Vatsala
This blog is based on the narratives from participants who have attended Sama’s short courses and workshops.
The issue of gender-based violence, popularly conceived within the criminal legal framework, has somehow led to a greater emphasis on formal reporting of these crimes. The concern that I raise here is that many efforts therefore look at encouraging more reporting, demanding stringent laws, etc., whereas the socio-political contexts and needs of GBV survivors get pushed to the fault lines within systemic responses and lack thereof.
The criminal justice approach aims at a singular goal of holding perpetrators accountable, and they often overshadow the broader context of GBV as a public health concern and fail to prioritise the needs and rights of survivors. The roles of other systems, such as the public health system, assume lesser stances within the popular responsiveness to GBV. However, the feminist and gender justice discourses compel us to look at the multi-sectorality of the issue, therefore demanding accountability throughout the linkages of the systems, including the strengthening of these linkages, which is necessary to address GBV.
Sama’s approach to GBV is shaped by a gender and intersectionality lens. By consciously examining the intersection of gender and health, Sama acknowledges GBV as a violation of multiple rights of survivors, with significant implications for their overall health, including their sexual and reproductive health rights. In other words, GBV is a health concern, which leads to asking questions about the responses that centre on these concerns. As a public health concern, our work has centred on the role and responsibility of the health system in responding to GBV.
Over the last two years, Sama has organised workshops with members of community-based organisations and short courses tailored for young people. These spaces are used to unpack GBV, strengthen the intersectional perspective, and bring forth accountability from systems. Across Bihar, Jharkhand, and Odisha, participants from over 100 community-based organisations joined us in these workshops and short courses.
The post-workshop interactions held with some of the participants have led to an opening of a Pandora’s box of interconnected issues of gender, health, and GBV, pointing to the need for continued and sustained dialogues on these issues. As a result of Sama’s engagements, there were some observable shifts in the understanding and discourses around GBV for the participants. This blog flags some of these shifts.1These observations reflect the verbal and written feedback and conversations that I had with the participants who attended the training sessions.
Shifts and transformations
Linking gender, health and GBV
With the focus of our engagement being GBV, violence as an entry point was used to unpack gender structures, power and patriarchy, systemic violence, and its relation to health outcomes. Within this framework, GBV as personal in nature or isolated incidents of violence was challenged, to be understood as being rooted in social structures of oppression(s) that have consequences for health and are an important public health concern.
This shift is pivotal. By reframing GBV beyond its immediate violent manifestations, it acknowledges its roots in systemic gender inequalities. Additionally, as participants in our short courses and workshops have not always worked in spaces that deliberately intersect health and gender, there is a realisation or a re-emphasis of this inherent linkage in relation to GBV. Their interface with the health system came up as an afterthought or as something seeming to compliment the criminal legal system, for example, to aid medico-legal cases.
Reflections from the participants shared below speak about the shift being mentioned:
“When women face any form of violence, it also has an impact on her health as well as their mental health, which can further other forms of illness.” — Young community leader, Bihar
“After attending Sama’s training, I learnt about gender-based violence, types of violenc, and how they are linked to health issues. In my understanding, women were not explicitly recognising the violence that was happening to them both at home and in the community. After Sama’s trainings, there is an effort to recognise all the different forms of violence at different levels—homes, communities, and public facilities—leading to demanding their rights in spaces like the health centre, the Anganwadi centre, at the panchayat, block, and at district levels”. — Community leader, Bihar
“As staff at the One Stop Centre in Odisha, we now try to address any health concerns the survivor may have first and are more actively in contact with doctors and nurses in the hospital.” — OSC staff, Odisha
“We have begun our interface with the health departments whenever we have training and awareness programs on violence against women. They now form part of our outreach with different stakeholders in our district.” — Community leader, Odisha
Furthermore, the need for creating more spaces to hold these intersectional dialogues got clearly underlined.
