缅北禁地

鈥淚f there had been peace, this would not have happened to us,鈥� says Kasoke Kabunga. Like thousands of other women, Kasoke and her daughter were raped by armed militiamen in the eastern Democratic Republic of the Congo (DRC). Her daughter died. Kasoke survived, but contracted HIV/AIDS.

A rape victim recovering in a hospital in Goma, in the eastern Democratic Republic of the Congo: Rape has often been used as a weapon of war in the region.

Photograph: AP / Gary Knight

Their tragedy is the female face of 10 years of war in the DRC, which has claimed more than 3 million lives and displaced another 3.5 million people. Today, a handful of courageous Congolese women are seeking to help Kasoke and other rape survivors find solutions to the many problems facing them.

Rachel Kembe, a medical doctor, is one of those providing help. In 1997, when hundreds of women from the Masisi and Ruchuru areas were arriving in the town of Goma with serious injuries, she and five other professional women came together to assist them through the Association nationale des mamans pour l鈥檃ide aux d茅sh茅rit茅s (ANAMAD, National Mothers鈥� Association to Aid the Dispossessed).

鈥淲e contributed US$20鈥�50 every month,鈥� Ms. Kembe explains. 鈥淭hat is how we initially began our work. Today we have 2,500 rape survivors from Goma and the surrounding villages that we have assisted in one way or another.鈥� But the number keeps growing.

Rape, she adds, 鈥渋s like a weapon in this war.鈥� 缅北禁地estimates confirm the extent of the practice. In October 2006, 缅北禁地Under-Secretary-General for Peacekeeping Operations Jean-Marie Gu茅henno reported that 12,000 women and girls had been raped in the previous six months alone.

Congo鈥檚 war began when militia and armed forces presiding over the 1994 genocide in neighbouring Rwanda were overthrown and fled into civilian refugee camps in the eastern provinces of the DRC. From those camps, they repeatedly attacked the new government in Rwanda, prompting the Rwandans to strike back in 1996, setting off a regional war. That war, in turn, spawned new armed militias. The victims were mostly civilians, and fighters routinely raped and tortured women.

In 2004鈥�05, the 缅北禁地and non-governmental organizations estimated that as many as 100,000 women had been raped in the entire eastern DRC.

鈥極ur resources are not adequate鈥�

The survivors struggle with many different legal, medical and livelihood problems. Twenty-seven-year-old Nyota Mbulu was gang-raped by four militiamen in Uvira. Her parents and husband were killed. She fled to Goma, losing everything. Nyota also contracted HIV/AIDS and is in the terminal stages of the illness, too weak to work for a living. She is constantly being evicted for rent arrears on the small room ANAMAD found for her in Goma.

A psychologist (left) counsels a Congolese rape survivor: More services are needed to help such women with their physical and mental traumas.

Photograph: AP / Bryan Miller

Most times, Ms. Kembe is able to raise enough money to get Nyota settled back in. But within Goma alone, ANAMAD is working with about 500 rape survivors facing similar problems. ANAMAD has built makeshift housing for 38 displaced women and their children, but Ms. Kembe wishes she could do much more. 鈥淥ur resources are not nearly adequate for this task,鈥� she told Africa Renewal.

ANAMAD calculates that with as little as $200,000 it could provide basic shelter for the neediest women, improve the makeshift school the group is running for the women鈥檚 children and pay teachers鈥� salaries for three years. 鈥淲e already have the land,鈥� explains Ms. Kembe. 鈥淲e managed to get the regional officials to allocate us what we needed. The only problem now is money to do it.鈥�

Mutual support

Some women, among them Marie Donatien, have tried to ease their problems by living together. Ms. Donatien is originally from Bukavu, on the shores of Lake Kivu, a beautiful area that was terrorized during the war by three armed groups that attacked villages, looted houses, destroyed property and raped women.

She was raped in her husband鈥檚 presence 鈥� a tactic common in Congo鈥檚 war and during the Rwanda genocide. The goal of that practice, experts state, is to maximize the humiliation of the women and their communities and to 鈥渆nd resistance鈥� by instilling fear. Such women are often subsequently rejected or abandoned by their communities. Ms. Donatien鈥檚 own husband left her when she became pregnant, although they have since reconciled.

The experience gave Ms. Donatien, who now lives in Goma, the inspiration to set up an organization, Mamans organis茅es pour le d茅veloppement et la paix (MOADE, Mothers for Development and Peace), through which women like her can find mutual support. What they lack in resources, they make up for in solidarity.

