Prevention of Sexual Exploitation and Abuse Policy

I. Introduction 

Partners In Health (PIH) is committed to ensuring that those who benefit from our work, including patients, families and community members, are treated with respect and dignity. We recognize that our work is rooted in vulnerable communities and, as a social justice organization, we are responsible for enforcing standards for the treatment of those we serve and consequences for those who fail to uphold these standards, which rest at the core of our mission—providing a preferential option for the poor. 

This Prevention of Sexual Exploitation and Abuse Policy (the “Policy”) is intended to protect vulnerable individuals from sexual exploitation and abuse by PIH Personnel. As a NonGovernmental Organization (NGO) working in resource-limited settings, the inherent imbalance of power that exists requires us to implement necessary safeguards to ensure that the power dynamic is not used to abuse or exploit the people we serve. 

PIH will not tolerate its employees, volunteers, consultants or any other representatives associated with the delivery of our work carrying out any form of sexual abuse or sexual exploitation, failing to report any allegations of sex abuse or sexual exploitation, or retaliation against those who report or participate in investigations. 

Because PIH takes allegations of sexual exploitation and abuse seriously, we will respond promptly to complaints and where it is determined that such inappropriate conduct has occurred, we will act promptly to eliminate the conduct and impose the necessary corrective and disciplinary actions. 

II. Scope of Policy 

This policy applies to PIH, all subsidiaries and affiliated organizations, and all PIH Personnel (defined below). This policy is subject to change at the discretion of management. 

Please note that this Policy differs from PIH’s sexual harassment policy. PIH’s sexual harassment policy addresses the behavior of PIH employees and collaborators internally toward one another and is found in PIH’s Code of Conduct and in separate policies adopted by PIH Sites. This Policy addresses the behavior of PIH Personnel toward third-party Beneficiaries of PIH’s work, as defined below. 

III. Definitions 

“Beneficiaries” means those individuals who are direct or indirect recipients of PIH’s work, including patients, patient families, children and participants in PIH programs, and those individuals who are community members in the areas where PIH works. 

“Child” means an individual below the age of eighteen (18) years old. 

“PIH Personnel” means any individual affiliated with PIH or a PIH subsidiary or affiliate organization including employees, seconded employees, local and international collaborators, volunteers, independent contractors, consultants and interns. 

“Sexual abuse” means the actual or threatened physical intrusion of a sexual nature, whether by force or under unequal or coercive conditions. 

“Sexual exploitation” means any actual or attempted abuse of a position of vulnerability, differential power, or trust, for sexual purposes, including threatening or profiting monetarily, socially or politically from the sexual exploitation of another. 

For the purposes of clarity, PIH recognizes that the terms sexual abuse and sexual exploitation are broad and cover a broad range of behaviors that are not limited strictly to the act of sexual intercourse. Such behaviors also include, without limitation, other sexual acts, attempts to obtain a sexual act, and unwanted sexual comments or advances, among others. 

Please note that while this Policy sets forth PIH’s standards for safeguarding the people and communities we serve, the Policy is not designed or intended to limit PIH’s authority to discipline or take remedial action for conduct it deems unacceptable, regardless of whether that conduct satisfies the definitions provided above. 

IV. Prohibited Behaviors 

PIH Personnel are strictly forbidden from engaging in any form of sexual exploitation and sexual abuse whatsoever. This applies at all times whether PIH Personnel are at or outside the workplace or during or outside of working hours. Other actions, such as inappropriate behavior toward or with a child, failing to report an allegation of exploitation or abuse, or retaliating against a complainant or a witness are also prohibited by this Policy. 

Because sexual exploitation and sexual abuse includes a broad range of activities, the following activities are meant to be illustrative and not an exhaustive list of prohibited behavior: 

