Louise Robin recently returned from an 11-month assignment in Chad as a manager for gender-based violence response and survivor support. Here, she reflects on her experience in a position led by Médecins Sans Frontières (MSF) and with a strong reporting link to GSF, a first for both organisations.
When I arrived in Chad’s Adré and Aboutengé camps in March 2025, MSF was already providing medical care for survivors of conflict-related sexual violence who had fled the war in Sudan. But one key challenge quickly stood out: in practice, it was difficult for survivors to access the medical services they needed. This can be explained by many factors. Fear, discrimination, language barriers, and limited trust prevented them from going to healthcare facilities. This has dire consequences: some survivors were unable to receive emergency prophylaxis treatment in time1 while others simply didn’t come at all to seek psychological or psychiatric care.
Within the MSF team, sexual violence was a difficult topic to openly discuss with staff, who often share the same cultural background as survivors. As a result, the messages passed to women attending various health-related sessions were at best timid, or didn’t mention conflict-related sexual violence at all. In some cases, conflict-related sexual violence was mentioned among broader gender-based violence messages with no clear distinction, creating confusion about terminology and which services could be offered.
A bridge
The idea behind my role was to bring MSF teams and other camp actors together to ensure the conversation around conflict-sexual violence was as clear, open and as holistic as possible. This was the best way to ensure survivors could receive the support they needed. I acted a ‘bridge’ between MSF’s various departments, (mental health, sexual and reproductive health and midwives, health promotion), GSF and the nine survivor-led organisations supported by GSF – who are essential and trusted relays with the men and women we hoped to reach.
It was a first on both sides; for GSF, collaborating with a major humanitarian organisation in such a context, and for MSF, having a dedicated non-medical position focused on sexual violence and liaising with the community. It took time to explain and build this new position and its goals, but the partnership proved useful and productive.
The needs arising from sexual violence require urgent attention and protection measures for survivors, who may face reprisals and security threats by identifying themselves as such. I worked on improving our awareness messaging and standardising our approach to minimise risks. For example, we developed an ‘image box’ that uses images instead of text to explain various concept around sexual violence, simplifying what can sometimes be complex. We also worked on a harmonised terminology around sexual violence that was then translated into Sudanese Arabic.
Starting with survivors
This role taught me that a more reparative approach cannot be built only around services. It has to start with survivors themselves, their experiences, and their understanding of what support means in their own community.
Many of the women we worked with were also often the first to listen, to notice when something was wrong, and the first to create a space where others could begin to speak. They knew what could be said openly, what had to be approached more carefully, and what would make support feel meaningful rather than imposed.
Restoring agency is not only about ensuring survivors could make choices about their own care -although that remained essential. It is also about recognising their ability, and right, to shape the response itself. Much of what we built with survivors led organisations came from survivors’ own ideas, analysis, and their own sense of what was missing. These initiatives were then strengthened through repeated discussions, training, focus group discussions and exchanges with MSF teams.
Impact
I observed very concrete operational improvements, and more human, qualitative changes that are sometimes less visible but just as essential. I witnessed increased engagement and coordination from MSF, stronger referral pathways for survivors, and more shared tools and knowledge. We also developed stronger links with GSF-supported partners.
What changes everything, however, is the quality of the relationships we build, the way we show up again and again, the words we choose and the respect we show. With a patient and careful approach, over time I saw that team members became more comfortable on discussing sexual violence, which is a vital step forward. I also understood that change does not always come through big gestures. Gradual progress came with more open discussions and consistent efforts to approach survivors with clear messaging. The discomfort has not disappeared, but there is more awareness and engagement than before. I observed similar changes with partner associations. Throughout my months in Chad, some partner organisations shared that what they valued the most is that they felt more recognised and valued.
These shifts can leave a lasting mark, and that is what gives me hope for the future of this position and the support we provide to survivors in Chad and elsewhere.