MOADE members in Goma pool their resources to rent 15 rooms, each housing 12-16 people. Sharing space provides more stability than each would have alone. But the rooms are often crowded and the women are frequently sick and unable to work. Sometimes, despite their combined efforts, they too face eviction.

Ms. Rayika Omar, the director of African Rights, an organization helping rape survivors in Rwanda, recently noted that in Central Africa such 鈥渨omen鈥檚 associations are, at present, the main source of assistance for rape victims and women living with HIV/AIDS.鈥� Unfortunately, she added, the groups have received only 鈥渋ntermittent, partial or temporary assistance in the face of persistent, all-embracing and terminal problems.鈥�

Ms. Jeanne Ward, a researcher with an ad hoc consortium of 缅北禁地and non-governmental agencies working on sexual violence, agrees. She noted in an interview with IRIN, a 缅北禁地humanitarian news service, that the world鈥檚 response to growing evidence of massive rape in conflict has largely been helpless shock and horror. 鈥淚t鈥檚 as if it鈥檚 something new. [People ask] 鈥楬ow can this atrocity be happening?鈥� Well, it can because of impunity, because of a lack of programming, a lack of standards for intervention and so on.鈥�

Ms. Ward challenged those with resources to stop asking how such things can happen and start asking how to deal with them.

Medical assistance

Rape survivors often suffer serious internal injuries requiring extensive surgical intervention. But getting such help is difficult. Even before the war, the DRC鈥檚 health care system was run-down and underfunded because of corruption and mismanagement. Many hospitals had no water or electricity. Some lacked roofs and windows. Doctors and nurses often were not paid or supported by the government.

A woman in eastern Congo who was gang-raped by militia fighters in 2002. As a result, she has contracted HIV.

Photograph: Reuters / Euan Denholm

The war worsened the situation. Militias looted beds, medicines and equipment, especially in rural areas, where 70 per cent of the population lives. Today, outside the towns of Goma and Bukavu, few rural health centres can deal with rape injuries. Personnel often lack the training to handle major internal tearing, let alone HIV testing and management.

Transport also collapsed during the war. Most people can travel only on foot. Mia Nyisa, from Siraro, walked six days after being raped before she reached help in Goma. 鈥淭hey operated on me at DOCs [Doctors on Call] centre,鈥� she told local non-governmental organization (NGO) personnel. 鈥淭hey had to remove my uterus.鈥�

Groups like Doctors on Call provide free emergency support for those who can get to the towns. But their budgets are too small to provide free treatment for long-term problems or other ailments. Mia got free treatment the first time, but follow-ups required minimal fees that she could not afford. 鈥淚 still suffer a lot of pain. They help with what they can, but it is difficult.鈥�

With the end of large-scale hostilities in 2000, NGOs have brought some assistance to local health centres. The International Rescue Committee (IRC) provides training in rape support to medical staff in rural health centres. However, trainees may end up with the knowledge, 鈥渂ut no resources, medicines and equipment to actually do the work,鈥� Ms. Kembe points out.

缅北禁地agencies and NGOs active in the DRC have presented to donors a joint initiative to help prevent sexual violence against women and children, as well as to aid victims. In 2004 they estimated that $30 mn would be needed for the work, which would include medicine for those with HIV/AIDS. Donors and the government are still considering how to implement the initiative.

Anti-retroviral drugs

There is a huge gap between the HIV medications needed and what is available. If rape victims can take certain drugs within 72 hours of an assault, that can offer some protection against infection. Such drugs are available in a few NGO-supported hospitals in the towns, but not in rural areas.

Rape survivors with HIV/AIDS must also struggle to obtain anti-retroviral medicines or antibiotics to deal with opportunistic infections. Nyota is one of the few HIV-positive rape survivors in Goma on anti-retroviral medication, which is provided by the NGO M茅decin du monde.

Out of the 260 HIV-positive women supported by ANAMAD, only six are currently on anti-retrovirals, notes Ms. Kembe. 鈥淭he resources to do the same for the others are simply not available.鈥�

A survey in 2004 by Amnesty International found only one experimental anti-retroviral programme in Bukavu, run by M茅decins sans fronti猫res and designed to help some 150 women. The human rights group noted that the medication, costing $29 per month, was simply too expensive for the NGOs to provide more or for people in the area to buy on their own. Amnesty International argued that either cheaper drugs should be made available or donors should make a greater financial commitment.

