The Consequences of Rape During Conflict in the Democratic Republic of Congo

The DRC has been war-torn for 20 years out of the 50 years it has been independent.4 The toll this conflict has taken on the country is tremendous but even worse is the toll it has taken on Congolese women. In the DRC women are the backbone of society. They are the caretakers, the breadwinners and the transporters. They are the mothers of the nation in every sense of the word and, incredibly, they are the ones carrying the brunt of the burden of a war started by men.5

The DRC has never really known peace. Independence came late and after a long period of colonial rule. There was little preparation for independence and the basic institutions of democracy were missing or too weak to prevent civil war. Since 1996 the country had to suffer almost constant violent clashes between different ethnic groups. These clashes will have extremely damaging consequences for the social fabric of the DRC.

The DRC is about the same territorial size as Western Europe with an estimated population of between 62 and 78 million people. There are 5 dominant ethnic groups with little capacity to govern. Sixty-six per cent of the population belongs to 235 unclassified ethnicities.6 As in many other African states, the DRC is divided. Clueless white Europeans drew its borders with little regard for African civilization. Africa was largely interesting for Europeans because of its resources. The DRC is a prime example of a country whose mineral wealth "caught the eye of the West."7

The country possesses vast reserves of gold, copper, diamonds and uranium, as well as oil, cadmium, cobalt, manganese, silver, tin and zinc. Coffee, cocoa, cotton, tea, palm oil, rubber and timber are all exported from the country today. In addition, it controls over 80% of the world's Coltan reserves, a mineral found in practically every cell phone produced today.8

Under different political circumstances, this country would and should be rich. Its mineral wealth is worth a potential $24 trillion dollars. However, 80% of its population lives on $2 dollars a day. Approximately 1 million dollars are stolen from the DRC every day.9 Corruption is rampant as is evident by the DRC's ranking of 164th out of 178 countries surveyed by Transparency International's 2010 Corruption Perceptions Index.10

It is clear that this country and the surrounding region are in desperate need of better governance and rule of law. It will require focused energy and coordinated efforts of the world community to prevent a complete collapse of governance, in particular the loss of hope of the people of the DRC for a life in peace. The pervasive corruption provides fertile ground for the lawlessness that underlies the high incidence of rape.

Systematic Rape

According to the Draft Convention Against Sexual Exploitation of January 1994, "sexual exploitation is a practice by which person(s) achieve sexual gratification or financial gain, or advancement, through the abuse of a person's sexuality by abrogating that person's human right to dignity, equality, autonomy, and physical and mental well-being."11 Despite this Convention, the Congolese military as well as illegal rebel armed groups usually use rape or sexual violence as a way to get revenge for supposed collaboration with rival groups. In March 2010 a survey conducted by the US Government Accountability Office (GAO) in the Eastern Congo came to the conclusion that between March 2009 and March 2010 an estimated 9 percent of the population had experienced some sort of sexual violence.12 Important to recognize is that accurate data on sexual violence is hard to obtain. A similar survey conducted by the Ugandan Bureau of Statistics claimed that 39% of women nationwide had been raped but only 0.5 % of the population had been raped in the north.13

Such contradictory statistics create uncertainty about the exact number of rapes. But this does not make the situation any less urgent. Addressing the consequences and causes of human rights abuses and sexual and gender based violence continues to be of great importance despite the fact that it is difficult to determine how many women are actually being assaulted every day.

Victimized women in the DRC are as young as 2 and as old as 80. Many of them are farmers and heads of households. When they are raped, it is very frequently in front of their entire family and community.14 The rape is usually followed by physical mutilations that can range from burning to beating to guns and sticks being stuck up women's vaginas causing painful injuries such as fistulas.

