How to improve our work with male survivors of sexual violence?

In early July 2022, the Alumni network of the Course “Addressing Sexual Violence in Conflict and Emergency Settings” held a discussion, moderated by Course Director Laura Pasquero, on how to improve work with male survivors of sexual violence. Three alumni, who completed the Course in 2022, shared their experience and lessons learned with fellow alumni, experts and survivor leaders, which generated a rich exchange of expertise and views.

Brian Lwanga, Sexual Gender-Based Violence and Persecution Assistant with the Refugee Law Project (RLP) in Uganda, presented the experience of RLP in the use of screening for timely identification of male victims/survivors of conflict-related sexual violence among refugee populations.

Brian explained how a proactive approach to enabling disclosures for male survivors in safe spaces and a careful and empathic approach can be effective in early identification of sexual violence harms and ensuring survivors have timely access to medical care and referrals. RLP’s screening consists of a series of carefully designed steps that start with engagement with community leaders and information sessions with communities about RLP’s work, role and process. The screening process is then carried out in a private and secure space and, where necessary, in the presence of a trusted translator. Discussion only begins after the person being screened has been explained the process and given their consent for data to be collected. That done, the “screening discussion” centres on open questions around “harms”, “untreated/unresolved war-related injuries” experienced or witnessed by the person, and where the dialogue is in the person’s control. Interviewers are carefully trained to avoid re-traumatisation, navigate people’s complex accounts, and avoid leading questions. The “positive” cases that disclose sexual violence-related harms during these discussions are offered specialised support and accompanied in exploring the available options to respond to their needs.

As Brian explained, RLP screening data shows that three men out of ten – compared to five women out of ten – disclose experiences of sexual violence during these dialogues. Results tend to be higher when the screening dialogues are held out in the communities than when they are held inside the RLP office. Brian also flagged that survivors’ feedback following this experience is usually positive, with survivors expressing a feeling of relief and satisfaction at being able to access support and appreciation about being listened to. “Now that I have managed to talk to someone about what I underwent, I believe I will get assistance/support” was a typical example of Brian’s feedback during his presentation.

Jean Jacques Lende, human rights defender and representative of the Men of Hope network, highlighted the importance of competent, timely and proactive services to be available and accessible to all male survivors. In a profound testimony about his experience, Jean Jacques explained his powerful journey from survival to activism. He first outlined the fear, sense of guilt, lack of self-esteem and several other serious mental health impacts male survivors may develop as a consequence of their sexual violence experience. He highlighted how accessing holistic support such as the one provided to survivors by RLP – which includes medical care, mental health support, shelter and financial assistance, among others – can be life-changing and help survivors gradually recover their physical and mental health. He emphasised, in conclusion, the importance of sustained access to competent support to bring hope into individuals’ lives, enable survivors to regain strength and trust in the future, and lead them and their families to thrive.

Didier Butara Byamungu, Project medical referent in Médecins Sans Frontières (MSF), shared his experience in Ethiopia, where MSF provided support to men and boys Ethiopian migrants who are survivors of ill-treatment and are deported from the Kingdom of Saudi Arabia in specifically-designed Therapeutic Counselling Centers. Didier illustrated the various barriers that initially impeded male survivors from accessing MSF facilities, such as the lack of male providers and specific pathways for male patients,  the exclusive focus on women and girl survivors, as well as other structural challenges such as the lack of specialised longer-term comprehensive support for victims of torture and prolonged ill-treatment.

Didier also explained some of the key intentional and specific operational decisions that eventually allowed MSF to enable more male survivors to be received and supported in this context. These included: the recruitment and training of an adequately gender-diverse workforce trained on sensitive handling of cases of sexual violence, including against men; the inclusion of gender-inclusive messaging during community awareness sessions; the creation of discussion groups in the Therapeutic Counselling Center for both women and men to enable disclosures and provide group support; and the involvement of victims of sexual violence previously treated in the facility, as focal points and in other key positions at the TCC and in their region of origin. Didier highlighted the importance of humanitarian workers engaging with survivor leaders and networks to build effective responses.

