Where Women Have No Doctor - A Health Guide for Women (Hesperian Foundation, 1997, 600 p.) Chapter 19: Rape and Sexual Assault (introduction...) Kinds of Rape and Sexual Assault (introduction...) Rape by someone the woman knows Rape by a stranger How to Avoid Rape (introduction...) These ideas may help any woman avoid rape Avoiding rape by someone you know Help children avoid sexual abuse Self Defense for Women If You Are Sexually Assaulted What to Do if You Have Been Raped (introduction...) If you go to the police Health Problems of Rape Pregnancy Sexually transmitted diseases (STDs) Tears and cuts Sexual relations after rape Overcoming feelings about the rape Working for Change

Where Women Have No Doctor - A Health Guide for Women (Hesperian Foundation, 1997, 600 p.)

Chapter 19: Rape and Sexual Assault

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Rape and sexual assault both mean sexual contact that a woman does not want. Rape is any time a man puts his penis, finger, or any object into a woman’s vagina, anus, or mouth without her consent.

¨ Rape is sexual violence. Women are not to blame for it.

Rape is sometimes called sexual ‘assault’ because it is an act of violence, using sex as a weapon. Sexual assault can include rape as well as other kinds of unwanted sexual attention.

Some people think that forced sex is rape only if the man beats up a woman or leaves her unconscious. They think she must try hard to get away and risk being killed rather than be raped. But even if a woman does not fight back, it is still rape. No matter what she decides to do, if it was not her choice, it was rape, and it is never her fault.

¨ As with other kinds of violence, the goal of the rapist is to gain power over and control his victim.

Any woman can be raped, but there is an even greater risk if she: · has a disability - if she is in a wheelchair, deaf, blind, or mentally slow. · is a refugee, migrant, or displaced person, or has lived in war situations. · lives on the streets or is homeless. · is a sex worker (prostitute). · has been arrested or in prison. · is being abused by her husband or boyfriend. A rapist may see these women as easy victims - because of their disabilities, or because they have lost the protection of a community.

Kinds of Rape and Sexual Assault

There are many different kinds of sexual assault. But only a few of them are seen by most people as rape. For example, sometimes life events can push a woman into having sex when she does not really want to. This can happen in a marriage. Some married women are made to feel that having sex is their duty, whether they want to or not. Although society does not punish this type of forced sex, it is still wrong.

¨ A woman often finds it harder to ask for help if the man is someone she knows. It is also harder to feel safe if she must see him again.

For other women, having sex is a way to survive - to get support for their children, to have a place to live or some money, or to keep a job. No matter what the reason is, a woman should not be forced to have sex if she does not want to.

In any relationship, a woman can choose to accept or refuse a sexual approach. If she refuses, the man then has a choice to either respect her and accept her decision, to try and change her mind, or to force her. Even if the woman knows the man and says “yes,” if saying “no” was not really an option, then it is rape.

Any time a woman is forced to have sex, whether or not there is other violence too, it can cause many problems with her health and emotions.

Rape by someone the woman knows

Most women who are raped know the man who rapes them. If the woman must continue to have contact with him, it can make it very hard for her to recover from the rape and to tell others about it.

Rape by a husband or ex-husband. If the law or traditional custom treats a woman as the property of her husband, he may think he has the right to have sex whenever he wants, even if the woman does not want it.

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A woman can be raped by her boyfriend. Her boyfriend may say he has the right to have sex because he has spent money on her, because they have had sex before, because she has teased him sexually, or because he has offered to marry her. But if he forces her, it is still rape. A woman may find it hard to talk about this kind of rape, because she fears others will blame her

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Sexual harassment. A woman may be forced to have sex by a co-worker or by her supervisor or boss so that she can keep her job. She may be threatened with losing her job or other punishment if she tells anyone.

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Sexual abuse of children. A girl or boy can be raped by a man in the family or any adult. If a father, stepfather, uncle, brother, cousin, or any other family member makes a child have sex, or touches her or him in a sexual way, this is rape. It is important to realize that children may be confused and may not understand what is happening to them, especially if they trust the person who is abusing them. Other members of the family may not know of the abuse, they may deny that it happens, or they may say it is the child’s fault. It is never right to blame the person who has been raped, but especially not a child.

Touching a child sexually is rape.

