– Gynaecologist, psychiatrist call for holistic care for victims
Sexual assault or gender-based violence has apparently assumed an alarming dimension in the country, as it appears to be the rave of the moment following an upsurge in the number of rape cases recorded by the police in recent times. From the popular cases of Vera Omozuwa and Barakat Bello to a host of voiceless others, the list seems endless.
Affirming the spike in sexual violence in the nation, the Inspector-General of Police, Mohammed Adamu, recently disclosed that the police had recorded about 717 rape incidents across the country between January and May 2020, which is an alarming situation in a sane clime. As a means of curbing the dastardly act, the Nigerian Governors Forum declared a state of emergency on rape and called on all states to set up a sex offenders’ register and to sign on to two federal laws which punish rape and violence against women and children.
It is so pathetic that with all these efforts by government to arrest the situation, perpetrators are not relenting in their devilish acts of endangering the health and lives of innocent children and women through rape and other sexual violence, as more and more cases are reported daily on the pages of national dailies and social media.
Health implications
A gynaecologist, Dr Gregory Ohihoin, in an exclusive interview with Pharmanews noted that the health implications of rape is far-reaching, saying that beyond the bodily or physical harm, the victim also suffers psychological hurt and post-traumatic stress disorder.
Ohihoin, who is the deputy director, Maternal and Reproductive Health Research, at the Nigerian Institute of Medical Research, also asserted that rape can mean a lifetime scar for a victim, and could, in fact, lead to death.
“Physical gynaecological implications for those that suffer sexual assault or rape, as the case may be, is that, first, the victim is predisposed to genital tract injury, tears, laceration and bruises.
“The victim is also in predisposition to sexually transmitted infection of all sorts. Bacterial and viral infections, which also include HIV (Human Immunodeficiency Virus), are some of the possible effects that the victim might also suffer. Victims are also predisposed to unwanted and unplanned pregnancies and that can also be catastrophic because in an attempt to try to terminate the pregnancy, it can lead to other complications which may include death”, he explained.
The story of a victim, Lindsie, corroborates the views of Ohihion on the health implications of sexual violence. Lindsie narrated her ordeal in the hands of a supposedly friend thus: “At about 2:30 p.m, Lawrence sent me and Ziyad into that back room to do some work. I was back there, minding my own business and doing my thing. Ziyad grabbed me by my arms and dragged me into the bathroom. I screamed. He put this hand over my mouth and started to undo his pants. Knowing what was about to happen I froze. My whole body went numb. I couldn’t move. After he was done, he got dressed and walked out of the bathroom like nothing happened. He left me there with my tears. When he walked out the door, he took with him my pride, my security and my virginity.
“I’m currently undergoing counselling two times a week, and I’m on pills for depression. I can’t fall asleep at night without the TV on. And I’ve already given myself an ulcer from worrying so much. I know things will get better and eventually I will be able to live a normal life again, but right now it is hard. Very hard,” Lindsie lamented.
Another victim of rape, Jennifer, also revealed how empty and humiliated she felt after being assaulted severally and later regretted her lack of confidence in pressing charges against her violators.
Sobbing while recalling the nasty experience, she said: “My self-esteem has never been very good. I fell into an abusive relationship when I was 16. That man abused and intimidated me in every way possible. I was very afraid of him, and especially afraid of what he might do to me if I upset him. He raped and assaulted me and had other men rape and assault me several times during our relationship. He humiliated and belittled me.
“The rapes were just an especially degrading item in his array of torture methods therapy. I never pressed charges. I thought about it, but decided that nothing could ever make up for what he had done to me, and that my life couldn’t stand any more intrusion, no matter how well-intentioned. Now, later, I wish I had gone to the police. What I want more than anything is to know that he can never do this to anyone ever again. What he did to me is beyond comprehension. He scarred my body, he wounded my soul.”
Further effects
A reproductive health expert further elucidated on the effects of rape, saying it could lead to several infections of the genitals, chronic pelvic inflammatory disease and can equally give rise to blocked tubes.
“These blocked tubes can also invariably lead to infertility in these victims. The injuries they suffer from, if it is severe enough, can leave behind scar tissues over a period of time. These scar tissues heal by fibrosis and when these tissues occur, it can block their pathway for child delivery and this is what we refer to as acquired gynatresia,” he said.
Speaking from a psychiatrist’s point of view, Dr Dapo Adegbaju, a consultant psychiatrist at the Federal Neuropsychiatric Hospital, Yaba, acknowledged the spike in rape cases and attributed the development to various factors including, past childhood sexual abuse, alcohol use, substance abuse, poverty, proliferation of pornographic materials and mental disorders, among others.
Adegbaju noted that if nothing is done urgently to stem the tide of sexual violence by beefing up the security and safety of citizens in the country, especially to protect the vulnerable gender from predators, there may be a surge in cases of mental illness as many people may become emotionally unbalanced in the society.
He said: “A lot of victims need to be helped psychologically, emotionally and spiritually. Supportive psychotherapy is very essential. If rape is not properly handled, it can lead to several forms of mental illnesses, ranging from acute stress reaction to post traumatic stress disorder to mood disorders to substance use disorders or schizophrenia and personality disorders.”
Submitting that sexual violence is not restricted to any gender, he proposed proper sexual training for children, psychological evaluation for perpetrators, with appropriate punishment, as well as formulation and enforcement of strict legislations on the use of pornographic materials, as means of ridding the nation of the heinous act.
“Why not trying to be chauvinistic, rape is not only attributed to males. Females also rape males. The essential thing is to teach and train children well about sexuality. Perpetrators should be evaluated psychologically and appropriate punishment meted out to them. Strict laws on pornographic materials should be enforced, while males should be encouraged to join advocacy groups too”, Adegbaju advised.
Care of victims
Still on the psychological effects of rape, Ohihoin called for a holistic care approach to aid victims’ healing process, as their levels of injury differ from one to another.
“This makes it important that in cases of sexual assault, the victims should receive holistic care, strong support structure, intervention of the psychiatrist and long term follow up.
“Those that may recover from physical harm can also find it difficult to recover from psychological harm, which is very difficult to heal because it manifests in different formats. There are cases where some of these victims become assailants and develop violent behaviours in the future and some may develop suicidal ideations,” he said.
The gynaecologist, who ruled out the option of total recovery for victims as they are already vulnerable to the act, said they will do well with a lot of support from people around them
“The victim already is vulnerable and at such needs to be supported. They need medical and gynaecological care from psychiatrists and trauma doctors. A multidisciplinary approach should be taken and it also depends on their age. They need to bring in a paediatric psychiatrist and a psychologist, if it is a minor. The parents also have to be involved.
“Also, the first thing is to allow the victim realise that she is not at fault and remove the sense of guilt, blame and shame from her mind. That burden should not be borne by the victim and it is also the responsibility of the society to put structures in place and ensure that the victim is well taken care of holistically. The victim just needs support; so the society and caregivers need to give adequate support to the victim during the period,” he stressed.
Government intervention
Although most states of the federation are yet to sign up to the sex offenders’ bill, President Muhammadu Buhari has assured Nigerians on the efforts of his government to fight gender-based violence.
Buhari, who made the statement recently during his Democracy Day Speech, expressed utter displeasure on the development, while he promised to bring perpetrators to book.
“I am particularly upset at recent incidents of rape, especially of very young girls.
“I wish to assure all our women of this administration’s determination to fight gender-based violence through the instrumentality of the law and awareness creation,” Buhari said.
“The Police are pursuing these cases with a view to bringing perpetrators of these heinous crimes to swift justice,” he added
