnic families. After the three years were over, I wanted to study and get a part -time job. That was when he also started to beat my face. I missed my oral entry exam, and I started to miss whole weeks from work because I could not have gone to work with black eyes, or a swollen nose. It would have been so shameful! Eventually I was fired, as the company could not afford to have an employee missing work week after week with no plausible explanation. (20 minutes)
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5. In the large group participants share their discussions. (20 minutes) 6. The facilitator and participants clarify and fills in gaps (10 minutes)

Facilitators notes The facilitator should ensure that the following issues are emphasised: Property grabbing: This often occurs after the death of a spouse and is usually perpetuated by the family of the deceased. Both men and women have been and can be victims of property grabbing although statistics reveal that the majority of victims are women. This is attributed to the fact that society in most cases does not consider the contribution of women towards acquisition of family assets and therefore does not appreciate the concept of joint ownership of family property. Stereotyping results in the belief that because men are the bread winners in a family they therefore are the ones who acquire property. Female empowerment has to a limited extent resulted in property being grabbed from men in the event of their wife passing away. Where families have noted the purchasing power of their female relative which has resulted in acquisition of assets, they have in some cases grabbed property from the husband. This scenario presents in instances where the man is unemployed or does not contribute significantly to family assets as expected by the family of the deceased woman. This scenario is however not very common. Socio-economic violence in the private sphere Most typical forms of socio-economic violence include taking away the earnings of the victim, not allowing them to have a separate income (housewife status, working in the family business without a salary), or making her or him unfit for work through targeted physical abuse. Socio-economic violence in the public sphere Socio-economic violence in the public sphere is both a cause and an effect of dominant gender power relations in societies. It can include denial of access to education or (equally) paid work (mainly to women), the denial of access to services, exclusion from certain jobs, the denial of the enjoyment and exercise of civil, cultural, social and political rights. Some public forms of socio-economic gender-based violence contribute to women becoming economically dependent on their partner (lower wages or very low child support). This in return gives a person with a tendency to be abusive in his relationships the chance to act without any fear of losing his partner.

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1.5 Gender Based Violence Gender-based violence encompasses a wide range of human rights violations, including rape, domestic violence, sexual assault and harassment, trafficking of women and girls and several harmful traditional practices. Any one of these abuses can leave deep psychological scars, damage the health of the victim who maybe both male and female, including childrens and womens reproductive and sexual health and, in some instances, result in death. Still, gender -based violence is shrouded in silence and shame. Victims of violence are often the most difficult to treat. Their chronic ailments and silent suffering frequently go undiagnosed, and the serious long-term effects can include irreparable damage to a womans sexual and reproductive health. Key Messages Gender-based violence not only affects women and girls; it affects men and boys and society at large and retards development. It also has a negative impact on children living in an abusive household. Studies show that some children who grow up in such an environment are likely to resort to violent behaviour as adults.

Time: 1hr 20 minutes

Content: Definition

Learning Resources and Materials: Flip charts / Stand Stick stuff Marker pens Community guidelines Hand outs

Magnitude of problem Significance

Specific Objective To give an overview of gender based violence To create an environment where participants can share freely their experience of violence To define GBV according to the GBV Act no.1 of 2011 To enable participants discuss gender based violence To identify the root causes of gender based violence To describe how community service providers should handle victims of violence when they come in contact with them.
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Methodology and learning activities Part I Divide participants into 4 groups and ask them to: 1. Define gender based violence and put this on flip chart. Give them the definition as stated in the Anti - Gender Based Violence Act No. 1 of 2011. (10 minutes) 2. Participants are divided into 3 groups to discuss the following: 2.1 Discuss Gender and how it contributes to cases of GBV 2.2 Discuss the Anti-Gender Based Violence Act no.1 of 2011 and pick out all the salient issues 2.3 Discuss the significance of having a gender violence Act and its contribution to ending GBV (30 minutes) 3. All groups report back in plenary. The facilitator and participants fills in gaps(15 Minutes) Part II Ask participants to look at Hand-out 15 - our experience Divide participants in 4 groups to discuss the following questions: 1. Are these statements familiar in your community? Share some of your stories of battery and other abusive treatments. Is violence on the increase? 2. Do you think the reasons men give for beating their wives are acceptable? 3. Do you think the reasons women give for abusing the men are acceptable? 4. What are the consequences for women who choose to leave their abusive husbands? What are the con sequences for their children? 5. What are some effective and life giving solutions for women and men who are frequently abused by their spouses? (20 minutes)
Part III - For Religious groups 1. Give hand out 10 Biblical background notes, and the appropriate texts to the group (1 Corinthians 13V1-13; Daniel 13 (Apocrypha); Judges 19; 2 Samuel 13: 1-21; Proverbs) 2. In small groups, discuss the texts and the background notes. 3. In the large group, bring out the main points in Hand-out 11. (30 minutes) (This part can be adapted to suit other faiths)

(5 minutes)

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Facilitators Notes The Anti-Gender Based Violence Act No. 1 of 2011 defines GBV as: any physical, mental social or economic abuse against a person because of that persons gender and includes:
a) Violence that results in, or is likely to result in physical, sexual or psychological harm

or suffering to the person, including threats of such acts, coercion or arbitrary deprivation of liberty, whether occurring in public or private; and
b) Actual or threatened physical, mental, social or economic abuse that occurs in a do-

mestic relationship Gender-based violence has its roots in gender inequality. It is therefore important to integrate a gender perspective into efforts to effectively prevent and respond to sexual abuse and exploitation. This means looking at what causes gender-based violence, analysing what happens to survivors because of gender discrimination, etc. It is important to stress that sexual abuse and exploitation is one form of gender- based violence. The impact of gender-based violence is far-reaching both for the victim, and for society at large. Strategies to respond to the many forms of gender-based violence must adopt a holistic approach and extend to all sectors. There is a wide range of contributing factors for the many forms of GBV, however gender inequality plays a part in all forms. Therefore, prevention strategies must address the vast array of contributing factors while systematically addressing gender inequality

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1.6 Consequences of GBV There are a number of health, psychological, and social consequences to the survivor of GBV. This session explores these consequences and after-effects in detail. Understanding the nature and extent of potential consequences will enable participants to understand the urgent need for basic minimum response services in all settings.

Time: 1hr 10 minutes

Content:

Learning Resources and Materials: Flip charts Masking tape Marker pens A4 plain paper Hand outs Stick stuff Community guidelines

Consequences of gender based violence

Specific Objective To review various forms of gender based violence To discuss consequences of gender based violence

Methodology and Learning Activities 1. Explain that the consequences of GBV can be organized into four general areas. 1.1 Health 1.2 Emotional, social and psychosocial 1.3 Legal/justice system 1.4 Community and physical safety and security. (10) 2. Divide participants into 4 groups representing each of the 4 sectors and ask the participants in their groups to: 2.1 List and discuss all of the consequences/outcomes and impact of GBV for their sector. Include individual consequences to the victim, and also outcomes for others community, family, government, etc.
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2.2 Prepare a flipchart paper with your groups list of consequences. 2.3 As each group reads their lists aloud, the facilitator writes the example at the top of the tree, forming the branches. (30 minutes) 3. The groups report back in plenary 4. Ask participants to read Hand outs (20) minutes) (10 minutes)

FACILITATORS NOTES Some forms of GBV that should be emphasised are: sexual harassment, rape, attempted rape, trafficking, prostitution, manipulation within the home, the workplace or school, domestic violence, battery, confinement, emotional abuse, pornography, harmful traditional practices, (i.e. FGM), early/forced marriage, dowry abuse, widow/widower ceremonies, punishments directed at women for defying cultural norms, denial of education, food and clothing to people by virtue of their sex. Ensure that all forms of gender based violence are covered. It is also important to explain some consequences of gender-based violence: Health: Individual consequences to the victim: Injury, disability, or death. STDs and AIDS. Injury to the reproductive system including menstrual disorders, childbearing problems, infections, miscarriages, unwanted pregnancies, unsafe abortions. Depression, leading to chronic physical complaints and illnesses. FGM, resulting in shock, infection, excessive bleeding or death, and longer-term affects such as emotional damage, including anger, fear, resentment, self-hate and confusion. Loss of desire for sex and painful sexual intercourse. Difficult pregnancy and labour, chronic pain and infection, infertility.

Impact on wider society: Strain on medical system

Emotional/Psychological: Individual consequences to the victim: Emotional damage including anger, fear, resentment and self-hate. Shame, insecurity, loss of ability to function and carry out daily activities. Feelings of depression and isolation. Problems sleeping and eating. Mental illness and thoughts of hopelessness and suicide. Gossip, judgments made about the victim, blaming the victim, treating the victim as a social outcast.

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Impact on wider society: Expensive, drain on community resources; family, neighbours, friends, schools, community leaders, social service agencies, etc. Victim/survivor unable to continue as contributing member of society; unable to keep up with child care, unable to earn an income. If perpetrators not apprehended or arrested, this sends a wrong message that the behaviour is somehow acceptable, leading to further incidents of violence.

Legal/Justice System Lack of access to legal system, lack of knowledge of existing laws, confusion regarding the most appropriate channels i.e. criminal, traditional etc. Victim/survivor reluctant to report due to heavy stigma attached to sexual abuse. Strain on police/court resources already challenged and overburdened. Lack of sensitivity to the issues expressed by judges. Costs incurred by the victim.

Security, Physical Environment of the Community Victim feels insecure, threatened, afraid, climate of fear and insecurity impacting womens freedom and perception of personal safety. Lack of female participation in the community life. Fear of travelling to school and work.

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1.7 Causes of gender based violence

Time: 2hr 10 minutes

Content: Power Violence use of force Consent

Learning Resources and Materials: Flip charts Stick stuff Marker pens

Specific Objective To identify the relationship between abuse of power and GBV. To understand that the term violence in the context of GBV means using some type of force, which may or may not include physical force. To understand the meaning of informed consent and its relationship to GBV.

Methodology and learning activities Activity 1: Power 1. On the flip chart, the facilitator writes the word POWER. 2. The facilitator asks participants what gives someone power? and writes their answers on the flipchart. 3. Participants discuss various types of powerask for some examples (without names) of people who have power in the world, in the community. 4. Facilitator explains that GBV is about abusing power. Whether the power is real or perceived, the victim of the abuse believes the power is real. 5. The facilitator fixes the Power flip chart on the wall nearby, where it can be seen and referred to later in the session. (30 minutes) Activity 2: Use of Force 1. On a new blank flipchart, the facilitator writes the word VIOLENCE. 2. The facilitator then asks each participant to take a piece of paper and write two words or phrases to describe what is meant by violence when people are talking about gender based violence. This is an individual activity, not group work. The facilitator allows a few moments for everyone to write their two words.

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3. The facilitator goes around the room, one by one, asking each person to give ONE word/phrase they wrote. The facilitator puts the words on the flip chart and keeps going around the room until everyones word is on the flipchart. 3.1 This should be a very quick exercise; participants should not repeat things from their lists that others have already said. 3.2 Participants usually give a combination of examples of types of violence as well as some definitions of the word violence. Everything should be put on the flip chart. 4. The facilitator then stands back from the flip chart and facilitates a short discussion while calling out the key discussion points. The facilitator clarifies any confusing points; crosses out any words or phrases that participants agree do not belong on the list. 5. At the top of the flip chart, the facilitator writes USE OF FORCE next to VIOLENCE. Should look like this VIOLENCE / USE OF FORCE 6. The facilitator summarizes by explaining that violence in this context involves the use of some type of force, real or implied and this is a key element in defining what we mean when we say gender based violence. 7. Stick the Violence flip chart on the wall near the Power flip chart, where they both can be seen and referred to later in the session. (40 minutes) Activity 3a: Informed Consent 1. On a new blank flipchart, the facilitator writes the word CONSENT. 2. The facilitator asks participants what consent means to them and writes their responses on the flipchart. 3. The facilitator discusses their responses and stresses that the two necessary components of consent; that it is informed and voluntary. 4. The facilitator summarizes the session by pointing to all three flip chartsPOWER, VIOLENCE/ USEOF FORCE, CONSENT. The facilitator then quickly reviews the main points of each of these key concepts. (20 minutes) Activity 3b: Informed consent Read the following examples to participants. Then ask each question and discuss the answers. In a very traditional and patriarchal family, the father of a 19 year old girl tells her that he has arranged for her to marry a certain man. The girl does not know the man very well, he is much older than she is, but she agrees to the marriage. 1. Do you think this kind of situation could happen? 2. Did she give her informed consent to this marriage? 3. Was there any force used in this incident? 4. Who is more powerful in this example father or daughter? 5. What kind of power does this father have? 6. What kind of power does the daughter have? 7. How does power relate to choice in this example?
(40 minutes)

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Facilitators Notes Power Perpetrators can have real or perceived power. Some examples of different types of power and powerful people are given below: Socialpeer pressure, bullying, leader, teacher, parents Economicthe perpetrator controls money or access to goods/services/money/ favours; sometimes husband or father Politicalelected leaders, discriminatory laws, President of Zambia Physicalstrength, size, use of weapons, controlling access or security; soldiers, police, robbers, gangs Gender-based (social)males are usually in a more powerful position than females Age-relatedoften, the young and elderly people have the least power Power is directly related to choice. The more power one has, there are more choices available. The less power one has, fewer choices are available. Un-empowered people have fewer choices and are therefore more vulnerable to abuse. Gender-based violence involves the abuse of power. Unequal power relationships are exploited or abused. Do all people with power abuse their power? (No.) Force might be physical, emotional, social or economic in nature. It may also involve coercion or pressure. Force also includes intimidation, threats, persecution, or other forms of psychological or social pressure. The target of such violence is compelled to behave as expected or to do what is being requested, for fear of real and harmful consequences. Violence consists of the use of physical force or other means of coercion such as threat, inducement or promise of a benefit to obtain something from a weaker or more vulnerable person. Using violence involves forcing someone to do something against her/his willuse of force. Consent means saying yes, agreeing to something. Informed consent means making an informed choice freely and voluntarily by persons in an equal power relationship. Acts of gender-based violence occur without informed consent. Even if she says yes, this is not true consent because it was said under duressthe perpetrator(s) used some kind of force to get her to say yes. Children (under age 18) are deemed unable to give informed consent for acts such as female genital cutting (FGC), marriage, sexual relations, etc.

ViolenceUse of Force

Consent

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1.8 History taking

Time: 1hr 30 minutes

Content:

Learning Resources and Materials: Process of general history taking from survivors of Flip charts / Stand GBV Stick stuff / masking tape Marker pens Case study/scenario

Specific Objective To demonstrate ability to take history from a GBV survivor

Methodology and learning activity: Role Play 1. Facilitator asks for 6 volunteers to take part in a role play about history taking. Scenario: A young person comes to the community worker for assistance while being escorted by an aunt; one participant plays the role of an aunt, one other participant plays the role of the young person; the other 4 participants are members of staff at the community centre (or home of a community worker). (1hr) 2. The rest of the participants watch and listen. 3. At the end of the role play the group makes comments while the facilitator clarifies any unclear issues. (30 minutes)

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Facilitators notes It is important to remember that the survivors of GBV experience profound trauma. Therefore a community worker needs to create an environment that facilitates the survivor to make positive decisions about how they will deal with the situation. The following steps are key to providing psychosocial support to a GBV survivor. When a survivor arrives at the centre or home of a community worker, they may be agitated, depressed, shameful, fearful, angry, feeling guilt etc. Greet the survivor and introduce yourself Then ask them to introduce themselves Create an environment of trust Ask them what made them visit you Discuss the survivors expectations Inform the survivor of the issues of confidentiality Discuss the problem at hand Ask about the fear and anxieties the survivor could have Explore how the survivor intends to deal with their fears and anxiety. Assure the survivor that it is not their fault it happened Use silence to give an opportunity for the survivor to think through what is being discussed. Encourage survivor to seek further management from police/health facility wherever necessary. (for children it is advisable not to have the parent/guardian present as the child may not feel free to give all the information needed) Create a climate of trust

(Refer to hand-out for more information) NOTE: the role play could be about any other scenario of cases of gender based violence that occur in the community and may involve male or female, adult or young person/child adapt according to the issue at hand.

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1.9 Reporting Procedures of gender based violence Key messages It is important to know how to handle cases and the procedure for reporting cases of GBV

Time: 1 hour

Content: Reporting procedures of GBV Mandatory reporting Consent

Learning Resources and Materials: Flip charts / Stand Stick stuff Marker pens

Specific Objective To discuss procedures for reporting cases of GBV. To discuss mandatory reporting of GBV.

Methodology and learning activities 1. Participants form small groups

(1 hour)

2. Each group to have flipchart paper and marker 3. Ask each group to discuss what they think is the procedure for reporting GBV and a brief description of what happens/will happen at each stage of the process 4. Each group should write on flipchart paper the major stages of the process 5. Each group should stick their flipchart paper on the wall 6. Ask a representative from each group to give a brief description of what happens/will happen at each stage of the process 7. At the end facilitator writes on flipchart the procedure for reporting and explains in detail each stage 8. In the large group participants discuss reasons why people do not report GBV cases to relevant authorities (both community members and survivors) 9. The facilitator wraps the activity while reinforcing main points

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Facilitators Notes: Procedure for Reporting The facilitator should give the following guidelines: a) Report to the Police, Victim Support Unit (discuss what will happen) b) Report to the medical staff to give information (discuss the procedure with parents/child, what will happen) c) Courts (discuss with parents what will happen in courts) Mandatory Reporting Mandatory reporting is being suggested or recommended as at the moment it does not exist. It is suggested that the following should be done:
a) It should be mandatory to report to the Victim Support Unit (police). b) Every member of the community should report to the police. c) It should be an offence not to report a case of child abuse.

Many survivors will keep the true cause of the injuries secret. Reasons for secrecy include the following: 1. Fear that he/she will not be believed; 2. Fear of injury from the perpetrator; 3. Being threatened by the perpetrator not to reveal the true cause; 4. Fear that the perpetrator will be informed that a report has been made; 5. Fear for his/her children if they are with the perpetrator; and Fear of support being withdrawn as a result of reporting (especially where perpetrator is a known person or relative). NOTE: It is important the reporting procedure is written out on cards which should be distributed to community members during sensitisation interventions, i.e. schools, community leaders and other community organisations.

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Why People do not report both Adult and Child related GBV cases 1. Fear of being victimised/killed/harmed by the perpetrator 2. Most survivors think what happened is their fault 3. In most cases perpetrators are powerful economically, socially, close relatives. 4. Culturally women are groomed to endure in their marriages and protect their husbands even when they are brutal. 5. People would rather negotiate to gain an income (compensation)/poverty 6. Ignorance/lack of information 7. Loyalty to the perpetrator 8. Rituals 9. Fear to be witness 10. Fear of the unknown 11. Fear to break up the family 12. Lack of confidence in the police 13. Long distance to facilities and cumbersome procedures

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REPORTING PROCEDURES AT COMMUNITY LEVEL

One Stop Centre Family member Political Leaders

Community Leaders

Police VSU Church Leader Teachers School

Peers

Child Protection Committee CPU

Medical Personnel Headmen Chiefs

Community Paralegal Ant-Gender Based Violence Committee NGO/CBOs Community Care Givers

CCPU/Neighbourhood watch

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1.10 Referrals for further Management of GBV

Time: 30 Minutes

Content:

Learning Resources and Materials: Flip charts / Stand Stick stuff / masking tape Marker pens

Community structures for survivors of GBV Referral procedures

Specific Objective To discuss community structures for cases of GBV. To discuss procedures for referral of survivors of GBV.

Methodology and learning activities Facilitator gives a brief presentation on community structures and referral procedures for survivors of GBV

Facilitators notes The facilitator should during presentation reinforce the following: Referrals for further management of GBV Community Structures It is essential that the following structures are available at community level so that survivors are served appropriately: Urban & Peri-urban Areas Gender sub-committee comprising representatives from Ministries of Gender and Child Development, Health, Community Development, Mother and Child, Local Government and Housing and Home Affairs (Police Victim Support Unit) and Civil Society Organisations operating in the respective districts/areas.

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Rural Areas In the rural areas the gender sub-committees will be led by the village development committee consisting of representatives from community leaders, i.e. Chiefs, Headmen, church representatives, etc Referral During referrals, it is important to remember that the survivor has experienced profound trauma. Community workers/professionals need to approach survivors of sexual violence in a professional manner. At this point, a survivor may be agitated, depressed, shameful, fearful, angry, feeling guilt etc. The community worker should explain the need for referring the survivor to other professionals for further management. The community worker should also explains that he/she works with other professionals. If the survivor needs and agrees to go to a referral centre with a friend or family member, please allow this. Before referral ensure that you have obtained history as completely as possible but with compassion, respect and sensitivity Since for children it is advisable not to have the parent/guardian as the child may not be free to give all the information needed, ensure that another trusted adult accompanies the child. The community worker should ensure availability and proper completion of the GFRI Form

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1.11 Safe Record Keeping

Time: 50 Minutes

Content: Record keeping

Learning Resources and Materials: Flip charts/flip chart stand Sticky stuff/Masking tape Marker pens Note books/pens

National Multi-sectoral Guidelines for GBV survivors Specific Objective To discuss record keeping for survivors of GBV Hand outs

Methodology and learning activity The facilitator makes a presentation on proper record keeping. A question and answer session follows to allow for clarification of issues

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Facilitators Notes

The facilitator should explain that if the records of a survivor were found by someone else not authorized by the survivor, this could be very embarrassing and traumatic and may put the survivor at risk. Authorized persons include medical personnel, parents or legal guardian, counsellor and police. At no time should the records come into the possession of the accused or suspected person. It is important to keep all records safely. Some of the things to consider doing are: All information collected from the survivors should be kept under lock and key. Ensure that there is a back-up system. Ensure that there are limited numbers of people having access to the information. Maintain safety and confidentiality of survivor records.

Confidentiality and privacy constitute essential ingredients in the counselling setting. Physical facilities that preserve this quality are important. Therefore counselling is not typically conducted in the counsellors home, the local coffee shop, or other informal, non -confidential setting. This is because records need to also be immediately kept away in a confidential and safe place.

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Appendices Hand out 1 Steps of the Learning Cycle

1.Recognition 2. Understanding

6. Application to GBV

Reinforcement, Integration & refinementRefinemen

3. Self-Assessment 4. Experimentation

Effective Adult Learning We learn best when: we see the knowledge as valuable the goals are clear we can make mistakes and together look at them and see why our own experience is valued and used we add new facts to what we already know we get direct, frequent feedback we can share and discuss our learning with others we feel respected and listened to we have input into how the teaching and learning happens We remember 20% of information when we only hear it. We remember 30% when we only see it. We remember 50% when we hear and see it. We remember 70/o when we hear, see and talk it. We remember 90% when we hear, see, talk and do it.

Remembering

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Hand out 2 JOHARI WINDOW KNOWN TO SELF UNKNOWN TO SELF

ARENA

BLIND SPOT

Facade Hidden Area

Unknown Area

Joharis Window was originally developed by two psychologists, Joe Luft and Harry Ingham, who were interested in exploring different styles of interpersonal communication. The window illustrates the degrees to which two people are aware of what each other knows, or how they can perceive the same situation two different ways. The person inside of the box represents a local person, or insider, and the person outside of the box represents the development worker, or outsider. During service provision, service providers should strive to create an open window when interacting with the community. Following are descriptions for the different windows. Which description goes with which window? OPEN: The insider and the outsider understand each other and are aware of each others needs and priorities. They can communicate openly. BLIND: The outsider feels that she sees the problems and solutions clearly and the insider does not. The outsider considers the insider to be ignorant, or blind. HIDDEN: The insider has beliefs, knowledge or feelings that she keeps to herself. They are hidden from the outsiders view. The insider may feel misunderstood and unappreciated by the outsider. UNKNOWN: There is a lack of communication between the two people. Neither the insider nor the outsider is aware of the other persons beliefs, knowledge, or feelings.
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Hand out 3 Sexual Abuse Sexual abuse is when one or more people using physical force or their position of authority or trust, develops an intimate emotional relationship with a child, use the child for purposes of sexual gratification with or without the childs consent (any child below the age of 18). Such as: fondling of the childs sexual parts (genitals, breasts, buttocks) insertion of finger or object into the childs private parts actual or attempted penetrative sex with a child whether vaginal or anal displaying or exposing a ones genitals to a child having oral sex with a child sudden lack of trust in a well-known adult, or trying to avoid the adult. new fear of being bathed or having clothes or nappies changed excessive or inappropriate sexual behavior for the childs age. preoccupation with sexual activities. awkward way of walking caused by pain or discomfort. expressing affection in inappropriate ways. serious rebellion especially against mother. Anxiety Fear Posttraumatic stress disorder Nightmares General problems Depression Withdrawn Suicidal Poor self-esteem Somatic complaints (Blood pressure, headache etc.) Mental illness Neurotic

Signs that the Problem May Be Sexual

Other Symptoms

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Aggression Aggressive antisocial behavior Cruelty Delinquent behavior Sexualised behavior Inappropriate sexual behavior Promiscuity School/learning problems Behaviour problems Hyperactivity Regression/immaturity Illegal acts Running away Self-destructive behavior Substance abuse Self-injurious behavior Composite symptoms Internalising Externalising Statutory law: Any girl below the age of 16 cannot give consent to sex under the law. Common law: Any girl who reaches puberty is deemed an adult because she can give birth.

The Law and Child Sexual Abuse

There are no age indicators. Importance of reporting: To safeguard the girl-child from being sexually abused by those who are capable. Credibility of Childrens Allegations of Sexual Abuse Depending on the age of the child, the reporting may be influenced by mistrust. It is believed however that generally the reports of child sexual abuse by the child herself is usually clouded with mistrust. It is not common for a child to lie about abuse. Factors which could influence credibility (the truthfulness of the child):

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language skills memory skills time concept Fantasy sexual knowledge childrens suggestibility consistency of allegations

The professional should not necessarily accept the perception of the eye of the beholder. There is a need for medical examinations to support verbal reports. Medical indications: Genital trauma Anal/genital abnormalities

Definitive indications: Semen Gonorrhoea Syphilis In most cases there are no medical indications.

Effects of Sexual Abuse The effects of child sexual abuse are complex. At times it is possible that there will be an absence of symptoms. In other cases the child might have multiple manifestations. In another instance, there could be long-term effects making a child vulnerable to other problems. Short Term Effects feeling of powerlessness Anger Fear increased anxiety phobias (object or people) Nightmares difficulty concentrating (e.g. day-dreaming) flashbacks of the event frequent vigilance of ones environment for fear of confronting the perpetrator.
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Long Term Effects Psychological Problems: Depression Chronic or severe anxiety Low self-esteem Guilt Sleep disturbance Dissociative phenomena Difficulties with trust and intimacy in relationships (frigidity) Adult survivors of sexual abuse have a high incidence of being re-victimised as adults by battery, sexual assault or both. Potential abusers Lack of assertiveness Aggressiveness Problem behavior Self-harm Drug use Prostitution Running away Relationship and sexual problems Social withdrawal Sexual promiscuity Re-victimization Learning disabilities Psychiatric disorders Eating disorders Somatisation disorders Post-traumatic stress disorder Borderline personality disorder 1. I believe you. 2. It is not your fault (a child can never be held responsible). 3. I am glad you told me. 4. I am sorry this happened to you. 5. I am going to try to help you.
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Five Things to Tell a Child who Confides in You

Family Responses to Sexual Abuse Families appear to go through five stages in response to the discovery that a member of their family has been sexually abused. Professionals need to understand how the response of the family influences how they present to you and how it affects their ability to demands you make upon them (e.g. to process Forms, to visit the hospital and police station, to provide detailed information in an interview).

1. Shock/helplessness: What is happening? 2. Denial: It didnt happen! 3. Anger: Who did it? Ill kill him! 4. Sadness: Our daughter what will become of her? 5. Resolution: We will take the following action. (Note: In certain situations, the family will be unable to move beyond stage 2, denial. For the family to progress to later stages, either a member of the family must champion the childs cause or a strong intervention from the community or the legal system must occur).