Rape by a stranger

This is the kind of sexual assault that most people think of when they hear the word ‘rape.’ A woman may be grabbed on the street, or attacked in her home. This kind of rape is very frightening, but it is much less common than rape by someone the woman knows.

Gang rape. A woman can be raped by more than one man. Sometimes a man starts raping a woman and other men see it and join in. Or sometimes young men and boys get together and rape a woman to prove their ‘manhood ‘to one another

Prison rape. Many women are raped by police or prison guards after they have been arrested. Also, rape is common between male prisoners as a way to establish who has more power.

War. Soldiers or fighters often use rape to terrorize women and their community, and to make people feel ashamed. Soldiers may gang rape women and girls in front of their families to show the enemy’s power. Women may be held in camps, and forced into prostitution or sexual slavery in order to stay alive, to keep their children safe, or to get food.

¨ Those who survive war rape need special care. If a woman gets pregnant, she and her child may suffer from the reminder that she was raped by an enemy.

Rape is a form of tenure when it is used in war.

How to Avoid Rape

There is no one right or wrong way to behave to avoid rape. But there are some things a woman can do that may make her less likely to suffer some kinds of rape. What a woman does depends on how well she knows the man, how afraid she is, and how much danger she thinks she is in. Remember, if a woman is raped, it is not because she failed to avoid the rape, but because someone stronger forced himself on her.

These ideas may help any woman avoid rape

· Do your work with other women. You will be safer and stronger if you work together in groups.

· Do not let anyone who makes you feel nervous into your home. Do not let him know if you are there alone.

· Try not to walk alone, especially at night. If you must go alone, hold your head up and act as though you feel confident. Most rapists will took for a woman who looks easy to attack.

· If you think you are being followed, try walking in another direction, or go up to another person, a house, or a store. Or, turn around and ask him very loudly what he wants.

· Carry something with you that will make a loud noise, like a whistle. Also, carry something that you can use to defend yourself. This could be a stick, something you can spray in his eyes, or even some hot spicy powder - like hot pepper or chili powder - to blow in his eyes.

· If you are attacked, scream as loudly as you can or use your whistle. If this does not work, hit back quickly to hurt him, so that you may be able to get away.

Protect yourselves. Work with others.

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Avoiding rape by someone you know

Learn to trust your feelings. A woman can learn to recognize when she feels good about a person or a situation, and when she does not. When a woman feels good about someone, she may feel warmth, caring, or attraction toward him. If she can learn to act on these good feelings, it can make her more confident that she will know when she does not like someone.

Be aware if you:

· have a lasting feeling that something is not right.
· feel afraid, or like you want to leave.
· feel uncomfortable with comments or suggestions the person is making.
· dislike the physical contact he makes.

It can be hard to act on these feelings because you may be afraid of what other people will think. In addition, if the person is someone you know or care about, you may not want to admit that he would do you harm. But it is always best to trust your feelings and get out of a situation that feels uncomfortable before anything bad happens.

Trust your feelings. It is better to offend someone if you are wrong than to be raped.

Be prepared to get away:

· Avoid going somewhere alone with a person who makes you feel uncomfortable or who you do not know well.

· Always have a way to get home if you decide you need to leave. It is better not to go somewhere if you will not be able to get back without the person’s help.

· Tell the person that his comments or touch make you uncomfortable. If he does not change the way he is acting you should get away from him as soon as possible.

If he has power over you (for example if he is your boss, your doctor, a teacher, or an official):

· The first time he does something that makes you feel uncomfortable, tell him to stop. If he is trying to take advantage of his power, he will look for someone who is easy to frighten. Let him know that you are not frightened. He is less likely to treat you badly (for example to fire you, refuse you medical care, or deny your request) if you can get him to stop bothering you before he has done anything that makes him look foolish.

· Talk to other women about him. You are probably not the only one he has bothered. If you must continue to deal with him, try to bring a friend with you so you are never alone with him. Warn other women to be careful.

¨ Be aware that if a man cannot gain control over a woman through sexual violence, he may try to gain control over her in other ways.

Help children avoid sexual abuse

· Teach children about the possibility that they may be touched sexually, and how to tell the difference between touching that is affectionate and touching that is sexual.

· If possible, have girls and boys sleep separately, especially after age 10 or 11 years old.

