Bir Savaş silahı olarak kadına yönelik cinsel şiddetin sağlık üzerine etkileri: Bosna Savaşı örneği

AMAÇ: Bir halk sağlığı ve insan hakları problemi olan savaşlarda kadına yönelik cinsel şiddetin sağlığa etkilerinin ve insan hakları boyutunun Bosna Savaşı örneği ile incelenmesi amaçlanmıştır. YÖNTEM: Bosna Savaşı, Birleşmiş Milletler kararları, Uluslararası Eski Yugoslavya Savaş Suçları Mahkemesi davaları, Sivil Toplum Örgütlerinin faaliyetleri, DSÖ yaklaşımı, Dayton Barış Antlaşması ve halen yürütülen sağlık programları, kadına yönelik cinsel şiddetin sağlığa etkileri ve insan hakları boyutu ile incelenmiştir. BULGULAR: Bosna Savaşı`nda kadına yönelik cinsel şiddet ve sistematik tecavüzler bir “etnik temizlik” aracı ve savaş silahı olarak kullanılmış, tahminen 20.000 ile 60.000 arasında kadın ve genç kız sistematik tecavüze uğramış, tecavüz kamplarında esir olarak tutulmuş, cinsel şiddete maruz kalmıştır. Kadına yönelik cinsel şiddet ve tecavüz sonrası tıbbi bakım; Yaralanmaların tespiti ve tedavisi, adli bildirim ve belgeleme, HIV/AIDS dahil Cinsel Yolla Bulaşan Enfeksiyonlara yönelik koruyucu ve tedavi edici hizmetler, acil kontrasepsiyon hizmetleri, güvenli tıbbi abortus, gebelik takibi, psikososyal destek ve takip hizmetleri ve sağlık çalışanlarının eğitimini içermelidir. Bosna Savaşı sonrası Ruh Sağlığı Reformu Bosna Hersek için öncelikli bir sağlık konusu olmuştur. Kurbanların sosyal açıdan damgalanmasını engelleyecek tedbirlerin alınması, ekonomik destek ve rehabilitasyon programlarının uygulanması, sosyal ve toplumsal bağların onarımı sürecinde faillerin cezalandırılması da önem taşımaktadır. Uluslararası Eski Yugoslavya Savaş Suçları Mahkemesi kadına yönelik cinsel şiddet ve tecavüz suçlarını da incelemekte ve cezalandırmaktadır. SONUÇ: Birleşmiş Milletler savaşlar sırasında kadınlara yönelik cinsel istismar ve tecavüzü “insanlığa karşı işlenen suç” olarak tanımlamıştır. Kadınların statüsünü iyileştirmenin yanısıra, tıbbi, adli ve sosyal kurumların işbirliği ile kurbanlara yönelik kapsamlı yaklaşımlar gerekmektedir.

[Health effects of sexual violence against woman as a War weapon: case of Bosnia War]

AIM: Health effects and human rights dimensions of sexual violence against women, a public health and human rights problem, evaluated by the case of Bosnia War. METHOD: Bosnia War, United Nations resolutions, International Criminal Tribunal for the Former Yugoslavia (ICTY) cases, activities of NGOs, approaches of WHO, Dayton Peace Agreement, current health programs were evaluated with the health effects and human rights dimensions of sexual violence against women. RESULTS: Sexual violence against women and systematic rapes were used as an “ethnic cleaning” tool and war weapon during Bosnia War, estimated 20.000-60.000 women and girls were raped systematically, captivated in rape camps, exposed to sexual violence. Medical care following the sexual violence against women and rape should include; Determination and teatment of injuries, forensic notice and documentation, preventive and curative services for Sexually Transmitted Diseases including HIV/AIDS, emergency contraceptive services, safe medical abortus, follow up of pregnancies, psychosocial support and services and training of health care professionals. Mental Health Reform became a priority health topic for Bosnia Herzegovina aftermath of the Bosnia War. Taking measures to prevent social stigmatism of the victims, economic support and implementation of rehabilitation programs, punishment of the perpetrators to repair social and community bonds are important. ICTY investigates and punishes the crimes of rapes and sexual violence against women. CONCLUSION: UN defines the violence against women and rapes during wars as “crime against humanity”. Besides improving the status of women, comprehensive approaches with the cooperation of medical, legal and social organisations are needed.

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