Introduction
- Law 30364 (to prevent, punish and eradicate violence against women and members of the family group) which establishes mechanisms, measures and comprehensive policies for the prevention, care and protection of victims, as well as reparation for the damage caused within the measures within a maximum period of 72 h after the complaint. Includes the issuance of necessary protection measures and reference to the Criminal Prosecutor's Office to initiate the process. This law also states that, if an obvious crime is noted, the aggressor must be arrested immediately. Promulgated in 2015. (Congreso de la Republica del Peru [17]) |
- Law 30314 (to prevent and punish sexual harassment in public spaces) which sanctions acts, comments and insinuations of a sexual nature, obscene gestures, improper touching and exhibitionism. Promulgated in 2015. (Congreso de la Republica del Peru [17]) |
- Law 27942 (on the Prevention and Punishment of Sexual Harassment) which addresses sexual harassment in the work environment. Promulgated in 2003. (Congreso de la Republica del Peru [17]) |
- Law 29819 which incorporates feminicide as a crime in the Criminal Code with a punishment of deprivation of liberty [jail sentence] for not less than fifteen years. Promulgated in 2011. (Congreso de la Republica del Peru [17]) |
- National Program for the Prevention and Eradication of Violence against Women and Members of the Family Group – AURORA: This program aims to design and implement actions and policies for the attention, prevention and support of people involved in acts of family and sexual violence at the national level. This program is attached to the Ministry of Women and Vulnerable Populations. Created in 2001 (AURORA 2020 [18]) |
- Protocol for joint action between Women's Emergency Centers (CEM) and Health Centers for the care of victims of violence against women and members of the family group: This protocol defines criteria and procedures for the comprehensive and effective coordinated action of two services that are part of the comprehensive care circuit for victims of violence. Created in 2009 (Observatorio Nacional 2019 [19]) |
Methods
Study setting
Research development and data collection
Participant recruitment
Judicial and police actors: KI-1, KI-16, KI-13, KI-14, KI-15 | Representatives of the Prosecutor’s Office at national and regional level. The Prosecutor’s Office’s function is to promote ex officio or at the request of a party, action in defense of legality and public interests protected by law. They ensure the independence of the legal bodies and the correct administration of Justice. They represent society in legal proceedings |
Representatives of Judicial Power at the regional level. The Judicial Power is in charge of exercising and administering justice in the country in accordance with the Constitution and laws, guaranteeing the defense of the goods and rights of citizens | |
Police representative in Puno | |
Health system actors: KI-3, KI-5, KI-8, KI-12, KI-16, KI-17, KI-6 | Representatives of the Ministry of Health at the regional level, including regional coordinator of the Mental Health Control and Prevention Program |
Representatives of the Ministry of Women and Vulnerable Populations. This ministry is in charge of directing, coordinating and managing public policies for the prevention, care, punishment and eradication of gender-based violence | |
Representatives of the Women’s Emergency Centers that are coordinated by the Ministry of Women and Vulnerable Populations | |
Health professional responsible for the local primary care center | |
Advocates: KI-2, KI-4, KI-7, KI-9, KI-10, KI-11 | Representative of the Ombudsman. The Ombudsman's Office is part of the Public Ministry, and exercises its functions under the supreme direction of the Attorney General of the Nation. It is responsible for ensuring the promotion, exercise and dissemination of Human Rights |
Members of the Catholic church that are involved in VAWG prevention and victim support initiatives | |
Member of indigenous groups rights organisation | |
Academic with national expertise in researching and responding to violence against women in Peru |
Data analysis
UN Women Framework principles, common characteristics and foundational elements | UN Women Framework Essential services and actions | Key findings | Recommendations for improving services for indigenous communities |
---|---|---|---|
Principles 1. A rights-based approach 2. Advancing gender equality and women’s empowerment 3. Culturally and age appropriate and sensitive 4. Victim/survivor centred approach 5. Safety is paramount 6. Perpetrator accountability Common characteristics 1. Availability 2. Accessibility 3. Adaptability 4. Appropriateness 5. Prioritise safety 6. Informed consent and confidentiality 7. Data collection and information management 8. Effective communication 9. Linking with other sectors and agencies through referral and coordination Foundational elements 1. Comprehensive legislation and legal framework 2. Governance oversight and accountability 3. Resource financing 4. Training and workforce development 5. Gender sensitive policies and practice 6. Monitoring and evaluation | Health | Accessibility • Outreach mental and physical health services to remote communities Appropriateness • Service provision in local languages Rights based approach • Integrating indigenous governance structures and justice concepts Culturally appropriate and sensitive • Inclusive and non-discriminatory services • Intercultural competency training for service providers | |
