"While I was in the office, they brought me a survivor," Dr. Joseph Johnson, a gynaecologist in northwest South Sudan, recently recalled. "They told me she was raped by her own boyfriend."
The woman had been brutally beaten and required urgent medical attention. "It was serious," Dr. Johnson told UNFPA. "Her life was now in danger. We needed to do an urgent operation."
Cases like this one are horrific - and they are all too common.
Violence against women and girls is one of the most pervasive human rights violations in the world. Today, 25 November, marks the start of the 16 Days of Action against Gender-based Violence, an annual international campaign that unites advocates, leaders and policymakers in the call to end all forms of violence against women and girls.
The campaign is now in its 28th year. Despite these decades of activism, the world remains unsafe for too many. Roughly one in every three women has experienced some form of abuse. One in five women or girls will be assaulted by their partner this year.
The costs of this violence are impossible to summarize. Gender-based violence - including sexual violence and rape - results in lost productivity, lost opportunities, broken bones and broken lives. If the world is to achieve its development goals, a critical precondition is the safety, equality and well-being of women and girls everywhere.
Survivors' rights and needs
In South Sudan, Dr. Johnson's patient suffered a terrible ordeal. But she was able to receive the full range of care she needed and deserved - including urgent medical attention and access to follow-up health services, psychosocial care and legal advice.
All survivors of violence deserve the same range of sensitive, confidential, victim-centred support.
But too many fall through the cracks, particularly in crisis settings, as protection systems break down and abusers enjoy impunity. UNFPA is working with other humanitarian organizations help ensure all survivors - no matter their circumstances - are able to receive protection and assistance.
Two weeks ago, this group of partners released the Inter-Agency Minimum Standards for Gender-Based Violence in Emergencies Programming, a guidance document about 16 basic steps and services that must be put in place to prevent violence and support survivors in every emergency scenario.
"I want to be there for women when their rights are being trampled"
UNFPA and its partners support programmes that offer the full spectrum of care. Dr. Johnson, for instance, works in a one-stop centre in Wau where survivors of gender-based violence can access medical care, counselling and justice services under one roof.
In Venezuela, amid the ongoing crisis, health workers were recently trained to provide care to survivors of violence. "Every day we examine many abused women, most of them young. It is crucial to build the capacity of health workers in clinics so they can serve victims' needs," said Luz Marina Alejo, a medical examiner from Apure.
And in conflict-affected Marawi, in the Philippines, teams of doctors, social workers and police work together to offer victim-centred care. "I want to be there for women when their rights are being trampled - anytime, including during an emergency," said Chrestine Espinorio, a police officer who works on one such team, with support from UNFPA.
When this kind of holistic support is unavailable, survivors are extremely vulnerable - both to lasting trauma and continuing abuse.
Salwa*, in Yemen, experienced childhood sexual abuse by an uncle, and subsequent depression. But when she decided to seek counselling, her psychiatrist tried to exploit her.
"He tried to harass me in the same way as my uncle," she said. "It was a big shock. I had already lost confidence in everyone, and when it happened again from a caregiver I could not take it anymore," she told UNFPA.
It was not until she found the Family Counselling Centre in Sana'a that she was able to receive qualified care and a wide range of services. "There was a huge difference in the way I was treated," she said.
We cannot afford inaction
But meeting these minimum standards of care - and even exceeding them - is not enough.
Leaders and policymakers must also move to end violence from happening in the first place.
This means working towards a more gender-equal world. It means educating people about their right to live free of violence and abuse. It means ending impunity and elevating the voices of women and girls.
A recent study by UNFPA and the Johns Hopkins University, in collaboration with Victoria University, the University of Washington and Avenir Health, found that the total price tag to end gender-based violence and harmful practices in 132 priority countries is just $42 billion.
It's not just affordable; it's necessary. The cost of inaction will be much higher - a toll measured in lives ruined, economies constrained and generations of human potential unrealized.
Change is possible if enough people join the effort. "I would like to contribute," Officer Espinorio told UNFPA, "to restoring our fellow women's and girls' dignity and hope."