1. Situation Overview: Report of UNFPA s action In Tunisia-Libya Border (11-17April 2011) As of April 17, 257,448 people crossed the Tunisian-Libyan border since February 20, 2011. The population in Ras Jdir camps (Choucha, IFRC and UAE) amounted to 6375, of whom the majority are Somali (21%). A massive influx of refugees at the Libyan border area, Dhibet, was recorded this week, with up to 2000 persons crossing per day. 812 people (132 families) are present at the Remada camp, located at 45 km from Dhibet. 49% are aged under 18. 2. UNFPA Response a) Main objectives Assess the situation in the second entry point of Dhibet and defining the role of UNFPA in the governorate of Tataouine. Test and validate the system of reference for sexual and reproductive health as well as for prevention, detection and care management of survivor (s) of sexual and gender based violence. Continue to provide psychosocial support to people affected by the crisis. Continue to provide sexual and reproductive health services in the context of the crisis, in order to include support for victims of sexual and gender based violence. Ensure integration of means of protecting women and children against gender based violence in all components related to the management of the camp. Coordinate with other agencies, organizations, funds and programs operating on the ground in response to the crisis, particularly in the context of sub working groups on gender-based violence and psychosocial support (chaired by UNFPA) and continue active participation in health working group, camp management working group, protection working group and interagency information/ coordination meetings. b) Mechanisms put in place i. Resources Human Resources - Team composed of 2 psychologists, 4 social workers and 2 midwives recruited locally. - A mobile team of midwives, nurses and social workers set up by National Family and Population Board. - Two national staff of the Tunisia UNFPA country office. 1
- A coordinator from the Morocco UNFPA country office ii. Organization a. Axis Chouha- Ras Jdir Psycho-social support The psycho social support fixed unit (UNFPA tent) was maintained Social support continued to be provided in Choucha camp Sexual and Reproductive Health The SRH consultation is provided by two midwives recruited locally, the minimum package of SRH services is available. A biweekly support is provided by the ONFP mobile unit in the IFRC and UAE camps. In addition, weekly supervision is provided by midwives from ONFP local Centre of Ben Guerdane. Psychological care of victims is provided at the UNFPA unit level of psychological support according to the referral system put in place by UNFPA. b. Axis Tataouine- Dhibet Psycho-social support UNFPA psychologist provides psychosocial support in refugee Remada camp within the Tunisian Association for Reproductive Health Unit. Sexual and reproductive health (SRH) UNFPA provides logistical support in terms of SRH through the provision of RH kits to the stakeholders (MSF, ATSR) and the structures of the MoH. Sexual and Gender Based Violence It is planned that the psychologist will be trained to receive the victims of sexual violence, within the training course organized by UNFPA and UNHCR next week. A referral system will be established soon at the axis Tataouine Dhibet. 2. Achievements More than 2,240 dignity kits have been distributed since the beginning of the crisis to women and girls in Choucha, IFRC and UAE camps. The distribution is continuing based on new arrivals and needs. Sexual and Reproductive Health Consultations 2
The assessment mission to the governorate of Tataouine was an opportunity to analyse needs and to examine the adequacy of the MISP implementation. UNFPA has carried out this mission in partnership with Tataouine section of the Tunisian Association of Reproductive Health (ATSR) and the need to implement the MISP was clear. It was decided by mutual agreement that UNFPA would offer logistic support to ATSR in Remada through RH kits provision and human resources support by appointing a psychologist with the association team in the camp in order to provide psycho-social support to the population camp. UNFPA is also planning to provide logistic support to second and third level health structures of the region. The referral system for victims of SGBV (Annex 1) established in consultation with other stakeholders (UNICEF, UNHCR, IOM, IFRC, military) define different steps for the management and follow up of SGBV cases as well as information sharing mechanisms. This reference system was tested this week and has already enabled effective coordination between the UNFPA team and other stakeholders (Military, UNHCR, IOM) for the management of 3 victims of SGBV. The SGBV sub working group is still working on finalizing the document on standard operating procedures. This document describes the roles, responsibilities of stakeholders involved in the management of SGBV cases. A training program on SGBV prevention and management (Annex 2) for the benefit of medical and paramedical service providers, psychologists and social workers was established in collaboration with UNHCR, three sessions are scheduled next week. In collaboration with Save the Children, UNHCR and Islamic Relief France, the UNFPA team has identified an area of service delivery for families located in the heart of the new family area. 3. Challenges a. The new family area will gather all families in the same area and thus ensure their better security conditions and better access to services available. However, many families refuse to be displaced and the coexistence of two family areas may make it difficult for women to have access to services. 3
