Testimony by Susan Markham, Senior Coordinator for Gender Equality and Women's Empowerment, before the Senate Subcommittee on International Operations and Organizations, Human Rights, Democracy, and Global Women's Issues

Tuesday, June 24, 2014


Good afternoon, Chairwoman Boxer, Ranking Member Paul and distinguished Members of the Subcommittee. Thank you for the opportunity to testify before you today regarding the critical issue of gender-based violence. It is an honor to be joined by my colleague from the State Department and by others working to effect change on this issue.

Under the leadership of President Obama, the United States has put gender equality and the advancement of women and girls at the forefront of the three pillars of U.S. foreign policy–diplomacy, development, and defense. This is embodied in the President’s National Security Strategy, the Presidential Policy Directive on Global Development, and the 2010 U.S. Quadrennial Diplomacy and Development Review. Women’s empowerment is critical to USAID’s core mission of ending extreme poverty and promoting resilient, democratic societies while advancing our security and prosperity and addressing pressing health and education challenges.

Preventing and responding to gender-based violence is a cornerstone of the Administration’s commitment to advancing gender equality. Such violence is often a direct result of existing inequalities and hinders the ability of individuals to fully participate in and contribute to their families and communities–economically, politically, and socially.

The United States Congress, and this Committee in particular, has long championed efforts to prevent and respond to gender-based violence. As a result of these tireless efforts, Congress has been a key driver in responding to gender-based violence in the context of early and forced marriage, female genital mutilation/cutting, and region-specific violence against women, from Latin America and the Caribbean to the Middle East and North Africa. Congress has played a critical role in highlighting the bipartisan commitment of the United States to preventing and responding to gender-based violence, and has helped strengthen ongoing U.S. efforts.

Statement of the Problem and Statistics

The United States has a strong interest in preventing and responding to gender-based violence around the world. Regardless of the form that gender-based violence takes, it is a human rights abuse, a public health challenge, and a barrier to civic, social, political, and economic participation. It leads to many negative consequences, including adverse physical and mental health outcomes, limited access to education, increased costs relating to medical and legal services, lost household productivity, and reduced income.

Gender-based violence cuts across ethnicity, race, sexual orientation, class, religion, education level, and international borders. The majority of survivors are women and girls, but men and boys are also subjected to this crime.   An estimated one in three women worldwide has been beaten, coerced into sex, or otherwise abused in her lifetime, with intimate partner violence as the most common form of violence experienced by women globally. An appalling 38 percent of all murders of women globally were reported being committed by their partners. Gender-based violence can also take the form of harmful traditional practices, such as female genital mutilation/cutting, so-called “honor killings,” bride abductions, and early and forced marriage.

An estimated 10 million girls are married every year before they reach 18.  Early and forced marriage is a practice that increases a girl’s risk of school dropout, maternal mortality, short birth intervals, and vulnerability to other forms of gender-based violence, among other adverse outcomes. Children are particularly vulnerable to violence, especially sexual abuse. According to the United Nations Population Fund, almost 50 percent of all sexual assaults worldwide are against girls 15 and younger.  In 2002, 150 million girls and 73 million boys under the age of 18 years experienced forced sexual intercourse or other forms of sexual violence.  Sexual violence is also often used as a tactic of war during conflicts. In the context of humanitarian crises and emergencies, civilian women and children are often the most vulnerable to exploitation, violence, and abuse because of their gender, age, and status in society. Women with a disability are two to three times more likely to suffer physical and sexual abuse than women with no disability.  Lesbian, gay, bisexual, and transgender persons also face heightened risk. Sexual violence can also directly lead to HIV infection. Gender-based violence can foster the spread of HIV by limiting one’s ability to negotiate safe sexual practices, disclose HIV status, and access services due to fear of reprisal.