Congolese, Ugandan, Burundi and Rwandan rebels all systematically rape women but the Interhamwe15 who committed the genocide in Rwanda are known to be the worst.16 Sixty percent of rebels are from Rwanda and have contributed to this misuse of women.17 Even international forces such as UN peacekeepers are known to have been involved in sexual abuse. These so-called peacekeepers have traded food for sex with girls as young as 10 years old. When the UN deputy chief of the region was asked about such incidences he simply answered: " You'll always have those who are more vulnerable than others in places that are poor with corruption."18

Rape has been qualified as a war crime in the past but it has never been used to this extent. Even police, criminals and bandits, taking advantage of the climate of impunity and culture of violence, abuse women and girls. Recently, rape has increased 17-fold within the country according to a hearing held on March 8th 2011 by the 112th Congressional Subcommittee on Africa, Global Health and Human Rights.19

But the DRC rape is a weapon of war used deliberately with the intention of destroying communities at the roots and not entirely for the sexual and perverse pleasure of the soldiers. Human Rights Watch explains in its report on The Sexual Violence Against Women and Girls in the Eastern Congo that in most cases the victims are unfamiliar with their perpetrator. Human Rights Watch qualifies this attribute as essential for the definition of the cases of sexual violence in the Congo as a weapon of war, as something, which is utilized to destroy the political enemy.20

In the documentary The Greatest Silence: Rape in the Congo a rebel soldier claimed that if there were not warfare, he would treat women like human beings with dignity. A further issue is that many of these soldiers, especially in the Maï-Maï rebel group, believe in magic potions.21 They are convinced that they have to rape women in order to make the potions work, to survive in the forest and to beat the enemy. To a certain degree these men see it as their patriotic duty to rape. They do not realize the consequences of their actions on the victim.

The Psychological Effects of Rape

Psychological studies of trauma from rape see this as a collision between "human vulnerability in the natural world" and "the capacity for evil in human nature".22 Sexual assault and rape fundamentally impact a person's core sense of safety and dignity. Some common short to medium-term responses include loss of a sense of control over one's life, depression, extreme anxiety, hyper vigilance, nightmares, flashbacks, difficulty sleeping, difficulty concentrating on any mental tasks, and a foreshortened sense of one's future. Women who have been sexually abused feel like they are "in the middle of a battlefield."23

Many societies often blame the victim rather than the perpetrator, which causes further harm. Finally, victims of rape can have a very difficult time protecting themselves from further assaults because they no longer trust themselves, or the world around them. Not all people respond the same way, of course, and many attempt to simply "move on" and not deal with their physical and mental problems, much like a soldier may not attend to a serious wound in the thick of the battle. Long term responses are more complex, and depend on the degree to which the victim gets help, social support, or can make sense of what happened to them. Culture plays an important role in coming to terms with rape as well.

The Effects of Rape on the Brain

Dr. Kaplan, the director of the University of Virginia's Sexual and Domestic Violence Services explains that the severity of rapes during warfare cause many women to be diagnosed with rape trauma syndrome, which is a subset of the life long and incapacitating post traumatic stress disorder (PTSD).24 PTSD was researched extensively for the first time following the Vietnam War in the 1970s. Before the Vietnam War there were no service agencies or advocacy groups for victims of PTSD or rape.25 Most survivors who are evaluated directly following an incident of rape meet PTSD criteria. An average of 94% of rape victims meets the criteria and 46% meets it three months later.26

Cognitive behavioral models of PTSD explain that when someone experiences a terrifying event, the brain develops a memory schema in order to detect similar situations. Scientists discovered that such schemata usually consist of three different layers.27 The first layer is a general collection of characteristics of the feared situation. The second is a more detailed combination of verbal, psychological and overt behavioral responses that occurred during the event and that will reoccur whenever the schema is activated. The third layer stores cognitions concerning the meaning of the feared situation and the responses of the victim to this interpretation. Schemas are "eyeglasses"28 through which our brain interprets and processes the world around us.

Sexual assault and rape fundamentally impact a person's core sense of safety and dignity.

Individuals who have never experienced trauma such as rape develop schemata that make them perceive themselves as invulnerable and the world around them as innocent. Rape induced changes in memory schemata can have detrimental long-term consequences. Victims of rape cognitively process the experience by assimilation and accommodation.

