Niamey – As one of the first-ever female urologist surgeons in sub-Saharan Africa, Dr Médina NDoye regularly faces students’ astonishment at her choice to embrace a “male speciality”.

“Unfortunately, this is a well-anchored stereotype in people’s mindset and surprisingly quite widespread in the medical community, too,” says Dr Ndoye. “As a female urologist, diving into this male-dominated world every day makes me feel like I am providing a concrete response to challenge this gender bias.”

To help challenge other gender-based issues, the Senegalese urology surgeon recently co-facilitated training on gender-based violence that the World Health Organization (WHO) organized in Niamey, Niger.

In line with the WHO’s “zero tolerance policy” for sexual exploitation, abuse and harassment, its mandate on violence against women and girls within its Global Plan of Action and its minimum commitment to provide services to gender-based violence survivors through the Health Cluster, the integrated training on gender-based violence    and prevention and response to sexual exploitation, abuse and harassment is part of WHO’s surge project to improve the capacity of all Member States in the African region to better prepare, detect and respond to public health emergencies.

For 10 days, 150 members of surge teams from Niger, Mauritania and Togo – epidemiologists, health specialists, veterinarians, firefighters, police officers, and other civil servants from various ministries – were trained on gender-based violence and how to prevent and report on sexual exploitation, abuse and harassment by the regional coordinators for gender-based violence   and prevention and response to sexual exploitation, abuse and harassment.

Sexual exploitation refers to any actual or attempted abuse of position of vulnerability, differential power or trust for sexual purposes. Sexual abuse means the actual or threatened physical intrusion of a sexual nature, whether by force or under unequal or coercive conditions.

Francesca Paola Crabu, the WHO Africa Regional Coordinator for the Prevention and Response to Sexual Exploitation, Abuse and Harassment, notes that working closely with communities is a key component of emergency teams’ interventions, which rely on trust between health experts and communities. If this relationship of trust is broken through sexual abuse and exploitation, it causes further harm to already-vulnerable populations and creates barriers. Ultimately, it hinders emergency teams’ ability to aid.

During recent disease outbreaks in the region, WHO began to implement mechanisms for the prevention of and response to sexual exploitation and abuse, including massive sensitization within communities and continuous learning events through the designation of community focal points. These focal points are essential as a safe and culturally accepted “bridge” between communities and WHO and the humanitarian system. Women-led organizations, religious leaders and various officials at schools and universities have been trained to help WHO raise awareness among communities about the six Inter-Agency Standing Committee’s principles on the prevention and response to sexual exploitation, abuse and harassment.

Additionally, every WHO staff who is to be deployed for either an emergency or general work mission now must participate in a training session on preventing and responding to sexual exploitation, abuse and harassment.

“Even though I have worked in a high-level position at the Ministry of Health for 10 years, this is the first time that I have heard about gender-based violence and prevention and response to sexual exploitation, abuse and harassment,” says Dr Aboubacar Gandou Issiakou, the Centre for Public Health Emergency Operations Coordinator at Niger’s Ministry of Health and a recent training participant. “After this training, I will advocate in my Ministry to establish standard operating procedures, train all staff and include a gender-based violence and PRSEAH module in the curriculum at university level.”

Women leaders in emergency responses make a difference

There is a long way to go to for WHO’s emergency teams to be gender equal. Having women occupy leadership positions in emergency responses is crucial for fighting stereotypes and preventing sexual misconduct, says Crabu.

In Niger, medical doctor and Lieutenant-Colonel Habibatou Ide Amadou has been designated to lead the national emergency team. With more than 25 years of experience, including with United Nations peacekeeping operations, coupled with her background as a paediatrician and epidemiologist, she is committed to ensuring that prevention and response to gender-based violence and PRSEAH is a top priority for each person working in an emergency. “When there are senior females in emergency settings, men have less degrading behaviour towards women and girls. Community members feel more comfortable to share their concerns,” she says. “This training comes at a timely moment. Since we started it, men are more and more at ease to talk with women and acknowledge their competencies.”

At the end of August, the surge training in Botswana will close the first batch of piloted countries. The next step will be to roll out surge training across the region and increase the number of gender-based violence and PRSEAH experts to be deployed as part of health emergency teams. The impact of the training will be visible throughout the operations, with gender-based violence and PRSEAH integrated into action plans.

In Niger, Mauritania and Togo training, the surge participants drafted a workplan for each country represented and constructively discussed them together. Going forward, all SURGE team members signed a Code of Conduct to prevent sexual exploitation, abuse and harassment. Efforts to introduce gender-based violence and PRSEAH at government levels are also ongoing.