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Sexual violence in Mexico: "You just have to break the barriers to be able to say: Enough"
Marbella is a sexual violence survivor who lives on the outskirts of Acapulco. She attended therapy with MSF psychologist Nadia Rivera for several months, which helped her to stop the abuse and recover her life. However, as with most victims, before that she had to face many obstacles.
In Acapulco, one of the places with the highest murder rates in the world, the violence can take many forms. In many parts of this city, murders, kidnappings, extortion, shootings, rapes and sexual assaults happen every day. Violence is a normalised problem that unfortunately touches all areas of life, both the public and private.
In this city, MSF carried out a psychosocial and mental healthcare project for victims of violence, including medical, psychological and social care focused on survivors of sexual violence, one of the most vulnerable groups.
"When we started this project, we realised that the violence had taken deep root and was normalised among the people of Acapulco,” says Nadia Rivera, an MSF psychologist working in Guerrero state. “The impact on the mental health of the population was evident; people had become used to living in fear. In addition, sexual violence had become a social and cultural common problem."
Women continue to be the most affected group, 85 percent of the cases treated by MSF are women and girls. "My family told me that it was normal, that this happened in all relationships and that I had to put up with it. In the eyes of others, I was the unusual one," says Marbella, a 22-year-old woman who was sexually abused by her husband.
Sexual violence is a public health crisis in Mexico, which should be treated as a medical emergency. In Acapulco, MSF is working to guarantee medical, psychological and social support services to all survivors of sexual violence, ensuring the right of access to health for all and sensitising the wider population about the importance of seeking immediate help.
In addition, MSF social psychologists, health promoters evaluated the needs of the population and carried out community activities, which included activities to prevent and detect cases of sexual violence.
"When I looked for help they told me it was my fault because I lived with the violence, then I started going to the MSF promoters' talks where I realised that nobody has to put up with a situation like that. MSF's attention came when I needed it most. I had lost hope, I felt ashamed and I thought that my family was right, that's why I stopped looking for help. So, finding someone who would listen and help me was very important," says Marbella.
"One of the great challenges of the project was to gain the trust of the people and get them to trust health professionals enough to tell us their experiences, such as having been the victim of sexual abuse, especially when it happened in the home," says Rivera.
The emotional wounds caused by sexual assault are deep and profound and receiving immediate medical attention after sexual assault is vital. Treatment in the first 72 hours can be enough to prevent the HIV and other sexually transmitted infections and unwanted pregnancies, so immediate care for survivors must be guaranteed and provided in a timely manner.
As the poor security conditions made it difficult for residents and health professionals to access the health centres, MSF offered health services and comprehensive medical, psychological and social care to survivors of sexual violence in two hospital units in the city, through a collaboration with the Guerrero State Secretary of Health. Thanks to this partnership, in 2018 MSF helped 58 survivors of sexual violence in Acapulco; 47 were women and 40 percent of the victims were minors.
"I had knocked on doors and they had rejected me. I faced many obstacles. I lived with violence in many ways. I approached the authorities without receiving an answer. As a woman it is not easy to raise your voice, but do not be afraid, there are always good people who help you. You just have to break the barriers to be able to say: enough is enough," concludes Marbella.