Background

Women displaced by emergency situations often encounter an inability to access education, livelihoods, healthcare, as well as face greater risk of sexual and gender-based violence (SGBV). While refugees cross an international boundary to seek safety, internally displaced persons (IDPs) have been involuntarily uprooted within their own countries. Regardless of title, women and girls in these populations have both been forcibly displaced due to persecution, disaster or conflict, however IDPs are not granted the same rights as refugees under international law and assistance to them is non-binding.1 Millions of IDPs around the world face prolonged conflict and inadequate plans or dedicated financial resources to address their protracted internal displacement.

Within IDP camps, there is a breakdown in social norms and an increased lack of sufficient protective measures for already vulnerable women and girls. They face domestic and community violence. In the last two decades, there has been a growing threat of sexual exploitation and abuse (SEA) from humanitarian actors, charged with helping displaced populations- an existence characterized by instability, loss of autonomy, and an often well-founded anxiety over disclosing experiences of sexual abuse. In a 2002 report from the United Nations High Commissioner for Refugees (UNHCR) and Save the Children UK, 1,500 people were interviewed in Liberia, Guinea and Sierra Leone. Their anecdotal findings revealed that Aid workers, peacekeepers and community leaders engaged in the trade of food, medical services and relief items for sexual favors, often with impunity. 2 Since this West African “aid for sex” scandal was brought to light 3, there have been sporadic cases of sexual misconduct among aid workers and peacekeepers. In 2007, 114 members of the 950 member Sri Lankan Army United Nations peacekeeping mission in Haiti were accused of sexual misconduct and abuse. The UN Mission for Justice Support in Haiti (MINUSTAH),one of most controversial UN mission’s, ended in October 2017 and has been linked to numerous SEA’s allegations in its 13 year tenure. 4 Throughout these instances, various high-level donor organizations, like the United Agency for International Development (USAID), instituted policies and proactive reporting measures to counteract perpetrators and support victims. However, as global conflicts push internal displacement to record highs around the world, the work of protecting women and girls remains a challenge, especially in conditions where inadequate and insufficient aid creates inequities in power relationships.

South Sudan gained independence from Sudan in 2011 after twenty years of bloody civil war, making it the world’s newest country. 5 New ethnic-based conflict broke out in December 2013 leaving more than four million citizens displaced from their homes. 6 According to the United Nations, as of October 2020, there are an estimated 1.6 million IDPs in South Sudan. Among them are thousands of women and girls, many of whom were subjected to sexual violence during the internal armed conflict, and now face danger when collecting firewood, water, and aid essentials like food and shelter materials.1

Risk Factors

SGBV is a risk factor for a range of adverse health outcomes such as poor mental health, chronic pain, coronary heart disease, poor reproductive health outcomes and even death.7 In an IDP camp, an inadequacy in relief assistance, as well as a decline in safety structures and social norms can lead women and girls into coercion and exploitation. SEA often goes un-or under reported due to fears of stigma, impunity for perpetrators, or a denial of essential relief items like food or medicine.5 Due to this lack of reporting, current data on the prevalence of this type of violence against women and girls is unknown. However, in a 2016 study on the prevalence of violence against conflict-affect women in South Sudan, a total of 2,244 women of varying tribes ages 22 to 26 in Juba city, Rumbek and Juba UN-controlled Protection of Civilian (PoC) sites were interviewed regarding their experiences during displacement. In all three sites, more than half of respondents reported severe and frequent episodes of intimate partner violence: 73% in Rumbek, 60% in Juba City, and 54% in Juba PoCs. 6

About 35% of female respondents experienced some type of non-partner sexual violence in their lifetimes; over 50% of these respondents reported that their first incidence of sexual violence occurred before age 20. The lack of livelihood opportunities for women in these cities, due to abandonment or death of the husband, places the woman at a higher risk for sexual exploitation. In both Juba City and the Juba PoCs, over 20% of respondents reported sexual exploitation. 6

Research Objectives and Research Questions:

Research Objective 1: To identify the prevalence, causes, and consequences of sexual exploitation and abuse by humanitarian actors against displaced women and girls in South Sudanese displacement camps.