Following Didier’s presentation, human rights defender Steven Kighoma, also representative of the Men of Hope network, strongly emphasised the crucial role played by health personnel in providing compassionate and timely support to male survivors of physical and mental harm caused by sexual violence. Based on his lived experience, Steven also highlighted how harmful attitudes by health personnel can prove profoundly damaging and discourage male survivors from seeking support, thus impacting negatively on their health and survival. Condemning the immense existing gaps in quality and long-term medical and holistic responses for individuals and families who bears the impacts of sexual violence, including in economically developed contexts like Northern Europe, Steven urged the alumni audience and the humanitarian community at large not to wait any longer before making efforts to dramatically improve efforts and interventions for survivors and communities in conflict and displacement settings.

Human rights professional and investigator Layla Clément concluded this series of alumni interventions by sharing her learning to interview male sexual violence survivors for accountability. Referring to contexts as diverse as Ukraine (2016-2019) and China (in the context of the Uyghur population), Layla provided an overview of some of the most common situations of sexual violence against men and boys that she has encountered in her work, which include sexual violence used in places of detention to punish and humiliate, and as a mean of torture to extract forced confessions or elicit forced cooperation. She also highlighted some harmful and re-victimising attitudes and responses, such as disbelief and lack of acknowledgement of the violence, that some judges show when confronted with cases of sexual violence against men.

Layla explained how crucial rapport-building between the interviewer and the interviewee/witness survivor in each interview is, how human rights professionals and investigators must consider the possible physical and psychological consequences survivors bear following incidents of sexual violence, and the importance of foreseeing adequate psychosocial support. Regarding this, Layla flagged that the scarcity in many settings of nearby essential services and protection responses makes human rights professionals and investigators reliant on referral systems being set up in advance of interviews with individuals. Layla also highlighted how, despite these important challenges, many survivors express a sense of relief at being listened to and of empowerment as a result of interviews when these are conducted empathically and competently.

Commenting on Layla’s presentation, course Steering Committee member and teacher of the Male survivors’ module, Professor Chris Dolan, interrogated the current model of investigation and justice processes highlighting how it needs radical improvements from a survivor-centred perspective.

Prof Dolan echoed Layla’s concern that several judges continue to prove themselves ill-equipped to adequately deal with cases of male survivors of sexual violence in courtrooms, thus heightening the risk of re-traumatisation of the person and undermining the positive work done by those investigators who are well-trained on how to handle and interact with such cases. Prof. Dolan also highlighted how difficult it is for international investigators – who carry out short-term missions in conflict settings – to establish trust with survivors through sustained contact with them, explaining how trust-building is fundamental for any meaningful interaction. He also flagged the need for international justice institutions to develop solid processes to adequately vet and check the quality of the services that survivors are referred to by investigators. He emphasised how such vetting of services to ensure that responders and providers are competent to effectively and respectfully respond to male survivors is both crucial and – inevitably – a long, in-depth and detailed process that may also require capacity building of those to whom referrals are to be made.

Conclusions

The alumni meeting gathered a series of crucial voices and learnings on how to improve responses to sexual violence in conflict and emergency settings. Hereby are some key messages that emerged from the discussions:

• The responsibility of all humanitarian responders is to create safer spaces for enabling safe disclosures for all survivors, including men. 

• All speakers highlighted the urgency of offering timely and competent responses to address survivors’ physical and mental health needs and to go beyond the needs of the individual to incorporate those of family and community members. Multi-survivor interventions should be implemented consistently across humanitarian responses.

• Concrete steps need to be taken now, in all programmes, to create a variety of entry doors and specific pathways, resources and support for male survivors of sexual violence. Who is recruited and how they are trained to handle disclosure greatly matters. Involving responders of diverse genders and backgrounds and ensuring they are fully equipped to handle cases with empathy and respect is of utmost importance.

• The Justice accountability process can prove empowering for survivors. Still, solid procedures must inform investigators and the overall judicial system to ensure the trust is built and survivors’ agency, needs, wishes and rights are centred throughout. Greater efforts have to be put into building adequate referral partners and procedures. 

• Finally, and importantly, engaging with survivor leaders and networks is crucial for all humanitarian and human rights actors alike – their voices, lived experience, knowledge and expertise must be centred in efforts in all sectors and long-term, meaningful engagement processes must be actively sought by all responders.

The Alumni network of the Course “Addressing Sexual Violence in Conflict and Emergency Settings” includes former participants, teachers and partners of the Course. The Network creates a space for reflection and ongoing peer learning, centring alumni’s expertise and collaboration, and aiming to improve responses for survivors and their communities.