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Hand out 4 International Laws addressing gender-based violence and Human Rights Instruments International and Regional Instruments on GBV Zambia being a member of the international community is obligated to have in place policies and laws that conform to the instruments to which she is a party. These international and regional instruments set out the minimum standards for human rights which must be adhered to by member states. The International Covenant on Civil and Political Rights and the International Covenant on Economic Social and Cultural Rights are legally binding treaties that set out the basic human rights standards at international law whereas the African Charter on Human and Peoples Rights is the main regional document. However in recognition of the fact that certain groups were particularly vulnerable to violence and discrimination, specific instruments were developed aimed at providing special protection of these vulnerable groups such as women, children and persons with disabilities. i. The Universal Declaration of Human Rights This was the first comprehensive document on human rights to be declared by the international community. It was adopted on December 10th 1948 by the UN General Assembly soon after the Second World War when the international community recognised the atrocities committed in that war and determined that such acts should never be repeated. The Declaration is not legally binding but is recognised as forming part of the international human rights jurisprudence. The Declaration contains both civil and political rights and economic social and cultural rights. Article 1 recognises that all human beings are born free and equal in dignity Article 2 provides that everyone is entitled to all the rights and freedoms in the Declaration without distinction with regard to race, colour, sex, religion, political or other opinion, national social origin, property, birth or other status. It also provides for the protection of such rights as the right to life and security of the person. ii. UN Protocol to prevent, suppress and punish trafficking in persons, especially women and children (adopted 2000)

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The Protocol covers the following: defining the crime of trafficking in human beings; essentially, trafficking is the transport of persons, by means of coercion, deception, or consent for the purpose of exploitation such as forced or consensual labour or prostitution: " rafficking in persons "shall mean the recruitment, transportation, transfer, harbouring or reT ceipt of persons, by means of the threat or use of force or other forms of coercion, of abduction, of fraud, of deception, of the abuse of power or of a position of vulnerability or of the giving or receiving of payments or benefits to achieve the consent of a person having control over another person, for the purpose of exploitation. Exploitation shall include, at a minimum, the exploitation of the prostitution of others or other forms of sexual exploitation, forced labour or services, slavery or practices similar to slavery, servitude or the removal of organs... The consent of a victim of trafficking in persons to the intended exploitation set forth [above] shall be irrelevant where any of the means set forth [above] have been used. facilitating the return and acceptance of children who have been victims of cross -border trafficking, with due regard to their safety; prohibiting the trafficking of children (which is defined as being a person under 18 years of age) for purposes of commercial sexual exploitation of children (CSEC), exploitative labour practices or the removal of body parts; suspending parental rights of parents, caregivers or any other persons who have parental rights in respect of a child should they be found to have trafficked a child; ensuring that definitions of trafficking reflect the need for special safeguards and care for children, including appropriate legal protection; ensuring that trafficked persons are not punished for any offences or activities related to their having been trafficked, such as prostitution and immigration violations; ensuring that victims of trafficking are protected from deportation or return where there are reasonable grounds to suspect that such return would represent a significant security risk to the trafficked person or their family; considering temporary or permanent residence in countries of transit or destination for trafficking victims in exchange for testimony against alleged traffickers, or on humanitarian and compassionate grounds; providing for proportional criminal penalties to be applied to persons found guilty of trafficking in aggravating circumstances, including offences involving trafficking in children or offences committed or involving complicity by state officials; and, providing for the confiscation of the instruments and proceeds of trafficking and related offences to be used for the benefit of trafficked persons. The Convention and the Protocol obligate ratifying states to introduce national trafficking legislation.

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iii. Rome Statute of the International Criminal Court (entered into force July 2002) The Rome Statute established 4 core international crimes (genocide, crimes against humanity, war crimes and the crime of aggression). Under the Rome Statute, the ICC can only investigate and prosecute the core international crimes (genocide, crimes against humanity, war crimes and the crime of aggression) in situations where states are unable or unwilling to do so themselves. The court can investigate crimes only in states that signed the Rome Statute unless authorized by the U.N. Security Council. The International Covenant on Civil and Political Rights Article 3 provides that states undertake to ensure the equal rights of men and women to the enjoyment of all civil and political rights set forth in the Covenant. The covenant also provides for the rights to life, not to be tortured and that no one shall be held in slavery or servitude. It also recognises the family as the fundamental unit of society and recognises the right of men and women of marriageable age to marry and found a family and that states have the responsibility to ensure the equal rights and responsibilities as to marriage, during marriage and at its dissolution. The UN Convention on the Elimination of all forms of Discrimination Against Women (CEDAW) Considering the Bill of Rights for Women, this Convention prohibits all forms of discrimination against women. Article 5 of the convention provides that States Parties shall take all appropriate measures to modify the social and cultural patterns of conduct of men and women, with a view to achieving the elimination of prejudices and customary and all other practices which are based on the idea of the inferiority or the superiority of either of the sexes or on stereotyped roles for men and women; In its approach, the Convention covers three dimensions of the situation of women. These are the civil rights and the legal status of women, the dimension of human reproduction (i.e. reproductive rights) and the impact of cultural factors on gender relations. The Declaration on the Elimination of Violence Against Women The declaration was adopted without vote by the United Nations General Assembly in its resolution 48/104 of 20 December 1993. Contained within it is the recognition of "the urgent need for the universal application to women of the rights and principles with regard to equality, security, liberty, integrity and dignity of all human beings".

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Convention on the Rights of the Child (CRC) This convention was developed to put a special focus on children. The overriding principal in the convention is that in all matters and decisions affecting children, the best interest of the child must be of primary concern. Rights under this include the right to survival and development, to have their views heard where decisions that concern them are being made, right to education, leisure and play and the right to be protected from all forms of violence. viii. African Charter on Human and Peoples Rights This is the main treaty governing the rights of people under the African system. The Charter also provides for civil and political rights as well as economic social and cultural rights similar to those under the UN system. However the Charter also goes further and provides for the rights of peoples as distinct groupings and duties of individuals ix. African Charter on the Rights and Welfare of the Child (ACRWC) This has similar rights to the CRC except that this charter also has corresponding duties that children have. x. African Charter on Human and Peoples Rights Protocol on the Rights of Women in Africa (Womens Protocol) This contains similar provisions to the CEDAW but also bring it to the African Context by providing for the elimination of harmful practices such as female genital mutilation and protection of women who are vulnerable to such practices as well as protection of women in armed conflict. xi. SADC Protocol on Gender and Development Its objective includes harmonising the implementation of the various regional, continental and international levels on gender equality and equity and to empower women, to eliminate discrimination and to achieve gender equality and equity through the development and implementation of gender responsive legislation, policies, programmes and projects. It provides for such things as affirmative action, equality in accessing justice, widows and widowers rights, participation etc.

Facilitator must show how these instruments relate to and help in the combating of GBV

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Hand out 5 ABUSE Abuse may have occurred if the survivor or accompanying person expresses the following: 1. Survivor is tense, fearful and apprehensive; 2. Survivor looks to companion for direction; 3. Survivor is unable to make decisions alone and/or leaves decisions totally to his/her companion, even those regarding physical needs and health; 4. Survivor is overly concerned about the perpetrator and/or children and has little or no concern for his/her own health needs; 5. Survivor minimizes the seriousness of the injury or how it occurred; 6. Accompanying person interrupts or constantly explains his/her version of the survivors injuries; 7. Accompanying person hovers over the survivor and is reluctant to leave her/him alone, even for examinations; 8. Accompanying person is pushy or demanding of the survivor or medical staff for information; Accompanying person appears more concerned about him/herself than the health issues for the survivor. Sexual abuse Includes: Fondling Obscene phone calls Exhibitionism Masturbation Intercourse Oral or anal sex Prostitution Pornography Any other sexual conduct that is harmful to a child's mental, emotional, or physical welfare May consist of a single incident or many acts over a long period of time. Abuse is more often perpetrated by someone known to the child. Abuse may escalate over time, particularly if the abuser is a family member.

Additional Features

Adult Reactions Many adults tend to overlook, to minimize, to explain away, or to disbelieve allegations of abuse. This may be particularly true if the perpetrator is a family member.

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NOTE: The absence of force or coercion does not diminish the abusive nature of the conduct, but, sadly, it may cause the child to feel responsible for what has occurred. It is important to assure the child they are not blame. Warning Signs: Physical Signs Difficulty walking or sitting

Bloody, torn, or stained underclothes Bleeding, bruises, or swelling in genital area Pain, itching, or burning in genital area Frequent urinary or yeast infections Sexually Transmitted Infections, especially if under 14 years old Pregnancy, especially if under 14 years old Regressive behaviours - thumb-sucking, etc Reports sexual abuse Inappropriate sexual knowledge Inappropriate sexual behaviour Nightmares or bed-wetting Large weight changes/major changes in appetite Suicide attempts or self-harming, especially in adolescents Shrinks away or seems threatened by physical contact Runs away Overly protective and concerned for siblings, assumes a caretaker role Post-Traumatic Stress Disorder or Rape Trauma Syndrome symptoms Withdrawal Depression Sleeping & eating disorders Self-mutilation Phobias Psychosomatic symptoms (stomach-aches, headaches) School problems (absences, drops in grades) Poor hygiene/excessive bathing Anxiety Guilt
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Behavioural Signs

Common Reactions

Talk to your child directly. Pick your time and place carefully!

Have this conversation somewhere that your child feels comfortable. DO NOT ask your child about child abuse in front of the person you think may be abusing the child!

Ask if anyone has been touching them in ways that dont feel okay or that make them feel uncomfortable.

Know that sexual abuse can feel good to the victim, so asking your child if someone is hurting them may not get the information that you are looking for.

Follow up on whatever made you concerned. If there was something your child said or did that made you concerned, ask about that.

Ask in a non-judgmental way, and take care to avoid shaming your child as you ask questions. I questions can be very helpful. Rather than beginning your conversation by saying You (the child) did something/said something that made me worry consider starting your inquiry with the word I. For example: I am concerned because I heard you say that you are not allowed to close the bathroom door.

Make sure that your child knows that they are not in trouble, and that you are simply trying to gather more information.

Talk with your child about secrets.

Sometimes abusers will tell children that sexual abuse is a secret just between them. They may ask the child to promise to keep it secret.

When you talk to your child, talk about times that its okay not to keep a secret, even if they made a promise.

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Build a trusting relationship with your child.


Let your child know that it is okay to come to you if someone is making them uncomfortable. Be sure to follow up on any promises you makeif you tell your child that they can talk to you, be sure to make time for them when they do come to you!

All children should know that its okay to say no to touches that make them uncomfortable or if someone is touching them in ways that make them uncomfortable and that they should tell a trusted adult as soon as possible.

Let your child know that you wont get angry at them if they tell someone no. Children are often afraid that they will get into trouble if they tell someone not to touch them.

Teach children that some parts of their body are private. Tell children that if someone tries to touch those private areas or wants to look at them, OR if someone tries to show the child their own private parts, they should tell a trusted adult as soon as possible.

Make sure to follow through on this if your child does tell you about inappropriate touching! Try not to react with anger towards the child.

Let children know that they will not be in trouble if they tell you about inappropriate touching.

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Hand out 6 THE TYPES OF ABUSE PROVIDED FOR IN THE ACT As indicated in the manual earlier, there are many types of abuse with several clusters under them; thus: 1.0 PHYSICAL: Battery: The actual intentional striking of someone, with intent to harm, or in a "rude and insolent manner" even if the injury is slight. Negligent or careless unintentional contact is not battery no matter how great the harm. Battery is a crime and also the basis for a lawsuit as a civil wrong if there is damage. It is often coupled with "assault" (which does not require actual touching) in "assault and battery." Harmful or Offensive Conduct: It is not necessary for the defendant's wrongful act to result in direct contact with the victim. It is sufficient if the act sets in motion a force that results in the contact. A defendant who whipped a horse on which a plaintiff was riding, causing the plaintiff to fall and be injured, was found guilty of battery. Provided all other elements of the offense are present, the offense may also be committed by causing the victim to harm himself. A defendant who fails to act when he or she has a duty to do so is guiltyas where a nurse fails to warn a blind patient that he is headed toward an open window, causing him to fall and injure himself. Aggravated Battery: When a battery is committed with intent to do serious harm or murder, or when it is done with a dangerous weapon, it is described as aggravated. A weapon is considered dangerous whenever the purpose for using it is to cause death or serious harm. State statutes define aggravated battery in various ways such as assault with intent to kill. Under such statutes, assault means both battery and assault. It is punishable as a felony in all states. Physical Abuse: Means physical assault or use of physical force against another person, including the forcible confinement or detention of another person and the deprivation of another person of access to adequate food, water, clothing, shelter, rest, or subjecting another person to torture or other cruel, inhuman or degrading treatment or punishment;

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Forced Abortion: Most abortions are carried out in private and therefore leave very little room for investigation. Victims of forced abortions are often afraid to report for fear of prosecution. Forced abortion is further perceived as embarrassing for the family therefore exposing the perpetrator is not even a consideration. However since 2003, gender-based violence (GBV) has been recognized and discussed as a public, rather than a private problem in Zambia. The victim may adversely suffer from one or more of these consequences; pregnancy complication, unwanted pregnancies, injury, disability, death, STIs and HIV and AIDS, Reproductive health disorders, Miscarriage, Unsafe abortions, Depression and chronic illness, Infection, Excessive bleeding. 2.0 SOCIAL AND ECONOMIC: Property grabbing: This often occurs after the death of a spouse and is usually perpetuated by the family of the deceased. Both men and women have been and can be victims of property grabbing although statistics reveal that the majority of victims are women. This is attributed to the fact that society in most cases does not consider the contribution of women towards acquisition of family assets and therefore does not appreciate the concept of joint ownership of family property. Stereotyping results in the belief that because men are the bread winners in a family they therefore are the ones who acquire property. Female empowerment has to a limited extent resulted in property being grabbed from men in the event of their wife passing away. Where families have noted the purchasing power of their female relative which has resulted in acquisition of assets, they have in some cases grabbed property from the husband. This scenario presents in instances where the man is unemployed or does not contribute significantly to family assets as expected by the family of the deceased woman. This scenario is however not very common. Socio-economic violence This form of violence can be both a means to make the victim more vulnerable to other forms of violence, but can also be the reason why other forms of violence are inflicted. Whereas world economic figures clearly show that one of the results of neo-liberal globalisation is the feminisation of poverty (making women generally more economically vulnerable than men), economic vulnerability is a phenomenon that exists on a personal level as well. It has been recognised in a vast number of abusive relationships as a distinct phenomenon, and that is why it has merited a category of its own. At the same time, a womans better economic status in a relationship does not necessarily eliminate the threat of violence because this can also lead to conflicts about status and emasculation in abusive relationships.
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Socio-economic violence in the private sphere Most typical forms of socio-economic violence include taking away the earnings of the victim, not allowing them to have a separate income (housewife status, working in the family business without a salary), or making her or him unfit for work through targeted physical abuse. Socio-economic violence in the public sphere Socio-economic violence in the public sphere is both a cause and an effect of dominant gender power relations in societies. It can include denial of access to education or (equally) paid work (mainly to women), the denial of access to services, exclusion from certain jobs, the denial of the enjoyment and exercise of civil, cultural, social and political rights. Some public forms of socio-economic gender-based violence contribute to women becoming economically dependent on their partner (lower wages, very low or no child -care benefits, or benefits tied to the income tax of the wage-earning male partner). This in return gives a person with a tendency to be abusive in his relationships the chance to act without any fear of losing his partner. 3.0 SEXUAL: 3.1 Rape: Rape occurs in homes, in the open community, and in hidden places. In times of war, sexual abuse (defilement and rape) is used as a weapon of war. The notion of rape in marriage has been contested for a long time. Anecdotal evidence however indicates that (women are often victims of rape in marriage. However due to the cultural beliefs and practices, marital rape is often disregarded and goes unreported. 3.2 Sexual Abuse: includes the engagement of another person in sexual contact, whether married or not, which includes sexual conduct that abuses, humiliates or degrades the other person or otherwise violates another persons sexual integrity, or sexual contact by a person aware of being infected with HIV or any other sexually transmitted infection with another person without that other person being given prior information of the infection; 3.3 Incest: These are sexual relationships between persons to whom marriage is prohibited by custom or law because of their close kinship. Ideas of kinship, however, may vary widely from group to group, hence the definition of incest may vary.

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3.4 Forced prostitution: This occurs both at the domestic level and at the wider society level. The increased levels of poverty in Zambia have forced families to send their children into prostitution as a means of supporting them. Incidences have been reported of situations where if a child fails to bring money or food in the home from prostitution she is denied the support including food. Girls are being exposed to bars and the streets where they provide sexual services to gain money or favours. In most cases they give sexual services in exchange for cash otherwise when they are involved in selling merchandise they are assured of selling their produce if they provide sexual services. 3.5 Engagement in pornography: Anecdotal evidence indicates that young women have been enticed to engage in pornography for purposes of making a living. The main targets for this activity have been young girls particularly in institutions of higher learning. There has been very little sensitisation on the issue and the extent of the problem goes undocumented. Scrutiny of police records does not indicate any cases reported but media records indicate such incidences. 4.0 EMOTIONAL: HARASSMENT, PSYCHOLOGICAL 4.1 Harassment: Means engaging in a pattern of conduct that induces in a person the fear of imminent harm or feelings of annoyance and aggravation. 4. 2 Emotional: Means a pattern of degrading or humiliating conduct towards a person, including: (a) Insults, ridicule or name-calling; (b) Threats to cause emotional pain or distress; (c) The exhibition of obsessive possessiveness which is such as to constitute a serious invasion of the persons privacy, liberty, integrity or security; or (d) Any act, omission or behavior constituting gender-based violence which, when committed in the presence of minor members of the family, is likely to cause them mental injury. 4.3 Psychological: Psychological abuse leads to anger, fear, resentment, self-hate, shame, insecurity, loss of ability to function in family and society, depression, sleep and/or eating disorders, Mental illness, Social isolation, Suicide, Blaming the victim, Isolating/rejecting the victim, Strain on community resources and supports.

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5.0 HUMAN TRAFFICKING 5.1 Trafficking in women and children: This is a criminal activity in which people are recruited, harboured, transported, bought, or kidnapped to serve an exploitative purpose, such as sexual slavery, forced labour, or child soldiery. This phenomenon has come with globalisation, liberalisation, reduced restrictions on travel and the legalising of prostitution in some countries as well as opportunities for employment in foreign countries through the use of agents. The rise in the number of cases has resulted in institutions such as UNICEF, The International Organisation for Migration (IOM) and ILO to develop a UN Joint programme on Human Trafficking and devise multi-media community campaigns against such acts. The extent of the problem is not known but it remains a form of GBV.

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Hand out 7 DEFINITIONS What Is Child Abuse? "Child abuse" can be defined as causing or permitting any harmful or offensive contact on a child's body; and, any communication or transaction of any kind which humiliates, shames, or frightens the child. Some child development experts go a bit further, and define child abuse as any act or omission, which fails to nurture or in the upbringing of the children. The Child Abuse Prevention and Treatment Act of the US defines child abuse and neglect as: at a minimum, any recent act or failure to act on the part of a parent or caretaker, which results in death, serious physical or emotional harm, sexual abuse or exploitation, or an act or failure to act which presents an imminent risk of serious harm. A child of any age, sex, race, religion, and socioeconomic background can fall victim to child abuse and neglect. There are many factors that may contribute to the occurrence of child abuse and neglect. Parents may be more likely to maltreat their children if they abuse drugs or alcohol. Some parents may not be able to cope with the stress resulting from the changes and may experience difficulty in caring for their children. Major types of child abuse are: Physical Abuse, Emotional Abuse, & Sexual child Abuse, Neglect (Physical neglect, educational neglect, emotional neglect) Physical Abuse: The inflicting of physical injury upon a child. This may include, burning, hitting, punching, shaking, kicking, beating, or otherwise harming a child. The parent or caretaker may not have intended to hurt the child, the injury is not an accident. It may, however, been the result of over discipline or physical punishment that is inappropriate to the childs age. Emotional abuse:actual or likely severe adverse effect on the emotional and behavioural development of a child, caused by persistent or severe emotional ill treatment or rejection. All abuse involves some emotional ill treatment.

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Sexual Abuse: The inappropriate sexual behaviour with a child. It includes fondling a childs genitals, making the child fondle the adults genitals, intercourse, incest, rape, sodomy, exhibitionism and sexual exploitation. To be considered child abuse, these acts have to be committed by a person responsible for the care of a child (for example a baby-sitter, a parent, or a day-care provider) or related to the child. If a stranger commits these acts, it would be considered sexual assault and handled solely by the police and criminal courts. Commercial or other exploitation of a child refers to use of the child in work or other activities for the benefit of others. This includes, but is not limited to, child labour and child prostitution. These activities are to the detriment of the childs physical or mental health, education, or spiritual, moral or social-emotional development. Neglect: The intentional failure to provide for the childs basic needs. Neglect can be physical, educational, or emotional. Physical neglect can include not providing adequate food or clothing, appropriate medical care, supervision, or proper weather protection (heat or coats). It may include abandonment. Educational neglect includes failure to provide appropriate schooling or special educational needs, allowing excessive truancies. Psychological neglect includes the lack of any emotional support and love, never attending to the child, spousal abuse, drug and alcohol abuse including allowing the child to participate in drug and alcohol use. Child abuse can have the following consequences: It will encourage your child to lie, resent, fear, and retaliate, instead of loving, trusting, and listening. It will alienate your child from you and the rest of your family & make him a recluse. It will lower your child's self-esteem, and affect your child's psychological development and ability to behave normally outside his home. When your child grows up, your child could probably carry on the family tradition, and abuse your grandchildren. Your child may exclude you from his adult life. For example, you might not be invited to your child's wedding, or not be allowed any contact or relationship with your grandchildren

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Hand out 8

Definitions
The Expanded Definition of Sexual and Gender-based Violence used by UNHCR and implementing partners, based on Articles 1 and 2 of the United Nations General Assembly defined GBV in the Declaration on the Elimination of Violence against Women as; ...any act that results in, or is likely to result in, physical, sexual or psychological harm or suffering to women because of being women and men because of being men, including threats of such acts, coercion or arbitrary deprivation of liberty, whether occurring in public or in private life. The SADC Protocol defines it as; ... all acts perpetrated against women, men, girls and boys on the basis of their sex which cause or could cause them physical, sexual, psychological, emotional or economic harm, including the threat to take such acts, or to undertake the imposition of arbitrary restrictions on or deprivation of fundamental freedoms in private or public life in peace time and during situations of armed or other forms of conflict; The Anti- Gender Based Violence Act defines it as; ...any physical, mental, social or economic abuse against a person because of that persons gender, and includes (a) violence that results in, or is likely to result in, physical, sexual or psychological harm or suffering to the person, including threats of such acts, coercion or arbitrary deprivation of liberty, whether occurring in public or private life; and (b) actual or threatened physical, mental, social or economic abuse that occurs in a domestic relationship

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Hand out 9 Definitions The Anti-Gender-Based Violence Act no.1 of 2011 defines Gender Based Violence as any physical, sexual, mental, social, or economic abuse against a person because of that persons gender regardless of whether it is perpetuated by people of the same sex. In the AntiGender-Based Violence Act no.1 of 2011, unless the context otherwise requires abuse means conduct that harms or is likely to cause harm to the safety, health or wellbeing of a person; aggravated in relation to gender-based violence, means any act of gender-based violence which:a) causes the victim to suffer wounding or grievous bodily harm; or b) the court otherwise considers to be so serious as to be aggravated, taking into account I. whether a weapon was used; II. evidence of pre-meditation; III. whether the victim is particularly vulnerable; IV. any failure, by the police, the court or any official body, to respond to previous warnings; and V. any other consideration the court considers appropriate; Definition of Gender Gender is ones feeling of being either female or male and performing social roles pertaining to that gender. Gender roles can be performed by either sex as normally accepted within a given culture, society or community. Gender therefore is a socially constructed or developed status(es). What Is Sex? We can understand sex as the anatomical being or construction of being a man or woman, boy or girl. For instance, we recognise a boy or girl-child at birth when we look at their genitals. Gender Identity This is another major component of females and maleness. Gender identity includes psychosexual development, learning social roles, and shaping sexual preferences. Social rearing, or socialisation, is a crucial element for gender identity. Sexual preference and choice of sexual object are tied to gender identity. Boys who consider themselves male and girls who consider themselves female are supposed to be sexually attracted to each other. This social dimension constitutes compulsory heterosexuality.

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What are Gender Roles? Gender roles are said to be socially constructed by society and communities and are accepted as norms in specific given societies/communities. These roles are not static and change over time and depending on the context, e.g. men cooking in hotels (work!). What Are Sex Roles? These are roles that are biologically determined and are not interchangeable, e.g. women giving birth. Why Gender Knowledge Is Important Gender knowledge is important as it affects our everyday activities and well-being. The roles that men and women perform are mainly affected by their gender. That is, the fact that they are male or female determines what they do and are involved in at a day to day basis. Gender Awareness Why Gender Awareness?

to attempt correcting misunderstandings between social and biological issues. If people understand that gender roles are determined by society then they can easily adapt. For instance, cooking is a gender role that is why we have men cooking in places of work such as hotels.

for developmental purposes of society and communities. If men accept that they can cook in their homes then working women could be more productive at work if men help them at home with the cooking and other household chores

Causes of gender imbalances:


Traditional beliefs, values and practices which put a female second to a male. Religious beliefs Insecurity some women feel insecure and find protection from men and this forces them to be subordinate.

This could also happen to men but it is more prominent among women. Helping Men to Change Values Men need to change their values in order to understand:

the new developments in socially assigned roles, for instance, a man can work as a secretary because this is a socially assigned role

the divisions of labour in homes the childrens developmental and welfare need. If a man keeps on believing that child nurturing is a womans role, he may not be aware of a childs needs and welfare which may consequently affect the child negatively.
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Men can be helped to change their values through: Education and information giving. When men are educated and given necessary information on child development and child needs it may help them understand what they can do for a child and how they can affect positive growth

Counselling Gender sensitization once the men are educated about the fact that they can perform almost all the roles women perform in society and the home, it will make them understand that there is no such thing as rigid womens roles

Helping Women to Know their Rights and Values Why should women know their rights and values?

to strengthen the family socially to help the family develop economically to protect and improve the status of children to improve the status of society through improving single households which are a core of any society. When

households improve economically, socially, politically, society also is expected to improve to develop our communities as we all become active participants in developing ourselves and changing our lives

to instill security in each other, as we become self-confident and not dependent.

How can women be aware of their rights and values?


by teaching them what the Constitution says. by giving them information about the Law by giving them information about agencies that deal in womens issues by empowering them economically through skills development and providing them with information on organisations that give loans

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Hand out 10 Identifying and providing support to survivors of GBV: It is critical that community care providers have the knowledge of identifying survivors from within the community which sometimes may not be easy as some survivors may fear to report GBV cases to any anyone. Therefore, community care providers should be keen observers/listeners in order to identify abuse. Many survivors, however, will keep the true cause of the injuries secret. Reasons for secrecy include the following: 1. Fear that he/she will not be believed; 2. Fear of injury from the perpetrator; 3. Being threatened by the perpetrator not to reveal the true cause; 4. Fear that the perpetrator will be informed that a report has been made; 5. Fear for his/her children if they are with the perpetrator; and Fear of support being withdrawn as a result of reporting (especially where perpetrator is a known person or relative). Identifying abuse It is the responsibility of the care provider to identify abuse where the survivor tries to conceal it. During history taking, the care provider should take note of inconsistencies in the survivors story and the indicators of abuse. Abuse may have occurred if the survivor or accompanying person expresses the following: 1) Survivor is tense, fearful and apprehensive; 2) Survivor looks to companion for direction; 3) Survivor is unable to make decisions alone and/or leaves decisions totally to his/her companion, even those regarding physical needs and health; 4) Survivor is overly concerned about the perpetrator and/or children and has little or no concern for his/her own health needs; 5) Survivor minimizes the seriousness of the injury or how it occurred; 6) Accompanying person interrupts or constantly explains his/her version of the survivors injuries; 7) Accompanying person hovers over the survivor and is reluctant to leave her/him alone, even for examinations; 8) Accompanying person is pushy or demanding of the survivor or medical staff for information; 9) Accompanying person appears more concerned about him/herself than the health issues for the survivor.
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Another key component of identifying abuse is the process of record keeping. Recording incidences as a chronology may help determine whether a person is at risk of abuse. Sometimes looking at one incident out context does not provide a clear picture. Therefore, community care providers should record all cases reported, however small or insignificant they may appear. Indicators of physical abuse 1. injuries, some of which may be visible such as bruising, cuts, burns, choke marks, black or swollen eyelids 2. any injuries, with no or questionable explanation(s) as to how they occurred 3. unattended injuries may be apparent such as old untreated fractures 4. serious bleeding injuries, especially to the face, head, and internal organs (Breasts, chest and abdomen are often target areas, especially if the woman is pregnant) Indicators of psychological abuse 1. Severe crying spells or feelings of isolation or inability to cope. 2. Depression, at times accompanied by suicidal thoughts. 3. Reports of acute anxiety attacks. 4. Intermittent or continual presence of stress reactions such as tension, hyperactivity, headaches, insomnia, pain in the back, chest or stomach which often have no clear physiological cause. 5. Intermittent or continual presence of fear, anxiety, depression, hopelessness. 6. Inconsistency between cognitive and emotional levels. Presence of any or all of above indicators with statements that the situation is alright and/or hopefulness that the situation will improve. Potential questions for the assessment of abuse 1. Does someone criticize or insult your thoughts or actions? 2. Does someone ever follow you, check your whereabouts, or call you regularly to make sure you are at home or work? 3. Do you stop saying or doing what you believe because you are fearful of your perpetrator's reaction? 4. During arguments, are you ever afraid of what he/she might do? 5. Has your perpetrator ever physically held or restrained you from going somewhere or doing something he/she objected to? 6. During arguments are you ever hit, slapped, punched or pushed?

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Probe in a sensitive manner if you suspect abuse 1. Let the survivor know that the information remains confidential 2. Assure the survivor that the information shared will not be passed on to the perpetrator 3. Ask the survivor how they feel about talking to you 4. Let the survivor know that you may have to act if you are concerned that they may cause self -harm or harm someone else or if they are in danger from the perpetrator or anyone else and that action involves keeping them in a safe place and not disclosing information to the perpetrator. 5. Ask the survivor if they think what they are experiencing is abuse - Ask clear, specific questions. - Approach the survivor from your understanding of the many complexities that exist around abuse. Some survivors may not perceive that what they are experiencing is abuse.