Research Questions

● How common is abuse by humanitarian actors in South Sudan?

● Do women and girls in South Sudanese camps feel a risk of sexual abuse, specifically by aid workers?

● What gaps exist within displacement camps that leave women and girls vulnerable to sexual exploitation by humanitarian actors?

● To what extent does coercion and abuse affect displaced women and girls’ ability to obtain the necessary resources for survival?

● What are the risks that lead to sexual exploitation and abuse within displacement camps?

Research Objective 2: To identify the effectiveness of the response to women and girls experiencing, or having experienced, SEA by humanitarian actors in South Sudan.

Research Questions

● What evidence gaps exist in understanding exploitative relationships by aid workers and service providers in displacement camps in South Sudan?

● Is it safer for displaced women and girls in camps where more women aid workers are present and involved in leadership and operations?

● What legal measures or precedence, internationally, have been enacted in cases of sexual exploitation, misconduct and abuse?

Research Methodology

Study Design

Measuring the prevalence of SGBV in conflict-affected regions is difficult due to the rapidly changing and breakdown of social, economic and geographical conditions. In addition, sexual violence is also used as a weapon during armed conflict and in the movements of IDPs and refugees. 8 Therefore, the parameters of key variables and measurements must be specified between SGBV during the phase of conflict when IDPs and refugees are in flight and when women and girls arrive at camps.

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Independent and Dependent Variable Associations

Research Objective 1: To identify the prevalence, causes, and consequences of sexual exploitation and abuse by humanitarian actors against displaced women and girls in South Sudanese displacement camps.

Independent Variable: Risk Factors ⇔ Dependent Variable: Sexual Exploitation and Abuse by Humanitarian Actors

Research Objective 2: To identify the effectiveness of the response to women and girls experiencing, or having experienced, SEA by humanitarian actors in South Sudan.

Independent Variable: Community/gender attitudes ⇔ Dependent Variable: Sexual Exploitation and Abuse by Humanitarian Actors

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Population: Displaced women and girls around the world

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Sampling Frame: Displaced South Sudanese women and girls at the Malakal IDP Center and Ikwoto IDP Camp.

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Sample: A random selection of displaced South Sudanese girls at the Malakal IDP Center and Ikwoto IDP Camp.

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Quantitative Research Methods

Quantitative data will be obtained using a semi-structured questionnaire administered in systematic sampling by trained female interviewers that work in tandem with local community health workers and health facilities. These cross-sectional surveys will determine prevalence. This method will only be utilized for prevalence, as cross-sectional surveys do not explain cause-and -effect. However, this method is useful for its ability to be deployed quickly. Key variables within these tools include: age, incidences of abuse, number of children, length of time at IDP camp, and awareness of reporting mechanisms for unethical behavior.

Based on the conceptual framework in Figure 1, it is evident that an imbalance of power, as well as stigma and lack of reporting mechanisms might increase or decrease the risk of sexual exploitation and abuse of women and girls in South Sudanese IDP camps. The behaviorally specific self-administered questionnaires will determine whether individual and community risk factors, and their severity, impact this study’s research questions.

