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This is an article from the spring 2020 issue of LSA Magazine. Read more stories from the magazine.
Some of the information Carly Marten (A.B. ’19) culls from patients’ medical records is the run-of-the-mill, standard stuff you’d find at any clinic in the world: a patient’s age, where they lived — basic demographic data. The other information she collects concerns the event that brought the patients to the clinic in the first place. Marten is investigating the experiences of sexual assault survivors who are treated at the One-Stop Center at Menelik II Hospital, a public hospital in Ethiopia’s capital, Addis Ababa.
The project was developed in collaboration with Dr. Thomas Mekuria, an OB/GYN on faculty at St. Paul’s Hospital, an affiliate of Menelik II Hospital, with whom Marten had also worked in the summer of 2018. “I had received funding from the Honors Program, the Department of Linguistics, and the Department of Women’s and Gender Studies to pursue research for my honors thesis. Dr. Mekuria translated my interviews from Amharic to English.” He also founded the One-Stop Center.
One-Stop Centers, such as the one where Marten works, were established by the Ethiopian government to provide comprehensive care to survivors of sexual assault. At the clinics, survivors can receive clinical care, meet with mental health professionals, stay in temporary housing, consult with legal advisors, and open a legal case against their perpetrator(s). The primary goals behind consolidating services in a single place are to provide comprehensive and immediate care, to minimize secondary victimization, and to encourage survivors to use all of the services available to them.
The Addis Ababa center where Marten works is one of the few such centers in the country, and is physically separated from the hospital. “It doesn’t look like a hospital,” Marten says. The hope is that it won’t feel like one either. The clinic walls are brightly painted with murals, and its rooms are filled with non-hospital furniture. In the nearly two years the clinic has been open, it has served approximately 500 patients. It is Marten’s goal to draw data from all of them.
Marten is gathering quantitative data about the assaults: where they happened, at what time of day, who the perpetrator was, and if there was clinical trauma. She’s particularly interested in knowing if legal charges were filed. In cases where they were filed, Marten wants to know whether they were dropped or pursued — and when they were pursued, she wants to know their outcomes. Marten is currently moving through all of the clinic’s existing records, and she hopes to soon be able to start collecting this data in real time, too.
The clinic treats people of all genders who have experienced any type of sexual violence, Marten says, but the patient population is overwhelmingly female. At the time of this writing, Marten had reviewed 325 cases, and she had drawn some preliminary findings. The survivors, on average, were 16 years old, and 318 of them were women. All of the perpetrators were men. In talking with people she met in Addis Ababa about her work, Marten says, her early findings surprised them.
“Because it’s a public hospital, many people believed our patients were poor and came from rural areas,” she says. “They also tend to believe that sexual violence is mostly a rural problem, but 85 percent of our patients came from Addis Ababa.” One of her early findings surprised no one: of the 325 cases Marten had reviewed only 10 had received some kind of conviction.
Even in the most favorable circumstances, prosecuting sexual assault cases is difficult. There are often no witnesses or scientific evidence, reporting is frequently delayed, and the experiences are often traumatic and painful to discuss. The same is true in Ethiopia, but the criteria for prosecution are even stricter. Marital rape is not criminalized, and the burden of proof for a survivor is almost insurmountable — and it’s incumbent on the survivor to collect the proof.
At the same time, there have been some significant recent events that might signal a change. The current prime minister campaigned on appointing women to 50 percent of his cabinet, and he appointed the first female president. Marten hopes her research will help to support this transition.
“If I weren’t here the research wouldn’t get done right now, but there are certainly people here who could eventually and very capably do it,” Marten says. “I’m really grateful to contribute a small piece to the work feminists are doing in Ethiopia, and with very few resources. It inspires, amazes, and astounds me.” Marten hopes her research will improve the clinic experience for providers so they can help future survivors, and she hopes to conduct qualitative research, too, so that survivors feel like they’re being heard.
For herself, Marten hopes the effort she’s made to develop focused knowledge will translate into an ability to provide skilled care. When she returns to the United States, Marten wants to go to medical school and join Doctors Without Borders, and it’s one reason she is working so hard to develop focused knowledge that will, she believes, help her to provide skilled care. Being in Ethiopia and at the Menelik II Hospital has only strengthened that goal. “I had never really, deeply thought about being an American before I came here,” she says. “I’d thought about being white and being a woman, but I never really understood the access my American passport affords me. I realize how lucky I am, and how fickle and random and faulty a border can be.” And with this understanding, Marten hopes the next small piece she contributes through her work can make the world a little more just, too.
Top photo by Marthinolly