Suffering in Silence: The Links between Human Rights Abuses and HIV Transmission to Girls in Zambia

This document from Human Rights Watch reports results of a study of human rights abuses of Zambian girls less than eighteen years of age, the majority orphaned by HIV/AIDS. It gives background information about the effects of HIV/AIDS on the continent of Africa, on women and girls more specifically, and in the country of Zambia. It then describes the situation of orphans and vulnerable children, of traditional practices which can increase the risk of HIV infection, and of sexual abuses related to the risk of HIV transmission. It details the shortcomings of the current legal framework of both international and national law and describes the state and international responses and their inadequacies.

The report comes from the findings of two Human Rights Watch researchers who visited 36 non-governmental organisations (NGOs), orphanages, or other centres for children and, with their help, interviewed approximately 100 girls under eighteen years of age. The summary background includes the following:

"In Zambia, as in other countries in the region, tens of thousands of girls - many orphaned by AIDS or otherwise without parental care - suffer in silence as the government fails to provide basic protections from sexual assault that would lessen their vulnerability to HIV/AIDS.

Through girls' own testimonies, this report shows sexual assault of girls in Zambia in the era of HIV/AIDS to be widespread and complex. It documents several categories of abuse that heighten girls' risk of HIV infection, including (1) sexual assault of girls by family members, particularly the shocking and all too common practice of abuse of orphan girls by men who are their guardians, or by others who are charged to assist or look after them, including teachers, (2) abuse of girls, again often orphans, who are heads of household or otherwise desperately poor and have few options other than trading sex for their and their siblings' survival, and (3) abuse of girls who live on the street, of whom many are there because they are without parental care. All of these situations of abuse must be addressed as part of combating the HIV/AIDS epidemic in Zambia....

As this report notes, one of the key problems in the state response is the failure of the criminal justice system to deal appropriately with complaints of sexual abuse. There are many barriers to effective reporting and prosecution of crimes of sexual assault, including additional elements of coercion. For orphaned girls being abused by men who are meant to be their guardians or otherwise to be helping to look after them, reporting the abuse may mean risking abandonment or violent punishment."

Among the recommendations are the following:
"To the Government of Zambia
• Design and implement programs that would afford girls some basic protections from sexual violence and exploitation. Such programs should include greatly increased capacity for reporting and investigating abuses and providing counseling and treatment for victims. These should include training of police, social welfare workers and legal officers to improve their capacity to work with girls and encourage them to report sexual violence and other human rights abuses, establishing clear procedures for reporting and follow up, and strengthening coordination among all service providers. The government should consider creating special centers where abuses against girls can be reported, staffed by trained police, medical personnel, and counselors, and should establish monitoring mechanisms to ensure that the procedures are effective and accessible. All of these improvements should be based on wide consultations with governmental and nongovernmental actors. Disseminate information about these initiatives as part of the national strategy to combat HIV/AIDS.
• Train all police officers in the recognition and combat of gender-based violence and child abuse, including developing relevant forensic skills. In particular, target the Victim Support Unit for sustained and in-depth training in investigating sexual violence and child abuse, as well as in national and international law prohibiting sexual violence.
• Strengthen support services for victims of rape and sexual assault, such as counseling, testing, health and medical services, legal and financial services, and providing the indicated short course of antiretroviral drugs (post-exposure prophylaxis) for rape victims. Promote the expansion of youth-friendly health services that address the physical and psychological health needs of girls, including counseling related to sexually transmitted diseases.
• Make spousal rape a crime along with other categories of sexual violence.
• Provide training to develop the capacity of medical, judicial, and law enforcement personnel to assist victims of child abuse and sexual violence. Train teachers, social workers, and counselors to identify vulnerable or abused children and to take steps to provide protection.
• Implement and enforce laws and regulations in conformity with the constitutional provision against discrimination and with international" standards, with specific reference to discrimination against women and girls in education, inheritance rights and custody of children. Promote gender equality under law and take steps to remove discriminatory provisions of customary law. Launch awareness campaigns to inform and educate all Zambians about these rights.
• Enact anti-discrimination laws to reduce human rights violations against children affected by HIV/AIDS. Ensure access of all children to HIV/AIDS-related information and education.
• Take steps to protect sex workers from violence, including training law enforcement and judicial personnel to treat their cases without discrimination or bias, and to provide them with HIV/AIDS information, counseling and treatment.
• Modify education policy to eliminate the practice of banning pregnant girls from school for any amount of time. Design and implement programs to ensure that pregnant students stay in school and return if desired after the birth of a child.
• Promote awareness of the dangers of cultural practices that put girls at risk of HIV infection. Engage traditional leaders, healers, birth attendants, and other guardians of tradition at the community level to recognize and address traditional practices that further girls’ vulnerability to HIV infection.
• Enact national laws to ensure compliance with human rights instruments to which Zambia is a party, particularly the Convention on the Rights of the Child (CRC) and the Convention on the Elimination of All Forms of Discrimination against Women (CEDAW). Put in place national institutions to promote and protect these rights and to monitor their implementation.
To the donor community
• Assist in the development of governmental and nongovernmental programs designed to address the link between sexual violence and coercion and HIV/AIDS in Zambia. Target support at programs to enhance protection of girls’ rights and to develop mechanisms to monitor these abuses. Provide financial and technical assistance to civil society organizations that seek to address abuses against girls, including legal services, counseling and testing, and medical assistance.
• Contribute to training law enforcement and judicial personnel on the links between sexual violence and HIV/AIDS, and on international legal standards. Assist law enforcement agencies in acquiring necessary forensic skills and equipment for investigating cases of sexual violence.
• Engage publicly and privately with the Zambian government to highlight the importance of including violence against girls and women in broader AIDS prevention programs. Ensure that the specific needs of girls at risk of HIV infection are addressed.
To the United Nations
• Engage in high-profile advocacy about the link between human rights abuses and HIV transmission to girls in Zambia, and reflect this link in HIV/AIDS programs support by the U.N. in the country. In particular, ensure that UNICEF programs reflect the special protection needs of girls with respect to the AIDS epidemic."

The report summary concludes with this statement: "International and national policymakers should muster the political will and take the steps necessary to break this cycle of abuse and transmission and must make protection of girls' human rights a central part of their anti-HIV/AIDS strategies. Allowing girls to suffer in silence not only perpetuates serious human rights violations; it ensures that the HIV/AIDS epidemic will continue on its destructive course."