Data Analysis Plan

Data will be collected and reported so that it can be disaggregated by perpetrator, type of violence, frequency and severity. With the variables now defined, researchers will inspect and clean the data, display variable frequencies through descriptive analysis, cross tabulate for inconsistencies, review variable distribution and then revisit and revise the hypothesis, if applicable

Qualitative and Participatory Research Methods

Due to the instability of conflict and humanitarian emergency settings, qualitative data offers a deeper understanding of context until the collection of quantitative data is more feasible for a more holistic view of the problem. To reveal the motivations and behaviors of the target population, narrative data will be collected through semi-structured personal interviews, focus groups and participatory research methods. These qualitative research methods will assess community needs, understand the cultural norms and behaviors in a specified location, as well as support the analysis of the motivations of perpetrators and the complex gaps that leave women and girls vulnerable. In order to guarantee a safe and open environment, this study will utilize local researchers familiar with cultural etiquette, language proficiency and nuance, access, and sensitivity. These local stakeholders will be involved in multiple data creation and collection steps before research methods are implemented. They will assist in determining and engaging with key informants who will include: IDP community leaders, village elders, and religious leaders. These individuals can provide information even when access is unavailable and grant researchers entry into community spaces.

Utilizing aid distribution points or community meeting posts as locations to engage the community with key informants, researchers will have focused yet conversational communication in order to gain a better understanding of the prevalence, causes and consequences of SEA by humanitarian actors. The following questions are a sample of the semi structured interview guide. These questions can also be repurposed for the larger focused group settings discussed later in the research plan.

·         Can you please tell me a little about yourself and how long you have lived in [insert camp name]?

·         What kind of difficulties have you ever encountered when trying to access medical care or food supplies?

·         How would you describe the relationship between people who live in the camp and the people who provide aid like food, water and medicine?

·         Who poses the greatest threat to the safety of women and girls here?

Focus Groups: Incomplete Stories, Free Listing & Ranking

This study will conduct multiple focus group discussions, four respectively at both Malakal IDP Center and Ikwoto IDP Camp. Each group will consist of 6-8 participants of similar age brackets to explore norms and beliefs, combined with participatory research where facilitators will conduct incomplete stories and ranking. In the focus group setting, questions utilized in unstructured personal interviews will be repurposed, as well as the following:

·         Where and where do women and girls experience violence in your community?

·         Who poses the greatest threat to the safety of women and girls here?

·         What are some of the difficulties women and girls encounter when trying to access medical care or food supplies?

·         What kinds of acts would you consider sexual exploitation?

·         What are the cultural attitudes of sexual exploitation by aid workers?

·         If an aid or NGO worker makes a woman or girl feel uncomfortable or abuses her, what do you think she can do? Is there any one she can report to?

·         What kinds of legal measures exist for aid workers who perform violence against women and girls? What type of measures do you think should be in place?

Focus group sessions will be audio recorded. Participants will be made aware of this recording prior to the start of the session. A note taker will also be present highlighted and timestamping notable moments.

As depicted in the sample incomplete story in Figure 2, participatory group members will be presented with an incomplete story to stimulate discussion on how this scenario may have ended. What should Amina do? Who should she tell? What are some challenges she may face in making a decision?

            In order to prioritize the problems and solutions in the causes of SEA by humanitarian actors, as well as the mechanisms or reporting abuses, the focus group will be given the opportunity to share the common challenges facing women and girls in the relevant camp setting. Participants will be asked:

1.      What types of dangers or violence against women and girls do you witness in [insert that participatory groups’ camp location]?

2.      What are some of the reasons you think women and girls in [insert that participatory groups’ camp location] face dangers and violence?

3.      If girls or women in [insert that participatory groups’ camp location] face dangers or violence, who are some people they can reach out to for help or protection?

 All answers will be recording on large post-its.  This exercise will then ask participants to rank the collected responses for question 1 from less common to most common and for question 2 and 3 from less important to most important.

