#HEALTHTALK 12: Combating rape: A pragmatic approach to the issues (Part 1)

The menace of rape has become a monster of sorts in this generation. Though we have witnessed increased activism against it, the monster still appears strong and fit in battle, especially here in Nigeria.

When a person is forced by someone to have sex with them, by using violence or the threat of violence, Merriam-Webster's Dictionary says that's rape. It is regarded in law as a crime, and as such, CAN ONLY BE DEALT WITH UNDER THE AMBITS OF CRIMINAL LAW.

In Nigeria, knowing when rape has occured depends on the location and the law that applies there. In Southern Nigeria, the Criminal Code dictates crimes and their punishments. In Northern Nigeria, the Penal Code of Northern States does that. And in the FCT and other states that have domesticated it, the Violence Against Persons Act of 2015 does that.

But, what is common to these Acts is that rape is penetration without consent, or with consent obtained by force, coercion, inducement or deception. Interestingly, they say nothing about whether or not the victim resists.

However, while the language of the Violence Against Persons Act 2015 does not specify a gender while defining rape, the criminal code specifically defines rape as a crime against women or girls ONLY.

It is also notable that these laws do not make a clear distinction between rape and what it simply terms "indecent assault", and they do not elaborate on that term either. They also make no definitions for other acts which may qualify as sexual harassment.

Rape is a traumatic experience that negatively affects victims in a physical, psychological, and sociological way. Even though the effects in the aftermath of rape varies among victims, individuals tend to suffer from closely related issues found within those three categories.

Sexual violence occurs across the spectrum. Children, adolescents, young adults and adults suffer as victims. A 2015 UNICEF report says that "one in four girls and one in ten boys have experienced sexual violence in Nigeria".

Similarly, according to a National Survey in Nigeria cited by Women At Risk International Foundation (WARIF), it was found that 24.8% of females, ages 18 to 24 years, experienced sexual abuse prior to age 18, of which 5.0% sought help, with only 3.5% receiving any services.

Again, just between October 2019 and now alone, there have been at least four highly publicized cases of rape which drew strong media attention and buzz. Yet, as we speak, none of these cases have resulted in a conviction in a court of competent jurisdiction.

This begs questions like: Is there something we aren't doing right? Is there something wrong with our nation's laws regarding rape? Is something wrong with how we as a society discuss and treat the issues concerning rape?

These and many more questions will be discussed during the course of this new #HealthTalk series on the subject, and we urge you to participate by making your voices heard in the comments section.

That being said, today, let's look briefly at the health impact of rape on women and girls specifically.

Physical Effects of Rape on Women and Girls

• Vaginal or anal bleeding or infection
• Hypoactive sexual desire disorder
• Vaginitis or vaginal inflammation
• Dyspareunia – painful sexual intercourse
• Vaginismus – a condition affecting a woman's ability to engage in any form of vaginal penetration
• Chronic pelvic pain
• Urinary tract infections
• Unwanted pregnancy
• HIV/AIDS
• Sexually Transmitted Disease/Infections

Psychological Effects of Rape on Women and Girls

Devastating mental health problems accompany rape, such as:

Post-Traumatic Stress Disorder (PTSD) 
An extremely debilitating disorder, occurring after a highly disturbing traumatic event. Most women and girls who are victims of rape go on experiencing PTSD for many years after the incident, which often impacts their ability to live normal lives.

Depression
Rape victims are three times more likely than non-victims to have ever had a major episode of depression. Depression remains a leading cause of suicide and suicidal thoughts.

Anxiety
After an attack, rape survivors have episodes of increased anxiety and fear. Feelings of dread, nervousness, tension, having a panic attack, and escape response become nearly common place in their lives.

Effects on Sexual Health

There have been a number of studies to observe critically the relationship between rape and sexual dysfunction. Sexual dysfunction includes difficulties with sexual functioning, including disturbances in sexual desire, alterations in the sexual response cycle, difficulties with sexual arousal, orgasmic disorders, and sexual pain.

Victims are more likely than non-victims to report at least one type of sexual dysfunction.

Types of dysfunction associated with sexual assault include fear of sex and arousal dysfunction, pain (medically explained and unexplained), and lack of sexual pleasure.

There are evidences that lingering mental health difficulties, such as depression and post-traumatic stress disorder may play an important role in initiating and/or prolonging these sexual difficulties.

Pragmatism: A new look and approach to the issues

One of the major problems of the fight against sexual violence in Nigeria is the absence of reliable data that reflects the true state of affairs. Most rape incidents in Nigeria among women and girls go unreported. But as we speak, there is no certainty about what the numbers really are.

To put this into perspective for you, currently, there is NO DATA on rape on the websites of both the Federal Ministry of Health and the National Bureau of Statistics in Nigeria! By contrast, this is not the same situation for the United Kingdom's National Health Services (NHS), and the United States' Department of Health and Human Services (HHS). And it says so much about how 'seriously' the Nigerian government really handles the issue of rape.

How exactly do we know for sure how serious the cases are if there are no numbers? If we're relying on assumptions and occasional data from the police, how credible and helpful are those in determining the actual impacts of the menace?

Furthermore, for fear of stigmatisation, police extortion and a lack of trust in the judicial process, many victims choose not to report cases to the authorities.

Many of those who do report come forward short of evidence to secure a conviction, or become used for activism and hashtag campaigns by organizations that aren't sincere enough in the fight to get justice.

For all intents and purposes, rape is a CRIME. This means that no amount of emotional outbursts on social media can lead to a punishment for alleged offenders. What will do so is securing a conviction based on the provisions of the criminal laws of the land. So, I believe that separating emotions from our approach to dealing with this monster is key to meaningful progress.

Combating rape starts by knowing the tools provided in law for that purpose, discovering the loopholes in the laws, and understanding how the provisions of the law applies.

In addition, there are other broad issues of social development for the boy child, which are often neglected, but which continue to bite hard at the matter.

To make significant progress, a new and pragmatic approach must be adopted, wherein we understand the issues, and fight smart.

In the next edition of #HealthTalk, we shall lay out the facts about what the provisions of the laws of Nigeria are in dealing with cases of rape and sexual assault. Please join us again next week Wednesday for that insightful discussion.


Chukwubuikem Anunaso, Lilian Eze, and Chisom Ogbonna contributed to this article.