Begin with Could...?

Open ended Questions Example Could you say more about how you feel?

Closed ended Questions Begin with Example Do...? Do you feel angry? Did...? Is...? Are...? When...? Where...? How long...? Did you like it? Is she coming too? Are you going today? When will you go? Where does she live? How long have you felt it? How many...? What/which...? How many months..? Which bus do you use?

Can you tell...?

Can you tell me what happened?

How...? What...? Why..

How did you feel then? What happened after? Why do you think he did it?

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Index of suspicion for life threatening situation or harm to the survivor 1. Previous history of injuries and present injuries are more serious, indicating frequency and\or severity of abuse is increasing. 2. Extremely controlling, aggressive, suspicious or stalking behaviour on the part of the perpetrator. 3. Direct threats or statements by the perpetrator that they intend to harm or kill the survivor. 4. The survivor states that there are weapons in the home; the abuser has threatened to use weapons and/or has used weapons in the past. 5. The survivor states that police have been involved, charges have been laid, or perpetrator has been convicted of assault or related charges. 6. Perpetrator has history of suicide attempts and/or has history of deterioration emotionally and physically. Assessment indicates that the survivor can't stand the abuse anymore and has history of suicide attempts or admissions to hospital and/or psychiatric facility. (Source: GBV National Guidelines)

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Hand out 11 A1 Corinthians 13:1-13: this passage from St Paul helps us to understand the Christian ideal of love better; Love is patient and kind it is not ill mannered or selfish or irritable: love does not keep a record of wrong... Pauls definition of love leaves no room for such humiliating and brutal behaviour as wife beating! B Daniel 13 (Apocrypha): this is a tale of sexual harassment, of threats and trickery. Susanna, a good, beautiful wife, is approached by two elderly men and harassed sexually, that is, she is disturbed or bothered by these men who demand sexual favours of her. If she refuses, they threaten to accuse her falsely of adultery with another man. Refusing to yield to these men and their threats, Susanna is falsely accused and faces death by stoning if proved guilty. She is brought to trial and is saved at the last moment through the efforts of the young prophet Daniel. The old men met their match in Susanna, a woman who respected herself more than she feared death. She was ready and willing to die rather than dishonour herself. C Judges 19: in this chapter from the Book of Judges we read of the most tragic, degrading and violent abuse of women imaginable. It is the story of a concubine who was freely sacrificed to men in order to spare her husband the humiliation of sexual abuse by urging of thugs, her life was sacrificed for his honour and dignity. The host in the story refused to allow his male guest to be dishonoured by homosexual acts, for this was an evil and immoral thing. But he did not regard the abusive rape of women as equally evil and immoral since he voluntarily offered his own virgin daughter and his guests concubine to satisfy the sexual appetites of the gang. In the end it was only the concubine who was thrown to the men outside to be used for their pleasure, and They raped her and abused her all night long and didnt stop until morning When day at last dawned, the concubine was found to be dead, no bible story points out as clearly the low status of women in society. Versus 23-24 establish without doubt the priority of value and the importance of men in that tradition and the inferiority of women. It was preferable so men reasoned, to sacrifice a defenceless woman rather than allow a physically stronger man to be disgraced and abused.

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D 2 Samuel 13:1-21: here we read of incest-rape where one of King Davids sons, Amnon, raped his own half-sister, Tamar. It is rare indeed when the Bible quotes the words of mere women, so it is all the more unusual to read here of Tamars verbal as well as physical struggle with her brother. After raping her, Amnon turned against her with hatred, throwing her out of his house. Tamar covered her head with ashes and tore her garments, symbolically proclaiming her deep sense of shame, mourning and sorrow. Another brother Absalom, took Tamar into his own home and cared for her, later taking revenge on Amnon for destroying Tamars life. She was apparently unable to marry because of the disgrace of being raped by her own brother. Her story ends pathetically. Tamar lived in Absaloms house, sad and lonely. E Genesis 19: 6-8: here we read about Lot offering two daughters to the men who wanted to rape Lots male visitors. No my friends. Dont do this wicked thing. Look I have two daughters who have never slept with a man. Let me bring them out to you and you can do what you like with them. But dont do anything to these men, for they have come under the protection of my roof. Points to ponder 1. Susanna in Daniel 13 is a remarkable example of a courageous woman who respected herself and honoured her marriage vows; even at the risk of possible death by stoning. She stood alone against corrupt men and their evil designs, resisting both sexual harassment and lies. And against all odds, she won! Susanna is a true sign of hope and resistance for women today in a patriarchal world that increasingly harasses and abuses women. 2. The two young daughters had no say in their father offering them out to men who were obviously ruffians in Genesis 19. 3. Men all too often abuse their God-given gift of strength by attacking and beating those who are physically weaker than they are. Using superior strength to control and subdue others is behaviour worthy of a bully and coward. A man who beats a woman in order to punish or control her shows lack of self-control as well as disrespect and contempt for women. Today, unfortunately, we see evidence of wife beating all around us. Some of these battered women are so severely injured that they die as a result of such harsh treatment. So it is altogether incredible when we sometimes hear from women themselves that beatings show how much a man loves his, wife; the more he beats, the more he loves! This is total myth! How can the act of physically injuring another person be an expression of love?

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If a man beats his wife until she dies, does this demonstrate the deepest love of all? It may help at this point to reflect once again on the Christian deal of love as found in Pauls First letter to the Corinthians 13: Love is patient and kind. Nowhere does Paul mention physical abuse as a sign of love and caring. If we truly love someone, we will do everything possible to protect that person from injury and harm. 4. Violence against women wears many faces, aside from that of wife bashing or beating. Women are frequently abused at work through sexual harassment where their employers or male co-workers demand sexual favours in return for the womans promotion or fair treatment. Women are violated on the streets when they are verbally or physically attacked and raped. Women are dishonoured and shamed in the media (press, TV, radio) through stories and advertisements that humiliate and exploit women and their physical attractions. 5. Women/girls are discriminated even as regards application of the law. (The Iris vs state case selective prosecution where was the man?) 6. Women are also abused through prostitution, a profession that humiliates and degrades men as well as women. The majority of women who become involved in prostitution do so for economic reasons alone. Given alternative skills and ways of earning a living, most would probably give up prostituting themselves. It is indeed strange how society condemns prostitutes as vulgar and sinful, and in some countries, unlawful, yet winks playfully at the men who keep these women in business. How can it be wrong for one sex, but right for the other? This is patriarchal thinking at its worst! 7. Newspapers inform us that crimes of rape and incest are on the increase in our communities. Many, including the police and some women themselves blame the female victims for this, claiming that they invite such treatment by their manner of dress or provocative behaviour. If that is so, how does one explain the rape of tiny children and elderly women? Social scientists tell us that men frequently turn to rape, not so much out of strong and uncontrollable sexual urges, but rather, out of a sense of frustration and anger aimed at society in general and women in particular. Men who feel they have lost their role and status in society, men who are unemployed and impoverished, men who feel useless and no longer needed, all these frequently turn crime and violence to help release their inner rage. And women are among the easiest victims to attack. Women become targets of male aggression.
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8. In order to effectively challenge male domination and aggression in the community, women need to join together in support groups, sharing their stories and designing new strategies for survival. But these strategies must include not only steps towards justice and equality between the sexes; they must also include plans for active peace building that will serve to bridge the angerisolation gap that presently exists between women and men. At present, support groups for women are essential; there is strength in numbers and courage in sharing. 9. Violence against women is a crime! (Source: Choose Life: Jacqueline Dorr MM)

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Hand out 12 1. Hidden Truth When my fellow filmmakers in the Samfya Women Filmmakers collective and I decided to produce our third film, we were determined to focus on an issue that is present in so many communities in rural Zambia, and that yet remains buried in the hearts and minds of so many women: domestic violence. We had seen bruises on women we know personally, and had heard stories of their emotional turmoil, and as filmmakers, we knew it was time for us to take action and expose the issue.. Watch the trailer of Hidden Truth!! 2. Risks While Making the Video The path to breaking the silence about domestic violence is a risky one, and yet one that we were compelled to take for the victims of gender-based violence are often not given an opportunity to speak about the terrifying conditions they endure. People used to say we had no respect because we were sharing this concealed story. So we had to be very careful when we were filming and also had to make sure to pay attention to those around us in public places so they did not damage our equipment. Someone once told us, Making a documentary about a human rights issue is not easy. In fact it was very hard and at times very scary. One day after an interview with the magistrate, I was called by the judge. Every crew member was afraid of what might happen. At the court I was asked where we planned to take the footage and how it would be used. I explained to the judge that our films are used for advocacy. The judge decided to collect the mini DVD tape from us and threatened to burn it. I pleaded with him not to, as the tape contained interviews with other subjects as well women survivors of violence but he took the tape anyway. We informed our partners from the Ministry of Education about what happened and they pleaded on our behalf, requesting that the court delete only the interview which was conducted in the court. The judge agreed and they deleted the interview shots of the building, the signpost any material relating to the court. That day I remember we could not shoot at all, as we were with the officer from the judiciary, waiting for him to check to make sure we had deleted everything related to the court. We were not sure if we would continue shooting.

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3. Challenging Cultural Beliefs Shooting in our own communities also had its challenges. When we approached some women in our community of Samfya about speaking on camera about their experiences, they were reluctant to talk to us. Some aspects of Zambian culture impose restrictions on women by telling them to be submissive and not speak their minds even if they find themselves in abusive relationships. Sharing stories about their abuse at home is considered disrespectful. Even if a woman is being abused, her family, friends and community members generally encourage her not to tell anyone. Theyll say, Just be strong, your husband will change in the future, or even, If your husband beats you, it just means he loves you. Women are taught to expect to be beaten when they get married and to keep it to themselves when they go through hard times. In this context, it was very hard to interview women who had experienced domestic violence. They were afraid to share their stories, and they were also intimidated by all of our large equipment. We explained that talking openly about the abuse they face is one way for other people to become aware of the hardships they are going through, and to take the initiative to put an end to the horrific acts of violence against women. One woman agreed to be filmed only if we concealed her identity, which we did by showing her shadow and not showing her face. Months later, she left her husband and she decided to do an interview with us with her face revealed. It was very moving to see her find the courage to change her life. We also wanted to include the voices of children in our film, because they too witness and are victims of domestic violence, but are often silenced. 4. Using Our Video to Influence Legislation We wanted to show this film not only to men, women, and children in our communities, but also to policymakers, to pressure them to pass a law that specifically outlaws domestic violence. Until this past spring, there was no law outlawing domestic violence in Zambia just a law outlawing assault, with a very insignificant sentence. But I am happy to report that the president signed such a bill into law in May 2011. However, as advocates, we filmmakers still have a lot of work to do to make sure that the law is enforced, and that women have the protection they need to be able to report incidence of domestic violence.

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We are also advocating for community members and decision makers to take steps to make our communities safer for women. Right now, there are no shelters for women who have experienced domestic violence in Samfya; there is not even a single place where a woman and her children can go to for refuge. We want to change that. I know that it is very difficult to change attitudes and behaviour, but I am hopeful. Hidden Truth has been shown in many local communities near Samfya, and people are responding strongly to the film. Women have come to us after viewing the film to talk about their own experiences of domestic violence for the first time. And men and women alike are recognizing what harmful impact violence is having on their families, and sharing their opinions about that at community screenings. Even though I have read about gender-based violence in newspapers, and watched shows on television about this issue, making this film made me understand just how strongly domestic violence impacts a woman how powerless and vulnerable she feels after being abused. Sometimes the other filmmakers and I would console a woman we interviewed after the shoot and encourage her to be strong. Film making about issues like this can be quite painful but if you are committed to change, then it is an incredibly powerful means of telling untold stories (Commentary on video making)

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Hand out 13 MR MOYO GOES TO THE DOCTOR Story: Mr Moyo goes to the Doctor What is your job? asked the doctor. I am a farmer, replied Mr Moyo. Have you any children? the doctor asked. God has not been good to me. Of 15 born, only 9 are alive, Mr Moyo answered. Does your wife work? No, she stays at home. I see. How does she spend her day? Well, she gets up in the morning, fetches water and wood, makes the fire, cooks breakfast and cleans the homestead. Then she goes to the river and washes clothes. Once a week she walks to the grinding mill. After that she goes to the township with the two smallest children where she sells tomatoes by the road side while she knits. She buys what she wants from the shops. Then she cooks the midday meal. You come home at midday? No, no she brings the meal to me about three kilo-meters away. And after that? She stays in the field to do the weeding, and then goes to the vegetable garden to water. What do you do? I must go and discuss business and drink with the men in the village. And after that? I go home for supper which my wife has prepared. Does she go to bed after supper? No, I do. She has things to do around the house until 9 or 10. But I thought you said your wife does not work? Of course she does not work. I told you she stays at home!
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Hand out 14 Gender based violence Background Sexual violence is a common and serious public health problem affecting millions of people each year throughout the world. It is driven by many factors operating in a range of social, cultural and economic contexts. At the heart of sexual violence directed against women is gender inequality. The World Health Organization (WHO) has identified violence, including violence against women, as a major public health problem in Africa. Gender-based violence creates conditions conducive to the transmission of HIV to women, since women in violent relationships often experience coercive, violent sex and are unable to negotiate HIV prevention. Furthermore, some women may be unable to leave violent relationships because of their economic and psychological dependence on their abusers. Womens unequal property rights also contribute to the HIV/AIDS epidemic in the region. Under the laws and customs of many sub-Saharan African countries, women neither inherit nor keep property upon divorce on an equal basis with men. This reinforces their dependence on men, sometimes locking them in abusive relationships. Sexual violence occurs throughout the world. Although in most countries there has been little research conducted on the problem, available data suggest that in some countries nearly one in four women may experience sexual violence by an intimate partner, and up to one-third of adolescent girls report their first sexual experience as being forced. Sexual and gender-based violence against women and children is common in Zambia, especially in Lusaka and the Copperbelt provinces. It is difficult to determine the true extent because many victims or survivors do not report the violence or underreport it. The Zambian polices Victims Support Unit had reports of 65 rapes of adults and 626 of children in Lusaka alone from January to August 2008. Sexual violence has a profound impact on physical and mental health. As well as causing physical injury, it is associated with an increased risk of a range of sexual and reproductive health problems, with both immediate and long-term consequences. Its impact on mental health can be as serious as its physical impact, and may be equally long lasting. Deaths following sexual violence may be as a result of suicide, HIV infection or murder the latter occurring either during a sexual assault or subsequently, as a murder of honour.

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Sexual violence can also profoundly affect the social wellbeing of victims; individuals may be stigmatized and ostracized by their families and others as a consequence. Coerced sex may result in sexual gratification on the part of the perpetrator, though its underlying purpose is frequently the expression of power and dominance over the person assaulted. Often, men who coerce a spouse into a sexual act believe their actions are legitimate because they are married to the woman. The following table shows chosen results in Zambia of a survey conducted in eight African countries published in the BMC Womens Health 2007, 7:11 % who said women do not have the right to refuse to have sex with their husbands or boy- 54% friends % who said women sometimes deserve to be beaten % who said if a women gets raped its her own fault % who said forcing your partner to have sex, is not rape % who said: In my culture it is acceptable for a man to beat his wife Table 1: Chosen male attitudes in Zambia taken from the a.m. survey Definition Gender-based violence (GBV) is common in southern Africa. Here we use GBV to include sexual and non-sexual physical violence, emotional abuse, and forms of child sexual abuse. The commonly used terms domestic violence and intimate partner violence (IPV) are often used to cover sexual as well as non-sexual violence and other forms of abuse in this setting. GBV is a complex phenomenon often including a combination of physical, sexual and emotional violence and deprivation or neglect. Domestic violence is not a single behavior but a mix of assaulting and coercive physical, sexual, and psychological behaviors designed to manipulate and dominate the partner to achieve compliance and dependence. Gender-based violence takes many forms, and can include physical, emotional, or sexual abuse. It can occur in wartime, or in times of peace. While both males and females can suffer from gender-based violence, studies show that women, young women, and children of both sexes are most often the victims. Gender-based violence can include rape and sexual assault, violence between intimate partners, and violence associated with war. Here we concentrate on sexual violence to girls, young women and older women.
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53% 20% 46% 38%

GBV increases gender inequalities and is an important cause of choice disability. The most pervasive form of gender-based violence is violence committed against a woman by her intimate partner. Violence against women is perhaps the most shameful human rights violation As long as it continues, we cannot claim to be making real progress towards equality, development, and peace. (Kofi Annan). Sexual violence is defined as: any sexual act, attempt to obtain a sexual act, unwanted sexual comments or advances, or acts to traffic, or otherwise directed, against a persons sexuality using coercion, by any person regardless of their relationship to the victim, in any setting, including but not limited to home and work. the victim is a difference regarding age, maturity and/ or power. The difference of power is labeled of dependency, age-difference, inferiority or other factors.

forced marriage or cohabitation, including the marriage of children; denial of the right to use contraception or to adopt other measures to protect against sexually transmitted diseases; forced abortion; violent acts against the sexual integrity of women, including female genital mutilation and obligatory inspections for virginity;

forced prostitution and trafficking of people for the purpose of sexual exploitation. Most perpetrators of child sexual abuse are known to the children concerned, suggesting that child sexual abuse often takes place at home, and school or in the surrounding neighbor -hood. Organizations cited an increasing number of children who were abused by their fathers, uncles or stepfathers. A few organizations also noted a number of young and teenaged boys who have been sodomised.

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The extent of the problem Data on sexual violence typically come from police, clinical settings, nongovernmental organizations and survey research. The relationship between these sources and the global magnitude of the problem of sexual violence maybe viewed as corresponding to an iceberg floating in water. In general, sexual violence has been a neglected area of research. The available data are scanty and fragmented. Police data, for instance, are often incomplete and limited. Many women do not report sexual violence to police because they are ashamed, or fear being blamed, not believed or otherwise mistreated. A growing number of studies, particularly from sub-Saharan Africa, indicate that the first sexual experience of girls is often unwanted and forced. Sexual violence in schools, health care settings, armed conflicts and refugee settings For many young women, the most common place where sexual coercion and harassment are experienced is in school. In an extreme case of violence in 1991, 71 teenage girls were raped by their classmates and 19 others were killed at a boarding school in Meru, Kenya. The research done in Africa, however, has highlighted the role of teachers there in facilitating or perpetrating sexual coercion. A report by Africa Rights found cases of schoolteachers attempting to gain sex, in return for good grades or for not failing pupils, in the Democratic Republic of the Congo, Ghana, Nigeria, Somalia, South Africa, Sudan, Zambia and Zimbabwe. A recent national survey in South Africa that included questions about experience of rape before the age of 15 years found that schoolteachers were responsible for 32% of disclosed child rapes. Factors increasing womens vulnerability One of the most common forms of sexual violence around the world is that which is perpetrated by an intimate partner, leading to the conclusion that one of the most important risk factors for women in terms of their vulnerability to sexual assault is being married or cohabiting with a partner. Other factors influencing the risk of sexual violence include: being young; consuming alcohol or drugs; having previously been raped or sexually abused; having many sexual partners;

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involvement in sex work; becoming more educated and economically empowered, at least where sexual violence perpetrated by an intimate partner is concerned; poverty. Factors increasing mens risk of committing rape Alcohol and drug consumption Psychological factors Early childhood environments Family honour and sexual purity Poverty Physical and social environment Social norms The consequences of sexual violence Pregnancy may result from rape, though the rate varies between settings and depends particularly on the extent to which non-barrier contraceptives are being used. Experience of coerced sex at an early age reduces a womans ability to see her sexuality as something over which she has control. As a result, it is less likely that an adolescent girl who has been forced into sex will use condoms or other forms of contraception, increasing the likelihood of her becoming pregnant. Gynaecological complications have been consistently found to be related to forced sex. These include vaginal bleeding or infection, fibroids, decreased sexual desire, genital irritation, pain during intercourse, chronic pelvic pain and urinary tract infections. HIV infection and other sexually transmitted diseases are recognized consequences of rape. Research on women in shelters has shown that women who experience both sexual and physical abuse from intimate partners are significantly more likely to have had sexually transmitted diseases. Violent or forced sex can increase the risk of transmitting HIV. In forced vaginal penetration, abrasions and cuts commonly occur, thus facilitating the entry of the virus when it is present through the vaginal mucosa. Adolescent girls are particularly susceptible to HIV infection through forced sex, and even through unforced sex, because their vaginal mucous membrane has not yet acquired the cellular density providing an effective barrier that develops in the later teenage years. Those who suffer anal rape boys and men, as well as girls and women are also considerably more susceptible to HIV than would be the case if the sex were not forced, since

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Explaining gender-based violence Gender-based violence is rooted in the historically unequal power relations (social, economic, cultural, and political) between males and females. The following indicators of gender -based violence and HIV infection are useful for understanding gender-based violence in relation to AIDS. Violence against women and children around the world has been reported to be most common where: gender roles are rigidly defined and enforced; the concept of masculinity is linked to toughness, male honour, or dominance; physical punishment of women and children is culturally tolerated; violence is accepted as a means of interpersonal conflict resolution; women are economically dependent and have limited access to employment, education, training, money and credit; children do not receive adequate care during times when their parents are absent; conditions of poverty result in children working, which include conditions that make them vulnerable to sexual exploitation; or where girls and women are at risk of rape in the course of their daily subsistence tasks; there are disincentives to reporting sexual violence to judicial authorities; there is a low conviction rate for crimes of violence and cases of gender-based violence are inadequately documented, followed up and prosecuted; and there are few or no organizations dealing with gender-based violence in research, law, education, social activism, political advocacy, and service In contrast, violence against women and children has been reported to be at low levels where: women have power and authority outside of the family; family members intervene to prevent and reduce the likelihood of domestic violence; there are all-women collectives; there are community sanctions against gender-based violence; and women are economically independent from men.

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Socialization The experience of having been physically abused as a child or having witnessed violence perpetrated by the father against the mother may predispose the survivor to early sexual debut, multiple partnerships and other high risk activities, or to abuse of partners later in life. In order to address this, research and interventions would have to be designed to identify and target girls at an early age. Social gender norms Gender roles are defined by societal norms that are learned from a young age. The relationship between men and women is also learned through societal norms. Constructions of gender categories are closely related to fantasies of power and identity. For example, for a man, having multiple partners may be a status symbol measuring masculinity and success among ones friends. Many organizations report what one organization called a second wife problem where men have multiple partnerships because it is considered a traditional right. Cultural and traditional reasons In many countries of sub-Sahara Africa there are some cultural and traditional habits which lead to gender based violence and make the HIV/AIDS situation worse. Especially affected are young girls. The phenomenon of the sugar-daddies is also to be mentioned as the high rate of rape of step fathers, uncles or cousins. Another myth which is common in sub-Sahara Africa is the belief that sex with virgin can cure HIV/AIDS. The high rate of poverty and the high numbers of orphans lead girls and young women into prostitution. Because of this reasons girls and young women are especially vulnerable for HIV/AIDS. They have a five times higher risk of a HIV/AIDS-infection than the males of the same age. Economic dependence The gender norms described above can be linked to economic sub -structures. These links are exacerbated by HIV/AIDS, which contributes to poverty and marginalization of women. Forms and contexts of sexual violence A wide range of sexually violent acts can take place in different circumstances and settings. These include, for example: rape within marriage or dating relationships; rape by strangers; systematic rape during armed conflict; unwanted sexual advances or sexual harassment, including demanding sex in return for favours; sexual abuse of mentally or physically disabled people; sexual abuse of children;

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anal tissues can be easily damaged, again allowing the virus an easier entry into the body. It is not just young women coerced into sex outside of marriage who are at risk. A young married woman engaging in monogamous heterosexual sex with her husband can also be at risk. In these circumstances traditional messages of prevention are of little relevance as condoms are less likely to be used inside marriage. For example, a study in Zambia found that only 11% of women interviewed believed that a woman had the right to ask her husband to use a condom even if he had proven himself to be unfaithful and was HIV-positive. In Kisumu, Zimbabwe, research has revealed that the majority of HIV positive women were infected by their husbands. Sexual violence has been associated with a number of mental health and behavioral problems in adolescence and adulthood. In one population-based study, the prevalence of symptoms or signs suggestive of a psychiatric disorder was 33% in women with a history of sexual abuse as adults, 15% in women with a history of physical violence by an intimate partner and 6% in non-abused women. Abused women reporting experiences of forced sex are at significantly greater risk of depression and post-traumatic stress disorder than non-abused women. A study of adolescents in France also found a relationship between having been raped and current sleep difficulties, depressive symptoms, somatic complaints, tobacco consumption and behavioral problems (such as aggressive behavior, theft and truancy). Women who experience sexual assault in childhood or adulthood are more likely to attempt or commit suicide than other women. Experiences of severe sexual harassment can also result in emotional disturbances and suicidal behavior.

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Hand out 15 Our Experience


My husband comes home drunk nearly every night and always finds Something to criticise or complain About! Sometimes it is my cooking, Sometimes the noisy children, and Other times it is money. And then he Starts to beat me. I cant take much more of this treatment!

I know what you mean! My husband is just the same; beating! Beating! Beating! When I scream and complain, he just laughs and says that beating shows how much he cares for me. it is a sign of love, he says frankly, Id rather have less love and more peace

Well, if being beaten means love, I wonder if we can say that Margaret was lo ved to death last year when her husband beat her until she died from her injuries. How can you call that love?

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GBV FIRST RESPONSE INFORMATION FORM

Name of Survivor: ...................................... Sex: M/F Approximate Age..........

Date:...................... Approximate time of incident:................ Place of Incident:....................................

Type of GBV being Reported:..................

Province:..................................................... District:.................................................... Any Witnesses: Y/N Number of times it has occurred: ........................... Relationship with Perpetrator(s): (tick applicable) Boyfriend Girlfriend Husband Wife Relative Elaborate) Stranger (s) Group (More than one) Friend (s)

Type of GBV Type of GBV being Reported (tick the GBV type) Rape Defilement Sodomy Attempted Rape Defilement Sodomy Brief description of the incidence: .................................................................................................................................. .................................................................................................................................. .................................................................................................................................. .................................................................................................................................. .................................................................................................................................. (Add another page if necessary) Assault Emotional abuse (Insulted) Property grabbing Threatened with violence Sexual harassment

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Action Taken by Response team .................................................................................................................................. .................................................................................................................................. .................................................................................................................................. .................................................................................................................................. Statement Prepared by Sign................................................... Full Name.......................................... Designation .................................... Time Prepared:................................ Survivor/ One reporting on behalf of a child Sign....................................................... Full Name..............................................

Statement Received by Sign :.............................................. Name:............................................ Date: ............................................. Designation:................................................ Time:..........................................................

Action Taken ...................................................................................................................................................... ...................................................................................................................................................... ...................................................................................................................................................... ......................................................................................................................................................

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References Anti-Gender Based Violence Act 1 of 2011 Ben Terlou (1998) Training Guide for Gender Based Violence: Assistance of Survivors Care International (2001) Advocacy Tools and Guidelines de Negri, B., Thomas, E., Ilinigumugabo, A., Muvandi, I., and Lewis, G. (1998) Empowering Communities: Participatory Techniques for Community-Based Programme Development. Volume 1 (2)on Gender Kakompe, R K. et al. (2013) GBV Community Guidelines Oxfam (1994). Gender Training Manual Sampa-Kamwendo, A. et al (1999) Trainer's Manual for Psycho-Social Counselling of Abused Children. CHIN, Lusaka. Zambia The Anti-Human Trafficking Act, No.11 of 2008 Vann, B. (2004) Training Manual Facilitators Guide. JSI Research & Training Institute/RHRC Consortium UNHCR (2000) Sexual and Gender Violence: Prevention and Response Training Package UNICEF (2000) Training of Trainers for Facilitators on Gender-Based Violence: Focusing on Sexual Abuse and Exploitation

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MODULE 2: POLICE, LEGAL/PARALEGAL RESPONSE Module Description This Module is an outline of the laws that govern gender-based Violence in Zambia. It is designed to give participants a better understanding of the law on gender based violence, the definition of GBV under the law, give participants an idea of the prevalence of GBV in Zambia and enable participants to understand international and regional standards applying to gender based violence. It is also intended to give guidance on best practices for police officers in handling cases of gender based violence. The module is intended to be interactive and to ensure that participants come away with a clear understanding of the key concepts presented. It employs both presentation and facilitation (interactive) sessions. Introduction Zambia is a member of the international community and as such is a signatory to various human rights instruments some of which pertain to matters of gender based violence. Further the country is also signatory to regional instruments that touch on matters of GBV. As a signatory to these instruments, Zambia has an obligation to domesticate the provisions of these conventions into domestic law. To this end, the country has made strides over the years to put in place measures to combat GBV. Some of these measures include the establishment of the Victim Support Unit and the Child Protection Unit under the Zambia Police to deal with victims of violence; the establishment of the Gender in Development Division under Cabinet office (now the Ministry of Gender and Child Development) to look into gender matters and develop polices which amongst other things are aimed at combating GBV; the enactment of the Penal Code (Amendment) Act No. 15 of 2005 to give stiffer penalties for gender based violence offences and most recently, the enactment of the Anti-Gender -Based Violence Act to afford protection to victims of violence. It is important that police officers and paralegals have a clear understanding of the laws that govern GBV when dealing with such cases in order for them to easily identify what laws have been broken and to deal with perpetrators in an authoritative manner Module Objectives To give participants an understanding of what gender and gender-based violence are both in the context of international law to which Zambia is a party and in the context of Zambian law itself. To give participants an understanding of the relationship between gender, power, and gender -based violence; and define gender-based violence. To describe the standard management of victims and GBV cases by police

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2.1 What is gender? Key Messages: Sex is determined by ones biological make up Gender is socially determined

Time: 30 Minutes

Content:

Definitions Basic concepts

Learning Resources Materials: Flip chart Sticky stuff Markers

and

Specific Objectives To give participants an understanding of the basic concepts of gender and sex. To foster an understanding of the distinction between sex and gender

Methodology and Learning Activities Participants can be asked to do one of these two exercises Activity 1 Participants are asked to classify different scenarios into gender and sex. This exercise will help the facilitator to ascertain participants understanding of the difference between the two concepts Examples:
i.

women braid their hair men keep their hair short

ii. women give birth to babies and men dont iii. women have to clean the house, men must wash the car iv. women must look after the babies, men must work and provide money for the household v. women breastfeed babies, men bottle feed babies vi. boys voices break at puberty, girls voices do not vii. little boys are tough, little girls are gentle

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Activity 2 The facilitator divides participants into groups In their groups participants are asked to write down what they do or are expected to do on their days off as compared to what their spouses or partners do. This works well as an ice breaker as each sex is happy to poke fun at the other. In many cases (although not all) it also shows that men have more leisure time whereas women have to face more work in terms of household chores, sorting out childrens issues etc.