Safety and Ethical Considerations

Displaced women and girls may have already experienced gender-based and/or sexual violence and trauma before participating in this observational research study. Researching violence against women and girls is a sensitive topic, but exploring potential breeches in trust and safety to displaced persons by actors charged to care for them presents complex considerations. Ultimately, researchers hope participants view the interviews and participatory exercises as a cathartic intervention, but the experience can cause emotional distress. Maintaining and upholding safety and ethical standards in this research is paramount, therefore staff will follow guidelines detailed in the World Health Organization’s Ethical and Safety Recommendations for Researching, Documenting and Monitoring Sexual Violence in Emergencies, starting with a risk-benefit assessment to assess potential harms and benefits. Researchers will uphold WHO framework standards by: providing culturally competent and specialized SEA/SGBV training for staff; ensuring informed consent and confidentiality; and maintaining locally available support services prior to the commencement of research activities. Interviews will take place in private areas, under the pretense of a women’s health study, to ensure confidentiality and the safety of participants. Before any interaction with research participants, research team members will identify local service providers where they can send referrals for care and psychosocial support after disclosing sensitive and traumatic information. In addition, there will be safeguards in place for any activity involving children under 18.9

All research team members will be carefully selected, screened, trained and provided ongoing support to cope with interacting regularly with potentially traumatizing information. Interviewers and translators will be female, as they will have the closest contact with the South Sudanese research participants. These individuals will also be crucial to adequately explaining informed consent and confirming that participants understand they do not have to participate and can sever ties at any time.

Dissemination of Results

This study’s purpose is to expose the prevalence of a potential problem and evoke social change. Before using the results as a call to action for humanitarian stakeholders, we will first hold community events where results are presented and explained. These women and girls in South Sudan are part of a larger displaced community in the nation, and a growing number of displaced people around the world- not just a target population. Through the entire study, researchers will ensure they do no harm and make participants a part of the process. This includes a comprehensive readout of research findings.

The team will feed findings into advocacy efforts and policy making by creating open source reports and policy briefs with implications for policy makers. These products will include recommendations for humanitarian aid stakeholders, as well as a “call to action” for organizational leadership.

References

1.         Displacement TB-LP on I. Improving the Protection of Internally Displaced Women: Assessing Progress and Challenges. Brookings. Published November 30, 1AD. Accessed January 28, 2021. https://www.brookings.edu/research/improving-the-protection-of-internally-displaced-women-assessing-progress-and-challenges/

2.         Ferris EG. Abuse of Power: Sexual Exploitation of Refugee Women and Girls. Signs: Journal of Women in Culture and Society. 2007;32(3):584-591. doi:10.1086/510338

3.         Refugees UNHC for. Investigation into sexual exploitation of refugees by aid workers in West Africa: Note by the Secretary-General. UNHCR. Accessed January 28, 2021. https://www.unhcr.org/excom/unhcrannual/3deb32dd4/investigation-sexual-exploitation-refugees-aid-workers-west-africa-note.html

4.         Sri Lanka to probe UN sex claims.http://news.bbc.co.uk/2/hi/south_asia/7076284.stm. Published November 3, 2007. Accessed January 28, 2021.

5.         Whitson A. Inequality and injustice: The deteriorating situation for women and girls in South Sudan's war. Accessed January 29, 2021. https://insights.careinternational.org.uk/publications/inequality-and-injustice-the-deteriorating-situation-for-women-and-girls-in-south-sudan-s-war

6.         Ellsberg M, Ovince J, Murphy M, et al. No safe place: Prevalence and correlates of violence against conflict-affected women and girls in South Sudan. Stark L, ed. PLoS ONE. 2020;15(10):e0237965. doi:10.1371/journal.pone.0237965

7.         Bonomi AE, Thompson RS, Anderson M, et al. Intimate Partner Violence and Women’s Physical, Mental, and Social Functioning. American Journal of Preventive Medicine. 2006;30(6):458-466. doi:10.1016/j.amepre.2006.01.015

8.         Parcesepe A, Stark L, Roberts L, Boothby N. Measuring Physical Violence and Rape Against Somali Women Using the Neighborhood Method. Violence Against Women. 2016;22(7):798-816. doi:10.1177/1077801215613852

9.         Weltgesundheitsorganisation, ed. WHO Ethical and Safety Recommendations for Researching, Documenting and Monitoring Sexual Violence in Emergencies. WHO; 2007.