A Syrian refugee waits to cross the border into Turkey. Photo: Uygar Onder Simsek/AFP/Getty Images
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Is the way the media reports Islamic State’s treatment of women making things worse?

As in any war, the “rape crisis” in Syria and Iraq is complicated, and the way it is reported shapes the false assumptions and stigma women face.

Anyone who has been following coverage of the conflict in Syria and Iraq will know that the region has seen a major rape crisis. Much of the media coverage has focused obsessively on the horrendous violence against Yazidi women and girls escaping from Isis captivity, with details sometimes bordering on the salacious about slave markets, forced marriage, and multiple rapes. Is it possible that this is doing more harm than good?

A group of scholars argued last year in the Washington Post that the coverage risks being counterproductive: “To scholars of sexual violence, these media narratives look typical in three related ways: They are selective and sensationalist; they obscure deeper understandings about patterns of wartime sexual violence; and they are laden with false assumptions about the causes of conflict rape.”

The violence against Yazidi women is unarguably horrific, an exceptionally extreme example of sexual violence. But this is not the whole story. As in any war, the “rape crisis” is complicated: it is not perpetrated by any one group. In Syria, regime forces have been using rape as a weapon of war since the conflict began in 2011. Islamist groups and rebels have also been responsible for violations. Women displaced by conflict, often left widowed or without a male guardian, face exploitation and abuse at refugee camps or in host countries.

Mandana Hendessi, the regional director for the Middle East for the NGO, Women for Women International, objects to the way that women have often been portrayed as victims. “With the Yazidi women, to some degree, I felt that their experiences were sensationalised,” she says. “In none of those articles have I read anything about how they resisted. There’s no mention of women trying to take things in their control. The very fact they ran away the moment they had the opportunity – that shows incredible resilience. Some self-harmed with corrosive substances on their faces to protect themselves from the men, and some shaved their eyebrows and eyelashes. But the way it has been portrayed in the media, it looks like these women had no power. Stripping them of agency removes their dignity.”

A recent article published by the Daily Beast argued that western journalists covering the violence against Yazidi women have sometimes been insensitive in their search for shocking details. “Does the public’s interest in knowing explicit details of sexual violence outweigh these victims’ urgent need for safety and privacy? I don’t think so and there are indications that victims would agree,” wrote Sherizaan Minwalla.

Hendessi notes that there is a risk of women being stigmatised. “Yazidi men are now the obstacle to women’s progress. They are not allowing the women to go anywhere as there is this fear that the women might be kidnapped again. To the community, it feels like a tremendous shame has fallen up on them.”

Of course, it is incredibly important that sexual violence is reported on, and that the issue is discussed widely in order to effect the kind of practical changes that can protect women. But it is also important that this reporting is done responsibly and in a sensitive manner, particularly given the shame and stigma associated with rape. “Refugee camps take away your individual dignity, and you are exposed to all sorts of professionals – doctors, lawyers, journalists,” says Hendessi. “There can be a lack of respect for women’s privacy.”

The Washington Post article argued that “reports of Islamic State imprisonment and rape of Yazidi women have effectively erased more common and complex patterns”. These more complex patterns include the exploitation of Syrian refugees in Lebanon and Jordan by landlords and employers; the trafficking of women from official refugee camps. There is a full range of issues, from abuse by regime forces, to the rape of men, to the extreme poverty of refugee populations, that are common to many conflicts around the world. These issues deserve attention too.

The steps that need to be taken to protect women are not particularly headline-grabbing initiatives: the proper policing of refugee camps, extensive psychosocial support for women who have been victims of sexual violence, and economic empowerment for women displaced by conflict. But only by understanding the complicated nature of the problem can effective long and short term solutions be put in place.

Samira Shackle is a freelance journalist, who tweets @samirashackle. She was formerly a staff writer for the New Statesman.

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The surprising truth about ingrowing toenails (and other medical myths)

Medicine is littered with myths. For years we doled out antibiotics for minor infections, thinking we were speeding recovery.

From time to time, I remove patients’ ingrowing toenails. This is done to help – the condition can be intractably painful – but it would be barbaric were it not for anaesthesia. A toe or finger can be rendered completely numb by a ring block – local anaesthetic injected either side of the base of the digit, knocking out the nerves that supply sensation.

The local anaesthetic I use for most surgical procedures is ready-mixed with adrenalin, which constricts the arteries and thereby reduces bleeding in the surgical field, but ever since medical school I’ve had it drummed into me that using adrenalin is a complete no-no when it comes to ring blocks. The adrenalin cuts off the blood supply to the end of the digit (so the story goes), resulting in tissue death and gangrene.

So, before performing any ring block, my practice nurse and I go through an elaborate double-check procedure to ensure that the injection I’m about to use is “plain” local anaesthetic with no adrenalin. This same ritual is observed in hospitals and doctors’ surgeries around the world.

So, imagine my surprise to learn recently that this is a myth. The idea dates back at least a century, to when doctors frequently found digits turning gangrenous after ring blocks. The obvious conclusion – that artery-constricting adrenalin was responsible – dictates practice to this day. In recent years, however, the dogma has been questioned. The effect of adrenalin is partial and short-lived; could it really be causing such catastrophic outcomes?

Retrospective studies of digital gangrene after ring block identified that adrenalin was actually used in less than half of the cases. Rather, other factors, including the drastic measures employed to try to prevent infection in the pre-antibiotic era, seem likely to have been the culprits. Emboldened by these findings, surgeons in America undertook cautious trials to investigate using adrenalin in ring blocks. They found that it caused no tissue damage, and made surgery technically easier.

Those trials date back 15 years yet they’ve only just filtered through, which illustrates how long it takes for new thinking to become disseminated. So far, a few doctors, mainly those in the field of plastic surgery, have changed their practice, but most of us continue to eschew adrenalin.

Medicine is littered with such myths. For years we doled out antibiotics for minor infections, thinking we were speeding recovery. Until the mid-1970s, breast cancer was routinely treated with radical mastectomy, a disfiguring operation that removed huge quantities of tissue, in the belief that this produced the greatest chance of cure. These days, we know that conservative surgery is at least as effective, and causes far less psychological trauma. Seizures can happen in young children with feverish illnesses, so for decades we placed great emphasis on keeping the patient’s temperature down. We now know that controlling fever makes no difference: the fits are caused by other chemicals released during an infection.

Myths arise when something appears to make sense according to the best understanding we have at the time. In all cases, practice has run far ahead of objective, repeatable science. It is only years after a myth has taken hold that scientific evaluation shows us to have charged off down a blind alley.

Myths are powerful and hard to uproot, even once the science is established. I operated on a toenail just the other week and still baulked at using adrenalin – partly my own superstition, and partly to save my practice nurse from a heart attack. What would it have been like as a pioneering surgeon in the 1970s, treating breast cancer with a simple lumpectomy while most of your colleagues believed you were being reckless with your patients’ future health? Decades of dire warnings create a hefty weight to overturn.

Only once a good proportion of the medical herd has changed course do most of us feel confident to follow suit. 

This article first appeared in the 20 April 2017 issue of the New Statesman, May's gamble

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