Patterns of Wartime Sexual Violence: Perspectives from Colombia

Sexual violence has been perpetrated as a strategy or practice in a number of conflicts across the globe, but research has found that the prevalence and practice of wartime sexual violence varies greatly between different conflicts, and between different armed actors within the same war (Cohen, Green, & Wood, 2013; Cohen & Nordås, 2014; Wood, 2008, 2009, 2011, 2012). The purpose of this project was to map out patterns of wartime sexual violence in the ongoing internal conflict in Colombia, in order to contribute to an emerging literature on the variation of wartime sexual violence at the conflict level. This task was taken on with an inductive starting point in which analytical categories were obtained from the empirical material, in dialogue with existing theory. Patterns were operationalized through focusing on three interrelated factors: the contexts in which sexual violence was perpetrated during warfare; the motivation of the perpetrators of this violence; and claimed and obtained identities of its victims. The analysis uncovered three main functions of sexual violence in Colombia: to extract information and intelligence, to secure and exert territorial control, and to control armed group behavior. The term functions was found suitable to label these categories, as it enables us to comprehend that the results of wartime sexual violence might be both the purpose, but also the consequence of the act. This finding warns us that the propensity within scholarly and advocacy literature for framing wartime sexual violence within the weapon of war framework, runs the risk of limiting our understanding of this complex phenomenon

Preparing for the unexpected: a comparative study of policies addressing post-terror health reactions in Norway and France

Abstract Background In the wake of terrorist attacks, protecting the health and psychosocial wellbeing of those affected and the general population, are important tasks for the healthcare system. The responses to such emergencies are often complex, including different phases and many actors, and may unveil insufficiencies that incite reforms to existing systems. Recently, initiatives have been promoted to strengthen cooperation and coordination regarding the governance of health threats in Europe. Comparative research is requested on how states prepare for health emergencies such as terrorist attacks. This study investigated how governments in two European countries with universal health coverage prepared to address the civilian population’s health needs after terrorist attacks, and the factors that contributed to shaping their chosen approach. Methods Utilizing document analysis and Walt and Gilson’s model for the analysis of health policy, national plans for post-terror health responses in Norway and France were studied with a focus on context, process, content, and actors. Results Whereas target groups for psychosocial care and certain measures were similar in both cases, the contents of prescribed policies and the actors responsible for enacting them differed. One of the most distinct differences was to what extent specialized mental healthcare was relied upon to provide psychosocial follow-up in the emergency phase. In the French approach, specialized mental healthcare practitioners, such as psychiatrists, psychologists and psychiatric nurses, provided early psychosocial support. In contrast, the Norwegian approach relied on interdisciplinary primary care crisis teams in the local municipalities to provide early psychosocial support, with further involvement of specialized mental healthcare if this was considered necessary. Historical, political, and systemic differences contributed to the variation in the countries’ responses. Conclusions This comparative study highlights the complexity and diversity of health policy responses to terrorist attacks across countries. Moreover, challenges and opportunities for research and health management in response to such disasters, including possibilities and potential pitfalls for the coordination of this work across Europe. An important first step could be to map out existing services and practices across countries to better understand if and how common core elements for psychosocial follow-up might be implemented internationally

The short-term impact of terrorism on public mental health: an emergency primary care approach

Abstract Background Terrorist attacks commonly have mental health consequences for those directly affected. Existing research is, however, divided when it comes to how and whether terrorist attacks affect the general population’s mental health. There is a need for studies investigating a broader range of mental health reactions to understand more about how different groups of the population are affected by terrorist attacks, while also illuminating important systemic factors. Methods In this study we investigated whether there was any change in the number of consultations with out-of-hours emergency primary care for psychological reactions in association with the 2011 terrorist attacks in Norway. Data covering the entire Norwegian population’s primary care contacts in 2008–2013, where the reason for encounter was coded as psychological concerns or psychiatric disorders, were studied. A time series intervention analysis, using ARIMA modelling, was used to estimate whether there was indeed a change in healthcare utilisation associated with the terrorist attacks. Results The analysis uncovered an increase in contacts with emergency primary care by the overall population for mental health concerns associated with the terrorist attacks. When divided into groups according to geographical proximity to attacks, no significant change was found in the area closest to the attack in Oslo, whereas an increase was found for the rest of the country. There was also heterogeneity across different age groups. An increase was found among youths, young adults, and middle-aged people, but not the other age groups, and an increase was found for both men and women. Conclusions These findings highlight the need for primary care services to be prepared to meet mental health reactions in the general population when planning for healthcare provision in the aftermath of terrorism. Simultaneously, it should be noted that needs may vary across different groups of the population

Trust after Terror: Institutional trust among young terror survivors and their parents after the 22nd of July terrorist attack on Utøya island, Norway

In the aftermath of terrorist attacks and disasters, public institutions play an important role in re-establishing safety and justice. However, little is known about the importance of institutional trust for victims’ potential for healing in the aftermath of mass trauma. This study examines levels of post-terror trust in the police and in the justice system among young survivors from the 2011 Utøya terror attack and their parents. Furthermore, it investigates how institutional trust develops over time among directly affected populations, and whether it is associated with psychological distress. 325 survivors and 463 parents were interviewed face-to-face at wave one (4–5 months post-terror) and 285 survivors and 435 parents at wave two (14–15 months). Levels of institutional trust in victims were compared to general population data from the European Social Survey adjusted for age, gender, and ethnic background. Measures included trust in the police and justice system, post-traumatic stress reactions, anxiety and depression, and quality of life. Trust in the police among survivors and parents was higher than or comparable to trust levels in the general population at wave one, but decreased for survivors and parents at wave two. Trust in the justice system was higher among those directly affected than in the general population, and increased from wave one to wave two. Levels of institutional trust were negatively associated with distress for survivors in both waves and for parents in wave two. Levels of institutional trust were positively associated with perceived quality of life in parents and survivors. Directly affected groups’ institutional trust differed from that of the general population following the terrorist attack, although being directly affected did not necessarily imply weakened institutional trust. This study found trust to be institution specific, however, trust in institutions changed with time, and the passing of time might be an important factor in better understanding whether trust will generalize across institutions or not. Institutional trust was negatively associated with psychological distress. This finding highlights the potential for institutions to create a healing post-disaster environment