Assimilation is defined by the brain's reconstruction of the rape memory to fit judgments made before the incident. The process of accommodation refers to a situation when the brain completely changes already existing beliefs to justify the rape i.e. beliefs of safety, power, efficacy, trust esteem or intimacy.29

Traumatic experiences such as rape have profound psychological repercussions that, if not treated correctly, can change an individual's brain chemistry. According to Professor Verna Folnegovic-Smalc , who writes on the psychiatric aspects of the rapes in Bosnia-Herzegovina, "abuses are commonly described as either psychological or physical, though the two types usually take place simultaneously."30

Dr. Kaplan explains, "we're still learning about it. For so long we thought there was a brain and the rest of the body. [Now] we know that the brain is really in control."31 Research has demonstrated that the amygdala, the part of the brain that is responsible for storing memories associated with emotions, is involved in the processing of responses to fear. The fear experienced during a traumatic event sensitizes the amygdala. The result is that the traumatized individual reacts much more quickly to fearinducing stimuli.

The hippocampus, the part of the brain involved in memory, is affected by traumatic experiences. This is because the part of the brain that controls emotion, known as the "limbic system" (which includes the amygdala), is in charge of transferring information to memory.32 The limbic system is also responsible for spiritual experiences and frightening hallucinations. 33 Emotions and memory are very closely linked. Patients with PTSD have often shown changes in their hippocampus.

Natural opiates are released when faced with danger. In people with PTSD these opiate levels remain high leading to the desensitizing of emotions.34 Neurotransmitters that activate the hippocampus or the memory are at higher levels in PTSD patients, which is why the playback of the experienced trauma is so preserved and realistic in their minds. Sigmund Freud calls this "intrusive imagery" and "active re-living".35 In a ‘Lecture on Psychoanalysis' he stated:

These patients regularly repeat the traumatic situation in their dreams; where hysteriform attacks occur that admit of an analysis, we find that the attack corresponds to a complete transplanting of the patient into the traumatic situation. It is as though these patients had not yet finished with the traumatic situation, as though they were still faced by it as an immediate task, which has not been dealt with; and we take this view quite seriously.36

Rape trauma syndrome forces women to constantly relive their painful experience in their minds like a horrific movie that will never end.

Genital Mutilation, Rape and Torture

Unfortunately, in the DRC women do not usually just get raped. A very common practice for the perpetrator is to physically abuse them either before or after the raping. Sticking guns or large sticks up women's vaginas is very common. In the best-case scenario this will cause genital traumatization that can nevertheless cause infertility and sexual dysfunction. In the worst-case scenario, the wall between the bladder and the vagina will be torn. This injury is known as a recto-vaginal or vesico-vaginal fistula and leads to urine and stool incontinence.37

Obstetric fistulas that stem from childbirth are also very common in the DRC. It can occur when a women has unattended obstructed labor or when a woman gives birth who has a womb that is not fully developed. In the DRC 65% of rape victims are children and adolescents under the age of 18 with 10% younger than 10 years of age.38 Obstetric fistulas frequently result from young girls being raped and becoming pregnant when their wombs are not yet fully developed.

Rape as a Multigenerational Issue

Rape not only has an impact on individuals, it has an impact across generations and on a community sense of identity. Dr. Mukwege is one of the most respected Congolese doctors and specializes in the reconstructive surgery for women suffering from fistulas. Since the opening of his hospital, the Panzi Hospital in Bukavu, he has performed reconstructive surgery on 21 000 women and girls.39

In a speech he gave at the University of Michigan in 2010 he proclaimed that the raping, torture and mutilation of women's genitals had ultimately resulted in the "collective loss of identity" in the DRC.40 He describes the vicious cycle of these rapes that have been responsible for completely humiliating and destroying the victim as well as those around her:

What we have observed about these rapes is that they have a huge impact that destroys communities. When a woman is raped in public, in front of her children, her husband, her neighbors, it is not easy for this victim to recover, especially psychologically. And, after children watch the torture of their mother, or a husband witnesses the torture of his wife or his daughters, they begin to question seriously their sense of belonging in the community. This results in a massive exodus of people from villages, abandoning them to their persecutors.41

Currently there are 10 million internally displaced persons (IDPs) in the DRC. This "massive exodus" caused by a cultural environment, which makes rape, torture and genital mutilation shameful is one of the reasons for such an astonishingly high number of IDPs.42 Rape forces women to flee their communities, their families and themselves. The DRC is left with a population that has little to no hope of finding a way to create the unity and social bonds necessary for a nation.

