"Only on Paper": Rights vs. Reality for Gender-Based Violence Survivors in Rural Bolivia

This paper presents testimony from a primary care physician about the challenges of navigating post-assault health service referral options and judicial remedies for adolescent survivors of gender-based violence (GBV) in rural communities in eastern Bolivia. We examine the protections outlined in various international, regional, and national laws; discuss relevant legal instruments and policies that aim to safeguard the sexual and reproductive health rights of adolescents; and outline mechanisms for their enforcement. We then apply the availability, accessibility, acceptability, and quality framework to analyze the extent to which post-assault health services and judicial remedies for adolescent survivors of GBV are sufficient, equitable, and effective. Through our application of this framework, we observe that many adolescent survivors likely experience re-victimization and re-traumatization as they navigate a fragmented patchwork of resources following their victimization. Based on this analysis, we argue for the integration of a human rights framework in designing, implementing, and evaluating post-assault care for adolescent survivors of GBV. We also contend that the 2023 ruling by the Inter-American Court of Human Rights in Angulo Losada v. Bolivia sets a legal precedent for holding Bolivia accountable for ensuring that adolescent victims of GBV experience their human and constitutional rights in rural, resource-variable communities in Bolivia.