“Sama is the first organisation for us that gave us training on health. With these trainings, we understood how to look at gender and health together, that is, how gender is linked to health. We used to think that gender was a different issue, and health was a different issue. This understanding has been very helpful for us in our work.” — Young community leader, Jharkhand
“Now, I am able to have more open conversations on sexuality and reproduction in our groups of young girls in the communities while talking about gender issues.” — Young community leader, Jharkhand
More participants echoed this feedback. This reiterates the need for reimagining what we as organisations mean by community dialogues, the need for unpacking complexities and intersectional barriers, and issues that emerge within GBV response.
Systemic violence, identifying barriers in support seeking and moving beyond victim blaming
We spent considerable time questioning, challenging the narrow understanding of GBV to include a systemic analysis—a complex discussion in simple terms. This led us to move towards the discussion around seeking accountability from the systems. The discussion on the importance of an accountable health system also came with reflections on the weakened roles played by the health system currently. Systemic violence, which is both a barrier to accessing support and a form of violence itself, was recognised.
“In many instances, we have seen—even in rape cases—that health services are denied without first filing an FIR. There are trust issues within the health system. There is always a demand for documents, or a police requisition, before providing the health service to survivors.” — Young Community Leader, Jharkhand
“Can women not access any services without their husbands? When women, by themselves visit hospitals to get medical services, doctors do not offer those services easily.” — Community Leader, Bihar
“To get out of violence at home, one needs to again face violence from the systems.” — Community Leader, Odisha
These conversations interrogated the silences around GBV or the stigma attached to GBV, complimented by weakened and often stigmatising responses from systems, and societal tendencies towards victim blaming. It pushed participants to see how slogans such as chuppi todo hinsa rokko (break the silence, stop the violence) cannot be directed towards survivors alone.
“It’s not possible to go get health services without a household member accompanying you. Young girls are often interrogated by their family.” — Community Leader, Bihar
“Because when girls or women cannot even wear clothes of their choice, then how can they access sexual and reproductive health facilities by themselves.” — Young Community leader, Jharkhand.
“There is a need to build awareness about gender sensitivity amongst health care providers and other stakeholders, not just at the community level.” — Young Community Leader, Bihar
An important takeaway that emerged through this churning was that GBV cannot be addressed without comprehensively understanding and addressing systemic violence, as much as this cannot be done without fostering the realisation of equal rights and bodily autonomy, even within the systems.
Towards a survivor-centred approach
“Until now, we would focus on punishing the perpetrator of violence in cases of GBV. What kind of needs do the survivors have, how to reduce their pain – we did not pay much attention to these aspects. While, actually, health systems can become very integral part to this approach to addressing GBV.” — Community leader, Jharkhand
In the face of unresponsive systems, there are still spaces of support that may not be as visible in the current discourse on addressing GBV. Front-line workers, community spaces, friends, and community leaders, many of whom have even attended our workshops and short courses, are also part of the support systems for GBV survivors. Deepening the understanding of GBV within the framework of gender and health rights is also strengthening the perspectives and capacities of support networks towards a survivor-centric approach to GBV.
Survivor-centredness here means prioritising the rights and needs of survivors when addressing gender-based violence (GBV). This includes respecting their bodily autonomy and their sexual and reproductive health rights. The survivor-centred approach is based on human rights principles and the principle of access to justice. It also aims to challenge the gender binary and take into account the various social contexts and realities from which survivors of GBV seek help and support, including those with diverse gender identities. This approach involves embracing the principle of inclusion and acknowledging intersecting identities to effectively resist the multiple systems of oppression.
Let us continue demanding accountable systems and gender-responsive structures; reconfigure the first-line support to centre the health and well-being of the survivor, centre their decisions, respect their right to privacy and bodily autonomy, etc. At Sama, we are planning this continuity.
Vatsala works with Sama. She has been engaging with and learning the complexities of gender-based violence over the last year.