6. feb, 2019

By     and     on June 1, 2018

ITM health policy unit, co-founder Culture4Change
Internal and Researcher, Health Policy Unit, ITM, Belgium; Masters (MPH) student, University of Vienna, Austria

Last Saturday (May 26), the very last (event) event of the World Health Assembly in Geneva was about one of the most embarrassing challenges in international health work:   "#AidToo: Sexual exploitation in international cooperation".

#AidToo is a sub-section of the #MeToo movement which absolutely needs no introduction, as the ripples have it all around the world. The growing activism and campaign against sexual abuse has been well received, and the issue has been debated in both virtual and traditional media platforms. Yet one question remains, why is this type of abuse structurally embedded in society and why is it so hard to tackle? This is of course a much more difficult and less popular subject matter. The truth is that the sexual abuse and exploitation go deeper than the glossy Hollywood magazines that were useful to amplify the voices or #MeToo campaigners, would have you believe. In fact, Tarana Burke,   the founder of the #MeToo movement , in calling for action ,  said  " Sexual violence knows no race, class, or gender, but the response to it does. "

As previously alluded to, the session in Geneva tried to address the issue of sexual abuse and exploitation within the "aid industry". Since the story about sex parties in Haiti broke, there has been an avalanche of similar stories in the world of aid, with NGOs, UN bodies and peacekeepers all being implicated. The resulting public outrage has ensured that the issue is now firmly on the agenda, and these days, almost all aid industry CEOs speak or  regaining trust .

The session was held under Chatham House rules which proved to be useful because after an initially slow start, people started opening up. At first there was a tendency to meekly accept blame and defend one’s agency efforts at making improvements, however, this soon gave way to people sharing sometimes bitter testimonies about how things at the very top in important agencies are not changing and how more senior staff manage to dodge their responsibilities. In the hands of the excellent facilitator we soon agreed on tasks that should be taken on by the ‘Aid Industry: there is a need to revaluate their response to allegations of abuse by their staff; to operationalise a common culture of integrity throughout what is in fact a very heterogenous sector; and to create survivor-centred response mechanisms.

Thus far, people seemed fairly comfortable sharing their opinions and experiences, yet at some  point we seemed to have got stuck at debating only how to end the abuse – whereas preventing it was not in sight. It was when the last presenter firmly brought the root causes back to centre that things became more complex. The discussion gradually veered from strictly ‘gender’ towards racial, class, and ethnic aspects of the issue. In other words, intersectionalityentered, and immediately illuminated the elephant in the room: power.

We were quickly chased out of our comfort zone, where we all shared disgust for the ‘bad behaviour of some males’, and had to face questions about the asymmetry of power. Talking about the abuse of power proved a lot more difficult than agreeing about the horror of abusing women. We proved Tarana Burke right: the response to sexual violence includes race, class and gender…and the distribution of power.

There was some discussion on ways of moving forward that require a complete paradigm shift in the power balance and the current way of working of the aid industry. For instance, shouldn’t the people who need help be put in charge, also of the funds available? And why shouldn’t they be held accountable – not by ‘our’ standards per se, but a set of standards which respects the people who we are talking about more?

It is not helpful when (opinion) leaders of the aid industry throw their arms in the air and declare helplessly that it is all very difficult, because anyway in those weird countries, men treat their women like commodities… #TheyToo! The behaviour of individual men does not give outsiders the right to make overall judgments that are – even worse – painful illustrations of the very power imbalance that leads to abuse.

To at least prevent this, it may be more helpful for the aid industry to strengthen the effort to understand how local values are also trampled by warfare and extremism, and how each culture has systems in place which protect against abuse and violence. Holding people accountable according to those culture-specific systems, makes perhaps more sense than only using the abstract ‘rights-based’ approach – that sometimes seems a cover for a lack of interest for the local truth. That may the beginning of some deep introspection into how the industry may unwittingly perpetuate the conditions that allow such abuse to take place, as well as a reflection about how to promote wider societal and structural transformations in behaviour, attitudes and institutional priorities to produce lasting change.

We did not find the final solution of course, but the debate was instructive and positive. And we have that truth in a quote once used, ironically, by a man who lost his position in the #MeToo slipstream. Kevin Spacey, playing president Frank Underwood in 'House of Cards': "  A great man once said, everything is about sex,  sex  is about power  ."