  1. Acts of sexual exploitation or sexual abuse by PIH Personnel including, without limitation: a. Unwanted touching or physical contact of a sexual nature b. Forcing sex or sexual acts against someone’s will c. Using sex or sexual acts as a condition of receiving support, treatment, or assistance d. Physical aggression, including rape, sexual battery, forcible fondling e. Recording sexual acts or interactions without consent 
  2. The exchange of, or an offer to exchange money, goods, services, or assistance for sex, sexual favors or other forms of degrading or exploitative behavior. This prohibition against the exchange of money for sex means that PIH Personnel may not engage the services of sex workers. 
  3. The exchange of, or an offer to exchange, recommendation for employment, offer of employment or an employment reference for sex, sexual favors or other forms of degrading or exploitative behavior. For the purposes of this section, the employer or prospective employer includes PIH or any PIH vendor or contractor. 
  4. Any sexual activity, or an attempt to engage in sexual activity, with a child regardless of local age of consent; ignorance or misbelief of a child’s age is not a defense. 
  5. Sexual interactions or relationships with a Beneficiary during the time they are receiving assistance from PIH, regardless of whether the Beneficiary consents to such interaction. 
  6. Physical force or violence against a Beneficiary regardless of cultural norms. 
  7. Behavior toward a child that is inappropriate or sexually provocative, including, without limitation, physical abuse, sexual abuse or exposing the child to sexual concepts or pornography. 
  8. Use of language or behavior towards a Beneficiary that is inappropriate, harassing, abusive, sexually provocative or that is intended to shame, humiliate or emotionally abuse. 
  9. Use of a computer, mobile phone, tablet, camera, social media, email, or other form of technology, without limitation, to exploit or harass a Beneficiary, or to access or distribute child pornography through any medium. 
  10. Use of PIH or PIH affiliate’s facilities, vehicles or any other property for the purposes of sexual abuse or sexual exploitation. 
  11. Doing things of a personal nature for an unsupervised child that the child can do for themselves (e.g., bathing, dressing). “Unsupervised child” means a child who is not supervised by an adult who is an immediate family member. 
  12. Sharing a bedroom with an unsupervised child. 
  13. Photographing a child who is not adequately clothed or who is in a pose that could be considered sexually suggestive. 
  14. Failing to report a suspected, alleged, or known violation of this Policy in a timely manner. 

Failing to disclose any convictions for, or investigations of sexual exploitation or sexual abuse. PIH reserves the right, in its sole discretion, to determine whether a particular behavior or incident rises to the level of behavior prohibited by this Policy, regardless of whether it is listed above. 

V. Reporting Requirements 

PIH Personnel are required to immediately report any suspected, alleged, or known instance of sexual exploitation or sexual abuse of Beneficiaries by PIH Personnel. 

It is the responsibility of all PIH Personnel to report any concerns or violations; it is not your responsibility to decide whether or not sexual exploitation or sexual abuse has occurred or to conduct any type of investigation into alleged behavior before reporting. 

VI. How to Raise a Complaint or Concern or Make a Report 

To raise a complaint or concern about something you have seen or heard or to make a report, you may use any of the following methods or contact any of the following individuals: 

By email: keepushonest@pih.org 

PIH Canada: Mark Brender, National Director, mbrender@pih.org; +1 (416) 646-0666 (Canada); or any individual listed below. 

PIH Boston: 

  1. Kate Rojkov, Chief Human Resources Officer, krojkov@pih.org 
  2. Lori Silver, General Counsel, lsilver@pih.org; + 1 857-880-5170 (US); lsilver.pih (Skype) 
  3. Judi Thomas, Human Resources Director, judiththomas@pih.org; + 1 857-880-5058 (US); judiththomas.pih (Skype) 

PIH Personnel may contact these individuals by email, Skype, telephone or mail to their attention at Partners In Health, 800 Boylston Street, Suite 300, Boston, MA 02199. 

Any PIH Site Executive Director or other Site staff member who receives a report also is required to promptly inform one of the PIH Boston officials listed above. 

When providing a report, people are encouraged to be as specific as possible, including the basic details of who, what, where, when and how any incidents occurred. Specific information will allow PIH to properly investigate the alleged wrongdoing. People who file reports will be contacted to confirm that their report has been received and that follow-up is occurring. 

VII. Investigation 

PIH commits to a serious, fair and expedited investigation into all allegations of sexual exploitation or sexual abuse. Internal investigations will be conducted in such a way as to maintain confidentiality to the extent practicable under the circumstances. PIH Personnel are expected to cooperate fully in any investigation, and refusal to cooperate may result in disciplinary action. 

PIH will contact local or national authorities in a timely manner as appropriate given the severity of the incident and where required by law and will work in collaboration with authorities to aid their investigation to the extent possible. 

VIII. Disciplinary Action 

If it is determined that a violation of this Policy has occurred, PIH will act promptly to eliminate the offending conduct, impose disciplinary action, and take other appropriate remedial action. Upon conclusion of an investigation, either internally by PIH or by authorities, a determination will be made about the appropriate course of action. This will be without prejudice to criminal proceedings. 

Depending on the severity of the behaviors and the availability and reliability of evidence, PIH will impose disciplinary measures upon the perpetrator(s). Disciplinary actions include but are not limited to mandatory training sessions, suspension or termination. 