· Make sure children know who they can talk to if something should happen to them.

· Believe a child who says he or she feels uncomfortable around an adult or older child - no matter who that person is.

¨ Sometimes sexual abuse of children continues for many years. A girl may be told that she will be harmed or even killed if she tells anyone about it.

Self Defense for Women

Practice these self defense movements with a friend, so that you will be prepared to fight off an attacker. Hit him as hard as you can. Do not be afraid to hurt him - he is not afraid to hurt you.

If you are attacked from behind Hit him hard in the stomach with your elbow. Step down hard on his foot with your heel. Reach back with your hand, grab his testicles (balls), and squeeze them hard. With your heel, kick him hard in his lower leg or knee.

If you are attacked from the front Dig your fingers hard into his eyes. Make 2 fists and hit him on each side of his head, or on his ears. Make your hands into fists and hit him as hard as you can on his nose. Lift your knee, and push it as hard and fast as you can into his testicles (balls).

If You Are Sexually Assaulted

If a woman is able to resist her attacker, she will usually be able to avoid the rape, even if the rapist has a weapon. The more different ways a woman tries to keep from being raped, the more likely she is to be able to avoid the rape, or to suffer fewer injuries and mental health problems from the rape afterward.

It is impossible to know ahead of time how a woman will react when someone is trying to rape her. Some women are filled with rage and feel strength they did not know they had. Others feel like they cannot move. If this should ever happen to you, know that you will do what you can.

Here are some ideas that may help you during a sexual assault:

· Do not cry, plead, or give in. It usually does not help. In fact, women who try this often suffer more injuries than women who fight back.

· Stay aware. Watch the rapist carefully. There may be times when he is not watching you, or when he loses his control.

· Try different things. Kick, yell, bargain, trick him - do whatever you can think of to make him realize you are not an easy victim. Try to make him realize that you are a person, not an object.

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· If you know the rapist, tell him how you feel. Do not let him believe that women like to be raped. Make him be aware of what he is doing to you.

· If the rapist is a stranger, try to memorize what he looks like. How big is he? Does he have scars, marks, or tatoos? What kind of clothes is he wearing? Try to remember them so that you can tell the police and warn the other women in your community.

· Use your best judgement. Only you can decide how much to fight back. In some rape situations, for example, during war, the rapist may have no reason to keep you alive if you resist.

¨ If there are several people trying to rape you, or if the rapist has a weapon, you can still resist, but it is usually better not to fight back physically.

What to Do if You Have Been Raped

Every woman’s experience with rape is different. But there are a few things you need to do to help yourself recover.

First, ask yourself these questions:

· Who can you ask for help?
· Do you want to tell the police about the rape?
· Where can you go for medical care?
· Do you want to try to punish the rapist?

You need someone to talk to when you feel sad, hurt, scared, or angry, to go with you for medical care, and to help you figure out what to do. Choose someone who cares about you, who you trust will not tell others, and who is strong and dependable. Sometimes a woman’s husband or parents are too upset themselves to be able to give much support.

¨ Do not blame yourself. You did not deserve to be raped. There was nothing you did that made it right for a man to force sex on you.

If someone you know has been raped Figure · Reassure her that it is not her fault. · Be supportive. Listen to her feelings, help her decide what she needs, and reassure her that she can go on with her life. · Respect her wishes for privacy and safety. Do not tell anyone else unless she wants you to. · Go with her to see a health worker, to report the rape to the police, to talk with someone who is trained to listen and support her, to see a lawyer, and to go to court if she wants to do those things. · Do not protect the rapist if you know him. He is a danger to every woman in the community.

The decision to use the law must be made carefully.

· Can someone go with you to talk to the police?

· Has the law helped other women in your community who have been raped?

· Do you want the rape to remain private? Can the police keep others from learning about the rape?

· Did the rapist threaten to hurt you more if you reported the rape?

· If the rapist is caught and you can prove that he raped you, how will he be punished?

If you think you may want to report the rape to the police, do it as soon after the rape as possible. Do not wash before you go, and bring the clothes that you were wearing in a bag. These things can help you prove that you were raped. Take a friend with you, and ask to have a female health worker examine you, if possible.

¨ If there is no health worker who can treat you, the information from Sexually transmitted diseases (STDs) and Tears and cuts can help you prevent and treat some of the problems yourself.