b. UNFPA's intervention in the axis Tataouine Dhibet should be adjusted according to the situation evolution. 4. Next Steps a. Strengthen the intervention of UNFPA in the axis Tataouine Dhibet. b. Build the capacities of the new UNFPA team. c. Continue the training program on SGBV and MISP for medical, paramedical and psycho-social service providers working in the field. d. Conduct regular field assessments to determine the needs of families. e. Order RH kits according to identified needs. f. Extend the information system set up at Choucha Camp to the rest of transit camps camps (UAE and International Federation of Red Cross). g. Advocate for the effective implementation of SOPs for the prevention and management of SGBV cases. Annex 1: SGBV Referral System 1. Prevention: Focus group discussion in the women tent (UNHCR and UNFPA) Possible Move of the tents that are too far for single women (Islamic Relief) Distribution of torches and whistles (UNHCR and UNFPA) Awareness raising sessions among men and women and community leaders primarily (UNFPA) 2. Detection and Reporting - Directly by UNFPA: Detection including sex workers (SWs) and questions to ensure they do not suffer violence. Field visits (observation and interview) for other cases and / or psychological care under the tent - Referenced by other organizations (military, Islamic Relief, and possibly others) Systematic referral of case to UNFPA team (if reported case, sharing with the team of UNFPA the reporting form filled out) Reporting of cases centralized by UNFPA (see reporting form) 3. Psychological Support i. The psychological support should be provided by UNFPA and UNICEF (if the victim is a child). Possibility supported by other teams if UNFPA and UNICEF psychologists are not present or for practical considerations. ii. The protocol of psychological care is as follows: a. Listen and ask relevant questions without being intrusive and non-judgmental for clarification. Do not squeeze the victim and have several interviews (thus establishing a relationship of trust). If the survivor/ victim blames herself (we use the feminine for ease of reference), she must be reassured and reminded that sexual violence is always the fault of the author and not that of the victim / survivor. b. Assess your needs and concerns, and give a particular attention to her security: ensuring that basic needs are met; encourage but not force the confidence to be established, etc.. Ensure the safety and help develop a safety plan if necessary. c. Provide honest and complete information on services and facilities available. d. Do not tell the victim what to do. On the contrary, promote her empowerment by helping her solve her problems, to identify ways to better cope, identifying choices, and evaluate the consequences of those choices. Possibility of referral to other services 4
accordingly. Engage dialogue and promote the resilience that can vary depending on the individual and culture. Stimulate the resumption of everyday activities. Encourage the active participation of the survivor / victim in family activities and community. If possible, teach relaxation techniques. Discourage survivor fall into negative ways of coping, such as alcohol and drugs, because trauma survivors are at high risk of developing problems of addiction / dependence. Where possible, increase family support as it can play a key role in supporting victims (when they are not the authors). For example, they can help victims / survivors to return to their habits ( child care, food, recreation, etc.). Conversely, the family may contribute to increased emotional trauma if its members blame the victim of the abuse, reject her, or are angry against her. e. Address the special needs of children. Reference to the UNICEF team when the victim is a child. Use creative methods (eg games, stories, and drawings) to help put children at ease and facilitate communication. Use language appropriate to the age and conditions. Where appropriate, include family members who are trusted to ensure that the child / young person is supported, and is returning to "normal" life. Do not remove children from family care to provide treatment (unless it is done to protect against abuse or neglect). Being constantly guided by the best interests of the child. f. Always observe the following guidelines: Ensure safety/ Ensure confidentiality/ Respect the wishes, choices, and dignity of the survivor- victim/ Ensure nondiscrimination/ All training in psychology support / advice should be followed by a field supervision. g. Advocating for the victim / survivor in terms of health, social, legal, and security h. Initiate community dialogues to raise awareness about the fact that sexual violence is never the fault of the victim / survivor and identify solutions to honor killings, denial, stigma and isolation i. Provide necessary material support through health or other services. j. Facilitate the participation and inclusion of survivors in the community. This can be done through activities of common interest (eg, leisure / education / etc.) and activities that enhance self-sufficiency (in the longer term and for long stayers). k. Link with other key actors in social support (non-food items, communication for behavior change, information, education, etc.). 4. Medical care UNFPA Sexual and reproductive Health consultation Moroccan Hospital It should be limited to these two points of health to the extent of post Rape Kits are available in these two health points and the specific protocol of care is known by both. If vaginal tears happen, the Moroccan hospital and the Tunisian military Hospital are entitled to intervene. 5. Safety: - In the immediate future: revisit the possibility of occupying a tent by the IFRC / otherwise try the Ministry of Women - In the short / medium term: to ensure the priority of repatriation (IOM) / priority for resettlement or other durable solution(unhcr) 6. Legal assistance: Support for filing a complaint and follow up legally: Military Tunisians (and Ministry of Women?) 5
* In addition, training sessions are organized by UNFPA on prevention, detection and management of SGBV (for health providers and social workers). Annex 2: SGBV training program DATE HOUR THEMES Social workers and psychologists training Tuesday 19/04 10h-12h Introduction to SGBV. The referral system in Shousha camp. Thursday 21/04 10h-12 h Interview techniques. Management of child survivors of sexual violence. Monday 25/04 14h-16h Human trafficking prevention. Secondary trauma and burnout.. Medical and paramedical staff training Thursday 21/04 12h-14h Medical management of rape cases. 6