Gender-based violence undermines the safety, dignity, health, and human rights of survivors as well as the public health, economic stability, and security of nations. The United Nations Secretary-General’s 2005 in-depth study on violence against women found that when calculated across 13 countries (Australia, Bangladesh, Canada, Chile, Finland, Jamaica, Nicaragua, Netherlands, New Zealand, Spain, Switzerland, United Kingdom and United States) the cost amounted to USD 50 billion per year.

USAID Work on Gender-Based Violence

For over two decades, USAID has partnered with non-governmental organizations, public international organizations, faith-based organizations, and host government institutions to increase awareness of the scope and impact of gender-based violence, improve services for survivors of violence, and strengthen prevention efforts.

Over the last two years, USAID has reinvigorated and strengthened its work on gender equality and women’s empowerment, launching a number of new complementary policies and strategies to bolster and leverage our efforts. These policies include USAID’s Gender Equality and Female Empowerment Policy, which provides guidance to our staff in Washington and in the field on pursuing more effective, evidence-based investments in gender equality and female empowerment and incorporating these efforts into our core development programming. The U.S. National Action Plan on Women, Peace, and Security focuses on gender equality and women’s empowerment in crisis and conflict-affected countries to promote the rights and well-being of women and girls and to foster peaceful, resilient communities that can cope with adversity and pursue development gains. The U.S. Strategy to Prevent and Respond to Gender-Based Violence established a government-wide approach that identifies, coordinates, integrates, and leverages current efforts and resources. The U.S. Government Action Plan on Children in Adversity is the first-ever whole-of-government strategic guidance on international assistance for children in adversity integrating assistance and measuring results to ensure that children ages 0-18 not only survive, but thrive. The USAID Vision for Action: Ending Child Marriage and Addressing the Needs of Married Adolescents highlights the need for development efforts to combat early and forced marriage and focus on regions, countries, and communities where interventions to prevent and respond to early and forced marriage are most needed and most likely to achieve results. The updated President’s Emergency Plan for AIDS Relief (PEPFAR) gender strategy prioritizes gender-based violence prevention activities as well as the provision of post gender-based violence care, and also seeks to address the harmful norms that perpetuate such violence. And finally, the USAID Counter-Trafficking in Persons Policy reinvigorates and focuses Agency efforts to combat trafficking on concrete, measurable principles and objectives.

USAID’s aspiration is simple—to use this framework to build on its global reach and expertise in development and humanitarian assistance to maximize the impact of Agency efforts to prevent and respond to gender-based violence.

USAID supports many programs that prevent and respond to gender-based violence around the world. All USAID gender-based violence programs seek to reach the most vulnerable populations— including women, children, persons with disabilities, lesbian, gay, bisexual, and transgendered persons and the elderly—who often face extraordinary levels of violence and abuse.  Sadly, women and children often fare the worst in war, and gender-based violence rates often increase in complex crises around the world. Gender-based violence threatens to undermine the rights and security of women and girls – and even boys and men. It also threatens to stall or even reverse the important development gains made in many of the countries in which USAID works.

Since 2013, USAID has funded 25 humanitarian assistance programs designed to prevent and/or respond to gender-based violence in countries affected by conflict and natural disaster, including the Democratic Republic of Congo, Syria, South Sudan, and the Central African Republic.

Programmatic Successes

USAID programs address the root causes of violence, improve prevention and protection services, respond to the health and economic needs of those affected by gender-based violence, and support legal frameworks that mitigate gender-based violence. Within these programs, USAID works to engage women and girls – and to engage men and boys as advocates to both prevent and respond to sexual harassment and assault.

Addressing the root causes of violence

Poverty, social norms, and the imbalance of power between men and women are often drivers of gender-based violence. In South Africa, USAID is supporting the scale-up of the Intervention with Microfinance for AIDS and Gender Equity (IMAGE) Project. The IMAGE project sought to find evidence about the scope of women’s empowerment and the mechanisms underlying the significant reduction in intimate partner violence documented by the cluster-randomized trial in rural South Africa. The findings, both qualitative and quantitative, indicate that economic and social empowerment of women can contribute to reductions in intimate partner violence.  The IMAGE intervention combined a microfinance program with participatory training on understanding HIV infection, gender norms, domestic violence, and sexuality. After 2 years, the risk of past-year physical or sexual violence by an intimate partner was reduced by more than half.