If you do not want to go to the police, or if you cannot go until later you should see a health worker anyway - even if you are not badly hurt. Tell the health worker that you have been raped. She should then check you for cuts or tears, and give you some medicines to prevent pregnancy and sexually transmitted diseases (STDs). Ask her to write down everything that she finds because it will help prove to the police or to others in the community that you were raped.

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To the health worker If you see someone who has been raped: Treat her with kindness and understanding. Do not blame her. Since she may find it difficult for you to see or touch hen explain everything and wait until she is ready to be touched. Remember that her feelings about the rape may last for a long time, even years. Treat her health problems. Give her medicines to prevent STDs and pregnancy. If she is already pregnant, help her to decide what she wants to do. Figure Write down who raped her and exactly what happened. If your clinic does not keep records, make one and keep it somewhere safe. If you can, draw a picture of the front and back of her body and mark the places where she has been hurt. Show or tell her what you have written and that it can be used to support the fact that she was raped if she goes to the law. Figure Treat her mental health needs. Ask her whether she has someone to talk to. Help her to respect herself again and to gain control of her life. Help her to make her own decisions. If she wants to go to the law, help her find legal services. Help her find other services in the community for women who have been raped. Help her to tell her partner or her family. If they do not know already, offer to help her tell them. You can help them find ways to support her until she recovers. Remember that family members usually also need help to overcome their feelings about the rape.

If you go to the police

In most places rape is a crime. But it may take a long time and be very difficult to prove you were raped.

The police will ask you what happened. If you know the rapist, tell them who it is. If you do not, you will need to describe what he looks like. You may have to go with the police to try to find him. You may also be asked to get a medical exam from a legal doctor who works with the police. This is not an exam to help you get well, but to help prove that you were raped.

In some countries, women have worked with the police to have specially trained female police officers to help victims of rape and violence.

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If the rapist is arrested, you will have to identify him, either in front of the police or in front of a judge in court. If there is a trial, try to find a lawyer who has worked with rape cases before. The lawyer will tell you what to expect and help you prepare for the trial. Always take someone with you.

Going to court for a rape is never easy. Describing what happened may make you have the feelings of being raped all over again. Not everyone will be understanding. Some may try to blame you or say you are lying.

¨ Always take someone with you to the police.

Health Problems of Rape

Pregnancy

Pregnancy can be prevented if you act quickly and use emergency family planning. You must use it as soon as possible, but no later than 3 days (72 hours) after the rape.

IMPORTANT
In some countries, abortion is safe and legal if a girl or woman has been raped. Ask a health worker or women’s organization if this is true in your country.

Sexually transmitted diseases (STDs)

STDs are passed more easily with violent sex because the skin in the vagina is often torn and the infection can get into the woman’s body easily. If the man who raped you had an STD, he may have passed it to you. Since you cannot know if he was infected, you should be treated just in case, so you can keep from getting the disease and passing it on to others. Take medicines for gonorrhea, syphilis, and chlamydia, and watch for signs of other STDs. Take the medicines whether or not you think you were infected. It is better to prevent an STD than to wait for one to start.

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You should also try to have an HIV test in 6 months. Until then, it is better to use condoms if you have sex to protect your partner from possible infection.

Tears and cuts

Sometimes rape damages the genitals by causing tears and cuts. These usually cause pain, but will go away in time. If there is a lot of bleeding, you may need to see a health worker trained to stitch tears. For small cuts and tears:

· Soak your genitals 3 times each day in warm water that has been boiled and cooled. Putting chamomile leaves in the boiling water can help soothe the tears and help with healing. Or you can put gel from an aloe plant on the tears.

· Pour water over your genitals while passing urine so that it will not burn. Drinking a lot of liquid makes the urine weaker so it will burn less.

· Watch for signs of infection: heat, yellow liquid (pus) from the torn area, a bad smell, and pain that gets worse.

· After violent sex it is also common for women to have a bladder or kidney infection.

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Sexual relations after rape

You can have normal sexual relations again after rape. You will need to wait until your genitals no longer hurt and any tears have healed. For many women, having sex makes them think about the rape. If this happens to you, talk with your partner about why you need to wait.