1. Identification of survivors of IPV 2. First line support 3. Care of injuries and urgent medical treatment 4. Sexual assault examination and care 5. Mental health assessment and care 6. Documentation (medico-legal) | VAWG survivors are not identified by the health system because of inadequate screening tools and protocols | ||
Lack of VAWG training for health professionals including on supporting survivors, sexual assault examination and required documentation for trial purposes and mental health | |||
VAWG is not perceived as a priority health concern leading to delays in service provision | |||
Health services are not accessible for indigenous populations | |||
Health services are not culturally appropriate for indigenous populations | |||
Indigenous survivors of IPV face stigma and discrimination when accessing health services | |||
Justice and policing | |||
UN Women Framework components 1. Prevention 2. Initial contact 3. Assessment/investigation 4. Pre-trial processes 5. Trial processes 6. Perpetrator accountability and reparations 7. Post-trial processes 8. Safety and protection 9. Assistance and support 10. Communication and information 11. Just sector coordination | VAWG survivors who report to the police are treated poorly and often blamed for the violence they experience | ||
Justice and policing systems are insufficient in rural areas because of underfunding | |||
Limited resources result in slow trial processes which deter survivors from continuing with their case | |||
The legal response to perpetrators is inadequate, they are not sufficiently punished which can lead to re-perpetration | |||
Corruption in the justice system works in favour of perpetrators | |||
Traditional legal systems and concepts of indigenous populations should be integrated into national VAWG response | |||
Social services | |||
1. Crisis information 2. Crisis counselling 3. Help lines 4. Safe accommodation 5. Material and financial aid 6. Creation, recovery, replacement of identity documents 7. Legal and rights information, advice and representation, including in plural legal systems 8. Psycho-social support and counselling 9. Women-centred support. Children’s services for any child affected by violence 10. Children’s services for any child affected by violence 11. Community information, education and community outreach 12. Assistance towards economic independence, recovery and autonomy | Available services are seen as ineffective and under resourced | ||
Coordinated psychological, medical and legal services provided by Women’s emergency Centres but there is a lack of continuity of care | |||
Economic barriers insufficiently addressed | |||
Some positive indigenous-focussed initiatives although these are limited to economic empowerment | |||
Services need to be tailored to indigenous values | |||
Coordination and governance of coordination | |||
National level: 1. Law and policy making 2. Appropriation and allocation of resources 3. Standard setting for establishment of local level coordinated responses 4. Inclusive approaches to coordinated responses 5. Facilitate capacity development of policy makers and other decision-makers on coordinated responses to VAWG 6. Monitoring and evaluation of coordination at national and local levels Local level: 1. Creation of formal structures for local coordination and governance of coordination 2. Implementation of coordination and governance of coordination | Law and policies are strong with national efforts towards coordinated responses | ||
Moving towards decentralisation of services to improve access for women in rural areas | |||
Legal and policy frameworks are not being applied consistently in practice | |||
Lack of coordination between different sectors with contradictory approaches | |||
Where regulatory and policy frameworks have been applied, these have not benefited indigenous communities, who are often outside of the formal health and social services sectors |
Results
Health
IPV survivors are missed by the health system
The problem we have had, and we are improving this all the time, is that out of 10 screenings or 100 screenings, we only detect five or six women that have experienced violence. We know that this is not the case.… the form has closed-ended questions; Yes or No. If the answer was no, you made an X and you didn't ask any more information. [KI-3]
But if women go to the hospital, they are not assessed as they should be. They do not move quickly [i.e. the case is not quickly assessed]. If a woman who has been assaulted goes [to a hospital], covered in blood, then maybe they will move and have everything checked. Nevertheless, she will be treated for that problem only [physical injuries], but it is not as it should be. [KI-7]
So, imagine a woman in our community that must go to the emergency centre in the province. She has to leave the community to go there… and what about the money? If you go there, you are going to leave your things behind, your children… and you have no money. Then, many times they say "It’s better that I endure this situation, right?... He brings me 10 soles to eat, I do my chacra [farming], in my house with my children.... I’m going to endure”. They have no other choice. Sometimes when women make a complaint, they withdraw it precisely because of this situation. [KI-2]
We have CEMs [women’s emergency centres] in rural areas, however only a few now […]. We are thinking to open more CEMs that are specific for indigenous populations (Quechua or Aymara)... the majority of the CEMs are in cities. [KI-17]
If we approach them [emergency services providers] to make a complaint, they immediately start to make fun of the way we say things. [KI-10]
Lack of VAWG training for health professionals
