Seek health services, medics advise survivors of sexual violence

Women who have encountered sexual gender based violence must not defer seeking health services. 

Dr John Nyamu, the executive director of Reproductive Health Services in Nairobi, advises such women to visit a health facility as soon as possible and within 72 hours of the occurrence of the incident.

"Those in need of this health service should not defer, due to the potential result in injuries (even death) and serious physical, mental, sexual and reproductive health problems, including STIs, HIV, and unplanned pregnancies," he said. 

Dr Nyamu, a Nairobi-based obstetricians and gynaecologist, spoke at a session to disseminate Ministry of Health's Covid-19 reproductive and maternal health guidelines on May 28.

He noted sexual gender based violence (SGBV) against women and violence against children tend to increase during emergencies, including epidemics.

"Anecdotal reports indicate rising cases of GBV occasioned by the effects of Covid-19 in Kenya," he said.

"The health impacts of violence, particularly domestic violence, on women and children, are significant and can be life threatening," he added.

Kenya has been under a curfew since early April while movement in and out of Nairobi and Mombasa was stopped two months ago.

Dr Nyamu, in his presentation, said care for SGBV survivors remains a priority and essential service and should not be interrupted.

"SGBV survivors on follow up with no complications and have a routine visit in the coming days, should contact the clinic /facility for advice and to agree a plan," he said.

Acting director general for health Dr Patrick Amoth said the MoH guidelines were borrowed from the World Health Organization, and countries such as China, Europe and the United States, which struggled with Covid-19 earlier than Kenya.

"They offer practical consideration of both preventive and clinical aspects of safe continuity of quality reproductive, maternal, newborn and family planning services during the Covid-19 pandemic in Kenya," he said. 

Veteran obstetrician and gynaecologist Dr Joseph Karanja stressed on the importance of skilled birth attendance during the pandemic.

"Home deliveries pose particularly high risk for acquiring Covid-19 and those giving birth outside health facilities are more likely to die when faced with complications," he said. 

The guidelines are intended to minimise maternal and child morbidity and mortality and ensure safety of the patients and the healthcare workers.

The ministry notes it is not known if pregnant women are more susceptible to Covid-19 than the general public.

"However due to changes that occur during pregnancy, pregnant women may be more susceptible to viral respiratory infections," the guidelines say.

The guidelines also seek to address the threat of sexual and gender based violence.

The WHO, in a fact sheet titled "Disaster Risk Management for Health - Sexual and reproductive health" says that in times of crisis, disruption in reproductive health services can lead to a range of adverse outcomes.

The fact sheet identifies negative outcomes including increase in sexually transmitted infections, possible spread of HIV, increased unintended pregnancies and unsafe abortions as well as maternal and neonatal deaths.

According to Jolly Mukangu, the programmes manager at Reproductive Health Services, counties and health facilities should publish information about services available locally for SGBV and the Marginalized communities.

Such information include hotlines, shelters, rape crisis centers, and counselling centres.

"There needs to be public education with emphasis on possibility of SGBV being perpetuated, even by known persons or close relatives within lockdown confines, during this period," she said.