Every day our medical teams in Papua New Guinea (PNG) treat women and children who are victims of family and sexual violence, many who remain trapped with their abuser due to the lack of a functioning protection system. Many plead with us not to go back to their families or communities.

While we do everything we can to find somewhere for them to stay, the reality is that, even for those who are brave enough to escape and speak out, we can’t promise them that they won’t have to return. This is because of the gross lack of services for protection.

One particularly devastating case was Joanne*, a severely malnourished mother, who came to one of our MSF-run Family Support Centres with her 10-month-old baby girl. After leaving her baby with the child’s father one day when she had to go out to beg for food, she returned to find the baby distressed.

The next morning, her daughter developed a fever and Joanne noticed that the baby’s genitals were swollen and bruised. Joanne immediately suspected the child’s father was the source of her baby’s distress, as some time ago, he had sexually abused her eldest daughter.

During her consultation, Joanne expressed her deep sense of hopelessness, believing there was nowhere she could go to escape the abuse. We tried to get both Joanne and her baby into short-term safe housing. However, every safe house was full. Joanne had no choice but to return home later that day.

Joanne eventually did find temporary accommodation in a safe house, but it didn’t provide financial assistance and safe-house rules require that children are never left unattended. Unable to leave the safe house without her baby to find work, or to beg, Joanne had no resources to get by. Eventually she returned with her child to her abusive partner.

The violence we treated in Papua New Guinea happened in the places people should be the safest in their homes and communities. And a large amount of the individual serious cases were repeat abuse.

It’s heartbreaking to treat young children who have suffered sexual abuse at the hands of someone in their family, or community, knowing they will inevitably be returned to that abusive environment.