In 2024 over 90 medical professionals, medical students and health facility managers in Romania learned how to recognize and support survivors of gender-based violence (GBV). The WHO Country Office in Romania co-organized 4 training sessions with the Romanian authorities under the title “Strengthening health system response to GBV”.
In recent years, the country has taken significant steps to enhance its health-care system to address GBV, and has acted to implement the Istanbul Convention, a human rights treaty that aims to prevent and combat violence against women and domestic violence.
Every year, the global 16 Days of Activism Against Gender-based Violence campaign sheds light on the progress made in preventing and responding to GBV and the challenges that still need to be addressed. In Romania, the National Agency for Equal Opportunities Between Women and Men established 10 centres for survivors of sexual violence. Located on the premises of county hospitals, their role is to facilitate survivor care through an integrated approach.
Listen, recognize and help
“No matter the specialty, every physician should be prepared to recognize and respond to GBV,” points out Elena Bernad, an obstetrician and associate professor at the Victor Babeș University of Medicine and Pharmacy in Timișoara, who helped deliver the latest training.
Elena’s journey has been shaped by personal experience. After reflecting on GBV cases that may have gone unrecognized in her practice due to a lack of information and training, she determined to strengthen the health-care response to GBV by improving education.
After taking part in a training session on protocol establishment, facility readiness and system-level barriers to access within the health-care system, Elena felt she possessed the skills to identify and manage GBV cases effectively. She has since shared her expertise with her peers, paving the way for meaningful change.
Elena’s approach centres on 3 core principles: listen, recognize and help. “It is not enough to recognize the signs of violence,” she explains, “One must listen without judgment, offer meaningful help, and ensure the survivor feels safe and supported throughout the process.”
Elena also stresses the importance of multidisciplinary collaboration within hospitals, where physicians, psychologists, social workers and legal professionals should work together to support survivors. Reflecting on her journey, she advocates for the integration of GBV management modules in medical school curricula, stating, “The attitude of a doctor can make all the difference.”
Providing a first line of support
For Carla Pop, a medical student planning to specialize in obstetrics and gynaecology, the training offered insight into how health-care providers can support GBV survivors. “Prior to this course, I had only a superficial understanding of how to support survivors. Now, I feel better equipped to provide the first line of support, whether or not I specialize in gynaecology,” she says.
Carla previously relied on self-directed learning to understand GBV. She underscores the importance of including this education in standardized medical curricula to provide broader and more nuanced knowledge.
“When education is standardized, it ensures students receive comprehensive and evidence-based training, going beyond theory to include real-life scenarios that truly prepare us for medical practice,” she explains.
As health-care facilities are often the first point of contact for GBV survivors, Carla highlights the importance of addressing both the invisibility and stigma around GBV cases. “Often they don’t recognize themselves as survivors. Doctors can be a lifeline, especially when survivors don’t seek help elsewhere, but we need to create safe spaces to ensure survivors feel supported.”
Carla believes that introducing mandatory GBV training across all medical specialties would significantly enhance the health-care system’s ability to address this issue. “GBV is not as rare as we might think. If every doctor is trained, we raise awareness about the importance of knowing how we can provide the best medical care.”
Pioneering holistic care
Simona Tămașan coordinates the Sexual Violence Intervention Centre, located on the premises of Pius Brînzeu County Emergency Hospital in Timișoara. She underscores the transformative impact of having a dedicated facility in a general hospital, in this case one of the biggest hospitals in western Romania.
“The Centre offers more than medical care – it provides integrated care for survivors,” she explains. “Since its launch 8 months ago, there has been significant educational progress among staff. The Centre has allowed us to raise awareness and destigmatize the very sensitive topic of sexual violence and intimate partner violence.”
Simona also emphasizes the need to create multidisciplinary teams that are trained to help GBV survivors: “By conducting GBV training across departments, from gynaecology to psychiatry and social services, we can create a network that ensures survivors receive comprehensive care.”
She further highlights the importance of addressing both risk and protective factors. “In almost all cases, this approach helps bring related issues like dependency and alcohol consumption to the surface.”
The training has enabled her and her team to develop a standardized tool to support survivors, filling a critical gap. Reflecting on the training programme, she focuses on its crucial role in destigmatizing GBV and fostering collaboration among medical, legal and social services. She also stresses that health workers need to receive support to manage the emotional burden of this work.
Next steps for Romania
The insights shared by Elena, Carla and Simona illustrate health-care providers’ critical role in addressing GBV. While the training has aided progress, challenges remain, including the need for more GBV modules in pre-service curricula, dedicated resources and ongoing professional development.
“The most challenging step – acknowledging the issue and creating dedicated centres – has been taken. Now, we must focus on education, collaboration and sustained advocacy to ensure that no survivor is left behind,” shares Simona.
Romania’s journey demonstrates the power of education, collaboration and compassion in tackling GBV. It is a journey that can undoubtedly inspire others.