Facilitators Notes

In this session, the facilitator can explain to the participants the difference between gender and sex.

The facilitator can also emphasise that these roles can (gender) change from one society to another.

The facilitator can also then bring out that gender roles have little to do with peoples actual abilities and how they can lead to violence. The facilitator must discuss how socialisation has led in many cases to the relegation of women and children to minority status which leaves them vulnerable to victimisation.

Sex refers to ones biological and physiological make up, i.e. male or female; whereas gender refers to the socially constructed roles, behaviours, activities, and attributes that a given society considers appropriate for men and women i.e. roles that are assigned to men and women. The AGBV Act defines Gender as female or male and the role individuals play in society as a result of their sex and status

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2.2 What is GBV? Key Messages: Definition of GBV is very wide and encompasses different types of abuse.

GBV is not limited to women, thus authorities receiving such complaints need to be alive to the difficulties of men who are victims

GBV involves the abuse of power GBV involves the use of some type of force, including threats and coercion. Although the words violence and force imply physical violence, the meaning of GBV is broader than that.

Time: 45 Minutes

Content:

Learning Resources and Materials: Flip chart Sticky stuff Markers

Definitions Basic concepts

Specific Objectives To give participants a better understanding of what constitutes Gender Based Violence To give participants a better understanding of the key concepts and basic issues that underpin all forms of gender-based violence. Methodology and Learning Activity 1. Facilitator divides the participants in groups. 2. Participants are asked to give their own definitions of gender-based violence which they will write on a flip chart 3. Participants are also asked to list as many different types of abuse as possible

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Facilitators Notes

Must bring out that gender based violence encompasses a wide range of violence. The main factor is that it is violence that is perpetrated on a person because of their gender. It includes physical, sexual, emotional and psychological abuse.

The facilitator must then bring out the different types of abuse which include physical, sexual, emotional and psychological, economic and harmful cultural practices.

Examples can be given under each head and Handout 3 can be distributed outlining the different types abuse with examples

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2.3 Factors that contribute to GBV Key Messages :

GBV is a result of uneven power relations

Time: 1 hour

Content:

Learning Resources and Materials: Flip chart Sticky stuff Markers Papers Handout 1 and 4

Definitions Basic concepts

Specific Objectives To give participants an appreciation of the factors that lead to gender based violence To make participants appreciate the consequences of GBV

Methodology and Learning Activities Activity 1: (20 minutes)

On flipcharts, the facilitator asks participants in their groups to give what they think may be the causes of GBV and what the consequences are

The aim of this is to help participants understand just how far reaching GBV can be.

Activity 2: (40 minutes) 1. The facilitator writes on pieces of paper, different descriptions of people and their professions or stations in life. Each paper is stuck on the back of some of the participants without telling them their descriptions. Participants are then asked to interact and instructed to treat each other in the way that society would usually treat a person of the station described on the participants backs. The participants must then figure out what they are from the treatment that they get.

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2. Facilitator must then ask the participants


how they were treated; how they felt when they were treated that way; to guess what label was placed on their back; and

3. Facilitator then asks participants to describe what vulnerabilities some of the people described on the papers are subjected to. 4. Facilitator also asks the participants to point out what power some of them may have over others 5. All rights reserved Facilitator gives out handouts defining and listing the different types of power, abuse, and defining informed consent and go through it with them This exercise is intended to demonstrate the different types of power yielded by people and how societys attitude to certain people may lead to their abuse or their getting away with abusing others.

Facilitators Notes

Facilitator needs to bring out the fact that GBV situations involve the abuse of power and the use of force

That the more power a person has, the more choices they have. That those with less or no power are the ones that are most likely to be abused. Facilitator must also make the link between power, abuse, violence and consent. Facilitator also needs to bring out the aspect of informed consent. That acts of GBV occur without the consent of the victim

Factors such as status, wealth, education, illiteracy can be highlighted Facilitator can then link this to the next part of the module on GBV and Human rights

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2.4

Prevalence of GBV in Zambia

Key Messages : Cases of GBV are too high GBV cases are still under reported GBV cases need to be adequately reported and documented The Police need to foster confidence in the public to be able to go to them

Time: 30 minutes

Content:

Learning Resources and Materials: Handout

Definitions Basic concepts

Specific Objectives:

To give participants an appreciation of the extent of GBV in the country To give participants an appreciation of the important of disaggregated data

Methodology and Learning Activity 1. The facilitator hands out statistics for GBV from Zambia Police for the last decade and asks participants to have a discussion on the statistics. 2. The Facilitator then leads the participants in a discussion on the statistics. (30 minutes)

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Facilitators Notes The facilitator must bring out the following points in the discussion;

It is important at this point to stress the importance of authorities who receive and record GBV complaints to ensure that the data is disaggregated. This will enable authorities to understand the true extent of GBV in terms of who the perpetrators are, their relationship to the victims, the most vulnerable age groups etc. This will give a better understanding of the extent of the problem and to enable authorities to devise more suitable interventions.

The facilitator should also encourage discussion on the factors that prevent people from reporting (these should include such factors as relationships between the perpetrators and victims, i.e. the perpetrator being a relative, a bread winner etc, threat of being ostracized from the community, lack of safe places to go if one reports, negative attitudes by authorities such as police etc.)

The need for police and other institutions receiving these complaints to be encouraging, confidential and to offer protection and safety as soon as possible (this helps to foster confidence)

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2.5 Human Rights Key Messages: Human rights are natural and inherent entitlements

A person has them by virtue of being human therefore they are not given and cannot be taken away. GBV is a human rights issue

Time: 1 hour 30 minutes Content:


Learning Resources and Materials: Handout

Definitions Basic concepts

Specific Objectives To understand what human rights are To understand the link between human rights and GBV To understand that gender based violence is an infringements of ones human rights To understand the key human rights instruments pertaining to gender based violence

Methodology and Learning Activity This session consists of a presentation by the facilitator followed by a plenary session. The facilitator will hand out copies of the relevant international instruments and briefly explain what they entail.

Facilitators Notes Facilitator must bring out the following;

What are human rights?

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Human rights are inherent entitlements that a person possesses by virtue of being human. They are inalienable, which means that they cannot be taken away They are universal, which means that all human beings are entitled to them They are indivisible and interdependent, meaning that they exist simultaneously and that one can-

not fully enjoy some rights if others are violated or not recognised. These rights are important because they enable a person to live a life of dignity and to be accorded respect and treated equally with all other human beings.

Human Rights and GBV

All human rights treaties are based on the principles of equality, non discrimination and protecting rights of vulnerable people. This means that all human beings must be treated the same regardless of where they come from, their sex, age, social status, religion etc; that a certain group of people cannot be favoured over other groups and that special measures must be put in place to protect the rights of vulnerable people. In many societies the socialisation of males and females has led to unequal power relations between them. This allows one group to exercise power over another which may lead to GBV and violations of human rights. Similarly, children being minors are under the control of adults who may sometimes take advantage of their vulnerability. Thus If a parent for example, decides to remove a child from school in order to force them into an early marriage, they are violating that childs right to education and the right to be protected from all forms of sexual exploitation and abuse. A husband forbidding his wife or daughters from working violates their right to work and also renders them vulnerable to abuse as they become wholly dependent on the bread winner. GBV is thus an obstacle to the attainment of equality for all.

Facilitator must then show how international instruments/standards relate to and help in the combating of GBV

Remember: Facilitator must also bring out the following

The enjoyment of human rights comes with a corresponding duty to respect the human rights of others.

Although the state is the primary duty bearer in terms of ensuring the realisation of human rights, individuals also have a duty to ensure that they do not violate the rights of others. The facilitator may then give examples or ask participants to give examples of how the state, organisations/institutions and individuals can violate peoples rights.

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2.6 GBV and the law (National Legal Framework) Key messages: Customary law can have a negative impact on Human rights Zambia has several laws and provisions dealing with GBV

Time: 1 hour 30 minutes Content:


Learning Resources and Materials: Handout

Definitions Basic concepts

Specific Objectives

To understand about Zambias dualist system of law To understand the laws pertaining to gender based violence

2.6.1 Zambias dualist system Zambia has a dualist system of law which means that it applies statutory law which is the received law from our former colonial masters and customary law which is manifestation of our traditions and practices handed down from one generation to the next. Customary law is practised by the majority of Zambians both in rural and urban areas. This can be evidenced in marriage rites that are carried out, rites after the death of a person etc. These customs are carried out even by people who opt to marry under statutory law. Methodology and Learning Activity 1 (30 minutes)

Facilitator asks participants to list as many customary practices as possible. Facilitator then asks participants to post them up on the board under the headings of good and bad practices.

Facilitator then leads a discussion on why participants feel that some practices are bad and some good

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Facilitators notes

Facilitator can discuss how some customary practices can lead to GBV. Must show how sometimes customary law comes onto conflict with the received law

The facilitator should also discuss that where customary law comes in conflict with the law, it is the law that prevails. For this he must refer to Section 12(1)(a) of the Local Courts Act which provides that that a local court shall administer the African customary law applicable to any matter before it in so far as such law is not repugnant to natural justice or morality or incompatible with the provisions of any written law;

The facilitator must also refer to Section 16 of the subordinate Courts Act which also provides that the Court shall administer African customary law only in so far as it is not repugnant to justice, equity or good conscience, or incompatible, either in terms or by necessary implication, with any written law for the time being in force in Zambia.

Further he may also refer to the case of Kaniki v Jairus (1967) Z.R. 71 (H.C.). This case holds the principle that were a customary practice is contrary to natural justice and morality, it cannot be enforced

2.6.2 GBV under Zambian Law Under Zambian Law, there are two main pieces of legislation dealing with gender based violence namely, the Anti- Gender-Based Violence Act and the Penal Code. A third piece of legislation is the Anti- Human Trafficking Act. Methodology and Learning Activity 2 (1 hour) The Facilitator presents the main GBV provisions in the laws followed by a plenary session. The facilitator must bring out the following aspects of the various pieces of legislation;

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Facilitators Notes The following points must be brought out;


The Penal Code This is the main law dealing with criminal matters in Zambia It criminalises certain acts of GBV

Most provisions that relate to GBV are found in Chapter XV of the Penal Code (Offences against Morality) as amended by Penal Code (Amendment) Act No.15 of 2005 and No.2 of 2011. However other provisions are also found under offences relating to marriage and domestic obligations, murders and assaults.

The Anti- Gender-Based Violence Act The mandate of this Act is protection, rehabilitation and empowerment of victims/survivors of GBV.

It is not a criminal piece of legislation but provides for the granting of protection orders to prohibit perpetrators from carrying out Acts of GBV.

It also provides for safe houses to keep victims/survivors safe and away from perpetrators Provides for the rehabilitation of victims Empowerment of victims to ensure they do not return to the abusive situation Facilitator must clearly bring out the protections under the Act and the various roles that can be played by the various service providers such as social workers, the police, CSOs, religious or traditional leaders etc. It is important to show this linkage so that participants understand the role that they play

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The Anti- Human Trafficking Act The Act provides for many offences against slavery, forced servitude, human trafficking, forced labour and sexual exploitation

The Act domesticates the Palermo Protocol on Trafficking in Persons The Education Act Criminalises the forcible removal of learners who are children from school for purposes of marrying them off

Also criminalises the refusal by parents to enrol children in school.

Note:

That these are talking points. The facilitator is supposed to elaborate on the provisions while teaching. He should thus hand out the relevant provisions of the Acts to the participants before the presentation begins.

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2.7 Dealing with victims/survivors of GBV - Police perspective Gender based violence can have far reaching consequences such as serious physical injuries, profound psychological trauma, and unwanted pregnancy, infection with HIV and STIs or death. Thus, the care of survivors of Gender Based Violence needs to address all of these as well as legal and forensic issues. Compassion, respect and confidentiality should be offered to all. For a survivor to have trust in the police, she or he must be handled professionally. Members of the Victim Support Unit (VSU) are usually the first place that victims/survivors report to and thus normally provide support services to the survivors. These support and other services must be provided in a professional manner so that survivors can quickly recover from the trauma. The interviewing and sample taking of forensic evidence must not cause additional distress to them. The survivor should be explained to that some of the questions are personal and may seem intrusive, but they are important in building a case for prosecution. The purpose of this part is to highlight existing police procedures for responding to cases of GBV, and to provide standards for the management of different cases of GBV. The overall goal is to enhance the quality and quantity of forensic evidence collection so as to facilitate prosecution of the crime. This guideline is designed for use by police officers in response to complaints of GBV throughout Zambia. It outlines the eight important steps to be taken by police officers when dealing with a victim/survivor of GBV. This session will be interspaced with case studies and role plays to give practical illustrations.

Key messages: The police and paralegals are an important part of the fight against GBV

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Time: 2 hour 30 minutes Content:


Learning Resources and Materials: Handout on dealing with survivors Flipcharts Markers

Definitions Basic concepts

Specific Objectives To give participants a clear understanding of the role police officers play in combating GBV To ensure that police officers learn the key steps to be taken when dealing with a victim/survivor of GBV To ensure that police officers do away with certain prejudices when dealing with victims of violence Methodology and Learning Activity 1 Dealing with Prejudices (30 minutes) 1. Facilitator divides participants into small groups 2. Each group is given the case study to read and asked to answer the questions 3. The group work is then stuck on the wall and discussed together Case Study 1 Anna is a fifteen year old grade 10 pupil at Lusaka High School. Her father died when she was three and her mother remarried a few years later. Anna and her family have had a lot of financial problems at home but her fathers friend uncle Joe has been very kind; giving her a lot of money. Uncle Joe convinces Anna that he is in love with her and the two begin a sexual relationship behind her parents back. The relationship continues for over a year. One day Uncle Joe invites Anna and her best friend; sixteen year old Sarah for lunch at a local lodge with his friend Jack. The two girls are plied with alcohol and end up in a room at the lodge. The next morning, the girls are woken by the cleaner and are surprised to find they are naked. Sarah begins to scream that her private parts and whole body are in pain. The men are gone and the lodge bill is unpaid and the girls are bundled up by lodge staff and taken to the police station.

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The police officers charge the girls with the offence of obtaining pecuniary advantage. The officers refuse to listen to their stories or to look for Uncle Joe and his friend stating that it was through their own fault that the girls had found themselves in this predicament. They should have been in school instead of playing around. What was the impact of the police action on the girls? What could they have done differently? Did the police officers have any obligations to the girls? What were these obligations?

Facilitators notes

Facilitator illustrates how the attitude that is exhibited by police officers or paralegals will affect the victim/survivor i.e. whether they can trust you or not or be comfortable around the person dealing with them

Can also discuss how certain pre-existing prejudices can get in the way of officers effectively doing their jobs

Methodology and Learning Activity 2 Dealing with child survivors (30 minutes)

Facilitator divides participants into groups Each group is given the case study to read and asked to answer the questions The group work is the stuck on the wall and discussed together

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Case Study 2 Mary took her ten year old daughter Lucy to the police station accompanied by her daughters teacher Grace Banda. They went to report that Lucy had been defiled by another teacher at school. The attending officer Mercy Lungu opened a docket, took their statements and told them that the station had run out of medical forms and thus turned them away. Mary then took Lucy to the nearest clinic which was 50km away. As they had no vehicle they had to walk and arrived too late. The clinic only had one nurse and a clinical officer who had knocked off for the day. They spent the night outside the clinic and were attended to in the morning. The clinical officer examined Lucy but stated that he needed a medical report from the police. Furthermore he had no PEP to administer. He advised them to take Lucy to the district hospital. Mary then had to look around for someone with transport to take them to the district hospital which was 200km away. This took one and a half days. At the hospital, Mary was informed that she could not be attended to without the medical form from the police. She took Lucy to the police station nearest to the hospital. The attending officer Inspector Mambo insisted that he needed to examine the victim in order for him to fill out his part of the form. When Mary refused for him to do so, he reacted harshly and shouted at them telling them not to waste his time. Mary returned to the hospital and explained about her encounter with Inspector Mambo. She was referred to Dr. Sambo who decided to examine Lucy and write a report. It had been 74 hours since Lucy had been defiled but the doctor decided to administer the PEP anyway although she warned them that it may not be effective. When Mary returned home with Lucy she went Back to see officer Mercy Lungu with the report from Dr. Sambo. She was informed that as the report was not on the official police form she could not use it as evidence
1. What was the impact of the police action? 2. What could they have done differently? 3. Can you discuss what the law pertaining to medical evidence is? 4. Did the police officers have any obligations to the girls? What were these obligations?

5. Discuss what special considerations the police should bear in mind when dealing these child victims/survivors

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Facilitators notes

Facilitator must bring out the special considerations for dealing with child victims (See handout on responding to the needs of a survivor )

Facilitator also needs to bring out the challenges sometimes faced when dealing with the medical forms

Methodology and Learning Activity 3 Role Play (30 minutes) 1. Each group chooses three people to do the role play; Max and two officers. The groups will be given 15 minutes to practice and 5 minutes each to do the role play. Role Play Max walks into the police station to make a complaint about how he is physically, verbally and emotionally abused by his wife. His wife Blessed is the bread winner of the family and Max is the main care giver for their children.

Facilitators notes

This exercise is meant to show the importance of empathic responses and good communication skills

Methodology and Learning Activity 3 Role Play (1 hour) 1. Facilitator breaks the group into smaller groups and asks them to outline the steps they would take when dealing with a victim of violence. 2. After each group has presented, the facilitator can then give out the hand out and go through each one them.

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References/Resource materials Legislation: The Constitution of Zambia, Chapter 1 of the Laws of Zambia The Penal Code, Chapter 87 Penal Code (Amendment) Act No.15 of 2005 Penal Code (Amendment) Act no. 2 of 2011 Criminal Procedure Code Chapter 88 for Zambia. The Anti- Gender- Based Violence, Act No.1 of 2011 The Anti-Human Trafficking Act, No.11 of 2008 Intestate Succession Act, Chapter 59 The Education Act No.23 of 2011 The Local Courts Act, Chapter 29 The Subordinate Courts Act, Chapter 28 Policies: The National Gender Policy The National Child Policy The National Guidelines for the Multidisciplinary Management of Survivors of Gender Based Violence in Zambia International and Regional Instruments: The Convention on the Elimination of Discrimination against Women The United Nations Declaration on the Elimination of Violence against Women The Convention on the Rights of the Child The African Charter on Human and Peoples Rights and its Protocol on Womens Rights The African Charter on the Rights of the Child The SADC Protocol on Gender and Development

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The Palermo Protocol on Trafficking in Persons Other materials North Dakota Sexual Assault Evidence Collection Protocol, 4th Edition. May 2005. SARPCO Training Manual on Violence against Women and Children, 2000, Pretoria, South Africa. World Health Organization, 2003, Guidelines for Medico-Legal Care for Victims of Sexual Violence Geneva: WHO. Zambia Society for the Prevention of Child Abuse and Neglect, 2006 Interdisciplinary Training Manual UNICEF Training of Trainers on Gender Based Violence: Focusing on sexual exploitation and abuse (Facilitators Manual)

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MODULE 3: MEDICAL MULTIDISCIPLINARY MANAGEMENT OF GBV

Module Description Medical management of survivors of gender based violence is essential in mitigating its adverse physical and psychological effects. This module will equip participants with knowledge, skills and attitudes to attend to survivors of GBV in a professional and comprehensive manner. Module Objective: To describe the standard medical management for survivors as per National Guidelines on Management of Gender Based Violence in Zambia. See learning goals in participants manual. 3.1 Gender Based Violence (GBV)

Time: 50 Minutes

Content: Definition Magnitude of the Problem Significance

Learning Resources Materials: Flip charts Masking tape Marker pens Trainers Manual

and

LCD machine and laptop Participants manual

Specific Objectives:

To define Gender Based Violence To discuss the magnitude of the problem of GBV To discuss the significance and consequences of GBV

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Methodology and Learning Activities: Participants are divided into 3 groups, to do the following 1. Define Gender Based Violence 2. Discuss the magnitude of the problem of GBV and 3. Discuss the significance and consequences of GBV (30 minutes) All the groups report back in plenary. Facilitator fills in gaps by giving an illustrated lecture. (30 minutes)

Facilitators notes Definition Gender Based Violence is any act which results in physical, sexual, emotional or psychological harm to women and men, including threats of such acts targeting individuals or groups of individuals on the basis of their gender . Magnitude of the problem of GBV: Gender based violence may present with a variety of medical ailments some of which may or may not be related to sexual abuse and physical injury. The health care provider requires a high index of suspicion to identify the reason behind presentation to the facility. The need for both treatment and evidence collection means that clinicians find themselves simultaneously advocates for the patient and assistants to law enforcement. GBV survivors come from all socioeconomic and racial groups. All ages are potential victims of GBV, from toddlers to elderly individuals. Children should be approached with extreme sensitivity and their vulnerability recognized and understood. Although men are also victims of abuse, the majority tend to be women and children. Elderly women and the physically challenged are particularly vulnerable as they usually cannot defend themselves. Reports from the ZDHS 2007 indicate that 54% Zambian women have suffered from spouse or partner abuse at some point in time (physical, emotional or sexual). Current best estimates indicate that 1n 6 women and 1 in 33 men will be a victim of sexual assault at least once in their lifetime. Reports from police VSU of 2009 indicate that there were 1676 defilement cases and 244 rape cases, 188 indecent assaults, 30 incest cases and about 53 human trafficking cases.

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The ZSBS of 2005 indicate that on average 15.1% of females reported having experienced forced sex (17.7% urban females and 13.7% rural females). Forced sex was most commonly reported among the 20-24 year old age group (18.5%) and that the perpetrators most commonly reported were husbands or live-in partners (67.5%). Other reported perpetrators were boyfriends (25%), male relatives (5.8%), former husband/boyfriend (2.5%) and strangers (1.7%). Significance and consequences of GBV The often visible consequences of GBV are physical injuries that vary from bruises, cuts, fractures, internal injuries and death. In the course of a sexual assault, any injury may be inflicted on the victim, up to and including life-threatening multi-organ system trauma. The full extent of the consequences of GBV affect not only the survivor but also other members of a family, friends and the wider community. The consequences of GBV can be immediate, short term or long term and they include the following: Death Physical injuries Emotional trauma Psychological trauma such as anxiety, depression, suicide or attempted suicide and posttraumatic stress disorder (PTSD). Contraction of sexually transmitted infections (STIs) Unwanted pregnancies

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3. 2 Clinical assessment (history taking)

Time: 70 Minutes

Content: Definition Significance

Learning Resources and Materials: Flip charts/ Flip chart stand Masking tape Marker pens Trainers Manual LCD machine and laptop Participants manual

Process of history taking in children, adults, general history taking and gynaeco logical history taking

Specific Objectives:

To define history taking To discuss the significance of history taking for survivors of GBV To describe the procedure for general history taking To describe the procedure of history taking for children and adults To describe the procedure of history taking for gynaecological cases

Methodology and Learning Activities: 1. Participants are divided into 3 groups, to do the following 1.1 Define history taking 1.2 Discuss the significance of history taking for survivors of GBV and 1.3 Describe the procedure of history taking for general cases and gynaecological cases (40 minutes) 2. All groups report back in plenary. Facilitator fills in gaps by giving an illustrated lecture. (30 minutes)

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Facilitators notes History taking During history taking, it is important to remember that the survivor has experienced profound trauma. Health care professionals (HCP) need to approach survivors of sexual violence in a professional manner.

At this point, they may be agitated, depressed, shameful, fearful, angry, feeling guilt etc. Ensure privacy and arrange for a chair for the survivor and whoever is accompanying her. HCP calms the survivor and provides crisis counselling depending on the need Create a climate of trust Reassure confidentiality will be observed Explain the need to take history The HCP explains that he/she will work with other professionals Obtain history as completely as possible but with compassion, respect and sensitivity Explain the need for examining the survivor If the survivor needs to go to the examination room with a friend or family member, please allow this (but just make sure that the friend or family member is supportive to the survivor and not one who the survivor is scared of). Restrict the number of people allowed into the examination room during the examination to the absolute minimum necessary

History taking for adults General history: During history taking, an HCP can use the following questions: Tell me about your general health. Have you seen a nurse or a doctor lately? Have you been diagnosed with any illnesses? Have you had any operations? Do you suffer from any infectious diseases? Do you have any allergies? Are you currently taking any tablets or medicine?

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Gynecological history: When was the first day of your last menstrual period? Had you had any sexual intercourse prior to this incident? Have you had any pregnancies? Do you use contraception? What type? Do you currently have a sexual partner? When did you have the last consensual sexual intercourse? History Taking for Children General approach: Establish a neutral environment and rapport with the child before beginning the interview Approach all children with extreme sensitivity and recognize their vulnerability. Always ensure survivors both auditory and physical privacy Try to establish the childs developmental level in order to understand any limitations as well as appropriate interactions. It is important to realize that young children have little or no concept of numbers or time and that they may use terminology differently from adults making interpretation of questions and answers a sensitive matter. Find out what the child likes to be called and the names s/he calls specific parts of the body you may wish to refer to, during history taking and interview. Stop the examination if the child indicates discomfort or withdraws permission to continue; always prepare the child by explaining the examination this has been shown to diminish fears and anxiety Encourage the child to ask questions about the examination If the child is old enough, and it is deemed appropriate, ask whom they would like in the room for support during the examination. Some older children may choose a trusted adult to be present Always identify yourself as a helping person Ask the child if s/he knows why s/he has come to see you. Establish ground rules for the interview, including permission for the child to say s/he doesnt know, permission to correct the interviewer, and the difference between truths and lies Ask the child to describe what happened, or is happening, to them in their own words (where applicable) Always begin with open-ended questions. Avoid the use of leading questions and use direct questioning only when open-ended questioning/free narrative has been exhausted. Structured interviewing protocols can reduce interviewer bias and preserve objectivity Consider interviewing the caretaker of the child without the child presence.

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Before proceeding, ensure that consent has been obtained from the child and/or the caregiver. If the child refuses the examination, it would be appropriate to explore the reasons for the refusal. Consider examining very small children while on their mothers (or guardians) lap or lying with her on a couch. If the child still refuses, the examination may need to be deferred or even abandoned. Never force the examination, especially if there are no reported symptoms or injuries, because findings will be minimal and this coercion may represent yet another assault to the child. Consider sedation or a general anesthetic only if the child refuses the examination and conditions requiring medical attention, such as bleeding or a foreign body, are suspected

History-taking is distinct from interviewing the child about allegations of sexual abuse. Ideally, history should be obtained from a caregiver, or someone who is acquainted with the child, rather than from the child directly; however, this may not always be possible. Nonetheless, it is important to gather as much medical information as possible. Older children, especially adolescents are often shy or embarrassed when asked to talk about matters of a sexual nature. It is a good idea to make a point of asking whether they want an adult or parent present or not; adolescents tend to talk more freely when alone. When gathering history directly from the child, start with a number of general, non-threatening questions before moving on to cover the potentially more distressing issues. What grade are you in at school? How many brothers and sisters do you have? The following pieces of information are essential for medical history:

When do you say this happened? When is the first time you remember this happening? Threats that were made? What area (s) of your body did you say was touched or hurt? Do you have any pain in your bottom or genital area? Is there any blood in your panties or in the toilet? Any difficulty or pain with voiding or defecating? First menstrual period and date of last menstrual period (girls only)? Details of prior sexual activity. History of washing/bathing since assault.