Disciplinary actions may also be imposed upon individuals who fail to report allegations of sexual exploitation or sexual abuse or who maliciously submit a false report, up to and including termination. 

Disciplinary procedures and disciplinary measures are subject to the local requirements of each PIH Site. 

IX. Protection Against Retaliation 

PIH will not tolerate any retaliation against PIH Personnel, Beneficiaries or others who report suspected prohibited conduct in good faith or who participate in investigations. PIH will take all necessary actions against PIH Personnel who seek or carry out retaliatory action against complainants, victims or other witnesses. If you believe that you have experienced or witnessed retaliation, you should immediately report your concern to one of the individuals listed above. PIH Personnel who engage in retaliation will be subject to disciplinary action, up to and including termination of employment. 

X. Confidentiality 

Because of the nature and sensitivity of allegations involving sexual exploitation and abuse, PIH will treat all reports and allegations with the greatest respect for confidentiality of all individuals involved. Sensitive information related to incidents of sexual exploitation or abuse shall be shared only with enforcement authorities and PIH agents and employees of the appropriate seniority or function who have a need to know such information. PIH Personnel who handle investigations and sensitive information are required to maintain the confidentiality of such information, and will be subject to discipline in the event of any unauthorized disclosure. 

To the best of its ability, PIH will work with victims of sexual exploitation or sexual abuse to address their concerns around confidentiality to allow effective investigations to go forward. However, effective and fair investigations typically require confronting the accused with allegations. In cases in which PIH has concerns about the safety and well-being of its employees or patients, PIH may take appropriate actions, while still respecting, to the extent feasible, privacy and confidentiality. 

In some circumstances, PIH may be required by its donors, regulators or via legal action to disclose allegations and related detailed information including the name and identifying information of the survivors and the accused. When providing such information to donors, regulators or law enforcement, PIH will seek to limit the distribution of this information to the extent possible and allowed by law, and when possible and in accordance with laws, will seek assurances that the information remain confidential. 

XI. Additional Organizational Responsibilities 

All PIH Personnel 

All PIH Personnel share an obligation to prevent and respond to sexual exploitation and sexual abuse. It is the responsibility of all PIH Personnel to read and understand this Policy and comply with its requirements. 

PIH Managers, Supervisors and Human Resources Staff 

PIH Personnel who are managers, supervisors and Human Resources staff must ensure that all PIH Personnel understand and comply with this Policy. Human Resources staff are also responsible for robust recruitment, induction and training related to this Policy. 

To prevent perpetrators of sexual exploitation and abuse from being (re)hired or (re)deployed, managers and human resources teams must ensure robust recruitment screening processes for all personnel, particularly for personnel who will have any direct or indirect contact with children. This could include use of background and criminal reference/record checks, verbal reference checks and interview plans that incorporate behavioral-based interview questions. Hiring managers should ensure they speak directly to an applicant’s former employer and thoroughly review any gaps in an applicant’s job history. 

PIH Site Executive Directors and PIH Senior Leadership in any Country 
PIH Site Executive Directors and PIH Senior Leadership must provide support and guidance for the implementation and enforcement of this Policy. They also must designate appropriate local personnel to promote PIH’s commitment to this Policy to Beneficiaries and actively seek feedback from communities on PIH’s role, staff behaviors and complaints. Senior PIH staff should provide feedback to communities on what changes have been made in response to complaints. 

Any questions, concerns or feedback on this Policy or its implementation should be directed to: 

  1. Kate Rojkov, Chief Human Resources Officer, krojkov@pih.org 
  2.  2. Lori Silver, General Counsel, lsilver@pih.org; +1 857-880-5170 (US)  
  3. 3. Judi Thomas, Human Resources Director, judiththomas@pih.org; +1 857-880-5058 (US) 

XI. Relation to Local Laws and Site-Specific Addendums 

PIH will comply with laws and regulations prohibiting misconduct at each of its Sites, but where this Policy exceeds any legal requirements, PIH will adhere to the standards in this Policy to the extent allowed by applicable law. 

PIH Site Executive Directors may incorporate additional safeguards and procedures to this Policy by implementing Site-specific addendums that address cultural considerations or local legal requirements and serve to further this Policy’s overarching purpose of protecting vulnerable individuals from sexual abuse and sexual exploitation. Each Site-specific addendum must receive the prior approval of the General Counsel of PIH and the Chief Human Resources Officer of PIH.