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Treating DRC’s victims of sexual violence
The hospital offers a full range of medical care including facilities for surgery where MSF regularly treats the war-wounded. “As well as providing consultations,” explained Yves, “the hospital is also equipped with a 30-bed emergency intensive care unit (ICU), 20 beds for surgery, and a 10-bed obstetric ward. We also have a 100-bed paediatric ward, and a surgery and maternity ward.”
While there is another government-run hospital in the region, there is a lack of drugs so it’s difficult to get adequate treatment. “As a result people decide to come to the MSF-run hospital. However, security is a problem,” said Yves. We monitored this and discovered that for people who live up to 20kms away, it’s relatively safe to access the hospital, but beyond this it’s very dangerous because of the security situation in the area.” Consequently, sexual violence is especially prevalent in the region, with more than 2,500 rape survivors treated by MSF’s medical teams in the 20-month period between June 2003 and January 2005. Rape and other forms of sexual violence are commonly used as weapons of war in the DRC. “Sexual violence is often used in a number of ways: as punishment for women suspected of collaborating with enemy forces, to terrorize members of other ethnic groups, to scare the civilian population into submission, or to provide gratification to militia following a defeat.”
“I remember one girl in particular,” said Yves. “She was seven years old and had come to the hospital because of vaginal discharge. It was not until my colleague examined her that we discovered that she had been continually abused every week since the age of four.” In response to SGBV and women’s health needs in the region, MSF provides special care and preventative treatments, including “morning after” emergency contraception to prevent pregnancy and post-emergency prophylaxis (PEP), which can help prevent the possible transmission of HIV/AIDS for those treated within 72 hours of rape. During Yves’ time in Ituri province, MSF carried out consultations for between 150 and 250 women a month. “GBSV is so common in the area that it’s important to speak out about it.” In addition to physical symptoms, Yves also witnessed the mental trauma associated with SGBV. “Shame, stigma and depression are the most common psychological repercussions resulting from sexual violence,” he said. MSF staff offer counselling to survivors in an effort to alleviate the psychological and emotional trauma. “One of the first steps is to encourage the victim to speak about their experience, which of course is very difficult. But we’ve set up a separate ward in an effort to lessen the stigma attached to victims of SGBV.” “MSF has decided to support Bon Marché for three years. We’re hoping for security to improve so we can help more people.”
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During
the past year, the north-eastern province of Ituri has been the epicentre
of violence in the Democratic Republic of Congo (DRC). Despite efforts
at disarmament and reintegration, principally by the United Nations, numerous
rebel groups continue to wage war, rendering large swathes of 
“We
have two nurses, six doctors: one paediatrician (myself), one for adults,
two surgeons, an anaesthetist and an obstetrician. National staff comprises
three doctors and many nurses, including specialised nurses who often
work alone and are capable of handling both diagnosis and treatment.”
The
number of survivors is surely only the tip of the iceberg because many
women are too frightened or ashamed to seek medical help or are living
in remote areas from which medical care is inaccessible. And while the
number of rapes is shocking, rape survivors have told MSF’s teams
about the extreme cruelty with which it has been carried out: among those
treated by MSF, an estimated 77 percent of rapes were committed by groups
of men and 30 percent by five or more attackers. Twelve percent of the
women said they were forced to endure other forms of torture and degrading
acts. Victims include women and girls – sometimes as young as three.