Medicus Mundi Spain | On the world-wide day of the Elimination of Violence against Women, we look at the case of Mauritania, where slavery persists, as well as the force-feeding or fattening of girls for aesthetic reasons. medicusmundi works in the field with the women of the community.

2020 will not only go down in history as the year of the global pandemic. It will also be the twelve months that have put women back at the center in an emergency context, aggravated by economic precariousness and social instability. One of the collateral damages is the increase in violence, sexual abuse and murder against women worldwide, although in many countries the magnitude is still unknown.

In Spain the state of emergency left a worrying balance in terms of gender violence. According to the Observatory against Domestic and Gender Violence, during the de-escalation there was a 61% increase in calls to 016, a number that deals exclusively with situations of possible gender violence. In China, complaints of abuse tripled during the month of February at the start of the pandemic. In Brazil, violence increased from 40% to 50%. In Liberia, to 50%. In Kenya almost 4,000 school children became pregnant due to school closure.

Mauritania is one of the countries in which the scope is still unknown. medicusmundi has been developing projects for Mauritania from a gender perspective since 2008, made posible by the aid worker Alejandra Carmona. She is responsible for projects of Sexual and Reproductive Health and, as an exceptional witness, tells us how the women there are more than just collateral damage of the great crisis unleashed by the coronavirus.

What have been the consequences of the pandemic among the Mauritanian population?

The most obvious consequences can be summarized as increased economic, health and educational vulnerability. The violence perpetrated against women becomes a medical, forensic and psychological emergency for which a specific protocol of action must be integrated into the socio-health structures.

Adolescent and adult women are in a serious situation of vulnerability accentuated by the pandemic, with difficulties in accessing health services, employment or governance. In addition to this, there is an increase in sexual assaults, as well as other types of gender-based violence such as spousal violence.

Violence against women in Mauritania also extends to girls who suffer, as a majority, from child marriage, female genital mutilation or force-feeding, as known as gavage. This practice responds to existing beauty canons in which obese women are more highly valued. Girls are subjected to force-feeding for weight gain. Even though this practice is decreasing, it is worth remembering that in 2008 the Association of Women Heads of Families (AFCF) documented 148 deaths from force-feeding and 12 cases of women dying after ingesting bird-feeding pills.

Female Genital Mutilation (FGM) remains one of the biggest problems in the region where we operate, Brakna, with 6 out of 10 girls being mutilated. It is currently prohibited in health structures, but it continues to be carried out mainly in rural areas. We must remember that between 2010 and 2015, 54% of girls were subjected to FGM before the age of 15.

Child marriage is primarily present in rural areas, with a prevalence of 41% among girls under 18 years of age and 17% among girls under 15 (Profil genre 2015). The presence of women in higher education (data from 2012) is 18%, which is closely related to early marriage.

In our intervention area, Brakna, 40% of children under 18 are married, compared to the national average of 35%.

According to the National Survey on Violence against Women in Mauritania (2011), another worrying aspect is sexual violence perpetrated within the conjugal context, which reaches 17.3% of marriages. Also, about 60% of women between 18 and 64 years old, married, widowed or divorced, claim to have suffered at least one act of psychological violence.

Girls and young women also suffer sexual violence outside of marriage, a very sensitive issue to deal with since it can be interpreted as extra-marital relationships, which are criminalized by law. According to Islamic law, sexual relations outside of marriage are still illegal today, and their penalty is known as zina conviction. The reporting of rape makes the victim a criminal defendant.

Within the health context, obstetric violence is practiced in many different ways. In maternal health services, misconduct such as ignoring patients, abusing them, insulting them, or making unnecessary interventions that impact women’s health, is reported. Even the women from high economic standings suffer from abusive C-sections, which are more expensive interventions for which private clinics make greater profits. Clearly, women’s health is relegated to secondary importance.

Another noteworthy aspect is slavery. Although it was abolished in 1981 and criminalized in 2015, it is still very present in Mauritanian society and especially among Haratin women, who continue to be victims of discrimination. Female slaves suffer sexual violence and exploitation inside their masters’ homes. They have especially suffered the consequences of violence in confinement.

Finally, it’s crucial to mention the violence against the elderly. There is a high incidence of moral and material neglect of older women. There are many men who abandon their life-long partners for younger women. Many women already in old age are left completely helpless.

What legislative advances, or social awareness, are there in the country in this regard?

There is no shortage of laws in Mauritania. What is lacking is their enforcement. There are several initiatives: local conflict management committees, regional coordination of family conflicts. The big problem is the taboo aspect: women do not have the courage to take legal action or go to court.

There are laws against Female Genital Mutilation, which prohibits its practice on minors under 18 (law 2005-015 art. 12) (CEAR 2019). There is legislative framework in the Family Code on child marriage, which sets the minimum legal age for marriage at 18 unless the consent of the legal guardian is given or the silence of the victim is imposed and interpreted as consent.

In May 2019, the Ministry of Health approved a specific protocol for the medical management of cases of sexual violence. But it has not been implemented due to the lack of budget despite being one of the government’s priorities. Currently only two hospitals in the capital include it in their practice, both to treat cases of sexual violence and other types of gender-based violence.

The penal code deals with cases of sexual violence in two of its articles (309 & 310), however, it abstains from legally defining the act of rape and/or sexual abuse, thus limiting the execution of the laws. The legal inconsistencies, along with the lack of resources, result in a lack of coordination among public actors with competence in responding to victims of gender violence: police, justice, social and health services.

In recent years, Mauritanian society and public institutions have started to become more aware of violence and identified it as a negative practice. The Mauritanian government now has a more open position and wishes to implement a national intervention strategy, which allows us to include the issue of sexual violence in our projects in order to address other types of violence, such as conjugal violence or early marriages.

Since 2008 medicusmundi has been collaborating in Brakna, and working inside community women’s networks, such as the members of the organization Fabouya, that in turn work with the Ministry of Social Affairs, Children and Family (MASEF). MASEF channels its work through these women facilitators. In Fabouya’s case, the President Marieta Dia explains that they are in charge of training women and monitoring medicusmundi programs in the area of sexual and reproductive health. The aim is not only to change behaviors in the communities, but also to provide women with a space for personal development with which to increase their self-esteem, positioning, and community awareness.

Report by Teresa Rosario, Medicus Mundi Spain , 25 November 2020
Read the original text in Spanish here