Documenting the case:


Be as clear as possible in your writing Write in capital letters if your handwriting is not mostly illegible Do not be afraid to include names and places as long as qualifying statements like the survivor states are included Note down all medical and forensic samples that you have taken and label them clearly
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3.3 Laboratory investigations

Time: 1 Hour 30 Minutes

Content: Investigations for clinical management Investigations for forensic purposes

Learning Resources Materials:

and

Flip charts/flip chart stand Masking tape/sticky stuff Marker pens Trainers Manual LCD machine and laptop

Specific Objectives: To explain the importance of a medical examination To outline the investigations undertaken for clinical management To outline the investigations undertaken for forensic purposes To demonstrate ability to collect specimen for both clinical and forensic purposes

Methodology and Learning Activities: 1. Participants brainstorm giving rationale the investigations undertaken for both clinical and forensic purposes; facilitator fills in gaps through an illustrated lecture using power point slides.(30 minutes) 2. Participants use manikins in turn for specimen taking. Facilitator uses observation checklist to assess the level of skills performance of each participants. (50 minutes) 3. Feedback is given and this is repeated severally until participants attain competency in each skill. Learning guides and checklists are annexed in this manual are used the process of skills building. (50 minutes)

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Facilitators notes Investigations for Clinical Management of the Survivor Basic investigations to know the general condition of the survivor will include urine specimens and blood tests as indicated below. Urine Urinalysis microscopy Pregnancy test Blood HIV Test Hemoglobin level Liver Function Tests VDRL Creatinine level Investigations Carried Out for Evidence Purposes Urine analysis for epithelial cells; High vaginal swab for evidence of spermatozoa. The health worker should collect the specimen, preserve it for appropriate storage and hand it over to the police for further investigations and processing in the courts.

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3.4 The Physical Examination and Evidence Collection

Time: 2Hour 10 Minutes Content: General physical examination, Systemic physical examination with emphasis on genital & anal exam in adult males & females, boys & girls

Learning Resources Materials: Flip charts/ Flip stand Marker pens Sticky stuff Trainers Manual

and

LCD machine and laptop Participants manual

Specific Objectives:

To discuss the purpose of physical examination To describe the procedure for general physical examination To describe the procedure for systemic examination with emphasis on genital and anal examination in adult males and females, boys and girls To demonstrate ability to undertake a physical examination of a survivor

Methodology and Learning Activities: 1. Participants are divided into three groups, to discuss the following 1.1 Purpose for physical examination 1.2 Procedure for general physical examination
1.3 Procedure for examining genital and anal areas for survivors of sexual violence

(30 minutes) 2. All the groups report back in plenary. Facilitator fills in gaps by giving an illustrated lecture. (20 minutes) 3. Participants examine models (if available) in turn with the use of learning guides. Facilitator uses observation checklist to assess the level of skills performance of each participants. (40 minutes) 4. Feedback is given and this is repeated severally until participants attain competency in each skill. (40 minutes)
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Facilitators notes Physical examination of a survivor Before starting the physical examination, take time to explain all the procedures to the survivor and why they are necessary. Give the survivor a chance to ask any questions. Allow the survivor to have a family member or friend present throughout the examination, if s/he so wishes. Throughout the physical examination, inform the survivor what you plan to do next and ask for permission (informed consent). Both medical and forensic specimen should be collected during the course of the examination. Make sure that the survivor understands that s/he can stop the procedure at any stage if it is uncomfortable for her/him and give her/him ample opportunity to stop the examination, if necessary. Always address survivors questions and concerns in a non-judgmental and empathic manner; use a calm tone of voice. Ensure a trained support person of same sex accompanies survivor throughout examination Specimen collection process Specimen collection should be done during examination. Basic investigations to know the general condition of the survivor will include urine specimen and blood tests as indicated below. Urine Urinalysis microscopy Pregnancy test Blood HIV Test Haemoglobin level Liver Function Tests RPR The health professional should collect the specimen, preserve it for appropriate storage and hand it over to the police for further investigations and processing in the courts. Head to toe examination for children The physical examination of children can be conducted according to the procedures outlined for adults. When performing the head-to-toe examination of children, the following points are important: Record the height and weight of the child; In the mouth/pharynx, note petechiae of the palate or posterior pharynx, and look for any tears to the frenulum; Record the childs sexual development stage and check the breasts for signs of injury

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The Genito-Anal Examination for Girls Remember that in most cases, a speculum examination is not indicated. It is only indicated when the child may have internal bleeding arising from a vaginal injury as a result of penetration.

In this case, a speculum examination should be done under general anesthesia Examine the anus. Look for bruises, tears or discharge. Help the child lie on her back or on her side. The child may need to be referred to a higher level health facility for this procedure. For small girls, a pediatric speculum is recommended. Whenever possible do not conduct a speculum examination on girls who have not reached puberty. It might be very painful and cause additional trauma. Check for injuries to the skin that connects the foreskin to the penis Check for discharge at the urethral meatus (tip of penis) In an older child, the foreskin should be gently pulled back to examine the penis. Do not force it since doing so can cause trauma, especially in a young child; Examine the anus. Look for bruises, tears, or discharge. Help the boy to lie on his back or on his side. The boy should not be placed on his knees as this may be the position in which he was violated. Consider a digital rectal examination only if medically indicated, as the invasive examination may mimic the abuse.

Genito-Anal Examination for Boys


The comments made about the collection of medical and forensic specimens in adults apply equally to children.

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3.5 Multidisciplinary medical treatment of GBV

Time: 60 Minutes

Content:

Learning Resources and Management of life threat- Materials: ening injuries Flip charts/flip chart stand Masking tape/sticky stuff Marker pens Trainers Manual LCD machine and laptop

Specific Objectives:

To explain with rationale multidisciplinary services To discuss how to provide SV multidisciplinary services To outline different injuries caused by sexual violence clinical management To describe how to manage each injury To demonstrate ability to manage each physical injury

Methodology and Learning Activities: 1. Facilitator leads an interactive discussion by asking the following questions: 1.1 What are the physical injuries inflicted by sexual violence? 1.2 How are these injuries managed? (20 minutes) 2. A DVD/Video on these injuries is used to familiarize participants with the injuries and to demonstrate how they are managed. This is accompanied by an illustrated lecture to fill in gaps. (40 minutes) 3. During observed practice with real clients trainers use a checklist to observe proper management of such injuries.

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Facilitators Notes Management of injuries in sexual violence Management of any life threatening injuries takes precedence over all other aspects of post-SV care. Minor cuts and abrasions should not delay the delivery of other more time dependent treatments Clean abrasions and superficial lacerations with antiseptic and either dress or paint with tincture of iodine, including minor injuries to the vulva and perineum.

If stitching is required, stitch under local anesthesia. If the survivors level of anxiety does not permit, consider sedation or general anesthesia. High vaginal vault, anal and oral tears and 3rd/4th degree perineal injuries should be assessed under general anesthesia by a gynecologist or other qualified personnel and repaired accordingly. In cases of confirmed or suspected perforation, laparatomy should be performed and any intra abdominal injuries repaired in consultation with a general surgeon Provide analgesics to relieve the survivor of physical pain. Where any physical injuries result in breach of the skin and mucous membranes, immunize with 0.5mls of tetanus toxoid.

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3.6 Prevention of HIV Transmission, Other Infections and Pregnancy

Time: 40 Minutes

Content: Prevention of HIV - PEP Prevention of other STIs

Learning Resources Materials:

and

Flip charts/Flip chart stand Masking tape/ Sticky stuff Marker pens Trainers Manual LCD machine and laptop

Prevention of unwanted pregnancies Prevention of Hepatitis B

Specific Objectives:

To describe procedures to prevent HIV infection to survivors of sexual violence To describe prevention procedures for STIs To describe procedures for preventing unwanted pregnancies To describe procedures for Hepatitis B prevention

Methodology and Learning Activities: 1. Participants brainstorm on the procedures for prevention of the following infections and pregnancy 1.1 HIV 1.2 STIs 1.3 Hepatitis B (20 minutes)

2. Facilitator fills in gaps through an illustrated lecture. (20 minutes)

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Facilitators Notes HIV transmission and post-exposure prophylaxis in sexual violence Post Exposure Prophylaxis (PEP) for HIV is the administration of a combination of anti-retroviral drugs (ARVs) for 28 days after the exposure to HIV that has to be started within 72 hours after the assault. The efficacy of PEP decreases with the length of time from exposure to the first dose, therefore administering the first dose is a priority. People presenting later than 72 hours after assault should be offered all other aspects of post rape care, but not PEP. Pregnancy prevention following sexual violence Emergency Contraception (EC) should be readily available at all times including beyond working hours and free of charge in all Government Health Institutions where women and/or girls are likely to present after being raped or defiled. MOA of contraceptives; Delay/inhibit ovulation Interfere with sperm migration and function Alteration in cervical mucus causing sperm trapping/impaired function, altered tubal transport Prevent fertilization Development and transport in fallopian tube and uterine cavity of zygote, morula and blastocyst Prevent implantation by impaired endometrial receptivity Corpus luteum dysfunction Prevention of Hepatitis B and Tetanus The generally available Hepatitis B Vaccines do not provide any protection from infection if given after an exposure (e.g.: sexual assault), but they do provide protection from future exposures. It is much less costly to vaccinate all survivors of rape/sexual violence, rather than to test everyone for Hepatitis B antibodies to see who might benefit. Ideally, if Hepatitis B Vaccines is available, it should be considered for survivors of sexual violence according to the national guidelines.

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3.7 Monitoring and Evaluation for GBV Service Provision

Time: 1 Hour

Content: What is monitoring? What is evaluation? Domains in monitoring Quality data management Indicators for a program Monitoring tools

Learning Resources and Materials: Flip charts/ Flip chart stand Masking tape/Sticky stuff Marker pens Trainers Manual LCD machine and laptop

Specific Objectives: To define the terms, monitoring and evaluation To identify the different domains in monitoring To discuss how to manage data effectively To discuss program indicators To develop/Identify monitoring tools

Methodology and Learning Activities: 1. Participants brainstorm on the meaning of monitoring and evaluation, domains of monitoring and essentials of managing data effectively facilitator fills in gaps and gives examples in a power point slide. (30 minutes)

2. Facilitator gives a brief lecture on program indicators and how to develop them and tools used in monitoring. (30 minutes)

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Facilitators notes Monitoring and Evaluation Monitoring is the routine, daily assessment of activities toward program objectives. It routinely looks at the service quality and what was achieved. Evaluation is the periodic assessment of the overall program. Social science research methods are used to investigate programs effectiveness by examining its effect. Monitoring and Evaluation Types Formative needs assessments are conducted during planning or re planning of the program to identify needs and resolve issues before the program is widely implemented. Guiding Questions in Formative Needs Assessment Is an intervention needed?

Who needs the intervention? How should the intervention be carried out?

Monitoring has three Main Domains:


Inputs, which are resources for conducting and carrying out the program. Process, which are activities the human and financial resources used to achieve the program results, such as the number of training sessions. Monitoring these activities will show what, how well and how timely they were done. Outputs, which are the immediate program results and may be in three forms: number of activities conducted in each area, such as training access or measuring service adequacy services used or measurement of extent services were used

Guiding Questions in Monitoring


Is the program directed toward a set target? To what extent are planned activities realized? What services are provided, to whom, when, how often, for how long and in what? How well are the services provided? What is the quality of services provided? Is the program running consistently within the design? What is the cost for each person served?

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Evaluation Accounts for what has been accomplished through project funds. Promotes learning in what works and what does not work. Provides feedback to stakeholders for decisions. Assesses the cost-effectiveness of the program. Enhances the effectiveness of project and program management. Contributes to policy development. Guiding Evaluation Questions What: Did it do what was said it could do? Why: What worked and what didnt work? So what: What difference did it make? Now what: What could be done differently? Then what: How to use the evaluation to continue learning? Cost-Effectiveness Analysis helps managers and planners make decisions about their budgets and funding. It combines monitoring data and cost data to help the manager make choices about allocating funds and deciding whether or not funds are spent appropriately. Monitoring allows a project, program or research objectives and activities to be revised early or completely overhauled, depending on the feedback. It measures the performance of the organization, person or intervention to ensure improvements or changes by identifying what is working as planned and what needs correction follow progress toward set standards. Day-to-day performance and quality monitoring should be a supervisors main concern. Quality Data Management This involves the process of accurate recording, timely reporting, and appropriate data entry and storage, prior to its analysis and feedback. Quality data management includes: Utilizing appropriate nationally approved recording and reporting tools for collecting, analyzing and reporting data. Accurate recording and entry of data Confidential and proper storage of client records To ensure quality delivery of sexual violence services, accurate measures of performance are needed. Health care professionals shall maintain registers and generate required accurate and current reports. The relevant records officers shall be expected to: Collect, summarise, submit and store the reports appropriately. ensure the data and reporting tools are available at the service delivery points Post-Rape Care Program Indicators An indicator is a measurable statement program objectives and activities. An indicator set includes at least one indicator for input, output, process, outcome and effect.

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Expressing an indicator Numerical indicators:


A number is commonly used for output, such as the number of women who received antiretroviral prophylaxis in a set time. A ratio compares two or more cohorts, such as comparing HIV incidence in 1215-year-olds with 1621-year-olds. Percentage compares two numbers and is usually used as an outcome indicator, such as the percentage of people who returned for post-test counseling out of the total number tested. Average divides the total by a smaller measure, such as the average daily count of all patients on antiretroviral at a site in one month. Rate is the number of new indicators compared in a total, such as new infections compared with the total population over one year; the prevalence rate. Friendly attitude towards clients Implementing protocols in the right sequence User-friendly physical environment

Qualitative indicators:

Monitoring can be applied within the facility with to


Improve service Monitor post-rape care Monitor post-rape care effect Card systems Data review Ongoing interviews Audits for standards Reports Checklists

Monitoring tools are


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3.8 Setting up One stop centers

Time: 10 Minutes

Content: Minimum requirements For setting up a one stop Center

Learning Resources and Materials: Flip charts/Flip Chart Stand Masking tape/ Sticky stuff Marker pens Trainers Manual LCD machine and laptop

Specific Objectives:

To explain the concept of OSC To discuss the minimum requirements for setting up a One Stop Center (OSC)

Methodology and Learning Activities: Facilitator gives a brief lecture on the requirements for setting up a One Stop Centre, a power point slide is used for this purpose. (10 minutes)

Facilitators notes Minimum requirements Staff clinician, nurse, psychosocial counsellors, police officer and data support staff. All staff working in a one stop centre should be trained in handling GBV survivors Equipment Lithotomy bed, colposcopy, light source, furniture, linen, toys and medical consumables. Space At least three rooms: - counselling room, examination room, waiting room, child friendly play room.

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3.9 Answers - Scenarios

Scenarios are aimed to contextualize the lessons and bring practical situations to which participants can identify with and apply themselves in a real life situation. Scenario 1: 32 year old Rosemary Brings out personal, social and cultural barriers in dealing with GBV and professional short comings GBV service providers may encounter. The participants should be allowed to express the rationale for the answers and where possible briefly debated them. Answers 1. No the nurse did not ensure confidentially She culturally believes Rosemary deserved the GBV she experienced and was using her situation as a lesson to others that GBV was acceptable if you deny your husband sex. Scenario 2: 12 year old Jane This scenario brings out the vulnerability and complexities of dealing with child survivors of sexual abuse and GBV. 1. Jane has been violated by both Mr Tembo and the mother. There is need to build trust in her by the health provider so as to be able to get the full story from Jane. The health care provider needs not be judgemental towards Jane. The health provider needs to handle Jane as a complete person who has suffered multiple forms of abuse, a teenager who may be undergoing emotional and physical maturation and need treatment and support. The treatment would include treatment for the physical trauma, prophylaxis against HIV/STIs and pregnancy and psycho -social counselling. Jane would also need to be linked to other GBV service providers as need may arise and the household/ family for Jane needs family counselling. 2. Jane is a minor and is devoid of mature judgement. Mr Tembo has identified and taken advantage of Janes vulnerability and drawn her to him with gifts. He exposes her to alcohol and sexually explicit content to further impair the minors judgement and sexually abuses her. Jane believes Mr Tembos sexual abuse is love and is prepared to defend their love. Also, the physical beating to the extent Jane experienced at the hands of the mother should be treated as a crime. A difficulty that may arise when Jane is called up as a witness is she may be unwilling to testify unless well counselled and assured both by family and all GBV service providers. Also, the entire family for Jane needs family counselling to help them get over the incidence and continue life as a family.
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Scenario 3: 5 year old Tumelo This scenario brings out the complexities when dealing with very small children and when the abuser is somebody very close to the child. It also shows that sometimes children may not be able to complain or express themselves but that the GBV service provider needs to be constantly alert to pick up clues children may give throughout their interaction with the GBV service provider. 1. Treat Tumelo for any physical injuries and possible infections. Collect specimens for medical and forensic purposes. Interview the patient and the mother separately and in view of Tumelos reaction when the uncle came, the law enforcement GBV service providers should be engaged at the earliest opportunity. 2. Tumelo is a vulnerable minor with difficult socio-economic conditions as the mother is a single mother who also is the sustainer of the household. Tumelos mothers job may not permit her to care for Tumelo all the time. There is need to engage the social services and other family members. The family will also need family counselling. Scenario 4: medical history and examination- Lushomo Mudenda This scenario is designed to show the importance of an elaborate clinical history and examination. The first clerking may be more common and easy but may not be of as much forensic value as the second.
1. History and examination too brief in Case 1 with no few details of forensic value. There is a lot of

detail that has been left out because the health care provider has just concentrated on the fact that the patient complained and because it is a rape victim...only the perineum was examined. The details of case 1 may be difficult to follow up at a later date or recall the details should the health care provider be required to testify at a later stage. Case 2 tried to address some of the minimum level of clerking and probably detail that may be expected in such a case yet being brief.
2. Information of forensic value in the clerkings

Case 1 Finding of

absent hymen

Case 2
Names

of possible suspects date and multiple rape drug intoxication

Possibility of Possibility of DNA

swabs which have been taken


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References
1. World Health Organization (2003).Guidelines for medico-legal care for victims of sexual violence. 2. Guidelines for the Clinical Management of Child Sexual Abuse.East, Central and Southern African Health Community July 2011. 3. McKerrow N H, (2007). STEP-BY-STEP GUIDE for the MANAGEMENT OF SEXUALLY ABUSED CHILDREN. Pietermaritzburg Metropolitan Hospitals Complex KwaZulu-Natal. 4. Gender in Development Division cabinet Office.(2011). The National Guidelines for the Multidisciplinary Management of Survivors of Gender Based Violence In Zambia 5. Zambia Society For The Prevention Of Child Abuse and Neglect (2004) Training Manual. 6. WHO- Clinical Management of Sexual abuse Survivors by World Health Organisation, Geneva , - Reproductive Health and Research and UNHCR - Health and Community Development 7. Riley, D. (ed) (1991) Sexual Abuse of Children: Understanding, Intervention and Preventions, Radcliffe Medical press, Oxford, pp. 2. 8. Bays, J. and Chadwick, D. (1993) Medical Diagnosis of sexually abused children. Child Abuse and Neglect, 17(1) , 91-110.
9.

Adams J,A. (2001). Evolution of a classification scale: medical evaluation of suspected child sexual abuse. Child Maltreatment, 6:3136

10. Zambia Society For The Prevention Of Child Abuse And Neglect Interdisciplinary Training Manual, 11. Ministry Of Health Standard Treatment Guidelines 12. Debra A Poole, Michael E Lamb (1998). Investigative interviews of children, a guide for helping professionals; 13. Pediatric Sexual Assault Forensic Examiners Training Manual 2012 , California. Clinical Forensic Medical Training Center

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MODULE 4: PSYCHOSOCIAL CARE AND SUPPORT TRAINING MANUAL FOR SEXUAL AND GENDER BASED VIOLENCE (SGBV) Gender Based Violence has been neglected in many societies, especially its mental, emotional psychosocial and physical implications. The GBV consequences can be serious and long-lasting, affecting the mental health, the psychological and physical abilities of a survivor. GBV both in children and adults can result in psychological and social impacts that can undermine the long term mental and psychosocial well-being of the affected person(s). Module Description This module is designed to be used to train psychosocial care and support providers to render standardized, effective, efficient support and rehabilitation including reintegration to those afflicted and affected by GBV. Additionally, the module provides guidance on follow-up care and referral of survivors to other service providers such as the police and social workers especially where there is an absence of the integrated model at health centres or in the community. Psychosocial care and support is a vital component of dealing with GBV for survivors of physical, emotional, psychological or socio-economic abuse. It becomes important to deal with individuals who have been abused and their caregivers in order to protect and improve their mental and psychosocial well-being. Survivors of GBV are more likely to experience depression, substance abuse, delinquent behaviours, Post-Traumatic Stress Disorder (PTSD) and may attempt to commit suicide immediately or in later life than their non-abused counterparts. Unfortunately, as indicated in Chapter One, by the time these problems are identified, the survivors may have suffered long - term patterns of abuse. They would have severe depletions in the manner with which they - handle their day to day life experiences. It is worth noting that some children and adults may need specialized interventions to address their suffering and help restore the flow of development and quality of life. GBV has direct negative psychosocial impact on the healing progress of the survivor. Therefore it is important for service providers to render psychosocial care and support to the family of the abused. In the case of children psychosocial care and support will need to be provided to siblings and parents including other family members.

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Module Objective The main objective of this module is to describe what psychosocial care and support are and the standard procedures for managing GBV survivors and their families 4.1What is Psychosocial Care and Support? Psychosocial care and support embodies the values, principles, actions, hopes and dreams that a particular people have for the well-being of each others lives, including vulnerable and abused children and other groups. It is expressed through caring and nurturing relationships that communicate understanding, unconditional love, tolerance and acceptance. The role of service providers in the provision of psychosocial care and support to children, men, women and communities in need, is to support them in ways that make it possible for them to reconnect with what they hold precious; i.e., their hopes and dreams for their lives.
Key Messages 1. 2. 3. 4. Psychosocial care and support enables children, women, men and communities affected by GBV to be in touch with their skills and competencies in solving problems and dealing with crises. A counsellor ensures that psychosocial care and support is mainstreamed into all efforts targeting the well being of children, women, men and communities affected by GBV A comprehensive package of psychosocial care and support influences a survivors sense of well -being. Psychosocial care and support can be provided at any level of intervention

Time: 50 Minutes

Content:

Definition

Learning Resources Materials: Flip charts Masking tape Marker pens Trainers Manual

and

Significance of psychoso- cial care and support in dealing with GBV

LCD machine and laptop Sticky stuff

Specific Objective:

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Define psychosocial care and support Discuss the significance of psychosocial care and support for survivors of GBV Describe the procedure for psychosocial care and support of children and adults

Methodology and Learning activities 1. The facilitator asks participants to define psychosocial care and support in the large group. The facilitator writes participants contributions on the flip chart. 2. Participants are then divided into two groups to carry out the following: 2.1 Discuss the significance of psychosocial care and support for survivors of GBV 2.2 Describe the procedure for psychosocial care and support of children and adults, including physically and mentally challenged persons 3. Groups report back in plenary. The facilitator and participants fill in gaps and clarify any misconceptions. (50 minutes)

Facilitators Notes: The facilitator should strengthen the activities by ensuring that participants understand that: Psychosocial care and support is about enabling children, women, men and communities affected by GBV to be in touch with their skills and competencies in solving problems and dealing with their crises. It is about consistently nurturing, caring and supporting what is expressed through family and community interactions that occur in everyday life.

Survivors seen at service provision centres immediately after the abuse are likely to be extremely distressed and may not remember standard advice and information given at this time. It is, therefore, important to repeat standard advice and information during followup visits. It is also useful to prepare standard advice and information in writing, and give the survivor a copy before s/he leaves the service provision centre (even if the survivor is illiterate, s/he can ask someone s/he trusts to read it to her/him later). Give the survivor the opportunity to ask questions and to raise concerns.
Survivors of abuse include those with psychological and social problems, like common mental disorders, stigma and isolation, substance abuse, risk-taking behaviour, and family rejection. Even though traumarelated symptoms may not occur, or may disappear over time, all survivors should be referred to the existing service provision centres dealing with GBV. A coordinated integrated referral system should be put in place as soon as possible. The majority of survivors never tell anyone about the incident. If the survivor has told you what happened, it is a sign that s/he trusts you. Your compassionate response to her/his disclosure can have a positive impact on her/his recovery.

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4.2 What is counselling? Counselling is a therapeutic relationship between a counsellor and a survivor which leads to change, growth, autonomy and care for oneself and others. Therefore, it is a very important intervention in taking care of survivors.

Time: 55 Minutes

Content:

Definition Significance of counseling in relation to GBV Counseling procedures

Learning Resources and Materials: Flip charts Sticky stuff /Masking tape Marker pens

National Multi-sectoral Guidelines for GBV Specific Objectives


Hand outs

Define counselling Discuss the types of counselling Discuss the role of a counselor in relation to GBV Discuss the significance of counseling for survivors of GBV Describe the procedure of counseling for children and adults including physically and mental challenged persons

Methodologies and learning activities 1. The facilitator asks participants in the large group to define counselling and lists participants contributions on the flip chart. Then the facilitator gives them the definition as contained in the National Guidelines for the Multidisciplinary Management of survivors of Gender Based Violence. (15 minutes) 2. The facilitator divides participants into two groups to 2.1 Identify types of counselling relevant to GBV 2.2 Discuss the identified types of counselling 2.3 Both groups report back in plenary
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3. Participants are divided into four groups to describe and discuss the following: 3.1 the role of a counsellor in relation to GBV 3.2 significance of counselling for survivors of GBV 3.3 qualities of a counsellor (15 minutes) 3.4 the procedure for counselling children and adults including physically and mentally challenged persons 4. All the groups report back in plenary. The facilitator and participants clarify misconceptions. (25 minutes)

Facilitators Notes: The definitions of counselling are numerous, but the following give a firm indication of its scope: A set of techniques, skills and attitudes to help people manage their own problems using their own resources.

a process of helping a person/people learn how to solve certain interpersonal, emotional and decisional problems.

The task of counselling is to give the survivor an opportunity to explore, discover and clarify ways of living more resourcefully and towards greater well -being

This means that counselling involves responding to both the feelings and thoughts of the survivor with the counsellor dealing with both attitudes and behaviours that particular survivor. Additionally, counselling involves a basic acceptance of the survivors perceptions and feelings, irrespective of outside evaluative standards. In other words, the counsellor must first accept where the survivor is at the present time before dealing with where the survivor could be. This means the survivor needs the counsellors understanding of their current situation and concerns before they can anticipate growth and change in a new direction (Hackney and Nye, 1973). Counselling can also be understood as the helping relationship, which includes the following: Someone seeking help. Someone usually trained and willing to give help, in a setting which permits that help to be given and received.

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The following lists types of counselling which participants may bring out. Include any that may not be on the participants list. (see Chapter three of the national GBV Multi-sectoral guidelines

Crisis Counselling Trauma counselling HIV/AIDS counselling Psychosocial counselling Developmental counselling Facilitative counselling Child counselling including physically and mentally challenged persons Peer counselling Family counselling Group counselling

Role of a Counsellor The role of a counsellor is to ensure that psychosocial care and support is mainstreamed into all efforts targeting the well-being of children, women, men and communities affected by GBV . A comprehensive package of psychosocial care and support will influence a survivors sense of well-being beyond the discreet points of care. The counsellor should provide basic, non-intrusive practical care. Listen but do not force her/ him to talk about the event, and ensure that her/his basic needs are met. Do not push survivors to share their personal experiences beyond what they would naturally share because it may cause further stress. The counsellor should ask the survivors if they will need a safe place to go to, and if someone s/ he trusts will accompany them when s/he leaves the service provision centre. If they do not have a safe place to go immediately, efforts should be made to link them to other service providers that can help them. If the survivors have dependants and is unable to provide for them as a result of the trauma, provisions must also be made for dependants and their safety.

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4.3 Initial psychosocial assessment The beginning stages of psychosocial assessment are especially important as initial conditions and survivors first impressions generally make a great impact and may set the tone for much of the interaction.

Time: 60 Minutes

Content:

Definition Significance of initial assessment for GBV survivors

Learning Resources and Materials: Flip charts/Flip chart stand Sticky stuff/Masking tape Marker pens

National Multi-sectoral Guidelines for GBV Hand outs

Specific Objective

Discuss survivor assessment Discuss the significance of initial assessment for survivors of GBV Describe the procedure of the initial assessment for children and adults

Methodology and Learning Activities Activity 1 1. The facilitator divides the participants into three groups to do the following: 1.1 Discuss survivor assessment (initial interview) 1.2 Discuss the significance of the initial assessment for survivors of GBV 1.3 Describe the procedure of the initial assessment for children and adults 2. The groups report back in plenary. The facilitator and participants fill in the gaps. (30 minutes)

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Activity 2: Role Play Facilitator asks for two volunteers to take part in the role play. 1. One participant acts as the counsellor and the other one as a child 2. The two do a role play of a child counselling session 3. The facilitator should focus on the following: 3.1 Find out the childs story of what happened to them. 3.2What are his/her fears? 3.3 How have the problems affected her/him? (15 minutes) 3.4 How has she /him handled their problems? (Even in small ways) 4. The larger group should observe and give feedback at the end of the role play. (15 minutes)

Facilitators Notes: The facilitator should give guidance to participants regarding the filling in of the in-take form as well as treatment of survivors when they report to them. The following are some of the key elements:

realism of their goals and expectations quality of their contact with the counsellor contact with consensual reality level of self-support and of environmental support cultural and social background ability to invest energy and commitment in the counselling process and any levels of risk to themselves or others Do not record names Be aware of the ways to ask questions politely Social hierarchies should be respected whenever possible but should not override the need to protect the confidentiality and privacy of the survivor Code of dress should be observed Involve the survivor at all phases Respect the dignity and worth of the survivor at all times Allow the survivor to speak for themselves Adopt assessment methods that allow children to express their views and describe their experiences

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Child survivors will likely express themselves through drawings and diagrams and they should be given rights of ownership of that assessment data. This means that they should have the right to say how materials they produce will be used.

