Zimbabwe – City of Harare, Gender Based Violence Clinic

Date: July 27, 2018
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The project is a 24 hour sexual gender-based violence (GBV) clinic that will ensure free emergency care for survivors. It was motivated by the need to give access to medical care to survivors of gender based violence in light of the unavailability of such services on a 24 hour basis and even during weekends. It was noted that most violations occur at night and those affected would have to wait for the critical services or even go to the hospitals which are already congested with other emergencies like accidents. The idea was to provide specialist and comprehensive medical care.

The clinic therefore removes barriers to access health care by survivors of sexual gender-based violence as well as providing HIV services such as testing and counselling. The project is innovative in that most clinic operate from 8a.m to 5.pm and this leaves a gap especially when a violation occurs.

The project was mooted following the realization that survivors of gender based violence like rape are also vulnerable to contracting HIV and the most critical hours are the 72 hours after exposure. Noting that most Council clinics operate from 8a.m to 5p.m there was a gap in terms of access to medical care in the event of a violation. With the available statistics indicating that approximately 1 in every 3 women is vulnerable to abuse and the age group it then became critical for Council to develop a 24 hour medical centre specifically to deal with the problems of sexual gender based violence. The major objective was to provide access to medical care for the survivors.

Secondly counselling and testing services had to be available to enable healthcare workers to come up with the necessary interventions. The clinic therefore provides the comprehensive health care required in the event that one is violated.

The third objective relates to providing access to medical attention and the services are offered free of charge. When one is violated especially in these difficult economic environment issues of capacity to pay had to be looked into.

The project, basically, aims to empower women and survivors of GBV through the counselling services provided, women are empowered to make informed decisions about their situations. Most of the violence occurs during the night and weekends when clinics are closed so the major objective was to provide the much needed medical attention. Also, to play a key role in developing safe cities, through the installation of solar street lights.

Research was a critical step that was taken into consideration in the implementation of the project. From the research it was noted that violence against women and girls is a major public health and human rights problem i Women who are poorly educated and economically dependent on their male partners are the most vulnerable. Sexual violence is also a major problem, with men being the most common perpetrators of rape and women, the victims.

The second step was identification of suitable site for the clinic. Having gone through research it was then realized that the already existing facilities can be used to house the GBV clinic. Wilkins hospital became the ideal site due to the availability of other facilities especially the sexual reproductive health centres, availability of counselling and testing facilities and even wards for admission of survivors.

The project has reached 3000 direct beneficiaries, 500 indirect beneficiaries and 400 online beneficiaries. It has stimulated the lives of GBV and rape survivors in many communities. The government of Zimbabwe has allocated $20000 to this project. In kind contributions amounted to $50 000. The total budget for this project is $70 000.

The main challenges relate to financial resources. The SGBV clinic is the only one stop model run by the Council and found in the Central Business. It was developed at a time when the City was operating in a constrained fiscal space. The money generated by the City is largely from the water and rates account and if the residents are not paying the city does not have capacity to deliver. The budgetary and financial constraints were overcome through working with a partner. Secondly the skills gap in dealing with the survivors of sexual gender based violence.

This was overcome through training and capacity building programmes. The training in counselling and handling such cases assisted in offering the one stop shop. Staff shortages to man the centre is also another major challenge that was faced. This was solved through redeployment and development of a shift system. This was solved through is found in Makoni where all the central service providers are located in a specially set up centre.

The Monitoring and Evaluation (M&E) framework is being used to measure the impact of the project. The M&E framework is a table that describes the indicators that are used to measure whether the program is a success. This framework is part of the M&E plan, which describes how the whole system for the program works, including things like who is responsible for it, what forms and tools will be used, how the data will flow through the organisation, and who will make decisions using the data.

Women have been empowered through awareness and availability of knowledge. The fact that there is a centre that can assist women as survivors of gender based violence is empowerment in its own right. Access to free facilities is definitely empowerment because in most cases women fail to access these services and this impact negatively on their health.

Social empowerment-and access to reproductive health information. The availability of the facilities brings with it confidence and good self-esteem for women who benefit from the facility. In recent years survivors of SGBV would get assistance from the conventional health centres without specialist care but in this instance there is provision of specialist care and this broadens the scope of the services. Also, survivors have basic access to reproductive health facilities.

Alice Nyamanhete says, “I am a woman aged 21 and had challenges of being abused physically by my boyfriend. I was referred to the SGBV clinic by a friend to get counselling since the abuse both physical and verbal was taking its toll on me. I went there and received counselling on how to also fight against abuse. Though I was not sexually assaulted I got information that empowered me not to stay in an abusive relationship because many women die due to abuse. The information encouraged me and now I am a registered vendor operating a flea market at Copacabana.”

Men have become supportive through supporting gender responsive service delivery. The City Health Director Dr Prosper Chonzi has made strides in attracting partners to support the City especially in the Health sector. The opening of the SGBV clinic at Wilkins Hospital is one initiative that was driven by Dr Chonzi. The SGBV clinic is the first of its kind in Harare and is offering the services for free.

Power relations have changed because women are more empowered, they now have access to information. Knowledge is power. Changes at the community level include the formation of women’s clubs and training of women to venture into income generation. Community participation is important in gender responsive programming, Access to information help women to make proper and well informed decisions.

The project can be replicated through opening other centres at City of Harare .The model of the SGBV clinic was that it was established at an already operational health centre which is Wilkins Hospital .The same can be done at Mabku.



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