I feel that one of the shortcomings is the lack of staff training, the lack of awareness of the treatment that should be given to women who suffer physical or psychological violence and also those who have been raped, girls, boys or women. [KI-9]
I feel that what we need is training, but also mechanisms, for example, to ensure that a girl who has been sexually assaulted can continue to keep the evidence that the judge requests, or how to ensure that the health system keeps a proper record of what was found. [KI-9]
There is no mental health hospital here in Puno. It is very disorganised. On one occasion I received a woman here in the house […] but her behaviour led me to look here in Puno if there was a [mental health] specialist […] her behaviour scared me, she was attacking other people who were here [in the refuge]. I wanted to take her out of the refuge immediately, but there are no specialists. So, they [health centre] said “We'd better send her to Lima. Yes, there is this psychiatrist in Lima”. [KI-7]
One of the teachers, who was a bit older, stood up and said to me: "I know this young man [the aggressor], because he was my student […] he was an introverted person, he didn't have many friends, but he always reacted violently." The question is, did anyone intervene...? I understand that he was also in the military. So, there were several filters, and we never screened this person. We never noticed this kind of behaviour because we thought it was normal. [KI-3]
IPV is not a priority health concern
We waited 3 hours and I could see that the woman was suffering, and I felt sorry for her. So, I said "When!?" and they told us "Maybe the doctor will not come, you better come back tomorrow." [KI-7]
They ask for proof, evidence. The only thing they can give evidence of is physical, isn't it? Proof of physical violence. But they [perpetrators] say: “You are good for nothing, you are ignorant, you don't know how to raise your daughter, you are a bad mother” and so many other things they say to her, how can there be proof? [KI10]
In terms of primary prevention, there is little that the Ministry of Health or health personnel can do. You can participate in community efforts to build a culture of peaceful conflict resolution and contribute to reducing gender inequality through how the health facility deals with women and how you teach women what their rights are and how they need to see them respected, but there is little they can do in terms of violence prevention[...] You can reduce the use of alcohol, that is something that health services can do directly and that would contribute to reducing about 34% of the violence related to alcohol use. [KI-4].
Justice and policing
Women survivors who report to police are treated poorly
We know that there is still a lack of preparation [by the police] to receive the [victim’s] complaint. I understand that there must be some protocol, but what is lacking is how they treat people. There is no empathy. [KI-3]
She goes to the police station, and they say: "It's your husband. Surely you have behaved badly, it is not someone else who is beating you, it is your husband". [KI-10]
It is true that for the police when they are assigned to violence against women, violence against the family, it is like a kind of punishment, they take it badly and then they take it out on the victims. [KI-4]
There may be institutions that do not exist in such remote places, there is no prosecutor's office, there are no courts or others […] However, there is a police office, you will always find a policeman around in any place. [KI-1]
The legal system is insufficient and ineffective
The negative side is that there has not been an increase in the number of people who deal with these complaints, because the law did not come with a budget to increase the number of police and to increase the number of prosecutors, so each one has a backlog of complaints to handle, and therefore once you have made the complaint to get the prosecutor to do the investigation and pass it to the judge to get the protective measures that theoretically should come within 48 hours according to the law, it takes six months. [KI-4]
There is also a great weakness of a slowness in the judicial processes, a slowness in the investigations, a slowness from when the woman makes the complaint at the police station and that this report goes to the forensic doctor and then goes to the court or to the public ministry so that later there are, at least, the protection measures, a lot of time passes and the woman gets tired, she gets bored. [KI-9]
We are just in the process of constructing the proposal to modify the statutes that we have been working on. Because autonomy must also be respected. That is why we talk about special justice and ordinary justice, but this special justice is totally abandoned, this special justice is not strengthened. We have the ordinary justice, the corrupt, racist ordinary justice we say, because everything is in Spanish, everything is seen from the cosmovision of cities, not necessarily the indigenous thought… then all this limits you. What we want is for the special justice to be strengthened. The community members themselves, in an assembly, decide if they have to sentence the person and then they coordinate with the ordinary justice. [KI-2]
…in peasant communities, you have to respect multiculturalism, customs. These customs must not be totally eradicated because the Constitution says that the customs of ancestral communities must be respected. We need to adapt those, make them understand that there are certain behaviours, which, although for them it is very natural, it damages the physical and psychological integrity of people. Because we are not going to be stuck in the 19th century with negative customs, rather you have to assimilate them, understand them and respect the customs that are positive and ancestral [KI-1]