Dr. Mukwege would agree with Dr. Kaplan when she says, "it's generational; it's a cycle."43 She further points out, "Kids who witness their mothers raped can grow up incredibly angry and violent." They feel as if "the world is violent and hostile and not safe and that [they] need to protect themselves from it [by means of violence]."

Such children also suffer from "dissociation," a process by which the normal connection of memory, knowledge, and emotion is disrupted due to an intense emotional reaction to a traumatic event. Dr. Judith Herman describes it in her book Trauma and Recovery as the "dissolving effect of intense emotion, which incapacitate[s] the synthesizing function of the mind."44 Children who suffer from "dissociation" are far more likely to be recruited by rebel forces and become perpetrators themselves.45

An estimated 8.2 million or one out of every eight people in the DRC is an orphan or a vulnerable child.46 What will become of the next generation? They do not know how to do constructive work. They become thieves and bandits. In the last 18 years 80% of children have not been to school.47 Since birth they have only known violence and war. According to Robert Dowden in his book on Africa:

The qualities needed to survive are opposite of the qualities needed to develop. To change the world around you, you must take risks, be open to new ideas and allow young people to experiment and break away from the old way of doing things."48

Atrocities can never be buried. This means that in order to develop in the DRC as prescribed by Dowden, the psychological recovery process of Congolese women has to be multigenerational. Solely working with the victim is not always the best approach. It is important to improve gender awareness and empower vulnerable groups by encouraging behavior change, communication and engaging boys and men.

Leo Eitinger, a psychiatrist who has studied Nazi concentration camp survivors explains "war victims are something the community wants to forget; a veil of oblivion is drawn over everything painful and unpleasant."49 This quote is an insightful description of the obstacles that the recovery process of Congolese women and their families, who have been traumatized by rape, face.

The Process of Recovery an Integrative Approach

The American Psychologist identifies the essential steps of recovery as creating safety, reconstructing the trauma story, and reestablishing the connection between survivors and their community. However, the nature of the Congolese situation reaches far beyond these requirements. The American Psychologist lays out the fundamental building blocks but not the complex web necessary for the Congolese case.50

An integrative approach is of utmost importance when dealing with women who have been raped in the context of warfare. Such an approach must begin with the recognition that traumatic experiences cause profound psychological problems, which affect the brain. A survivor can never assume to be completely healed. Certain changes are permanent. This is why recovery must include individual as well as group psychological counseling. Recovery is based on the empowerment of the survivor and the creation of new connections.

Social networks give individuals strength and positive reinforcement. Group counseling has been so effective because individuals are social beings and naturally seek the approval of others. A victim is more likely to improve her situation and stop blaming herself if she realizes that she is not the only one who has had such an experience. Dr. Mukwege's Panzi Hospital is an ideal model. Women who are patients at Panzi are required to have individual psychological counseling as well as regularly meeting with a group.51 Furthermore, while undergoing treatment the women live at the hospital and are constantly surrounded by other victims of sexual assault who are undergoing the same procedures and have lived through similar experiences.

A strong human rights discourse is an essential part of an integrative approach to help women who were raped in conflict zones. Such a discourse must do two things: qualify the individual to be equally protected against psychological and physical threats as well as take more severe measures towards defining rape as a crime against humanity whether it was committed systematically during conflict or not. Dr. Judith Herman explains in her book Trauma and Recovery that without a strong human rights movement "the active process of bearing witness inevitably gives way to the active process of forgetting."52Continued on Next Page »