The Vicious Circle of Health Security: Vaginal Fistula in Conflict Settings and its Interdependency with Female Oppression

Abstract

The complex and multilayered interdependence of health and security gets exceedingly obvious in conflict-related sexual violence (CRSV); however, its scientific study is exceptionally invisible. Political unrest increases incidence of gender-based violence (GBV). Rapes, including gang rapes, and forced insertion into the female genitalia of foreign bodies such as bottles, sticks, and weapons can lead to injury of the vagina and the development of traumatic vaginal fistulas (TVF). This paper aims to give structure to the particular characteristics of traumatic vaginal fistula in conflict settings and its immanent linkage to human security. The authors reviewed all papers concerning prevalence and causes of CRSV-caused TVF (CRSV-TVF) that were available on PubMed and GoogleScholar in February 2021. Findings were integrated into feminist theory on CRSV to identify the connecting linkages of security, health, and gender equality. CRSV-caused TVF illustrate well the complex interdependences of health and security: (1) insecurity leads to a higher prevalence of sexual violence; (2) sexual violence can serve as a weapon of war; (3) insecurity prolongs sufficient medical care; (4) vaginal fistula impede female empowerment and societal development. The multiple threads of their connection reveal several implications for the prevention and treatment of TVF. The reciprocal connection of CRSV and security exemplifies a vicious circle of health security.