6. feb, 2019

C4C is a partner in the Mental Health course in Complex Emergencies

September 16 to 26, 2018

Kampala, Uganda

The  Mental Health at Complex Emergencies Course  is an intensive multidisciplinary ten-day training course for mental health workers and humanitarian program staff who wish to gain insight and competency in establishing mental health or psychosocial programs in (post-) conflict areas or in areas affected by complex disasters including refugee settings.

In the first week, the course will provide practical training and mental health and mental support (MHPSS) and strengthen the role of assistant in complex humanitarian emergencies and relief operations, such as assessments, monitoring and evaluation, understanding the humanitarian context, security, and self-care. In the second week, students may choose from a number of three-day workshops in which particular topics relevant to humanitarian emergencies will be explored in depth, facilitated by specialists.

The course is organized by the Institute of International Humanitarian Affairs (IIHA or Fordham University in New York.) Course Directors are

Larry Hollingworth, CBE - Humanitarian Programs Director, Center for International Humanitarian Cooperation (CIHC), Visiting Professor, Institute of International Humanitarian Affairs (IIHA), Fordham University

Lynne Jones, OBE, FRCPsych. Ph.D. - Visiting Scientist, FXB Center for Health & Human Rights, Harvard University School of Public Health

Willem van de Put - Co-founder, Mental Health in Complex Emergencies Course 
Founder and Director, Culture for Change (C4C) Research Fellow, Fordham University 
Scientific Expert at the   Institute of Tropical Medicine Antwerp

Peter Ventevogel, MD, PhD. - Senior Mental Health Officer, United Nations High Commissioner for Refugees


View the MHCE Syllabus

6. feb, 2019

Interesting session today in Geneva as one of the side events of the  World Health Assembly  : #AidToo:  Sexual exploitation in international cooperationCould not help but notice that the problem of abuse was less discussed. It seems that one way of avoiding abuse or unequal power is to shift responsibility (and power) to the refugee population, rather than having them being managed by expatriate NGO staff. But much more interesting would be what we mean by accountability. In terms of legitimizing the job opportunities form local people, accountability should be in the very first place, rather than donors and constituencies. In terms of gender, abuse and 'the others', we could respect local values ​​and local ways of preventing and addressing violence.

6. feb, 2019

21 May 2018: At the request of the  Joint Learning Initiative  , a Washington-based international collaboration on evidence for faith groups, and C4C is conducting a literature review. We are looking into the specific roles, caveats, most effective strategies and demonstrated impact of Faith-Based organizations in social and behavior change. The role of faith-based organizations in health and development is often underestimated, and needs to be more effective and relevant in creating positive change.

6. feb, 2019

PHNOM PENH, April 19, 2018-  The  World Bank Group and the Sexual Violence Research Initiative (SVRI) awarded $ 99,900 to Monash University, Buddhism for Health, and Culture for Change (C4C) to reduce gender-based violence GBV) in Cambodia. Click  here  for a poster of the project). 

The Award, part of the 2018 Development Market for Gender-Based Violence,* will study and support  interventions by Buddhist monks and female devotees to stop violence. Specifically, the award will help test how women, men, girls and boys use their local cultural references to understand what they have experienced or witnessed. Through collaboration with a Buddhist network, they will be responsible for and help GBV and mitigate its effects. They will also document why perpetrators and survivors sought help from monks and female devotees, and how it changes attitudes towards women and girls.

"Cambodia has important advances against gender-based violence, but understanding cultural attitudes is important to GBV succeed," said Miguel Eduardo Sanchez Martin, World Bank Acting Country Manager for Cambodia.  "We congratulate the winners on this innovative approach and look forward to learning about the effects of GBV."

The World Health Organization estimates that  35 percent of women worldwide have experienced physical or sexual partner violence or non-partner sexual violence  in their lifetime. According to UN Women, in Cambodia, at least one in five women is a victim of GBV and more than half of all children's experience of some form of physical violence by an intimate partner, parent or adult relative, or community member. These figures seem comparable with other countries, but not express how the nature of violence in Cambodia is debilitating and accepted as a part of life.

"Studies show that  gender-based violence can cost up to 3.7 percent or GDP due to lost productivity,"  said  Caren Grown, Senior Director, Gender, World Bank Group "The World Bank Group is proud to support the Development Marketplace winners, whose projects seek to find sustainable and scalable approaches to preventing GBV for us today and for future generations."