Health Services for Gender-Based Violence: Médecins Sans Frontières Experience Caring for Survivors in Urban Papua New Guinea.
BACKGROUND
Levels of gender-based violence in Papua New Guinea (PNG) are high; health services for survivors are limited. Evidence from the few existing health services for survivors can inform improvements in care in this and similar settings.


METHODS
Médecins Sans Frontières supported health services for survivors in Lae, PNG from 2008-2013. Routine monitoring data from August 2010-April 2013 were used to describe patient and service characteristics.


RESULTS
5,892 individuals received care over 6,860 presentations, the majority self-referred or referred by friends and family. Presentations were attributed to intimate partner violence(62%), non-partner sexual violence(15%), other forms of violence(3%), and past (but not current) violence(21%). 97% were female; an estimated 4.9% (95%CI:4.8-5.0%) of females resident in the catchment area presented to the programme during the 2.8years analysed. Of presentations for non-partner sexual violence, 79% knew their abuser and 50% were children <16 years. 92% of presentations reporting current violence received medical treatment for injuries. The majority of patients who received multiple counselling sessions reported improved functioning and decreased severity of psycho-social complaints.


CONCLUSIONS
Community awareness of the availability of free, best-practice, accessible, confidential medical and counselling services for sexual and gender-based violence in Lae, PNG resulted in many survivors presenting for care. High levels of ongoing intimate partner violence and child sexual abuse by known abusers indicates that alongside comprehensive medical care, access to effective services in non-health sectors such as policing, protection and legal services are needed if survivors are to escape the cycle of violence.
National Centre for Epidemiology and Population Health, Research School of Population Health, the Australian National University, Acton, Australia.|Médecins Sans Frontières (MSF)-UK, London, United Kingdom.|Femili PNG, Lae, Papua New Guinea.
Kamalini
K
Lokuge
MSF-Operational Centre Amsterdam, Amsterdam, the Netherlands.
Meggy
M
Verputten
Angau Hospital, National Department of Health, Lae, Papua New Guinea.
Maryanne
M
Ajakali
MSF-Operational Centre Papua New Guinea Programme, Port Moresby, Papua New Guinea.
Bianca
B
Tolboom
National Centre for Epidemiology and Population Health, Research School of Population Health, the Australian National University, Acton, Australia.
Grace
G
Joshy
National Centre for Epidemiology and Population Health, Research School of Population Health, the Australian National University, Acton, Australia.
Katherine A
KA
Thurber
Femili PNG, Lae, Papua New Guinea.|Angau Hospital, National Department of Health, Lae, Papua New Guinea.
Daisy
D
Plana
Femili PNG, Lae, Papua New Guinea.|Development Policy Centre, Crawford School of Public Policy, the Australian National University, Acton, Australia.
Steven
S
Howes
Angau Hospital, National Department of Health, Lae, Papua New Guinea.
Anastasia
A
Wakon
National Centre for Epidemiology and Population Health, Research School of Population Health, the Australian National University, Acton, Australia.
Emily
E
Banks
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D003376:Counseling / Q000458:organization & administration / Q000706:statistics & numerical data; D003695:Delivery of Health Care / Q000379:methods / Q000458:organization & administration / Q000706:statistics & numerical data; D017579:Domestic Violence / Q000517:prevention & control / Q000706:statistics & numerical data; D005260:Female; D005602:France; D006801:Humans; D007398:Interpersonal Relations; D000066511:Intimate Partner Violence / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D010219:Papua New Guinea / Q000453:epidemiology; D010820:Physicians / Q000458:organization & administration*; D012189:Retrospective Studies; D012737:Sex Factors; D012742:Sex Offenses / Q000517:prevention & control; D012955:Societies, Medical / Q000458:organization & administration / Q000706:statistics & numerical data; D014754:Violence / Q000517:prevention & control / Q000706:statistics & numerical data; D055815:Young Adult