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Sometimes a woman’s partner may reject her after she has been raped. He may feel ashamed or act as though he is angry with her. This can be very hard for a woman who is already dealing with many difficult feelings.

Overcoming feelings about the rape

The rape may still bother you long after your body has healed. Here are some common reactions:

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It is important for a woman who has been raped to talk to someone or to do something to help herself feel better after the rape - every woman needs to find her own way to heal. For some women, this can mean performing a ritual. For others it means trying to punish the rapist, or working to prevent other women from being raped. Whatever you do, be patient with yourself and ask others to be patient, too.

¨ It may take a long time before you feel better, but talking with someone you trust, or who has also survived rape, can help you to heal.

Working for Change

Rape affects everyone in a community. Women who have been raped can suffer long-lasting problems because of the rape. But almost all women, whether they have been raped or not, learn to be afraid. They learn not to trust men, and they learn not to do things that attract attention. Women learn not to walk alone, or not to talk to men they do not know.

To create a world in which rape does not happen, we need to work toward having:

· communities where a person’s choices and behavior are not limited by whether the person is a man or a woman.

· an equal chance for everyone to participate in the community.

· the chance for men and women to talk openly and honestly with each other about what they each expect from a sexual relationship.

But until we achieve these goals, we need to find ways to help women who have been raped. We can:

· educate elected leaders, clergy, and teachers about rape. Ask for their help and make a plan for change.

· train doctors and health workers to treat women who have been raped. They should be trained to provide STD testing, emergency family planning, and how to listen and be kind to the woman and her family.

· encourage health workers to find out what information their country’s laws require in order to punish a rapist, so they can help the woman fill out legal forms.

· teach women and girls how to defend themselves.

· teach boys and girls about sex and sexuality. Teach girls to be clear about their wishes, and teach boys to ask girls about their wishes and then respect them.

· learn about laws in your country that protect women who have been raped, and teach them to others.

In a small town in El Salvador, the police refused to stop a known rapist because he was the son of a wealthy man. So the women of the town began painting the word ‘rapist’ outside his house. His family was so ashamed that they forced him to stop. Figure

How a community in South Africa organized against rape Early one Saturday morning, a 59-year-old woman was raped and stabbed by a man who had raped other women in the past. The victim pointed the rapist out to the police. He was arrested and the woman was taken to the hospital. But the police released the rapist the same afternoon. He was not charged with rape or assault - he was free. We women of the township were very angry. The police had protected a man who made women afraid to walk alone on the streets. The township’s women’s organization decided to organize a protest. Most of us work as domestic servants for rich white women who live in a nearby city. So all of us stayed away from our jobs, demanding that the police charge the rapist with rape and assault, before we would go back to work. We also asked the women we worked for to come to speak with us. We wanted to show and tell them about our problems. We know that all women, black and white, fear rape. We felt the white women might understand and be sympathetic to us. We also wanted the women whose husbands worked for the police to explain our problems to their husbands and how bad it was for them to release a violent rapist back into the township. But the white women were not sympathetic - they just got angry. We think they were upset because they had to do their own housework. When the Employers’ Federation came to see about the protest, we told the men, “Please do not speak for us. This is a women’s problem. Men do not get raped.” The Employers’ Federation would not meet with us, but after a week, a group of white women came to talk to us. We showed them around the township, and they decided to meet with us again. We called off the protest, even though the rapist was only charged with assault, and not rape. But people in the township were so angry that the rapist could no longer live there. The police arrested several of us who had organized the protest. They did not believe that women had organized the protest. They think men are behind everything that women do. But we women had become very strong. It is very important to talk openly about the problem of rape. Most people don’t talk about rape - they feel ashamed and shy. Often the family of the raped girl or woman does not want to talk about it. But here it is different. We started organizing in the community for education, child care, pensions, and so on. We started talking about all the problems and things that we need to change. So we talk about rape, and any sexual assault on a woman. People now see sexual assault as another kind of oppression. Men and women think the same about this; we are united in the struggle. A raped woman is trusted. If she says she was raped, we support her, no matter who she is. Even if she is a drunkard, a rape is still a crime against her. In fact, it is worse because she was in a weak position. Our women and men do not blame a woman for a rape. We do not say that the rape was the woman’s fault. So women can talk about sexual violence openly and they will get community support. Figure