BEIRUT: Two months ago, Fatima (not her real name) was subjected to a horrifying act of violence at the hands of a man. She won’t say what exactly, only that she ended up needing medical treatment as a result.
Although it was initially difficult to find out what services were available, she said the process was quick and easy once she got in contact with a non-governmental organization. She was referred to a community center where a doctor gave her the treatment she needed for free, and the NGO even gave her money to get there.
“The people I dealt with were compassionate and respectful,” Fatima said by email in order to protect her identity, “but I know not all NGOs have professional staff.”
A couple of years ago, having such a tailored experience involving specially trained professionals would have been rare for survivors of rape, domestic abuse or other forms of gender-based violence in Lebanon. But the influx of Syrian refugees, many of whom had similar experiences, has focused international attention on boosting services in the country to address the phenomenon.
“In an ironic twist, in some ways the Syrian crisis is actually helping women in Lebanon,” said Hillary Margolis, a researcher on Syrian women’s rights at Human Rights Watch. “Because hopefully what will come out of this is more attention to establishing a national protocol and making sure staff are properly trained.”
Stories from Syria of sexual harassment at checkpoints, punitive gang rapes during house raids and genital torture of both male and female detainees have been widely reported. For many Syrians, the suffering continues even after they have made it to safety in Lebanon, with instances of domestic violence, prostitution and early forced marriages – to name a few – well documented.
In response, international and local organizations have channeled funding, training and material support toward initiatives to treat both the physical and psychological wounds of such abuse.
Although a number of local NGOs and one or two ministries had long been working to improve services related to gender-based violence – the preferred term over “violence against women,” although most gender-based violence is against women and girls – the resources available were limited in reach and efficiency.
One of the biggest gaps, for example, was the lack of health care professionals specially trained to deal with victims such as Fatima. Those who did have some specialized training were forensic doctors who tended to approach cases from a legal perspective, with an emphasis on collecting evidence that could stand up in court.
“Now we are trying to ensure as many different types of medical staff as possible are trained on this subject,” said Jihane Latrous, UNICEF’s child protection and gender-based violence specialist. “Nurses, gynecologists, emergency room staff and so on.”
Since 2012, UNICEF and Abaad, a Middle East-based group that promotes gender equality, have trained up more than 150 people.
They plan to conduct another 15 training sessions this year covering about 300 different people, as well as provide refresher courses for previous attendees.
“We have been training doctors on how to deal with child survivors, how to help people lodge a complaint, how to talk to a survivor without creating more harm, without judging them. We also teach them to respect the patient and their confidentiality,” Latrous said.
“This feeds into our belief that it’s important not to just see the survivor as a body of evidence but to respect them and their choices.”
Also lacking in the country was access to post-rape treatment – including drugs to reduce the risk of contracting HIV – outside of Beirut and other city centers.
The costly medicine, which must be taken within 72 hours of the incident, was not widely available before, according to Latrous.
Up until 2012, rape survivors who went to a hospital would have to be referred to the Health Ministry’s National AIDS Program to get the drugs. Of the 23 centers able to give such treatment listed on NAP’s website, 16 are in Beirut, two are in the Bekaa Valley and a handful are in the south. There are none listed in the north.
To remedy this, the U.N. Population Fund last year provided an extra 17 hospitals and primary health care centers all over Lebanon with post-rape treatment kits that also included emergency contraception and STI medicine, covering the potential needs of more than 1,000 survivors.
The kits, like all the GBV services mentioned in this article, are available for people of any nationality, whether Lebanese, Syrian, Palestinian or Sri Lankan. Everything is free and NGOs also help with transport costs where necessary.
The refugee crisis has also prompted, or perhaps sped up, the creation of secular midway houses – temporary shelters for women and their children at high risk of being beaten, raped or even murdered.
“There are now three new such houses in Lebanon – in the north, in the Bekaa Valley and in the south,” said Ghida Anani, the director of Abaad. “They were set up mainly for Syrian refugees but they will stick around even after this crisis is over.
“There were about four before, but they were largely church-affiliated, so these new houses are filling in a major gap.”
The availability of such places, and the creation of appropriate referral pathways, could be the difference between life and death for people such as Roula Yaacoub.
Although Yaacoub’s husband was last month acquitted of beating her to death, the final medical report noted evidence of nonlethal injuries in the form of bruises, and her family continues to insist he beat her regularly. The judges’ ruling also relied partly on Yaacoub’s daughters’ testimony that their father had not beaten their mother “that day.”
All of these extended services have been made possible by the increase in money available, NGO and aid workers say, largely due to the rolling media coverage of the plight of Syrian refugees.
“Of course we have had more funding because of the crisis,” said Anani. “And this has allowed more money to be invested in GBV services in a way that will benefit country beyond the crisis.”
But the Syrian crisis hasn’t proved a boon for everyone working on the issue. A draft law criminalizing family violence has been stuck in the bowels of Parliament since last summer due to a stalemate at all levels of government that has been blamed on the war in neighboring Syria.
“We need to wait for a Cabinet so that the General Assembly can approve the draft law,” sighed Zoya Rouhana, director of KAFA, a Lebanese NGO that promotes the rights of women and children. “This would be a very important law concerning GBV.”
“It also concentrates more on protecting the victim rather than just penalizing the prosecutor.”
But with negotiations over a new government still painfully slow, Rouhana is pessimistic:
“The Syrian crisis has slowed down the whole process of the government; it has affected all parts of society, including us and our work.”
Rouhana’s opinion is one that is echoed by the highest echelons of the medical establishment.
“All these sorts of problems take second place right now,” said Nagi Souaiby, a veteran emergency physician and forensic doctor who specializes in gender-based violence cases.
He points to an enormous gap in the role of local authorities and the implementation of existing laws.
“Most of the laws are there, but the application is problematic,” Souaiby said.
“The Justice Ministry needs to do more,” he added. “We need special police trained to receive GBV cases, for example, and special judges to deal with the cases in courts.”
KAFA is already spearheading a UNFPA-funded project with the Internal Security Forces – which was in the works long before the Syrian war – that has seen them set up women-friendly spaces in 12 stations across the country. They are now training up personnel to respond to gender-based violence.
But the traditional mentality and stigma surrounding the issue in many parts of Lebanon means that for some people, just accessing those services can be a huge step, something that will take NGOs and aid agencies years, even generations, to break through.
“My husband first hit me three days into our nine-year marriage,” explained Reem Zakaria, a 30-year-old writer from Akkar.
“But when I told my mom she told me it was normal ... She said I should obey my husband.”
Even when Zakaria was beaten so badly that she ran away, fearing for her life, almost everyone in her family apart from her parents shunned her. When she started speaking out about how she had been treated, everyone from the mufti to the mayor in her village tried to get her to shut up. Only her parents stood by her.
Now divorced, she has since moved to Beirut to find work and build a new life for herself.
“I would have been the second Roula Yaacoub if I had listened to my family’s advice. I got away with my life because I spoke out.”