Sexual Violence During Conflict
During conflict, the risk of sexual violence increases, both for civilians and those involved with armed groups. Sexual violence can include rape, genital mutilation, forced incest, sexual torture, sexual humiliation, and sexual slavery (Medecins Sans Frontieres, 2009; Onyango & Hampanda, 2011). In recent decades, more attention has been given to this trauma and in 1993, after the conflict in the Balkans, it was recognized as a crime against humanity. While both males and females are at risk of this crime, the majority of reported cases have been by females.
During most of the world’s recent conflicts, such as in Central African Republic, Democratic Republic of the Congo, Sierra Leone, and Sudan, reports of sexual assault and sexual violence have spiked (Doctors Without Borders, 2005b; U. N. Special Representative on Sexual Violence in Conflict, 2012a; UNICEF, 2005). Sexual violence has been recognized as a war crime for its tactical use to inspire fear and humiliation in a population. It can be used a psychological tactic to terrify or intimidate the population or as a reward mechanism for soldiers. It can also be used as a form of “ethnic cleansing” by impregnating women from the opposing side (Machel, 1996). In the Democratic Republic of the Congo, it has been used for economic or political control (United Nations Security Council, 2012a).
The United Nations’ top relief official, in referring to conflicts in sub-Saharan Africa, stated that “organized, premeditated sexual attack had become a preferred weapon of war . . ., with rapists going unpunished and victims of rape shunned by their communities” (Hoge, 2005, ^1). Even in camps for those who have fled the violence, the risk of sexual assault remains high. This is due in part to the fact that these criminals are aware that there are a high percentage of women living there unprotected, not even by a front door (Ali, 2013; “Sexual violence continues,” 2008). The perpetrators may also be government troops assigned to protect the camp or nongovernmental organization (NGO) workers who are supposed to aid them (“Camps offer little refuge,” 2008; “Rape on the rise,” 2011). Even UN peacekeepers have been found to sexually exploit the population, such as exchanging food for sexual intercourse (Martin, 2005).
Although awareness of sexual violence during times of war and conflict has risen and it is now recognized as a war crime, for the most part perpetrators continue to act with impunity. Regardless of gender of the person assaulted, there is often a lack of faith in the justice system, especially if the perpetrator was a member of the state forces (“Sexual abuse survivors,” 2007). In some cases, national law may be insufficient for prosecution. For example, the rape of a man may not even be recognized as a crime under the laws of that nation (Medecins Sans Frontieres, 2009). Prior to 2006, the law in the Democratic Republic of the Congo lacked a definition of rape and was not gender-neutral. These shortcomings have now been addressed, but prosecutions remain extremely low, while sexual violence remains extremely high (Zongwe, 2012). Male victims may fear reporting could lead to a prosecution against them if homosexual acts are outlawed in their country (Onyango & Hampanda, 2011; Sivakumaran, 2007).
In the Democratic Republic of the Congo, sexual assault has become extremely widespread. While it is committed by all sides in the conflict, the vast majority recently has been by government forces, apparently to punish community members for suspected collaboration (United Nations Security Council, 2012a). In addition, the situation in this nation exemplifies how conflict can help tear down societal norms and the rule of law as sexual violence perpetrated by civilians has also increased markedly (Bartels et al., 2012; Nelson et al., 2011). However, this may be due in part to the demobilization; those who were soldiers are now in civilian clothes rather than a uniform (United Nations Security Council, 2012c).
