Sexual harassment testimonies expose bleak reality for majority women health workforce

Power imbalance major driver of human rights violations in health

The alarming level of violence and sexual harassment faced by healthworkers is a serious human rights violation for women who make up 70 percent of the global health workforce and 90 percent of frontline staff.

An upcoming report by Women in Global Health Her Story: Ending Sexual Violence and Harassment of Women Health Workers set to be published on December 13, exposes the sexual harassment and abuse at work experienced by significant numbers of women health workers.

The report lists several excerpts of anonymous stories submitted by 230 women in 37 countries across the world.

In one example, in Senegal, a woman doctor describes an experience in which she was locked into a hospital room by a much older supervisor who became sexually aroused and pushed against her. The woman managed to kick her way free. When she told colleagues about the incident, she remembered, “They refused to believe me and advised me to shut up and move on.”

In the US, a woman community health worker endured the advances of a male co-worker who made several attempts to have her removed, “He had repeated meetings with upper management and begged them to fire me. The day my job contract ended, I received a string of text messages from him asking me out on a date, telling me how pretty I was, and that he was excited my job ended because he wasn’t my boss anymore.”

In another example in Mexico, a student doctor was offered good grades by her supervisor in return for sexual favours. He said, “You know, I am offering you an easy way out. If you reject my offer, you risk failing the rotation.”

In Portugal, a student surgeon details her repeated sexual harassment at the hands of a hospital Vice Director. When she reported incidents to senior male colleagues, she was told, “He’s a great teacher. He just loses his mind a bit when it comes to girls. Ignore it.”

A major driver of the abuse, the report found, is the power imbalance favoring men in the hierarchical health profession. Men currently occupy 75 percent of all leadership roles in health, with women clustered into lower status, low-paying roles. This power dynamic, it says, has created an enabling environment for perpetrators. Women’s position in the health sector makes them more vulnerable to abuse from male colleagues, male patients and members of the community and in a weak position to report that abuse.

“It’s a problem rooted in the abuse of power, more than by sexual attraction. If the male perpetrators knew they would be sanctioned and lose their jobs; that they would be publicly shamed, they would be unlikely to do it. They know they can get away with it,” said Dr Roopa Dhatt, Executive Director, Women in Global Health.

The report was compiled from stories submitted by women health workers as part of the #HealthToo project–a Women in Global Health online platform and research project. In the absence of comprehensive data, Women in Global Health harnessed the power of personal testimony to bring the reality and nature of the abuse to life, as well as the conditions that enable it. The stories, excerpts of which are included in the report, were supplemented by existing research on the topic.

“Personal stories are harder to ignore. They describe the compliance of colleagues, the lack of reporting, fear of reprisal and job loss, the lack of mechanisms for receiving complaints, the absence of laws to prosecute. The testimonies present a clear view of an enabling environment for perpetrators,” said Dr Dhatt.

From global, to institutional to personal level, the report calls for establishing the legal foundations for gender equality in the workforce and for a culture change so that perpetrators of abuse are reported and sanctioned.

“We need organizational cultures that encourage upstanders not bystanders. Leadership from the top. The need for employment legislation and employment rights to protect women is key, particularly to enable reporting, with provisions for confidentiality. Such measures would also serve as a deterrent to other would-be perpetrators,” said Ann Keeling, Senior Fellow with Women in Global Health and lead author of the report.

Other recommendations include: equal leadership representation of women in health; addressing social norms and stereotypes on gender equality, and providing safe and decent work environments. Also recommended is the need to work collectively for change through the introduction of investigatory systems that center on and protect survivors, including ensuring that perpetrators face justice promptly.

ENDS