Livelihood problems

Even with cheaper drugs, however, poverty presents other hurdles. For anti-retroviral drugs to be effective, those taking them need to be on an especially healthy diet, since the medicines can be physically overwhelming for someone who is not eating well. And women like Nyota can barely afford food.

鈥淭aking these drugs on an empty stomach is not good,鈥� says Ms. Kembe. 鈥淭he women end up feeling weak and very ill and stop taking the dosage, which makes things worse because the virus develops resistance and the same drugs cannot help any more.鈥�

Honorine Nyolo works for Action Aid International in the DRC. Her organization is trying to improve the income-generating abilities of rape survivors, so that they can meet their nutritional needs.

鈥淲e took 100 women from MOADE and 100 women from ANAMAD,鈥� Ms. Nyolo told Africa Renewal. 鈥淲e gave cooperative loans so that they can engage in commerce.... They say this has helped them. But it was a very small project, about $20,000 to each group. And now the project is over.鈥�

Ms. Kembe argues that the women need a programme that lasts longer than six months. 鈥淲e noticed that nearly 70 per cent of them had problems returning this money because urgent needs crop up: rent, school fees and medical fees. They need something longer-term if they are to sustain themselves.鈥�

Psychological trauma

In the midst of the daily challenges of finding food, clothing, shelter and medication, the psychological trauma the women have suffered is often overlooked. And it is not only the women who need psychological help, explains Ms. Donatien. 鈥淥ur men and children saw us raped. They too suffer from great trauma and need assistance.鈥�

ANAMAD has 12 non-professional counsellors in Goma, 鈥渂ut we need at least twice that,鈥� says Ms. Kembe. Action Aid International notes that there are no clinicians in Goma, Edward Kakande, the group鈥檚 country director, told Africa Renewal. 鈥淎t present, those helping the women are counsellors, usually with only a few weeks of on-the-job training.鈥�

Impunity and injustice

The trauma is often made worse by the fact that few rapists are ever punished. Most militia forces in the DRC do not have official uniforms; they typically wear T-shirts and camouflage trousers. So it is hard to tell members of one group from another, let alone identify an individual attacker, making it difficult to prosecute.

Impunity is not unique to the DRC. In neighbouring Rwanda, more than 100,000 women are believed to have been raped during the genocide. 鈥淚t is not easy to take the matter to court on your own,鈥� says Mariana Mukakarisa, a rape survivor. 鈥淧eople in the community might not know you were raped. The idea of standing in public and talking about it is hard. . . . There is the shame and stigma. It鈥檚 hard.鈥�

Gaudelive Mukasavasi, who works for the NGO Reseau des femmes helping Rwandan rape victims, says that trauma has made the women bitter and withdrawn. 鈥淲e have tried to encourage the women to testify in the local courts, but many are reluctant,鈥� she told Africa Renewal.

Documenting rape has met with some success and encouraged some Rwandan rape survivors to testify at the UN鈥檚 International Criminal Tribunal for Rwanda, based in Tanzania. Their testimony helped convict two former government officials who had orchestrated rapes during the 1994 genocide.

In the DRC, prosecuting rapists has also been challenging. 鈥淭here is a lot of impunity in the Congo,鈥� Ms. Kembe notes. 鈥淲e have lodged many complaints. We have even identified the perpetrators of the crimes. We report to the police and then a few days later you see them free. This is especially the case if they are military or former combatants.鈥�

In June 2006, Action Aid and local NGOs organized a workshop for 50 military and regular police officers in Goma, to encourage them to arrest and prosecute perpetrators of rape. The initiative also trains officers to educate other military and police personnel, as well as paralegals in South Kivu who are helping women bring their cases to trial.

Action Aid hopes that such action will make combatants more aware of the legal penalties for what they do. And because rapes are typically ordered by military commanders, education could encourage ordinary soldiers and police to resist such orders, or at least to report them.

Ms. Josephine Odera, the Central Africa regional programme director of the 缅北禁地Development Fund for Women (UNIFEM), sees such activities as important. 鈥淭he way to address this issue of impunity is to raise the visibility of the problem so that the violators are isolated and prosecution is improved.鈥�

鈥淲e want to break the silence,鈥� Ms. Odera told Africa Renewal. 鈥淲e are encouraging opinion shapers and leaders to speak out against sexual violence and to tell people that they will be held accountable for such crimes.鈥