Keep promises made to child survivors Be an empowering experience that leads child survivors to feel greater commitment and ownership of the assessment process and findings and any actions that result from it. Be a flexible process that is continuously evolving, adaptive and responsive to the needs and circumstances of the survivor.

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4.4 Types of Counselling

Time: 55 Minutes

Content:

Identification of types of counselling

Learning Resources and Materials:

Flip charts/Flip chart Procedures of talking to stand children affected by GBV Sticky stuff/Masking tape and HIV/AIDS Steps in providing counseling Marker pens National Multi-sectoral Guidelines for GBV survivors Hand out

Specific Objectives

Identify types of counseling that can be used in relation to GBV Describe the procedure of talking to children affected by GBV Describe the procedure of talking to children affected by GBV and HIV Describe steps in providing psychosocial, facilitative and developmental counseling for survivors of GBV

Methodology and Learning Activities 1. In the large group the facilitator asks participants to brainstorm on the types of counselling (10 minutes) 2. Participants are divided into three group to describe the following: Procedure of talking to children affected by GBV Procedure of talking to children affected by GBV and HIV Steps in providing psychosocial, facilitative and development counselling to survivors of GBV. (20 minutes) (Each of the groups select one participant to write and present during plenary) 3. Groups report back in plenary (15 minutes) 4. The facilitator gives a focused lecture on psychosocial, developmental and facilitative counselling. (10 minutes)

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Facilitators Notes The facilitator should ensure that the following types of counselling are noted by participants and explain that there are other types of counselling used in dealing with survivors of GBV. The type of counselling used may depend on the issue at hand. Psychosocial counseling Psychosocial counselling is given to survivors that have relational problems in families or society. It involves providing psychosocial support which is fundamentally concerned with issues of motivation and social energy. Other than providing basic requirements like food, clothing and shelter, psychosocial counselling deals with the emotional and psychological well-being of an individual as well as the social setting in which one lives. Developmental counseling Developmental counselling focuses more on problems that may come as a result of growing up or changes in ones environment and is derived from developmental psychology. Developmental psychology is the study of the continuous process of development and behavioural changes throughout the lifespan. It provides for the study of every stage of development from pre-birth through death. Developmental psychology also considers the three domains: biological (biosocial), cognitive, and psychosocial. Developmental psychology is also often referred to as human development. In cases where a person is sexually or physically assaulted, there are a lot of disturbances in the individuals development. As a result, it is important to re-establish normal development following the trauma. The developmental counselling process is similar to psychosocial counselling with more emphasis on the continued personal growth of the survivor. Facilitative counseling Facilitative counselling occurs when a counsellor creates an environment that facilitates the survivor to make positive decisions about how they will deal with the situation. This is done through the use of different counselling skills found in the above counselling types. Steps in providing psychosocial, developmental and facilitative counseling : Greet the survivor Introduce yourself and ask them to introduce themselves Ask what made them visit you Discuss all expectations by the survivor Inform the survivor of the issues of confidentiality Discuss the problem at hand Ask about the fear and anxieties the survivor could have Explore the survivors intentions to deal with their fears and anxiety Challenge irrational beliefs and unrealistic experiences Use silence to give an opportunity for the survivor to think through what is being discussed Discuss alternatives and allow the survivor choose the best alternative Agree on implementation of the best alternative Arrange for follow-up

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4.5 Group, Peer and Family Counselling Group counselling is a forum where certain unique therapeutic experiences are made possible when people meet regularly with others who share the same problems but who do not share a life together.

Time: 70 Minutes

Content:

Group, peer, and family counselling Procedures for group formation Peer counseling skills Additional issues to consider while dealing with female and male survivors of GBV

Learning Resources and Materials: Flip charts/Flip chart stand Masking tape Marker pens

National Multi-sectoral Guidelines for GBV survivors Hand out

Specific Objectives

Discuss essentials of group counseling Describe the procedures for group formation Identify peer counseling skills Discuss family counseling Discuss additional procedures in dealing with female and male survivors of GBV

Methodology and Learning Activities


1. 2. The facilitator leads a group discussion on defining group counselling and its purpose. Participants are divided into three groups to

2.1 Discuss group formation 2.2 Identify peer counselling skills 2.3 Discuss family counselling (30 minutes) 3. The groups report back in plenary. The facilitator leads a brief discussion on the presentations and fills in gaps. (20 minutes) 4. The facilitator finally presents and leads a discussion on additional procedures for dealing with female and male survivors of GBV (20 minutes)

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Facilitators Notes Facilitator asks groups to select one group member to record and present at plenary. The facilitator should go through the following notes to ensure that participants understand all the concepts in this session: Essentials of group counselling

Some of the objectives of group counselling among other things are: It allows people to see that there are other people experiencing the same problems they might be experiencing; It allows them the opportunity to help others and be helped. It increases each members hope and optimism as others in the group strive to overcome difficulties similar to his or her own. It provides a sense of belonging to a special supportive community. It allows new information to emerge that might be more difficult to disclose in individual or family meetings. Children and adults spontaneously reveal their concerns in the presence of other children more than in the presence of single adult therapist or family. Groups can provide opportunities for practicing more successful interactions and coming up with solutions on interpersonal problems. Groups increase understanding, acceptance and rebuild trust.
How to set up a group:

1. Composition of the group: same age, or mixed, same sex or mixed, same problem or mixed? 2. Membership: Open: Members join at anytime Closed: Once members are identified, membership is closed. Members go through with the identified group to the end. 3. Format: It is either activity oriented or talk oriented or both are applied. 4. Group size: For good communication, the more activity oriented a group is the larger the group size can be. For intensive therapy groups, using talking only, the ideal size is no larger than seven. 5. Time limit: What is the best time limit? For intensive psychotherapy conducted in groups, one to one and half an hour is optimal. For larger activity oriented groups, one to two hours is optimal. 6. Frequency of sessions: To maintain continuity, at least once or twice a month. 7. Group boundaries: Can group members visit each other outside the meeting times? For intensive psychotherapy groups, group members are discouraged from meeting together outside of group times in the belief that outside discussion about group members weakens the power of the group when they meet. For support groups, members are encouraged to visit one another outside of the group.

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8. Role of therapist: Directive vs. Non-Directive. Does the therapist set an agenda for the group or allow the group to determine what they wish to talk about? In-groups that focus upon a specific issue such as drug abuse or sexual abuse, the therapist may take a leading role in the early sessions to establish a direction for the group. In activity oriented groups, the therapist sets the agenda. In-groups using personality exploration as their objective, group members are encouraged to determine their own agenda. 9. Working with other systems: Does the group interact with other systems like police, parents, schools and communities? Advocacy groups would interact more frequently with other systems.
Peer Counselling: This is a form of counselling among people of the same age range, sex and possess similar characteristics such as interests, habits, and educational background. Peers may also be people experiencing similar disease or trauma.

Peers must be trained in counselling skills and techniques that can be used in conducting either face to face or group counselling skills. These skills can include:

HIV and AIDS counselling skills Trauma counselling skills Crisis counselling skills

Assertiveness skills Peers can play an important role in helping others faced with GBV or any other form of trauma. They can also play a role of a buddy. Family Counselling: This is a form of counselling given by a trained counsellor to families or couples. Family counselling provides families an opportunity to discuss pertinent issues that often could be hidden and difficulty to address at an individual level. The principle is that, the family or couple avails itself during face to face contacts with a counsellor. Often issues of communication, planning and home life management or relationship are discussed and resolved. The facilitator should also explain that women and men survivors of sexual assault have many challenges to contend with. Therefore the counselors should look at the following: Special considerations for women

Female survivors of sexual assault are likely to be very concerned about the possibility of becoming pregnant as a result of the rape. Emotional support and clear information is needed to ensure that they understand the choices available to them if they become pregnant. In most cases the choices are made after a thorough counselling session where advantages and disadvantages of each option are discussed. There may be safe home facilities which could be provided by institutions like Young Women Christian Association (YWCA), Social Welfare and other institutions such as the church. Where necessary, link the survivor to the facility.

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Women who are pregnant at the time of a sexual assault are physically and psychologically vulnerable. In particular they are susceptible to miscarriage, hypertension in pregnancy and premature delivery. In the event that a survivor is not in a one-stop centre the counsellor should determine the course of management and treatment by linking to other service providers. Pregnant women should be encouraged to attend antenatal care services regularly throughout the pregnancy.
Special considerations for men

Male survivors of sexual assault are less likely than women to report abuse, because of the extreme embarrassment that they experience due to negative perceptions of society. While the physical effects differ, the psychological trauma and emotional after-effects for men are similar to those experienced by women.

When a man is sodomised, pressure on the prostate can cause an erection and even orgasm. Reassure the survivor that, if this has occurred during the rape, it was a physiological reaction and was beyond his control.

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4.6 Preparing the survivor for medical examination and court proceedings The primary aim of preparing the survivor for medical examination is to develop awareness through a sustained enquiry into the survivors subjective experience, honouring all aspects of their being and their circumstance. For most abused survivors, the healthcare facility is their first and frequently only contact with the system that provides intervention and support. It is important for the counsellor to create a safe and trusting environment for the medical interview, examination and subsequent care. Before preparing a survivor of GBV for the court process it is important to get acquainted with specific laws in Zambia that determine who can give consent for minors like the Juveniles Act and who can go to court as an expert witness and how and when to report abuse cases Where the child is a witness, rapport building is vital because the child is intimidated by the courtroom and everything that it encompasses. Asking children to describe a favourite activity may help build rapport. To make a child at ease, take them to the court to familiarize him or her with the environment.

Time: 90 Minutes

Content:

Preparation of the GBV survivor for medicals Preparation of GBV survivor for court proceedings

Learning Resources and Materials: Flip charts/ flip chart stand Sticky stuff/Masking tape Marker pens

National Multi-sectoral Guidelines for GBV survivors

Specific Objectives

Discuss how to prepare a survivor of GBV for medical examinations Discuss the procedure of preparing GBV Survivors for court

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Methodology and Learning Activities 1. Participants are divided into two groups to do the following: 2. One group choses two people to role play preparation of a survivor for medical examinations; one plays the part of a service provider, the other the part of a survivor while the others watch and make notes. (30 minutes) 3. The second group also choses two people to role play the preparation of a GBV survivor for the court process. One plays the part of a survivor while the other plays the part of a service provider; (this part may require someone familiar with court proceedings, ie a police officer, a lawyer). (30 minutes) 4. The facilitator then leads a discussion on the two role plays. (30 minutes)

Facilitators Notes The facilitator gives the following guidance to participants in relation to preparing GBV survivor for medical examinations and court proceedings: The counsellor should: Explain the medical examination process Explain the importance of the examination Explore the overall medical process with the survivor in a broader way Assess whether counselling is likely to be helpful to the survivor

Preparing the survivor for court proceedings A. Provide all survivors with the following information: 1. 2. Role of court personnel including the judge, crown, defence lawyer, prosecutor, court reporter, clerk of the court, the accused, witnesses and jury. Rules for witnesses such as: Listen carefully Tell the truth Speak loudly and clearly Answer out loud (do not nod or shake your head) Say when you forget, do not understand, or dont know the answer Say when you forget, do not understand, or dont know the answer

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3. The difference between the truth and a lie, oaths and affirmations, and promises to tell the truth.

4. The role of the judge as a listener in court, whose job is to gather information from many sources and put that information together to help make a decision about the accused.

5. That the judge has no prior knowledge about what happened and needs to hear as much information from the child as he or she can remember.

6. The court process including: Information about subpoenas Arriving and waiting at the courthouse before testifying Reviewing statements or videotapes Open courts Examination procedures Trial outcomes Sentencing B. Role playing is an integral part of the court preparation process because it: Reduces anxiety by acquainting the child with unfamiliar rituals of the court and may make the practice a fun activity; Provides an opportunity to practice dealing with leading, confusing and difficult questions; Helps children learn when and how to say they do not know the answer or do not understand the question.

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4.7 Special considerations for children Understanding the emotional needs of children helps us to understand the arising behaviour as a result of trauma. The manifestation of trauma might be rebellion or rejection of parental values, defiance, idealism, and experimentation with drugs or sex. These behaviours are manifested by children at different ages and may be distressing to parents. In situations where children are traumatized, they may perceive their emotional needs as more immediate and pressing. As a result, they may seek relief through attention-seeking behaviours. After experiencing abuse, children could lose faith in adults and therefore will seek with greater immediacy satisfaction of their needs for more freedom and direction. As a result, the behaviour of rebellion and defiance may appear in a more extreme form of running away and destructive behaviour towards themselves and others.

Time: 1hr 40 minutes

Content:

Learning Resources and Materials: Flip charts/flip chart stand Sticky stuff/Masking tape Participants note books/pens Marker pens

Dealing with child survivors of GBV

National Multi-sectoral Guidelines for GBV survivors Specific Objective


Hand outs

Discuss how to prepare a survivor of GBV for medical examinations Discuss the procedure of preparing GBV Survivors for court

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Methodology and Learning Activities Activity 2 1. The facilitator asks participants to stand up. 2. Then the facilitator says Walk around the room feeling extremely strong, nothing can hurt you. You are so big and strong your head feels as though its sailing through the clouds. Experience how that feels. Now you have become very small. At any moment a bit of wind could blow you away or a shoe might come down and squash you like an ant. Experience that. 3. Next the facilitator gives each participant a piece of flip chart paper. Participants fold the paper in half and put one half face down on the floor. On one half, using pens, they draw themselves feeling very strong. They turn the paper over, on the other half and draw themselves feeling very weak. Participants hold up the strong drawings so everyone can see. 4. The facilitator observes the following:

How big is the drawing? How bold or vibrant? How strong does it look? What is the emotion on the face? What are the arms and legs doing (are they strong or weak)?

5. The facilitator instructs participants to now hold up the weak drawing. 6. The facilitator makes comments based on number 4 above 7. The facilitator mentions that: Childrens bodies show you their feelings. - To understand childrens drawings, put yourself in the exact posture of each figure. What do you feel? - Apart from their feelings, children also experience the world through their bodies. 8. The facilitator then says draw you and your Family doing something together (family origin) (40 minutes)

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Activity 2 1. Before this activity starts the facilitators asks participants to bring in one toy each at least. 2. The facilitator puts participants in pairs and explains that they will take turns in playing as a child. The facilitator then gives them the following instructions:

First stand opposite one another. One of you is looking in the mirror. The other person is your reflection.

Whatever the leader does you follow. Use your hands and move slowly. It is important to always follow the childs lead. Never interfere with what they are doing.

3. Play for 10 minutes and then switch roles. 4. Use hand out 3 - the adults guide to play (30 minutes) Activity 3 1. The facilitator asks participants to discuss how to communicate with a child survivor of GBV. 2. Facilitator then asks for two volunteers to play the part of a child GBV survivor and service provider. 3. The two volunteers role plays the scenario of the initial interview of a child survivor while the other participants watch and take note of any omissions. 4. The facilitator concludes the activity by filling in gaps (30 minutes)

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Facilitators Notes The facilitator should emphasis the following issues: Children communicate in various ways:

They use body language They use play They use spoken language.

Service providers should be knowledgeable about child development and growth as well as normal child anatomy. It is recommended that service providers receive special training in counselling and assessment of children who may have been abused. All service providers should also be acquainted with the children and human rights in order to help the survivors better.

Interviewing a child survivor

The goals of an interview with a child survivor are:


To ensure there is no further trauma to the child survivor and offer protection. To ascertain the abuse and who the abuser is. To obtain accurate information needed for referrals, case investigation, management and medical treatment To offer protection to the survivor

Where a parent/guardian is present, they should be informed of the purpose of the interview and this should be explained in a straightforward manner and cooperation should be ensured so that the child feels safe to talk with the interviewer. The parent/guardian should be informed that any facial expressions of shock, disbelief, or disapproval, or any verbal or physical signals to the child could jeopardise the interview.

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1. It is important to assess the child's verbal skill level and to use terms that the child can easily understand. This assessment can be accomplished by asking topical questions about family, school, television, and every day events. After a degree of rapport has been established, the child can then be asked to describe what happened. The counsellor must be aware of some special/ common words used to communicate in a particular community (e.g., to imply sex, body parts). 2. Begin the session by asking open-ended questions such as, what can I do for you? However, younger children tend to have a short span of attention. In this case, the counsellor should avoid long and openended questions and provide short rest periods at appropriate intervals during the interview. For example, questions like " Tell me about the abuse?"would be open-ended questions that require a long answer and should not be used. Instead, it is better to use a series of short questions calling for direct responses such as, " tell me about what happened? Did someone touch you in a way that made you uncomfortable?" The counsellor should remember to ask age-appropriate questions at all times. 3. Assure the child it is acceptable to respond I do not know to any questions if they do not know the answer. 4. Be patient, go at the childs pace; do not interrupt their train of thought. 5. An assessment of the child's emotional state is a vital part of the counselling process. Age is an important consideration in the interpretation of an assessment based on factors such as how the child relates to others, their body posture and the language used. 6. It may be necessary for the counsellor to follow the child's description with clarifying questions in order to learn exactly what happened. For instance, in situations where penetration did not occur but where there was other sexual contact, the child may not at first differentiate between oral and physical stimulation. 7. Younger children do not have the same sense of times and dates as adults do. In order to establish a time frame in which the abuse occurred, it can help to discuss favourite events or activities. These could include asking about television shows, a holiday, and a trip to see a relative, or a birthday, church gatherings, or any other special event.
8. The use of interview aids is extremely helpful. Drawings, pictures, and anatomically -detailed dolls are particularly effective. When using these aids, ask the child to name the different body parts (i.e., nose, fingers, knees, etc). Then, ask the child what she or he calls the intimate areas without correcting them. Make note of the terms used and what areas or body parts these terms represent. 9. Statements made by the child should be recorded accurately. The child should not be led in such a manner that she or he answers questions to please the counsellor. The facilitator should explain that in order to serve the best interest of the child the counsellor needs to be aware of the situation depicted in the box below:

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If a parent asks a question that you dont think is appropriate to answer in front of the child.
The counsellor should feel free to define some information as being for adults only or for kids and parents to share. Children are used to such boundaries and parents should be able to set such limits on their children listening to adult conversations. The counsellor can then meet privately with the parent to share adult only information and use this time to model for the parent how and why certain questions might be inappropriate to ask in front of the child.

Guidelines for communicating with children Use proper phonology Speak to the child using proper pronunciation. Do not use baby talk. Do not guess what a child might have said. Remember that a child may pronounce words differently from an adult.

Use appropriate vocabulary A word might have different meaning to the child. Avoid introducing new words (e.g., body parts) before the child has mentioned them. The ability to answer questions about the time of an event is very limited before 8 -10 years. Try to narrow down the time of an event by asking about activities or events that children understand. When a child mentions a specific person, ask follow-up questions to make sure that the identification is unambiguous. Beware of shifters (Changers in thoughts). Avoid complicated terms. Phrasing questions in concrete terms rather than abstractly makes it easier for younger children to understand. Abstract questions do not usually fall within the comprehension of children under the age of ten. Pay attention to syntax Use sentences with subject-verb-object word order. Avoid embedded clauses. Place the primary clause before qualifications. Ask about only one concept per question. Avoid negatives. Do not use tag questions. Children learn to answer what, who and where questions more comfortably than when, how and why questions. A why question is generally not understood before the age of eight or ten. Avoid nominalization.

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Other pragmatics Different cultural groups have different norms for conversing with authority figures or strangers. Avoid correcting a childs non-verbal behaviour unless it is interfering with the ability to hear the child or the interview. Be tolerant of talk that seems off topic and avoiding interrupting children while they are speaking. Children may believe that it is polite to agree with a stranger. It is especially important to avoid leading or yes -no type questions.

Sometimes the child may need more encouragement to open up. They may have difficulty expressing themselves or they may be shy to share something that is troubling them. Some techniques that encourage the child to talk are:

Asking questions Checking your understanding Naming the feelings Normalizing

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4.8 Support for child survivors of GBV and their families

Time: 1hr

Content:

Learning Resources and Materials: Flip charts/flip chart stand Sticky Stuff/Masking tape Marker pens Noted books and pens

Procedures for dealing with child survivors of GBV

National Multi-sectoral Guidelines for GBV survivors Hand outs

Specific Objective

Discuss how to deal with child survivors of GBV Discuss how to support the family of child survivor of GBV

Methodology and Learning Activities 1. Participants are paired up and role-play counselling an abused child in turns. Participants should role play counselling for different types of abuse. (40 Minutes) 2. While each pair is role playing other participants watch and take note. After the role plays the facilitator leads a group discussion to fill in gaps and clear misconceptions (20 minutes)

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Facilitators Notes The facilitator should at the end of the activities explain the following: General issues to consider when counseling a child Care and support for parents/guardians: Some parents/guardians may be so emotionally distraught or disbelieving when hearing the childs account that their presence can have a negative impact upon the child during the counselling/ examination process. When these situations occur, the parent/guardian should be taken to a private area and provided with support and comfort. Implications: Counsellors must be aware of the long-term implications of their questions for children. While the immediate goal is to ensure the clearest possible information from the child, the counsellor should be aware of his or her own feelings about child sexual assault, so as not to communicate any attitudes which might create or increase the child's trauma. Being supportive and sensitive: The counsellor should be supportive and sensitive through tone of voice, body expression and the maintenance of eye contact. The counsellor should also sit at eye level with the child so that the child is not intimidated and so that the interviewer is perceived as genuinely interested. Trusting: It is important that the child be believed at all times, especially in cases where the childs account is disputed by adults. Avoid making face judgments and demonstrating any shock or surprise. The counsellor should find ways of validating the childs information rather than disputing what they say as the child tends to think that all adults are the same. Assurance: It must be made very clear to the child, throughout the session that the child was not at fault for what happened and that professionals are there to give help and protection. Working with the abused childs family:

In working with the family, you want to encourage a supportive, non -judgmental environment which allows each family member to heal from the trauma they have experienced. You want to help each member to develop an understanding of what happened and how it affected each of them. Most importantly, you want to help the family to move on to find success and areas of gratification in their future life, rather than being permanently crushed under the burden of this event. To do this, one must be aware of several ideas: Obtain each family members point of view. Observe who has the authority in the family and who makes the decisions. Observe who is excluded in the family or whose voice is silenced. Observe who gets the most attention and the least attention in the meeting. Observe whose opinion is listened to. Observe who wants you on their side. Where there are power imbalances, vacate all family members, with the permission of the authority figure, and speak to the weaker member alone to obtain their point of view.
With children, give them something to play with or draw while you are talking to the family. Watch their behaviour throughout the meeting. What do they do and at what points in the session do they stop, listen, or try to interrupt? The behaviour of the children can provide you with valuable information about what might be happening in the family .

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4.9 Co-joint child-parent sessions These are sessions in which the child and parent meet with the counsellor to review educational information, practice skills and engage in open communication. The counsellor and family should decide together whether joint sessions are needed earlier in treatment or whether there should relatively be fewer or more conjoint sessions.

Time: 50 Minutes

Content:

Learning Resources and Materials: Flip charts/ Flip chart stand Sticky stuff/Masking tape Marker pens Note books/pens

What works and what does not work in Co-joint counselling

National Multi-sectoral Guidelines for GBV survivors Hand outs

Specific Objective

Demonstrate co-joint counselling Discuss what works and what does not work in co-joint counseling

Methodology and learning activity 1. Facilitator asks for two volunteers; one to act as a child and the other as a parent while facilitator takes on the part of a counsellor. The three act out a counselling session. (20 minutes)

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2. The rest of the participants watch and take note. 3. The facilitator leads a discussion focused on what works and does not work in conjoint counselling (30 minutes)

Facilitators Notes The facilitator should explain that: Successful intervention in the lives of abused and neglected children and their families requires the concurrent involvement of many different systems. Interventions aimed exclusively at the individual survivor often ignore or underutilize the family and the environmental resources available to the child. This approach can perpetuate the childs experience of isolation and exacerbate his/her victimization. A time-limited, hourly counselling session with a child will not guarantee his/her safety nor will it guarantee successful interactions in his/her home, school, or community. Careful assessment and utilization of family members and caregivers as well as liaison with school personnel, health, law enforcement and court -related personnel and child welfare agencies increases the likelihood that the child will benefit from treatment, remain safe, and promote healthy relationships with others. Case management includes advocating for siblings in the family. Siblings often need help addressing the following issues: Fear and heightened sense of vulnerability Confusion, guilt, or envy (why not me?) or self -blame for failing to protect the victim Embarrassment or shame; and Misunderstandings regarding the abuse of children including blaming the victim, scapegoating the victim, sexualizing the sexual abuse victim.

When the perpetrator is a family member, especially a parent, the siblings, as well as the primary victim, will need services to address the following: Changes that may have occurred in the family; Divided loyalty; Anger at the victim for disclosing abuse; and Learned behaviour, including victimization of younger Sibling, inappropriate problem-solving skills, and issues related to gender and the use of power

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4.10 When to terminate a counselling session Sexually abused children suffer a wide variety of symptoms and problems within the home and in different institutions. Therefore, the criterion for discharging children differs from one child to another.

Time: 50 Minutes

Content:

Learning Resources and Materials: Flip charts Flip chart stand Sticky Stuff/Masking tape Marker pens Note books/ pens

terminating a counseling session

National Multi-sectoral Guidelines for GBV survivors Hand outs

Specific Objective

Discuss procedures for terminating a counselling session

Methodology and learning activities 1. The facilitator presents a talk and gives guidelines on how to terminate a counselling session (15 minutes) 2. The facilitator then asks for two volunteers from the participants to dramatize termination of a counselling session. The first drama depicts the right way of ending the session while the last one depicts the opposite. In both dramas the facilitator plays the role of a counsellor (15 minutes) 3. The facilitator wraps up the activity while emphasising on the main points. (10 minutes) 4. The facilitator then explains the importance of follow-up care (10 minutes)

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Facilitators Notes

The facilitator should reiterate the need for proper termination of a counselling session and give the following: Five general points are essential to meet before the discharge. 1. The abused child must have at least one adult caretaker in the family to whom the child can talk when he/she is upset about the abuse or any other matters. 2. The child should be able to talk about a range of feelings both in therapy and to friends. Remember abused children have great difficulty in feeling safe and so many children hide their feelings to avoid feeling vulnerable or being teased. This avoidance of feelings serves to isolate the child from developing close friendships which are important to promote healing. 3. Check if the child is doing as well in school and with friends as she/he was prior to the abuse. The child should be at about the same level of functioning as he or she was prior to the abuse. 4. The child should not be symptomatic (e.g., child should be free of intrusions, bedwetting, panic attacks, sleep problems and many other symptoms related to abuse). 5. Family conflict should be resolved. There should not be premature termination of counselling session. Follow-ups should be used at increasing periods of time (for example, with severely traumatized cases start meeting every week, then every two weeks, then once a month, and finally once every six months to determine the survivors progress). Counselling is one of many important strategies to help sexually abused children move beyond the role of victim and continue their progress toward positive and productive adulthood. Therapy with abused children is often demanding and challenging. However, it offers the immediate reward to the therapist of knowing that he/she is making every effort to help the child and the family who are struggling to overcome the effects of abuse. For this reason, counselling is a valuable service and a major contributor to the well-being of sexually abused children and their families. The facilitator should also explain that it is important survivors continue to receive support even after termination of the counselling sessions. It is especially important that psychosocial care and support services are provided to the survivor, ensuring that long-term support is available by referring her/him to other service providers. This is important for survivors who may experience on-going hidden psychological trauma. Traumatic events destabilise people for weeks, months or even years. Personal feelings of control, the ability to protect yourself and others, are undermined by assaults. It is also important to ensure that survivors are supported for safe family and community re-integration through: Linking to the existing community and district service providers such as the Department of Social Welfare and Department of Community Development, VSU/CPU(child protection unit), churches, NGOs, FBOs. (Use Counsellors referral form Appendix 15)

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Link to community led initiatives aimed at providing protection, care and support. Ensuring community collaborative mechanisms to address issues of resource and logistical constraints, i.e. transport, place of safety, hospital care, etc.

Provide maximum input during the first visit, as this may be the only visit. It is possible that the survivor may not or cannot return for follow-up.