Improve prevention and protection services

USAID recognizes that protection of vulnerable populations must be addressed in both public and private spaces. USAID’s Safe Schools Pilot Program worked to reduce school-related gender-based violence in selected schools in Ghana and Malawi and to support prevention programs and support services for 30,000 girls and boys. By the end of the project, teachers and students exhibited changed attitudes about gender-based violence. The program was scaled up and launched in the Dominican Republic, Senegal, Yemen, Tajikistan, and the Democratic Republic of Congo. In addition, USAID has formed a partnership with the Peace Corps to use the Safe Schools materials and train volunteers on how to create a safe classroom environment, integrate gender-equitable practices into teaching and classroom management, and promote primary school reading.

Gender-based violence is a longstanding problem in Haiti where the risk of violence and sexual exploitation is exacerbated by poverty, poor security, and a lack of awareness. USAID provided direct support and technical assistance to the Ministry of Women’s Affairs for a campaign against rape.  In addition, USAID is training Haitian health care providers at 31 facilities on how to identify and manage gender-based violence cases and provide referrals to social and legal services. Since 2012, more than 177,000 people have been surveyed and sensitized on gender-based violence, including 485 staff, over 118,000 patients, and over 58,500 community members living in high‐risk areas.

Because the crisis in Syria is fundamentally a failure of protection of the civilian population, our overall humanitarian response strategy within Syria is informed by a protection analysis and includes measures to promote the protection of the population—including prevention of and response to gender-based violence. Our five protection priorities to address the crisis in Syria are gender and protection mainstreaming, gender-based violence prevention and response, child protection, psychosocial support, and humanitarian access. Additionally, specific activities include improving access to urgent clinical care and support, establishment of safe healing and learning spaces, basic needs provision, livelihoods opportunities and emergency shelters, and, within refugee hosting communities, efforts to prevent early marriage, human trafficking, child labor and domestic violence.

Responding to health and economic needs

Effective approaches to providing services to survivors are most often holistic in nature. This includes improving access to comprehensive sexual and reproductive health services and mental health care for survivors of sexual violence so that they can rebuild their lives on their own terms, and physically and emotionally move beyond the point in time when they were victims of assault.  In 2013, USAID's Victims of Torture program in the Democratic Republic of the Congo in the geographical areas of North and South Kivu reached more than 42,000 beneficiaries to provide medical treatment, psychological and social support, legal assistance, awareness raising and economic strengthening. An impact evaluation of the mental health components of this program documented positive results for survivors participating in therapy, validating research tools that can be applied to similar programs in low-resource settings. For example, in this case we learned that women who participated in group cognitive processing therapy experienced a stronger reduction of post-traumatic stress disorder symptoms than women who received individual counseling. Having these tools helps us design tailored approaches that are effective for supporting survivors in different contexts.

Through the Gender Equity Program in Pakistan, USAID is providing social and economic rehabilitation of gender-based violence survivors by supporting twelve shelters and helplines across Pakistan. Through this model, thousands of gender-based violence survivors in Pakistan are receiving legal services, psycho-social counseling, technical and vocational skills training, and economic rehabilitation services for the first time. The successful implementation of this model has attracted government shelters to adopt a similar approach. The Gender Equity Program has also developed a strategy on combating gender-based violence which will work as a guideline for the provincial governments on addressing gender-based violence issues. The strategy has already been endorsed by three provincial governments.

Supporting legal frameworks to mitigate gender-based violence

This type of engagement with local governments to strengthen laws and policies is critical in combating gender-based violence. Even as we strengthen our support for survivors, we know that impunity for conflict-related sexual violence and other forms of gender-based violence is a major challenge for prevention. In 2013, USAID provided funding to support a state-of-the art training with Justice Rapid Response on the investigation of gender-based violence under international law. The training expanded the number and regional diversity of experts available to serve on a dedicated roster of gender-based violence experts that provides the international community with a rapidly-deployable, stand-by capacity to investigate these crimes. The training focused on Middle East and North Africa regional experts and Arabic-speaking interpreters. We anticipate that some of these participants will serve on commissions of inquiry looking into allegations of human rights violations and abuses in the Middle East and North Africa region.