Inadequate legal measures for perpetrators
There is no justice in this country. Moreover, they say “let's put all machistas [sexists] and rapists in jail” […] and then the jails are full…And what do they do there [with the perpetrators]? They come out threatening, and tougher. What kind of justice do we have in our country? [KI-2]
“That's not a crime, it's an offence” they [police, judiciary system] say. And who would believe it?... Out of 100, One becomes a crime, 99 don’t. So, in this situation the man comes out from the police feeling strengthened...he says, "nothing is going to happen to me" and he goes back home. [KI-4]
Violence is not going to go away easily. One, because the authorities that administer justice are too slow and are easy to corrupt. That's the problem. If a man is reported and goes to the police and offers him money or something else, what do you think? The evaluation and the preliminary report come back mild, and the guy walks free…[KI-12]
Social services
Mixed perceptions about the effectiveness of available services
Other people say "No, it's just a joke, it's like the 105 call to the police and they never answer”. [KI-12]
I see that the service provided by the CEM with a social worker, for example, at least it helps, the psychologist also [helps] when I ask for help, but as I said, I understand that the services are overloaded with work, but sometimes it takes a lot of time. I would like that when the woman arrives, there is continuity in care. But there is not. They tell them "I'll be here at such an hour", but the person does not arrive. The next day the woman is still waiting. [KI-7]
They provide services with this work, professionals like psychologists or social workers and the police station; they work coordinating to support the woman. But I feel that it is not enough, because when women leave their homes, when they have suffered violence, they leave without clothes, without money, right? [KI-7]
Creating services tailored for indigenous populations
This house has also been lent to them while the woman was working and raising money, so she has already raised a small amount of capital, and can now open her own place, for example, a cosmetology place or a restaurant. We have helped in this way. Maybe we do not solve anything, but at least we empower and promote the fact that women know how to do things. [KI-10]
There has to be theoretical work in the language vernacular that allows us to understand that there are some universal values, for example, treating each other with affection, feeding everyone equally… which are values that you also see in the communities that speak Aymara and Quechua […] I think that we have to find these values and these truths and they are universal so that it doesn't seem that we are simply trying to impose some culture and destroy the culture that existed, which is also done a little bit, but we shouldn't do that. [KI-4]
Coordination and governance
Strong laws and policies with national efforts towards coordinated responses
Law 30364, which is the law against violence against women and family members, is a law that has been revised and improved countless times. The first time it came out it was dreadful and over the 20 years it has improved a lot and we can say that it is getting much closer to international recommendations. [KI-4]
Last year, 2020, in June, the new operations manual of the Aurora National Program was approved, and among the new features, territorial units were created. We need to consider that before its creation, under the National Program against violence, it had a working structure where all its units were in Lima and the services were decentralised at the national level but monitored from Lima. [KI-7]
Legal and policy frameworks not applied in practice
At the institutional level we implement well, but slowly, as if something is wrong. We are not efficient […] It is like we take [too much] time, and it is like we are also discouraging the assaulted woman and the aggressor, going from office to office and that could be done in a short period of time. She does not need to go for hours, until 11 o'clock at night without lunch. So, things like that are discouraging. I do not know if it is a matter of organisation, but I find that very difficult. [KI-7]
The point of the Ministry of Health, there is a problem with the protocols. If you compare, for example, the protocol for joint care of the women's emergency centres and health facilities that was written by the Ministry of Women's Affairs and you compare the language of the clinical practice guidelines for attention to violence, now they are writing a new one but the one from the Ministry of Health, you realise that the one from the Ministry of Women's Affairs has a more modern approach and is better adapted to the recommendations of the WHO on violence against women. They insist on the theory that, well, these are the global recommendations, but we have to adapt to the national reality and the first fallacy is that we don't know what the national reality is because […] the research that is done here is of very poor quality when it is done. [KI-4]
Of course, those who are in the services must enter a process of reflection, a process of questioning their privileges as well. The need to do real justice because it does not exist. I am sure they have been given a talk, but with a talk you do not change anything. Sometimes this process is permanent, the justice worker must be in a permanent process of reflection... Because when you go to make a denunciation, they tell you "Ah, you… what have you done now?" [KI-2]