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4.11 Safe Record Keeping

Time: 30 Minutes

Content:

Learning Resources and Materials: Flip charts/flip chart stand Sticky stuff/Masking tape Marker pens Note books/pens

Record keeping

National Multi-sectoral Guidelines for GBV survivors Specific Objective

Hand outs

Discuss procedures for safe record keeping

Methodology and learning activity The facilitator makes a presentation on proper record keeping. A question and answer session follows to allow for clarification of issues (30 minutes)

Facilitators Notes

If the records of a survivor were found by someone else not authorized by the survivor, this could be very embarrassing and traumatic and may put the survivor at risk. Authorized persons include medical personnel, parents or legal guardian, counsellor and police. At no time should the records come into the possession of the accused or suspected person. It is important to keep all records safely. Some of the things to consider doing are:
All information collected from the survivors should be kept under lock and key. Ensure that there is a back-up system. Ensure that there are limited numbers of people having access to the information. Maintain safety and confidentiality of survivor records. Confidentiality and privacy constitute essential ingredients in the counselling setting. Physical facilities that preserve this quality are important. Therefore counselling is not typically conducted in the counsellors home, the local coffee shop, or other informal, non-confidential setting. This is because records need to also be immediately kept away in a confidential and safe place.

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Hand out 1 Objectives of counseling In GBV the objectives of counselling are to:

Facilitate the survivor to make desirable and realistic decisions about their situation; Change behaviour in order to have required outcome; Be able to access support network and services; Draw in-depth understanding of issues and challenges in providing care for survivors of sexual and gender-based violence; Review and practice counselling skills needed for trauma counselling; Enable survivors to understand that they were not responsible for the violence. Tell the survivor that s/he is not the only one ones Approachable: able to make someone feel at ease and not threatened. Available Empathetic: willing to relate to the feelings others are experiencing. Concerned: having a genuine interest and willingness to help and support. Attentive: giving full, individual attention to another person. Composed: making a thoughtful and considered response; giving importance to the issue without under/over-reaction. Trustworthy: having integrity and responding to others honestly and respecting counselling ethics. Observant: being sensitive to changes in appearance or behaviour. Wise: having the understanding or the experience to offer useful support.

Qualities of a good counsellor include:


Counselling the GBV survivor The following skills and techniques are helpful when dealing with survivors of GBV:

Greet the survivor Offer a seat Introduce yourself to the survivor and tell them your role Ask them to introduce themselves and how they would want to be addressed Use their preferred name Make them your central focus Be respectful Be sensitive to the survivors culture

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Be professional Be calm Exercise patience Observe eye contact as much as is culturally appropriate Be empathetic Be non-judgmental.

As a result of trauma, survivors are at increased risk of a range of symptoms and signs which include:

feelings of guilt and shame; uncontrollable emotions, such as fear, anger, anxiety; nightmares; suicidal thoughts or attempts; numbness; substance abuse; sexual dysfunction; medically unexplained somatic complaints; social withdrawal.

The counsellor needs to find out what the survivors are experiencing to determine what sort of help they will require (use the counsellors check-list, appendix 2). Agree with the survivor and guardian in case of a child on the course of management and/or treatment. Encourage, but do not force, her/him to confide in someone they trust. Encourage active participation in family and community activities. All survivors of sexual and gender based violence should be counselled. The counselling should include conversations around the following:

Medical treatment The risk of transmission of STI and HIV. The efficacy of PEP. The efficacy of EC Rapid HIV testing Sero-conversion Preventive measures. Process of criminal investigations Court procedure

In addition depending on the needs of the survivor, counselling could cover early marriage, teenage pregnancies, abortions and their negative effects.
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Hand out 2 Types of counseling When thinking about the survivors suitability, the counsellor needs to be clear about the range of their skills and their ability to decide what type or level of counselling is suitable for which survivors and to put that decision into action. Be aware of these interventions and consider the survivors suitability, discussing their advantages and disadvantages if appropriate. There are many types of counselling used when dealing with any survivor. Some of the types of counselling are:

Crisis Counselling Trauma counselling HIV/AIDS counselling Psychosocial counselling Developmental counselling Facilitative counselling Child counselling Peer counselling Family counselling Group counselling

1. Crisis Counselling Crisis counselling involves the short-term use of specific skills and strategies to help a survivor cope with difficult and confusing situations resulting from emergency events they cannot understand or cope with. If a trauma or crisis is not resolved in a healthy manner, the experience can lead to more lasting psychological, social and medical problems. Crisis counselling provides education, guidance and support.

Crisis counselling is not long-term and is usually no more than 1 to 3 months. The focus is on single or recurrent problem[s] that are overwhelming or traumatic.

There are many descriptions and a great deal written about crisis intervention and crisis counselling. Regardless of the theory and author, there are universal elements in the process by which a crisis counsellor can help people face and move past distressing and traumatic events in their lives.

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Education. There is a natural ability within most people to be resilient and therefore recover from a crisis, provided they have the support, guidance and resources they need. The very heart of crisis intervention is to face the impact of a crisis. Effective crisis counselling provides information; activities and structure that will help a survivor recover and move past the crisis. More importantly, crisis counselling will ensure that one does not prolong a crisis and will help ensure that one does not create more problems in life and the lives of others. Confrontation through information and discussion may be an important part of crisis intervention.

Observation and awareness. A crisis in ones life can be the result of low self-awareness or not recognizing the impact her/his behaviour has on others as well as the impact it has on ones self. Increasing awareness can lead to choices that promote recovery and wellness. The survivor cannot help her/himself if s/he cannot see the problem and how s/he may be contributing to the crisis. In some cases, family dynamics and communication problems within families can prolong a crisis.

Discovering and using individual potential. Every crisis represents an opportunity for personal growth and to discover an individuals highest potential and true self. The greatest hero in any crisis is the person who does not believe s/he is a hero, but is nevertheless prepared for the challenge by the undiscovered qualities and abilities that are come to light when s/he is facing tragedy and the inevitables of life. While support is important, this does not mean that the person in crisis should not be allowed, encouraged and sometimes required to make decisions and take action to resolve the crisis and improve the quality of her/his life.

Understanding individual problems. During any crisis, it is important to recognize or discover ones true and deepest intention. One must keep her/his intentions in mind no matter what s/he does or how unskilfully s/he may act. While the intent is usually to make life better, ones behaviour can be misguided, misunderstood and less effective than hoped for. Self-understanding as well as understanding how others may keep one from overcoming their individual problems is an important key to recovery.

Creating necessary structure. The most important aspect of crisis intervention and counselling is to provide a social container for the survivors experience that will allow her/him to express, explore, examine and become active in ways that help insure the crisis is not prolonged. For each survivor, there are necessary activities and routines in her/his life during times of distress that provide comfort and support. These do not include alcohol, medications or other drugs. Medications should only be used to prevent a physical or psychological breakdown.
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Hand out 2

Challenging irrational beliefs and unrealistic expectations. Few people have the necessary skills to fully examine what they think, assume and expect from themselves and from others during times of crisis. Ones thoughts, especially the ones that have not been expressed, contribute a great deal to how the survivor feels and what s/he may do next in response to her/his feelings. It is, therefore, important to explore these and evaluate them.

Breaking vicious cycles and addictive behaviour. Unhealthy escape and avoidance of emotional pain and distress may involve the use of medication, drugs, alcohol, sex, thrill-seeking, parties or working excessively. Taking the role of a "victim" can cause others to rescue a person in crisis. Prolonging the crisis by refusal to deal with it can create further difficulties. When a person becomes dependent on others and avoids dealing with the problem a vicious cycle can develop. Vicious cycles start with behaviours that are intended to avoid or escape emotional pain. Ultimately, these avoidance and escape behaviours create more problems or prolong the same problem through avoidance.

Create temporary dependencies. During a crisis, it is often helpful to form brief relationships with others in order to gain support. A healthy dependency is usually temporary and will always lead to increasing independence. Unhealthy dependencies are long-term and create increasing dependency rather than independence.

Facing fear and emotional pain. A crisis is usually a time of fear or sadness. How one responds to these emotions is important. There is a "monster" in the world for every person who "runs" in response to their fear or sadness. When one faces their fears and the roots of their problems she/he may eventually discover that the pain subsides. Facing emotional pain is the healthiest response. This does not mean one should make her/himself miserable. From a counselling standpoint, when one suffers, it is important to help her/him feel less alone in the world.

Steps in providing crisis counselling


Be calm. The crisis may overwhelm the counsellor. Assess the stage of the crisis quickly (denial, anger, bargaining, resignation or acceptance stage) in order to give appropriate counsel. Apply active listening. Discuss all expectations by the survivor. Begin where the survivor is. Accept the clients definition of the crisis. Ask what has already been done

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Explore all the issues involved. Does the client see their problems? Challenge irrational beliefs and unrealistic experiences. Ask what new thing could be done to solve the problems. Use silence to give an opportunity to the survivor to think through what is discussed. Ask the necessary activities or routines which provide support in time of stress. Agree on a timetable of implementation of a plan made to resolve the crisis. Ask if there is a trustee who could help monitor the implementation of the agreed plan. Arrange for follow-up.

2. Trauma counselling Trauma counselling is given to all survivors who undergo physical and psychological injury in order for them to overcome the pain through re-living the experience in a protected environment. Trauma is a type of damage to the psyche (mind) that occurs as a result of a very painful event. When that trauma leads to PTSD, damage may involve physical changes, which may affect the person's ability to cope with stress. A traumatic event involves a single experience, or an enduring event that completely overwhelms the individual's ability to cope or integrate the ideas and emotions involved with that experience. The sense of being overwhelmed can be delayed by weeks or years, as the person struggles to cope with the immediate danger. Trauma can be caused by a wide variety of events, but there are a few common aspects to all traumatic events. They usually involve a feeling of complete helplessness in the face of a real or subjective threat to one's life or to that of loved ones. There is frequently a violation of the person's familiar ideas about the world and of their human rights, putting the person in a state of extreme confusion and insecurity. Psychological trauma may accompany physical trauma or exist independently of it. Typical causes of psychological trauma include the experience of sexual abuse, violence and wars. Long -term exposure to situations such as extreme poverty or other forms of abuse, such as verbal abuse, can be traumatic. Different people will react differently to similar events. One person may perceive an event to be traumatic that another may not, and not all people who experience a traumatic event will become psychologically traumatized. People who go through traumatic experiences often have certain symptoms and problems afterwards. How severe these symptoms are, depends on the person, the type of trauma involved, and the emotional support they receive from others.
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Panic attacks are an example of a psychosomatic response to such emotional triggers. Consequently, intense feelings of anger may surface frequently, sometimes in very inappropriate or unexpected situations, as danger may always seem to be present. Upsetting memories such as images, thoughts, or flashbacks may haunt the survivor, and nightmares may be frequent. Insomnia may occur as lurking fears and insecurity keep the person vigilant and on the lookout for danger, both day and night. Emotional detachment, also known as dissociation or "numbing out", can frequently occur. Dissociating from the painful emotion includes numbing all emotions, and the survivor may seem emotionally flat, preoccupied or distant. The survivor can become confused in ordinary situations and have memory problems. Some survivors may feel permanently traumatized when trauma symptoms do not go away and they do not believe their situation will improve. This can lead to feelings of despair, loss of selfesteem, and frequent depression. If important aspects of the survivors self and world understanding have been violated, the survivor may question their own identity. These symptoms can lead to stress or anxiety disorders, or even post -traumatic stress disorder, where the survivor experiences flashbacks and re-experiences the emotion of the trauma as if it is actually happening. Symptoms to look out for in traumatized children Cognitive trauma symptoms: problems with concentration and memory, irrational beliefs/thinking, unhelpful thoughts, intrusive memories, feeling like the traumatic events are recurring (flashbacks: thoughts or images of the traumatic event which suddenly come to mind). Relationship problems with peers: loss of interest in activities, feelings of detachment from others, flattened affect, poor problem solving, or social skills, maladaptive strategies for making friends, impaired interpersonal trust. Affective problems: increased anxiety/fearfulness often in response to reminders of the trauma, sadness, anger (agitation), irritability, and mood cycles of depression, poor ability to tolerate or regulate negative affective states. Family problems: parenting skill deficits, poor parent-child communication, and disturbance in parent-child bonding. Traumatic behaviour problems: avoidance of trauma reminders; thoughts, conversations, places, people, or events which act as reminders of the trauma.
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Somatic problems: sleep difficulties, disturbed sleep, nightmares, physiological hyper -arousal and hypervigilance towards possible trauma cues, somatic symptoms (headaches, stomach-aches). Trauma narrative The creation of a trauma narrative has been utilized in the treatment of children who have experienced sexual abuse.

The initial trauma narrative is a baseline because it provides the counsellor with some information about how avoidant the child is prior to working with him/her on any emotional regulation or stress management skills. The object is to help the child gain mastery over his/her upsetting, intrusive memories and images of the trauma. In this early stage it is not necessary to push the child for further details. Rather it is more important to focus on building rapport and praising the child for sharing whatever he/she managed to reveal.

Skills to use to help a child (and adult) with trauma symptoms Step 1: ask broad, open ended questions

What happened next? Make clarifying and reflective statements such as tell me more about.; I wasnt there, so tell me..; I want to know all about..; repeat that part about

Step 2: ask about the survivors thoughts during the trauma


What were you thinking? What where you saying to yourself? How were you feeling?

Psycho education Step 1: provide general information to both the child and parent about the traumatic event. This information can include the frequency of the specific trauma that the child has experienced, who typically experiences it and what causes it. Step 2: provide information about common emotional and behavioural responses to the traumatic event that the child has experienced. Step 3: provide any available empirical information bearing on the issue. This includes:

Symptoms, diagnosis and descriptions of available interventions/treatments. Strategies to the child and parent to manage current symptoms. These breed confidence in the counsellor and the survivor Hope is important when families encounter difficult challenges.
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What if the child has multiple co-morbid conditions? Wont providing psycho education about these problems lead to pessimism rather than optimism about the childs future? Always be as honest as possible about the childs difficulties, while still emphasizing the positive aspects of the childs and family circumstances. Accurately identifying the childs co-morbid conditions can actually be a relief to parents who might have spent many years wondering what has been the cause of the childs many problems, which may have predated the traumatic events that brought the child to counselling/treatment. Diagnosing co-morbid condition in the face of acute or on-going traumatic exposure can be very difficult, so it is very helpful to families if the counsellor is clear in discussing differential diagnostic possibilities, along with a plan for how each of these possibilities will be evaluated.

Other skills

Relaxation Affective modulation Cognitive coping and processing Trauma narrative In vivo mastery of trauma reminders Co-joint child-parent sessions Enhancing future safety and development Greet the survivor Apply active listening Discuss all expectation by the survivor. Assess the trauma the survivor has gone through Ask for what has already been done Discuss the trauma as they go through their daily lives How do they handle issues that remind them of their trauma Explore all the issues involved. Do they see what their problems are? Challenge irrational beliefs and unrealistic experiences Ask what else could be done to solve the problem Use silence to give an opportunity for the survivor to think through what is discussed. Explore and develop a time which provide support in time of stress Agree on a timetable of implementation of a plan made to resolve the crisis Ask if there is anyone the child can trust to help monitor the implementation of the agreed plan Arrange for follow-up visits
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Steps for providing trauma counselling


In vivo mastery of trauma reminders A child who was sexually abused in the bedroom of her home may be unwilling to sleep in the bedroom because this bedroom reminds her of the sexual abuse. In another situation, a child whose mother has been battered by her father is afraid to go to school, even though the father is in jail, because she is afraid something will happen to her mother if left alone. In vivo exposure is an intervention designed to overcome this type of avoidance and thereby allow the child to regain optimal functioning. Let us assume the child has been unable to stay at school for more than an hour on any day for the past month and has been allowed to come home. Here is a sample of a childs in vivo exposure: Week 1 Stay in school for 2 hours Monday and Tuesday 3 hours Wednesday and Thursday 4 hours Friday without calling home Each day the child reaches her goal, she gets a reward or a star Week 2 Stay in school for 4 hours Monday 5 hours Tuesday and Wednesday 6 hours Thursday and Friday Week 3 Stay in school all day Same plan as above Week 4 Stay in school all day Same plan as above In vivo exposure reliably changes most avoidant behaviours, which in itself has value for childrens and families adaptive functioning. By learning that they can overcome their terrifying memories and fears, children gain self-efficacy that can have far-reaching positive consequences in their lives.

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3. HIV/AIDS counseling This is an important type of counselling for all survivors who are worried about HIV/AIDS and seek information on the best way of reorienting their lifestyle in order to reduce the risk of contracting HIV. In the case of GBV, survivors who may be worried of being at risk of infection are those who are sexually assaulted, and those who have been involved in a physical fight where there was contact with blood and/or other bodily fluids. Counselling could be done using different techniques. One useful way of remembering basic principles of counselling is the acronym GATHER. G Greet the person: Put them at ease, show them respect and trust with more emphasis on the confidential nature of the discussion. A Ask about their problems by encouraging them to bring out their anxieties, worries and needs. As a counsellor, assess their present degree of risk behaviour. Then determine their access to support and help in their family and community, if possible. Steps that they have already been taken should be asked so as not to be repeated. Encourage the survivor to express their feelings in their own words. Show respect and tolerance to what they say and do not pass judgement. Encourage them through helpful questions. T Tell them any relevant information they may need. Provide accurate and specific information in response to their questions. Give information on how they can reduce their risk of becoming infected in view of what could have happened to them at that time of sexual assault. H Help the survivor make a decision. This can be done through exploring various alternatives. Be careful not to let your own views, values and prejudices influence the views of the survivor. E Explain all that they need to know. Explain that their fears may be myths and common misperceptions so that they are clear as they make key decisions. R Return to follow up on your survivor. Make arrangements for a follow-up visit or referral to other service providers if you cannot make a follow up. If follow up is not necessary, give a number of institutions whom they can contact in case they need help. Steps for providing HIV/AIDS counselling

Greet the survivor Introduce yourself and ask them to introduce themselves

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Enquire why they are visiting Apply active listening Enquire about their concerns Show respect and tolerance Do not judge the survivor when they talk about themselves in relation to HIV/AIDS Encourage them to ask questions regarding their difficulties Provide accurate and specific information in response to specific questions they ask Inform the survivor on issues of confidentiality Discuss issues of disclosure in case the result is positive Challenge irrational beliefs and unrealistic experiences Discuss treatment plans Discuss window period and re-test after three months in case the result is negative Discuss prevention measures in order to remain negative Arrange for follow-up visits

4. Psychosocial counselling Psychosocial counselling is given to survivors that have relational problems in families or society. It involves providing psychosocial support which is fundamentally concerned with issues of motivation and social energy. Other than providing basic requirements like food, clothing and shelter, psychosocial counselling deals with the emotional and psychological well -being of an individual as well as the social setting in which one lives. 5. Developmental counselling Developmental counselling focuses more on problems that may come as a result of growing up or changes in ones environment and is derived from developmental psychology. Developmental psychology is the study of the continuous process of development and behavioural changes throughout the lifespan. It provides for the study of every stage of development from pre-birth through death. Developmental psychology also considers the three domains: biological (biosocial), cognitive, and psychosocial. Developmental psychology is also often referred to as human development. In cases where a person is sexually or physically assaulted, there are a lot of disturbances in the individuals development. As a result, it is important to re-establish normal development following the trauma. The counselling process is similar to that in psychosocial counselling with more emphasis on the continued personal growth of the survivor.

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6. Facilitative counselling Facilitative counselling occurs when a counsellor creates an environment that facilitates the survivor to make positive decisions about how they will deal with the situation. This is done through the use of different counselling skills found in the above counselling types. Steps in providing psychosocial, developmental and facilitative counseling:

Greet the survivor Introduce yourself and ask them to introduce themselves Ask what made them visit you Discuss all expectations by the survivor Inform the survivor of the issues of confidentiality Discuss the problem at hand Ask about the fear and anxieties the survivor could have Explore the survivors intend to deal with their fears and anxiety Challenge irrational beliefs and unrealistic experiences Use silence to give an opportunity for the survivor to think through what is being discussed Discuss alternatives and allow the survivor choose the best alternative Agree on implementation of the best alternative Arrange for follow-up

7. Group Counselling 7.1 Essentials of group therapy Group therapy is a forum where certain unique therapeutic experiences are made possible when people meet regularly with others who share the same problems but who do not share a life together. Its objectives are:

Among other things, group therapy allows people to see directly that they are not alone with their problems; it allows them the opportunity to help others and be helped.

It increases each members hope and optimism as others in the group strive to overcome difficulties similar to his or her own. It provides a sense of belonging to a special supportive community. It allows new information to emerge that might be more difficult to disclose in individual or family meetings. Children spontaneously reveal their concerns in the presence of other children more than in the presence of single adult therapist or family.

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Groups can provide opportunities for practicing more successful interactions and coming up with solutions on interpersonal problems.

Groups increase understanding, acceptance and rebuild trust.

7.2 How to set up a group: 1. Composition of the group: same age, or mixed, same sex or mixed, same problem or mixed? 2. Membership: Open: Members join at anytime Closed: Membership is closed. Members go through with a certain group to the end. 3. Format: Activity oriented or talk oriented? 4. Group size: What is the ideal size for good communication? The more activity oriented a group is the larger the group size can be. For intensive therapy groups, using talking only, the ideal size is no larger than seven. 5. Time limit: What is the best time limit? For intensive psychotherapy conducted in groups, one to one and half an hour is optimal. For larger activity oriented groups, one to two hours is optimal. 6. Frequency of sessions: To maintain continuity, at least once or twice a month. 7. Group boundaries: Can group members visit each other outside the meeting times? For intensive psychotherapy groups, group members are discouraged from meeting together outside of group times in the belief that outside discussion about group members weakens the power of the group when they meet. For support groups, members are encouraged to visit one another outside of the group. 8. Role of therapist: Directive vs. Non-Directive. Does the therapist set an agenda for the group or allow the group to determine what they wish to talk about? In-groups that focus upon a specific issue such as drug abuse or sexual abuse, the therapist may take a leading role in the early sessions to establish a direction for the group. In activity oriented groups, the therapist sets the agenda. In-groups using personality exploration as their objective, group members are encouraged to determine their own agenda. 9. Working with other systems: Does the group interact with other systems like police, parents, schools and communities? Advocacy groups would interact more frequently with other systems.
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8. Peer Counselling This is a form of counselling among people of the same age range, sex and possess similar characteristics such as interests, habits, and educational background. Peers may also be people experiencing similar disease or trauma. Peers must be trained in counselling skills and techniques that can be used in conducting either

face to face or group counselling skills. These skills can include: HIV and AIDS counselling skills Trauma counselling skills Crisis counselling skills Assertiveness skills Peers can play an important role in helping others faced with GBV or any other form of trauma. They can also play a role of a buddy. 9. Family Counseling This is a form of counselling given by a trained counsellor to families or couples. Family counselling provides families an opportunity to discuss pertinent issues that often could be hidden and difficulty to address at an individual level. The principle is that, the family or couple avails itself together during face to face contacts with a counsellor. Often issues of communication, planning and home life management or relationship are discussed and resolved.

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Hand out 3 An Adults Guide to Play (for children 10 years and below) The Importance of Play A. An adult can understand the childs world by observing the child at play. B. The adult can more naturally relate to the child through play activities than through a verbal discussion. C. Play is the childs natural medium for self-expression and consequently is essential in counseling. D. Through play the child expresses their thoughts and feelings. Through play the child recreates the events of the day or their life ad seeks to understand them. In contrast, adults review everything in their heads Types of Play 1. Physical 2. Board Games/Crafts 3. Imaginative How to Play with a Child A. Get down to the childs level. If the child is on the floor, join them. (if this is not culturally acceptable, come down as close as possible to where the child is playing). B. Show an interest in what the child is doing. C. Occasionally comment on what you see. Example: oh, look at that. The two dolls are dancing together. D. Once you and the child feel comfortable with each other, you may ask would you like me to play? E. If the child says yes, ask the child what they would like you to do. Do whatever the child says as long as the actions do not hurt you or the child. F. Your job is now to follow whatever the child is doing. Follow their lead. Do not take over the play. (adapted from the CHIN Psychosocial counseling manual for abused children)

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Hand out 4 Ways in Which Children Communicate to Others There are three primary languages of children. These are: Body Play Spoken language (which is learnt last) Children communicate through: a) play, e.g. A 3-year-old child was yelled at by his teacher at school. He came home and collected a pile of stones. He put some stones in rows. Then he took a big stone and started to beat on one of the small stones saying stupid, stupid boy! b) body language, e.g. Our bodies express our feelings. When a child is tense or scared, they get headaches or stomach aches. Even a baby, when it is unhappy, will wriggle or squirm, expressing its displeasure. c) spoken language Understand the childs world according to their age. Do not impose your adult interpretation upon the child: Example: A 3-year-old who has been raped will say that the man pricked her with a thorn. She will not understand that this is sex. There are other ways children communicate. These are: a) drawings, e.g. a 10 year old girl who was raped by her father was asked to draw the things she is afraid of. She drew a snake, hyena, and her father without his pants on and his private parts exposed. b) drama and song. Children can show you in a drama or sing to you about their experiences. (ask group for example) Ways in Which Adults Communicate with Children: a) finding time to play with children in order to understand their thought and feelings, b) showing interest and listening to children c) allowing children to decide for themselves, e.g. their career, d) Being honest and open

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Understanding the Childs World Behaviour: A. Between 0-5 years, children have a strong need for security. Whatever happens they need to know that they have a home and someone to take care of them. B. Between the ages 6-12 children feel recognised for their accomplishments. They will want to demonstrate how intelligent they are, athletic competent, etc. They want to be able to do things on their own, as well. C. Between the ages of 13-18 years, teenagers are preparing for adult life. They are seeking role models and values which guide them through life. Their defiance and rebellion is an attempt to find values which will guide them through life. They will often want to be independent to try things on their own and not those of their parents.

(adapted from the CHIN Psychosocial counselling manual for abused children)

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Hand out 5 Counselling Intake Form Name of Service Provision Center: _________________________________________________________________________ Particulars of the service provider________________________________________________ Date: _______________Time of Visit: __________ Case Number: _____________________ Name of Survivor: ___________________ DOB/Age: ___________Sex: ________________ Marital Status: ____________________________ Religion: _________________________ Occupation: ____________________________________________________________ Residential address/directions: _________________________________________________________________________________ ____________________________________________________________________ Survivors Contact Number: ___________________________________________________ Next of Kin: __________________________________________________________________________ Next of Kins address: _________________________________________________________________________ Incident description:

Relationship with perpetrator: Name of service provider conducting counselling: Job Title:.Signature:..Date:

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Hand out 6 Counseling Checklist

Key counsellor tasks Introduce self to client Describe role as counsellor Explain and discuss contract Assess survivors reason(s) for coming for guidance and counselling Explore most recent risk exposure/ resilience behaviour When With whom Where Why How

Done?

Comments

Assess risk triggers Summarize and reflect back the clients story and risk issues Risk pattern Risk triggers Risk concerns

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Hand out 7 Relaxation techniques to reduce fear and anxiety Relaxation techniques are helpful in reducing the physiological manifestation of stress and PTSD, such as faster heart rate in response to stress, hyper-vigilance, agitation, difficulty sleeping, and restlessness, irritability and anger reactions. Other bodily reactions to stress include quick shallow breath, muscle tension, anxious feelings, headaches, stomach aches, nausea, skin rashes, itching and other irritations. Breathing technique Have the child find a comfortable position in a chair, leaning back slightly if possible. Tell the child to think about a place where he feels happy and safe. Instruct the child to close his/her eyes and breathe in deeply so that the abdomen protrudes during inhalation and recedes during exhalation. This is the opposite of chest breathing, where the chest expands and the abdomen is pulled in during inhalation. Let the child know that he/she can control feelings of nervousness by putting enough oxygen into his lungs and blood that his muscles are not starving for oxygen and will relax and let him be in charge. Muscle relaxation technique Ask the child, for example, to squeeze lemons for a count of five. And then relax his hands until they are like the rag dolls hands to a count of five. Remind him to breath normally during this exercise. Progressive muscle relaxation This is a helpful technique for children who have difficulty falling asleep or who have many somatic symptoms. Explain that when our muscles are not relaxed, we feel tight and tense, but when we relax those muscles, it helps us to feel easy and loose. This technique is best practiced in a lying down position or in a relaxed sitting position. Instruct the child to first tense and then relax one set of muscles at a time, starting with the toes, then the feet, then the ankles, etc. Ask the child to use these either of these techniques anytime she feels worried.

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Affective modulation Children who have experienced significant trauma may have a predominance of painful, difficult feelings as well as deregulation of affect. They often fear that they will be overwhelmed by the strength of their feelings. Young children may not have the vocabulary to express the highly intense feelings they are experiencing. Affective expression and modulation skills help children express and manage their feelings more effectively. By helping them gain a greater ability to express and modulate these frightening feelings, children may have less need to use avoidant strategies. Techniques include: A. Feeling identification with children

Ask child to write or say all different feelings he/she can think of in 3 minutes. Then take turns with the child, picking feelings from the list and describing the last time each felt this particular feeling (e.g., tell me a time when you felt embarrassed.)

Then ask them to approximate the intensity of their feeling on a 10 point scale. Then ask the child to identify and express thoughts and feelings by asking the child why he/she was worried.

The technique facilitates the ability to access a variety of cognitions and feelings.

B. Cognitive coping and processing The term cognitive coping refers to a variety of interventions that encourage children and caregivers to explore their thoughts in order to ultimately challenge and correct cognitions that are either inaccurate or unhelpful. Knowledge and life experiences help individuals make sense of traumatic events. However, given childrens limited experiential and knowledge base, they may be particularly prone to inaccurate or dysfunctional thoughts about traumatic experiences.