USAID in El Salvador is working with the judicial system, the Attorney General’s Office, the national police, and the Salvadoran Institute for the Development of Women to ensure domestic and sexual violence survivors receiving humane, efficient, and professional treatments. The project also focuses on training police officers and judicial staff across the country to protect and respond to the needs of survivors who are often forgotten. With USAID's support, 16 Victims Assistance Centers have opened, and there will be a total of 31 centers by 2018.

Looking Ahead

Looking ahead, USAID will continue to refine tools and interventions to effectively address gender-based violence. USAID is developing sector-specific toolkits that will help project design teams, project managers, and program officers integrate gender-based violence prevention and response efforts into USAID programs. USAID will continue to provide resources and training to staff to assist them with integrating gender-based violence issues into their work.

The Agency is actively involved in finding ways to adopt appropriate technology that provides innovative, effective, and cost-efficient solutions to address gender-based violence. USAID co-sponsored a Gender-Based Violence and Innovative Technologies: Opportunities, Challenges and Ethical Considerations event to bring together select researchers and programmers from the United States and abroad who are implementing innovative technologies to address gender-based violence in a range of settings.

USAID and many other Agencies, donors and foundations have invested in programs to prevent and respond to gender-based violence; however, there have not been enough rigorous evaluations of these programs to investigate what aspects of programs addressing gender-based violence are successful and what may need adjustment. USAID will continue to encourage stronger evaluations of activities that address gender-based violence.

USAID has invested in numerous research studies focused on understanding the gaps in preventing and responding to gender-based violence. In India, USAID is supporting research on the effectiveness of conditional cash transfers on delaying marriage among girls until the age of 18. In Uganda, USAID is investing in research to evaluate the effects of innovative scalable behavior change communication programs to prevent gender-based violence, which focus on working with adolescents and community gatekeepers to promote and establish gender equitable norms, as well as engaging fathers to promote positive parenting roles and to reduce conflict between men and their wives. In Pakistan, research on the scope and scale of violence against women has resulted in more targeted, regionally specific interventions and ultimately more effective service provision for survivors. In Afghanistan, USAID recently finalized a study on engaging men in ending gender-based violence and is funding the upcoming Demographic and Health Survey, which will generate detailed data on gender-based violence trends. The Afghan Government will use the survey to develop programs to address gender-based violence issues.

In September of 2013, Secretary of State John Kerry announced the Safe from the Start initiative, a joint USAID and State Department effort to build capacity of the humanitarian system for timely, quality and effective prevention and response. Agency resources are being used to support strategic investments to close knowledge and capacity gaps, enhance accountability to ensure gender-based violence prevention and response are a priority from the onset of an emergency, and build on the significant humanitarian funding State and USAID provide to prevention and response efforts each year.  Safe from the Start also represents the U.S. government’s commitments to the Call to Action, a closely related, multi-country effort launched by the United Kingdom last year which also aims to drive change across the humanitarian system to better meet the needs of women and girls in emergencies. The United States is proud to lead the Call to Action in 2014.

Gender-based violence is a pervasive problem around the globe, and in order to effectively combat gender-based violence, USAID needs to work with a wide network of partners. Therefore, USAID will continue to address gender-based violence through partnerships with host governments, civil society organizations, universities, donor organizations, foundations and private companies.

Chairman Boxer, Ranking Member Paul, thank you once again for the opportunity to speak to this vitally important issue.  I welcome your continued advice and counsel and would be pleased to take any questions you may have.

Committee on Foreign Relations, Subcommittee on International Operations and Organizations, Human Rights, Democracy, and Global Women's Issues