MGH Global OB-GYN Newsletter

From Academics to Advocacy and Action
 

December 2019

Massachusetts General Hospital                          Vincent Program in Global OB/GYN

Welcome to the December newsletter! Our goal is to share with you stories from our work around the world, important new publications from academia and the media on global women’s health, a few fun facts, and tips on how to stay safe while traveling. We’d love your input, so if you have a story, or wish to share a tip, send them our way!  globalobgynnews@partners.org

From the Editors: AK Goodman, Adeline Boatin, Tom Randall

Approximately one-third of women have experienced some form of domestic violence. The prevalence of gender-based violence increases significantly after the occurrence of natural disasters and other emergencies.  Nevertheless, discussions and interventions on gender-based violence in emergency settings are mostly lacking. In this newsletter, we would like to share stories and literature on gender-based violence in emergency settings.

Notes from the Field
Annekathryn Goodman, MD, MPH

Pic: Mass Casualty Training, Israel, November 2019

Pic: Ak Goodman (Training: pet therapy for acute stress management, Israel, November 2019)

 
Disasters are events either natural or man-made where the scope of casualties, deaths, and destruction to property overwhelm the local resources of a community. Training and responding to disasters is relevant to healthcare professionals in sexual and reproductive health (SRH). In many disasters, women are disproportionately affected. For instance, the 2004 Indonesia Tsunami killed an estimated 227,898 people in 14 countries.  Women were three times more likely to be killed than men. The reasons pertain in part to the differing roles of women and men. Women had children to carry and protect, they could not run as fast, and in South and Southeast Asia, women’s traditional long dresses and long hair tangled them in debris and increased their risk of drowning. There is a second crucial reason why SRH experts must be involved as disaster responders. Rates of gender-based violence (GBV), both intimate partner violence and rape by strangers increase by a factor of 16 after disasters. Studies from the 2005 Katrina Hurricane catastrophe showed an extraordinary uptick in domestic violence following the storm.
 
This data should drive the training of disaster responders to include education and protocols for screening and intervention for GBV. At MGH, we have started a pilot training program for this. Being sensitized to this, I am interested in what other training programs offer. In November 2019, I attended an intensive weeklong training on mass casualty disaster planning and response in Israel1. The 18 participants came from Canada, Asia, and the US.  Both didactics and hands-on training spanned topics of cyberattacks, bioterrorism, medical triage, extraction of injured, and acute stress reaction. We visited the city of Sderot, which has been exposed to missile attacks from Gaza since 2001. The day before our visit, 16 missiles had been launched into the city. While fatalities are rare, the stress of attacks leads to acute stress reaction and behavioral challenges for children. One intervention is a pet therapy center, which was mobbed the day after the missile attacks. Yet there was no program for GBV nor any data on how constant stress may impact intimate partner relationships. On the other side, I did not have the opportunity to visit Gaza, a community under blockade and in constant crisis. I did find more data about what women in Palestine face. According to one source, gender norms and traditions contribute to violence against women in Palestinian territories2.  According to a violence survey, 37% of women are survivors of GBV but in Gaza, the rate increases to 51%3.  Ultimately it is our duty as SRH experts to include identifying, and when possible referring and/or intervening when GBV exists. The first step is training and dissemination of knowledge on this topic.
  
References:
1. Sponsored by the Israeli Ministry of Health and American Physicians Fellowship (APF)
2. Mahjne A (2019). How Israel’s blockade exacerbates violence against women in Gaza.        https://www.972mag.com/women-in-gaza-violence-israel-blockade/141508/
3. UNFPA Palestine Gender-Based Violence. https://palestine.unfpa.org/en/gender-based-violence
Fun Fact
June 19 is the International Day for the Elimination of Sexual Violence in Conflict.
https://www.un.org/en/events/elimination-of-sexual-violence-in-conflict/index.shtml
 
Paperchase
Using Mental Health Indicators to Identify Postdisaster Gender-Based Violence among Women Displaced by Hurricane Katrina:
News Bulletin
Natural Disasters & Domestic Violence May Have An Alarming Connection
https://www.bustle.com/p/natural-disasters-domestic-violence-may-have-alarming-connection-79673

Efforts to End Gender-Based Violence are Underfunded Around the World
https://msmagazine.com/2019/06/25/efforts-to-end-gender-based-violence-are-underfunded-around-the-world/


Study: Sexual, Gender-Based Violence Rises After Natural Disasters
https://www.voanews.com/east-asia/study-sexual-gender-based-violence-rises-after-natural-disasters
GBV Trainings
Managing Gender-Based Violence Programs in Emergencies: free online training to understand GBV in emergencies and strategies to tackle it. https://extranet.unfpa.org/Apps/GBVinEmergencies/index.html

Free online courses on gender-based violence: https://www.classcentral.com/tag/gender-based-violence 
Announcements and Events
Save the Dates!!

Gender-Based Violence Symposium (June 9, 2020, Assembly Square Row, Somerville)
 
Travel Grant of $2000.00 is available to support residents, fellows, and faculty who would like to embark upon a global health trip. If interested, please contact Ak Goodman (agoodman@partners.org). 

International Tumor Board ECHO Sessions: International Gynecologic Cancer Society holds monthly gynecologic oncology tumor board meetings including gynecologic oncologists and GYN-ONC trainees all over the globe. Interested fellows and residents, please email Thomas Randall (TRANDALL@mgh.harvard.edu) or Ak Goodman (AGOODMAN@mgh.harvard.edu)






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