Step1involves the recognition and sharing of internal dialogue. It is best to begin with a nontrauma-related exercise.

Step 2 involves explaining the cognitive triangle to help a child recognize the relationship between feelings and thoughts.

Step 3 involves encouraging the child to learn how to generate alternative thoughts that are more accurate or more helpful in order to feel differently.
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What are anatomically detailed dolls? Anatomically-detailed dolls are usually soft, cloth or plastic dolls intended to be a general replica of human body with sexual body parts

Male dolls have a penis and testicles Female dolls have vaginal openings All dolls have oral and anal openings Adult female dolls have developed breasts Both adult male and female dolls have pubic hair

CAUTION Remember to only introduce anatomically detailed dolls to children if you are sure that the child was sexually abused, otherwise the dolls can be suggestive.

Use of the anatomically-detailed dolls

They are used to assess allegations of abuse since sexually abused children cannot always give coherent verbal accounts.

Anatomically-detailed dolls can be used in an attempt to address communication gap or difficulties with communication.

Anatomically-detailed dolls: enhances communication and recall: nonverbal tool for young children; reduces motivational problems, especially if the child feels embarrassed or ashamed of describing sexual acts; can be used to assist in focusing a childs attention on sexual issues and body parts.

Presence of dolls can serve as a sign of permission for the child to talk about or demonstrate sexual knowledge and experiences Eligibility criteria to enrol into the course is:

First level of counselling Psychosocial counselling At least 1year experience of counselling Pass thorough and interview
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Hand out 8 Enhancing future safety and development 1. Offer the following suggestions to adult survivors:

Educate yourself about sex. Many women have been taught by men to believe that a man cannot control himself sexually once he reaches a certain point. This is simply not true. Many women have also been socialized by fathers who do not allow a daughter to say "no." It is important to learn to say "no" to things one does not like.

Think twice about going to a man/womans room or apartment. Most rapes occur on the perpetrators turf. Be careful about inviting a man/woman into your room or apartment. Some men/women see this as an invitation to sexual activity.

Until you begin to know a person well, try to arrange meetings around public spaces such as movies, dinner, concerts.

Trust your feelings and thoughts. Sometimes women have a sense that something is wrong, yet fail to act on it. If someone makes comments which display hostility toward women, or insists on making all the decisions, or seems extremely jealous or possessive, this person may not be respectful of your right to refuse sex.

Communicate your limits. You need not apologize for the limits you set. Be firm! If you try not to hurt feelings by hinting in a nice way, your implied no may be ignored. It is okay to be direct and firm with someone who is sexually pressuring you, even if it causes hurt feelings. After all, this person is not attending to your feelings.

You have the right to set and to reset sexual limits. Your body is your own, and nobody has the right to force you to do something you dont want to do.

If you decide you do want to say No to a person wanting sex:


make your statements short, clear, and audible try to maintain direct eye contact and upright posture use facial expressions and gestures to add emphasis

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Hand out 8

Heavy petting or removing some of your clothing may confuse some men/women about what you are willing to do sexually. When you send conflicting messages, the situation becomes more difficult for you and the other person to control.

2. Use the following strategies to enhance the future safety of children:


Teach safety skills to a child who was sexually abused Guard against grooming techniques of perpetrators Maintain open lines of communication with children Provide age-appropriate sex education as well as information about sexual abuse. Teach children that they have the right to say no to a not OK touch.

3. Inculcating good parenting skills 3.1 Specify how to effectively give praise

Praise a specific behaviour Provide praise as soon as possible Be consistent Provide praise with the same level of intensity that you would provide criticism

3.2 Identify behaviours that parents often respond negatively to but would be better selectively ignored, such as:

Temper tantrums or angry verbalizations directed at the parent Making nasty faces, rolling eyes at parents Mocking the parent Provocative comments meant to be intentionally annoying

3.3 Teach other parenting skills


Parents should have contingency reinforcement skills Encourage parents to praise their kids more. Give parents skills to help them avoid being so harsh and critical with children.

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4. Enhancing problem-solving and social skills 5. Enhance problem solving and social skills to children and adults who have experienced chronic or interpersonal traumatic experiences and may have learnt maladaptive coping responses in social situations. 6. Appropriate problem solving involves several steps that can be summarized as follows:

Describing the problem Identifying possible solutions Consideration of the likely outcomes of each solution Picking the solution most likely to achieve the desired outcome and implement that choice Evaluating your choice to see how it worked If it did not work out as hoped, figuring out what went wrong Including what you just learned the next time a problem arises 7. Issues for the professional counselor 7.1 Common communication pitfalls There are three basic kinds of communication patterns which are common in ordinary interaction but inappropriate in the counselling relationship. These maybe identified as follows:

under-participation over-participation distracting participation

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The counsellor who is an under-participator may have a fear of involvement either with the survivor or with a certain problem area. The under-participatory counsellors verbal communication is not direct; such a counsellor often relies on nonverbal communication.

The over-participator counsellor relies heavily on action-oriented, confrontational statements and jumps to conclusions without much awareness of the survivors feelings. The counsellor who is an over-participator might be using the response to cover up his feelings of anxiety during the interview.

The distractive counsellor is one who exhibits a distracting kind of participation during the interview. This counsellor maybe involved, but he has difficulty focusing on the survivor and responding to the primary stimuli emitted by the survivor. This sort of counsellor frequently responds to secondary and irrelevant aspects of the clients communication.

During counselling it is important to take note of the above and ensure that such participation as stated above is avoided. Knowing yourself Counsellors need to look carefully at their feelings and experiences, how they influence their work and how they act on them. Knowing ones characteristic responses to GBV and abused children can help in recognizing personal vulnerabilities. In general one needs to:

be aware of personal handicaps and blind spots (issues that may be difficult to approach/discuss) remember that as a therapist one is part of the therapeutic system. A counsellor may act out family dynamics. Keep a running internal dialogue like: What do I feel now? Is this experience unusual for me? Am I acting in a way that expresses these feelings?

Understanding ones own motives for working with GBV survivors is a vital part of knowing oneself. Knowing oneself makes it far easier to be honest and straightforward with both children and adults.

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Professional supervision One of the ways to contain all the feelings which are projected onto counsellors by survivors is by having good, professional supervision for counsellors. When we face an onslaught of emotions and confused, powerful responses which are projected onto us every day, we can begin to feel powerless, confused, helpless and chaotic. We can feel like the survivors we are trying to support. By having a supervisor whom we can trust who is willing to hold up a mirror to our own confusions, we can contain our own emotions and we can ensure that we are not projecting those onto an already confused child or adult survivor. To keep our boundaries for our survivors we must make sure we know where our own boundaries are. We must not reflect and repeat the formless and uncontained lives which many abused children are forced to lead because their families are unable to hold things together. The economic and psychological pressures upon many families are enormous; it is difficult for many to survive. For us as workers there are pressures of the organization as well as personal pressures, and the stress of the work itself. We must be aware of when we are feeling unfit to work with children and be able to rely on our supervisors to tell use so, if we cannot see it ourselves. Qualifications required for counselling GBV survivors A professional counsellor is a person who has received training in counselling from a recognized training institution Some of the recommended training institutions are: University of Zambia Zambia Open University Mulungushi University Chainama College of Health Sciences Kara Counselling Chikankata Hospital Luanshya Vocational and Technical College

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References 1. Gender in Development Division cabinet Office.(2011). The National Guidelines for the Multidisciplinary Management of Survivors of Gender Based Violence In Zambia 2. Sampa-Kamwendo, A. et al (1999) Trainer's Manual for Psycho-Social Counselling of Abused Children. CHIN, Lusaka. Zambia 3. Ben Terlou (1998) Training Guide for Gender Based Violence: Assistance of Survivors

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MODULE 5: MEDIA AND ADVOCACY Module Description The Module for Media and Advocacy on multi-disciplinary response to Gender-based Violence is a training manual, which is the result of various professional collections over years of experience, testing, workshops and seminars for planning interventions to address gender-based violence (GBV) in our community. Introduction As we may already know gender-based violence is a long standing, complex, global problem. It requires attention and effort from a wide range of actors. In populations affected, GBV is one among many protection concerns for the community and the organizations assisting the community. Although guidelines and other relevant publications lay out guidelines, standards, and recommendations for GBV prevention and response, many compassionate actors are not aware of their specific responsibilities and many have not been trained to carry them out. Additionally, effective GBV prevention and response requires good multidisciplinary planning, coordination, collaboration, and communication. In humanitarian settings, multi-disciplinary coordination is one of the greatest challenges, and GBV coordination is no exception. This training module is intended to train media practitioners in media coverage of GBV and increase their participation in interventions aimed at combating it. Module objectives a) To build principles and standards aimed at increasing the journalists awareness of GBV and providing the journalists with important theoretical and practical knowledge that has the potential to play an enormous role in improving the quality of stories regarding GBV and womens rights. b) To build the capacity of an interagency, multi-sectoral team to prevent and respond to genderbased violence. The training will build individual knowledge, understanding, and skills while building a sense of teamwork and collaboration. c) Participants will be able to describe the relationship between gender and power, and gender -based violence; and define gender-based violence.
d) e)

Participants will be able to Identify types of GBV, causes and perpetuating factors To Building constructive relationships with the media

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5.1 Examining current media coverage of gender-based violence

Time: 70 Minutes

Content:

Learning Resources and Materials: Flip charts / Stand Masking tape / Stick stuff Marker pens Hand outs

Media reporting of GBV cases How news items are prior- itized Current media coverage of GBV

Specific Objectives

To identify strengths, needs and gaps in the setting for the prevention and response to GBV To illustrate the scope and dimension of GBV in the country. To discuss the current media coverage of GBV issues

Methodology and Learning Activities Activity 1 Prior to the exercise, the facilitator prepares a flipchart with statistical data on different types of gender-based violence in the country. To better illustrate the scope and dimensions of gender based violence to the participants, the facilitator is expected to include statistics from a variety of sources, such as NGO reports, UN reports, and government sources, where available. 1. The facilitator then presents facts and statistics on gender-based violence in the country. Then in the large group, engages participants in a discussion focusing on:

1.1 Reported prevalence of various types of gender-based violence (i.e. domestic violence/ sexual assault/sexual harassment/trafficking) 1.2 effects of various types of gender-based violence (30 minutes)
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Activity 2 Prepare in advance and bring to the session copies of newspaper articles, video tapes of television coverage, and audio tapes of radio coverage that address specific forms of gender based violence (i.e. domestic violence/sexual assault/sexual harassment/trafficking). 1. The facilitator leads a guided discussion and analysis of the current media coverage of gender -based violence issues and activities in the country. During the guided discussion participants should cover the following questions: a) What drives the media coverage of gender-based violence? b) What makes gender-based violence newsworthy? c) d) e) How are perpetrators portrayed? How are victims portrayed? Is gender-based violence mentioned? If so, does coverage include community experts,

prevention and community response? f) How is the violence portrayed? 1. As a complete surprise? 2. As an unpredictable or unavoidable tragedy? 3. As an isolated incident? g) What sources are used when reporting and how do these sources highlight or obscure important gender-based violence issues? (If this is true, emphasize the point that media coverage focuses heavily on the perpetrator and sensationalizes gender-based violence. Engage media representatives in a discussion of factors that play a role in selecting topics to be covered- i.e. what sells newspapers?) (40 minutes)

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Facilitators Notes

Effect of Information Source The facilitator should emphasize that a change in source changes the content of the coverage; for example, a relative will express shock and remorse and say it was an unpredictable tragedy, and ask that the privacy of the family be respected; a gender -based violence expert will flag patterns of abuse that led to the violence e.g. murder and focus on the violence as part of a broader social phenomenon. What common myths about gender-based violence are present in the coverage? The facilitator should highlight the point that the media quiet often reinforces the perception that incidents of gender based violence are isolated cases (e.g. domestic violence murders are often portrayed as isolated family tragedies) and does not challenge common myths about gender-based violence. In doing so, media representatives miss opportunities to broaden the publics understanding of gender based violence, its warning signs and possibilities for prevention and community intervention. The facilitator then asks the following questions for a short discussion: Do the reporters ask law enforcement agencies about whether a particular incident of gender based could be considered a crime under national law? Do the reporters note the sources loyalties when deciding whom to quote?

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5.2 Tips for covering gender-based violence

Time: 1 hour

Content: Tips on GBV

Learning Resources and Materials: Flip charts Masking tape Marker pens Hand outs

Specific Objectives To identify useful tips in relation to media coverage of GBV To discuss the identified tips and how they can contribute to positive media coverage of GBV

Methodology and Learning Activity 1. The facilitator gives a presentation giving tips for covering gender -based violence in the media. (20 minutes)

2. The Facilitator emphasizes the following ideas and allows time for discussion: 2.1 Find out what the relationship was between the perpetrator and the victim(s). 2.2 Be aware of how source selection influences the story. 2.3 Search for patterns of violence and control. 2.4 Pay attention to language. (20 minutes)

Prepare a hand out with the tips and recommendations listed above prior to the exercise. 3. The facilitator puts participants contributions on the flip chart and clarifies any misconceptions (20 minutes)

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5.3 Considering the interests of survivors of gender-based violence

Time: 1 hour

Content: Definition GBV issues in the community

Learning Resources Materials: Flip charts / Stand

and

Masking tape / Stick stuff Marker pens Hand outs Community guidelines

Specific Objectives To define GBV To identify the issues that keep men/women in abusive relationships/environments To discuss the identified issues and how they can contribute to the elimination of GBV

Methodology and Learning Activity 1. The facilitator makes a presentation to participants about gender-based violence and why it happens. (15 minutes)

2. The facilitator then leads a focused group discussion on reasons why men/women stay in abusive relationships/environments followed by a question and answer sessions. (20 minutes) 3. The facilitator asks for two volunteers to role play one of the issues identified. (15 minutes) 4. The facilitator wraps up the session by correcting any misconceptions (10 minutes)

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Facilitators Notes The facilitator should explain the reasons why women appear to put up with genderbased violence (i.e. why women stay in abusive relationships/ environments) and the dangers in leaving. Ensure that the following issues are tackled: Consider safety of the person being interviewed. Protect childrens privacy. Word questions so they are not judgmental. Dont focus on sensationalist information (i.e. blood/gore in domestic violence/sexual assault cases, prurient issues in trafficking/sexual harassment cases etc. Dont assume certain cultures or classes are violent

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5.4 Preparing sample questions to ask a GBV survivor

Time: 90 Minutes

Content:

Learning Resources Interview Questions for a Materials: GBV survivor Flip charts Masking tape Marker pens Hand outs Community guidelines

and

Specific Objectives: To identify media interview questions for a GBV survivor To discuss the identified media interview questions for a GBV survivor

Methodology and Learning activities Activity 1 1. The facilitator leads a brainstorming session to create a list of sample questions to ask in an interview with a survivor of gender-based violence. The facilitator asks each of the participants to share their ideas randomly or in turn. The ideas are not criticized or discussed; participants may build on ideas voiced by others. Write down each answer as they are offered on a flipchart without any comments, notes or questions for 5-7 minutes. Then discuss the ideas. After discussing the ideas, post the list on the wall so it is visible throughout the training workshop.

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2. Facilitator summarizes the results of the brainstorming and highlights the following sample questions: 2.1 What made it hard for you to leave/end the violent relationship? 2.2 If a woman is not ready to leave, what should she do to get ready? 2.3 Where did you find help? 2.4 Could the police have helped you? 2.5 Who else would you seek help from? 3. The facilitator follows up with a mini lecture examining best media practices from the country of training and other countries:

Activity 2: Role-play

1. Facilitator divides the participants into 3 groups and distributes role-play scenarios on a specific incident(s) of gender-based violence, so that each group has to role play a different scenario. 2. Facilitator assigns roles to the participants (for example, reporters, survivors, perpetrators and other sources [i.e. police, NGO staff, prosecutors, judges, lawyers, doctors, family) and gives the participants 35 minutes to prepare the role-play. 3. After 35 minutes, small groups act out their respective role-plays. Discussion in a larger group follows. NOTE; Prepare the role-play scenarios beforehand and write them down on sheets of coloured paper

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Facilitators Notes

The facilitators lecture emphasizes the following points: Educate yourself on the legislation in your country that addresses gender -based violence, through interviews with law enforcement, prosecutors, judges and lawyers. Identify and address common questions and misconceptions. Put gender-based violence in context. Shed light on the causes and contributing factors for gender-based violence; warning signs for gender-based violence. Be careful of sources who are emotionally involved with the perpetrator. Avoid quoting distant acquaintances/colleagues. Compile publishable sample materials on gender-based violence through collaboration with local victims advocates, service providers, and list references to NGO services and other resources for survivors of gender-based violence available within the country of training.

Facilitator may want to list types of sample materials on flip chart: Examples: Warning Signs of Domestic Violence Suggestions for Helping Someone Who is Facing Domestic Abuse Tips for Women and Girls who are thinking about Working Abroad Sexual Harassment: What Can I Do?

This session presupposes that the participants will already have an understanding of the national law applicable to gender-based violence. If this is not the case, the facilitator should ensure that this information is covered in this or later sessions.

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5.5 Summary and closing The facilitator closes the session, emphasizing the following ideas: The media is one of the most important socializing factor influencing peoples behaviours and lives. It is important to note that negative and stereotypical images of women, girls, boys and men in the media, and the ways in which the media reports gender-based violence (as a lesser crime or violation) contributes to the acceptance of gender-based violence against women and girls especially by our society.

The dominant myth is that the media is neutral and objective. However, each media representative brings to the coverage his/her views, opinions, believes and attitudes. These inform the way in which media representatives view a particular issue.

The media as it is run by people with feelings, certain beliefs and with their own understanding of things does not simply transfer information to society, it also makes judgments. The media informs our understanding of issues, and therefore has a critical role to play in what we do, how we behave and what we believe in.

5.6 Questions and comments

The facilitator should end the session by asking if there are remaining questions or comments related to the above session. Keeping track of feedback will allow the facilitator to make useful changes to future presentations.

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5.6 .1 Situation Analysis

Time: 60 Minutes

Content: Definition of situation analysis in relation to GBV Basic ingredients of situation analysis

Learning Resources Materials: Flip charts Masking tape Marker pens Hand outs Community guidelines

and

Specific Objectives To define situation analysis in relation to GBV To understand the basic ingredients of the situation analysis as regards GBV

Methodology and Learning Activities 1. In the large group ask participants to define situation analysis (5 minutes)

2. Depending on the number of participants, divide the participants into at least four groups and ask them to write down the procedure of solving a problem related to GBV (15 minutes) 3. Groups present their work in plenary (20 minutes)

4. Acknowledge their efforts and explain the process of how to resolve a problem. (15 minutes) 5. Sum up the activity with the revision of important points (5 minutes)

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Facilitators Notes

The facilitator should start with an explanation of what a situation analysis is before participants start working on activities. The facilitator should explain to the participants that a situation analysis is an approach that gives an opportunity to the people to analyses problems and look for ways to solve them. The analysis starts from analyzing what is the problem, why is that a problem and ends at defining the solution.

Participants are first divided into groups. The facilitator then asks participants to select 3 people from each group; one to facilitate the activity, another for time keeping and the last one to present the group work.

The facilitator should explain that everyone in the group should be given a chance to express his/her thoughts.

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5.6.2 State and Power Structure

Time: 1 hour

Content:

Learning Resources State structure and power Materials: concentration Flip charts / Stand Masking tape Marker pens Hand outs

and

Specific Objectives To define state To discuss and understand the state structure and power concentration

Methodology and learning activities 1. The facilitator divides participants into three groups and participants are asked to state what they understand by the following words. 1.1 State 1.2 Market 1.3 Civil society (15 minutes) 3. The facilitator then gives them the definition of the three words already put on the flip chart 4. In the large group participants brainstorm on the hierarchy of power in tribal societies. 5. In the groups earlier formed participants are asked to draw a map of power (that is who in terms of position is holding power in government, market or civil society?) 6. The facilitator sums up the activity with the revision of important points (30 minutes)
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(15 minutes)

2. Groups report back in plenary. The facilitator notes their responses on the flip chart

Facilitators Notes

The facilitator should explain to the participants that it is very important to understand the power structure before going for the resolution of GBV. It is also very important to understand the state structure and analysis of power in order to bring to the fore the magnitude of the problem and end GBV.

Explain that the state structure stands on three pillars; legislature, judiciary and administration. Inform the participants that whenever there is analysis of the power structure, there is understanding of who holds the power. For example the government machinery holds the power and it uses that power as a tool of control. In most homes, men hold the power and control women and children in it.

Therefore, if we want to resolve the GBV issues/problems, we need to identify the specific state organs that can help us in the resolution of these issues/problems. These are the organs that should be at the centre of focus in media and advocacy activities.

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5.6.3 Community and Social Mobilization

Time: 1hr 20 minutes

Content: Definition

Learning Resources Materials: Flip charts / Stand

and

Concept of community and social mobilization

Masking tape / stick stuff Marker pens Hand outs Community guidelines

Specific Objectives 1. To define community and social mobilization 2. To discuss the concept of community and social mobilization in relation to GBV

Methodology and learning activities 1. The facilitator gives a brief presentation on the community and community mobilization. (10 minutes) 2. In the large group participants state what they understand by the community. The facilitator notes their points on the flip chart and shares the definition of the community (15 minutes) 3. The facilitator asks participants to itemize the characteristics of a community. The facilitator notes their responses on the flip chart. Then the facilitator explains the characteristics of a community. (20 minutes) 4. Depending on the number of participants, they are divided at least into three groups to draw a problem tree about GBV issues prevailing in their area/community. (20 minutes) 5. Groups present their work in plenary. The facilitator then leads a discussion on how the media will help resolve the identified GBV issues. (15 minutes)

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Facilitators Notes:

The facilitator explains that a community may be defined by geographic boundaries, political boundaries, or demographic characteristics. A community can be a neighbourhood, a village, a township, a city, or even defined within a particular setting such as the school system, worksites, or healthcare delivery system.

A community has the following characteristics: Has one or more roles that define its identity within society. Has a set of goals - provides a sense of direction. Is organized within a set of formal/informal beliefs, values, expectations and behaviors that defines the boundary of the community. The boundary may be explicit (physical) or implicit (defined by the shared characteristics of its members). Has ownership of its members. There is some form of communication between members. Has skills and resources that are shared between the members. Balance the needs of the community with the needs of its members. Often has clubs, teams, groups etc. within the community.

While different communities have different roles in society, they all share the same characteristics. These characteristics could also be described as its social construction. They provide the building blocks that the community is built on. While it is preferable for communities to have all these characteristics, communities that do not have all, or where a characteristic is severely lacking, could be considered as a Dysfunctional community. An institution is an important part of the social construction of the community. The institution describes the means of cooperation, order and stability within the community.

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5.6.5 Advocacy

Time: 50 Minutes

Content: Definition of advocacy

Learning Resources Materials: Flip charts / Stand

and

Advocacy issues in the community Significance of advocacy in the elimination of GBV

Masking tape / stick stuff Marker pens Hand outs Community guidelines

Specific Objectives To define Advocacy To identify the issues the community can advocate for in relation to GBV To discuss how the identified advocacy issues can contribute to the elimination of

Methodology and Learning Activity 1. The facilitator asks participants in the large group to define advocacy (10 minutes) 2. Depending on the number of participants, the facilitator divides participants into two or more groups and asks them to: 2.1 Identify advocacy issues in the community in relation to GBV 2.2 Discuss how the identified advocacy issues can contribute to the elimination of GBV (25 minutes) 3. Groups report back in plenary and the facilitator winds up the session after clarifying any misconceptions. (15 minutes)

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Facilitators Notes The facilitator explains what advocacy is and emphasizes the following points: Advocacy is not new and is part of everyday life. People advocate (or speak up) every day for themselves, for their children, for their relatives and for their friends on issues that affect them and that they feel need attention. Concerned individuals advocate for vulnerable people whose rights are particularly at risk of abuse and whose contribution as citizens is undervalued. There is a spectrum or continuum of advocacy, which ranges from legal advocacy through to the informal support and/or encouragement of a friend. Very often, these forms of 'advocacy' have evolved organically. Lawyers and advice providers obviously advocate to some extent for their clients, but would not necessarily use the word 'advocacy' in their title. Family members, carers and friends often have to take on the role of advocate. Although each of the different forms of advocacy is distinct, there are links between them. Rarely are a person's needs addressed entirely by one form of advocacy. Sometimes more formal methods of advocacy are required and this is often referred to as Independent advocacy. Advocacy is a tool that can be used in a variety of ways to ensure that minority and disadvantaged groups in society have a means to know about, and gain, the same life opportunities as others. Independent Advocacy aims to achieve a more equal and just society. There are many people in our society who are ignored because they have difficulty in gaining the attention that is needed to make sure their views and opinions are listened to and acted upon. This leads to them being marginalized and often socially excluded. Advocacy has the potential to make a considerable difference in the individuals' lives. Some of these differences are small and indefinable, such as an increase in confidence and understanding choices, or gaining the skills to speak up for oneself. Other differences are much more significant and tangible, where the new " voice"obtained through advocacy support has meant that people are listened to in a way that allows them to influence the services they receive: for example, to live in a home of their own choosing or to have their human and civil rights upheld by challenging systems. Whether differences are big or small, the impact is the same: that of improving the quality of a person's life. Independent Advocacy offers support for people who are seeking resolutions to any issues that are of concern to them, by ensuring that their voice is heard and they have to understand their civil and human rights. Advocacy is closely linked to the principles of Human Rights, disability discrimination, the social model of disability and the equality of opportunities.

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An advocate is a means through which issues are redressed addressing the balance of power by providing a mixture of: Support Signposting links to other services sharing information and knowledge to support decision making being a 'voice' to ensure that people's rights are respected.

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5.7.5 Why Advocacy

Time: 45 Minutes

Content:

Learning Resources Importance of advocacy in Materials: GBV Flip charts / Stand Marker pens Hand outs

and

Masking tape / stick stuff

Specific Objectives To understand the importance of advocacy in dealing with GBV

Methodology and Learning Activity 1. The facilitator reminds participants about what advocacy is. (5 minutes) 2. Participants are divided into two groups to discuss why advocacy is important to the understanding and elimination of GBV. (20 minutes) 3. Participants report back in plenary (10 minutes) 4. The facilitator fills in any gaps. (5 minutes)

5. The facilitator winds up the activity while highlighting the important points. (5 minutes)

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Facilitators Notes

The facilitator highlights the following points:

The Media plays an enormous role in shaping the perceptions around women and children and their respective roles in a society. Transformation of negative stereotypes around women, men and children as well as perceptions on gender based violence would not be possible unless there is an active media involvement. With this purpose series of outreach activities, workshops as well as a series of round table discussions aimed at national and local media need to be planned and implemented. The major objective should be to raise awareness of media representatives on the womens rights discourse as well as the GBV issues in the country as it affects children, women and men. Advocacy offers an effective means to: express choice develop the confidence to express satisfaction or dissatisfaction receive information minimise risk offer control to avoid exclusion provide strength to attain empowerment

Advocacy is guided by the principle that every person should be valued and respected, and ensures that people are not ignored and excluded because of the prejudices they face. Advocacy promotes a person centred approach in everything it aims to achieve and is based on the belief that everyone has the right to: be respected and listened to be involved in decisions that affect their lives have aspirations for their future

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Appendices Community:

Hand out 1

This is a social group of any size whose members reside in a specific locality, share government, and often have a common cultural and historical heritage. A geographic area whose size should be determined by members and includes economic, environmental, and social/cultural features of that area. The drawing below gives the definition of community in different ways.

Adapted from Keithhopper.com Aside from locality, communities can be defined by their interaction, like a discussion group community. A community can be a segment of society, like the homeless community, or a group with shared interests, like the software development community. If you think about a community as a series of interconnected circles, with whats in a circle as the community and whats outside a circle as not part of the community, you start to build a fairly interesting picture of how communities can be defined and how they might even share multiple characteristics. Potential overlaps between communities introduce interesting twists on the power of such combinations. Take for example; a special interest group also bound by their religious beliefs, like, say the Mothers union of UCZ, the Catholic Womens League, etc. Dictionary definitions, for all their permutations seem to miss a good deal of implied meaning in the word community. There are community actions and community goods, retirement communities and planned communities.
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Hand out 2 What is advocacy? Advocacy is the act of pleading or arguing in favour of something, such as a cause, idea, or policy. It also means giving ones active support. When we advocate against GBV, we argue in favour of happy families, peaceful communities and a balance of power between men and women. At the national level, GBV advocacy includes efforts to influence public policies, practices and laws through various forms of persuasive communications with those in authority. CARE International (2001) defines advocacy as the deliberate process of influencing those who make policy decisions. Policy makers have the power to make laws and regulations, distribute resources, and make other decisions that affect peoples lives.

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References Hopper Keith (2013) Defining Community, down loaded on 8th January 2013 from Google engine world-wide website 123Helpme.com/view.aspid=20613 Munir, S. and Ayaz, S. (2001). Advocacy and Lobbying Training Manual. Islamabad. Embassy of the Federal Republic of Germany.

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