Supporting women survivors of violence in Papua New Guinea’s Highlands
While strong data is lacking, it’s estimated that almost 60 per cent of women and girls across Papua New Guinea (PNG) have experienced some form of physical and sexual violence, a rate which is almost twice the global average. Médecins Sans Frontières (MSF) has been working alongside the communities of Jiwaka, a province in the Western Highlands region, to strengthen access to healthcare services for survivors of violence.
PNG is one of the most linguistically and culturally diverse nations on earth, with more than 800 languages spoken and a multitude of tribal groups. After gaining independence in 1975, PNG has found itself in a difficult transition that led to heightened generational and gender conflicts, making it more difficult to resolve conflicts that had previously been settled internally through local traditions. Gender-based violence has become a common conflict-resolution mechanism, making most women and girls victims of violence within communities.
In addition, poverty has increased, and access to weapons and cheap alcohol has been facilitated. Intercommunal fighting breaks out regularly, particularly in the Highlands region, where clans and tribes clash over land, livestock, and gender-based disputes. Violence also erupts episodically over election outcomes or sporting results, often resulting in machete injuries. In Jiwaka, an autonomous province since 2012, violence stemming from sorcery accusations can also occur, and typically involves an older, vulnerable woman being violently attacked because of claims she has used sorcery – although men and younger women can also be targeted by this type of violence.
Barriers to healthcare
At clinics across Jiwaka province, health workers offer care in response to these various forms of violence – from suturing wounds, to providing family planning options and treatment for sexually transmitted infections (STI).
Julie Tope is a community health worker with the provincial health authority, who runs the STI and HIV clinic at Minj Health Centre. In caring for patients, she hears about the impact of violence on their lives. “The ladies or the girls may not want to have sex with the boys, but the boys use their force to have sex with them,” says Julie.
Despite the dedication of health workers like Julie, there are many barriers to survivors receiving adequate care. The Highlands region is very mountainous, with vast tracts of rainforest and few sealed roads or transport options, which makes it challenging for people to even reach health centres. Some communities live several days’ walk away from the nearest clinic, meaning many people simply go without care.
Some people are also deterred by the stigma towards survivors of sexual violence, or fear of reprisal, particularly in cases of tribal violence. If survivors do reach a clinic, there’s often shortages of essential medicines or supplies, a fee-for-service model, a lack of safe and confidential spaces and healthcare workers who are not always supported with adequate training.
Strengthening services
MSF has been working alongside health workers, community leaders, local organizations and authorities in Jiwaka since mid-2024 to strengthen quality of care and access to services for survivors of violence.
Janet Kilea is a health promotion and community engagement supervisor with MSF. She brings her personal experience to her role.
“I’m one of the survivors,” she says.
“I’m one of the survivors in terms of emotional abuse, physical abuse, economic abuse. Working with MSF is like being an advocate by using my experience to go back to the community, to empower women to make better decisions and see where the medical services are,” she says.
Janet and her colleagues conduct health promotion activities with communities to boost their understanding on topics such as women’s health and gender-based violence, as well as the available medical services in the area.
Village health volunteers like Jonah are dedicated to improving the health of their local community on a voluntary basis. He regularly visits people in his community to provide health information, and works towards changing attitudes at the same time.
“Men think they’re the ones in charge… maybe we should act like we’re in charge to resolve things in a non-violent way. We have to take responsibility,” he says.
MSF has been providing training to these village health volunteers as well as community healthcare workers employed by the local health authority, to build their skills on topics including wound and burns care, mental health counselling, sexual and gender-based violence care, and management of orthopaedic injuries.
The team is also working to support changes on a policy level, such as forming a provincial gender-based violence committee to strengthen the referral pathway for survivors. The committee has recently endorsed the provincial gender-based violence strategy, providing additional funding and resources for survivors.
Longer term, the team is collaborating with partners to establish a family support centre at Minj Health Centre in Jiwaka, connecting survivors of sexual and gender-based violence to all the services they need, from safe houses, to legal support and social workers.
In the meantime, Janet and her team are continuing to work at a grassroots level to build knowledge and understanding at community level.
“When we go down to the community, we educate, we talk, talk, talk. You know, information is power, to change people's mindsets. I tell women that I was once like you, but I feel strong with all the information that I’ve acquired.”