The genocide in the Darfur region of Sudan caused a high level of chaos and sexual violence. A report compiled by Doctors Without Borders (2005b) stated that as a result of the violence, almost 2 million people in the region fled their homes. However, even when they reached a camp for displaced persons, the violence continued. Women had to leave the relative safety of the camp to collect firewood and water, and they were attacked while pursuing these daily activities. In a 6-month period, Doctors Without Borders treated almost 500 rape victims and believed that number was only a portion of the actual victims. In more than half of the cases, physical assault accompanied the sexual assault, and almost one-third were raped more than once. Eighty-one percent of the women were assaulted by military or militia forces that were armed. Women are typically discouraged from reporting by police and can face great shame in their community if the attack is known. Doctors Without Borders included the following case study in its report to illustrate the repercussions of sexual assault:
A 16-year-old girl was collecting firewood for her family when three armed men on camels surrounded her, held her down and raped her, one after the other. When she arrived home, she told her family what had occurred. They threw her out of the house and she had to build her own hut away from them. Her fiance broke their engagement, stating that she was now disgraced and spoiled. When she was eight months pregnant as a result of the rape, the police came to her home and they asked about the pregnancy; she told them she had been raped. They told her that since she was not married, this was an illegal pregnancy. They beat her with a whip and placed her in jail for 10 days in a cell with 23 other women in the same position. These women were forced to clean, cook and fetch water for the police officers. The only food and water she had was that which she could scrounge in the course of her duties. (Summarized from Doctors Without Borders, 2005b)
While women have received the bulk of the attention for being victimized through sexual assault, this is not to say that men do not experience this trauma or that women cannot be perpetrators. For example, a survey conducted in the Democratic Republic of the Congo in 2010 found that 40% of the women and 24% of the men experienced a form of sexual violence; these numbers may actually be low as the interviewers could not enter areas with active combat. Women were perpetrators in 40% of the violations against women and in 10% of those against men (Johnson et al., 2010).
As men rarely report sexual violence due to cultural stigma, it goes untreated (Christian, Safari, Ramazani, Burnham, & Glass, 2011). Men may discuss “torture” they have experienced but are reluctant to name it as sexual assault. This shame is why it is an effective tool against men. It is meant to be shaming, to state that they are not truly men, as a “man” should not only be able to have prevented the assault but also be able to deal with its consequences (Sivakumaran, 2007). Some male survivors report that their wives left them after learning of the assault and that other villagers refer to them as “bush wives” (Gettleman, 2009). In other cases, the men left their families due to their shame. They felt that two wives could not live in the same family and the assault had made them a wife of the armed force, rather than a husband (Christian et al., 2011). However, due to the lack of attention, there is little funding for services for men and policy manuals do not include them.
Men may also be violated in other ways than being assaulted themselves. A man may be forced to witness the rape of his wife or daughter, or be forced to commit the act himself, in order to degrade and humiliate him (Ward & Marsh, 2006). It is meant to show that he cannot fulfill his gender role of protector. Enforced sterilization, nudity, and masturbation are also other ways that men may be victimized (Sivakumaran, 2007).
Readers are referred to Sivakumaran (2007) for an excellent exploration of this topic.
Sexual violence can have many long-term impacts. Physical impacts can include vaginal or anal tearing, fistulas, pregnancy, and HIV, among others. The psychological scars can be even more devastating. One study in Liberia found that of the 40% of female combatants and 32% of male combatants who experienced sexual violence during the war, 74% and 81% percent, respectively, had symptoms of PTSD, significantly higher than those who had not (Medecins Sans Frontieres, 2009). As noted earlier, the shame and stigma experienced by male survivors can break families apart and isolate them from their communities. Men may feel unable to work due to the trauma they have experienced, increasing poverty for the household (Christian et al., 2011). The stress placed upon men, including the shame of the rape of their wives, can lead to domestic violence, causing further problems within the household (Suarez-Orozco, 2001). The mental health impact of these sexual assaults can be long standing and require targeted interventions to heal.
UNICEF has established programs in affected countries to provide counseling and to help decrease the stigma associated with their assault (UNICEF, 2005). Medica Mondiale (www.medicamondiale.org) is a German organization dedicated to helping women and girls heal from the trauma of rape during times of war and conflict. Founded in 1993 in reaction to the mass rapes occurring at that time in Bosnia, it currently operates in a number of countries, including Afghanistan and Democratic Republic of the Congo. Through networking of women and advocacy, they are helping to create change to heal those affected by wartime sexual violence.
Medecins Sans Frontieres (2009) has established programs in a wide variety of countries where conflict-related sexual violence occurs. Social workers and psychologists help survivors through the initial physical exam as well as considering the long-term impact. In Democratic Republic of the Congo, sexual violence had become so common that survivors did not consider it as something special that would require attention. Therefore, Medecins Sans Frontieres worked with each village to have them select a maman conseillere (mama counselor) who would be a point person within the village for anyone who was a victim. This person would support the victim and encourage him or her to seek prompt medical care.