Trauma Therapy takes time

“In Congo, being a woman is more dangerous than being a soldier,” says Charlotte Isaksson, the former Gender Adviser to EUFOR forces in the Democratic Republic of Congo. The figures speak for themselves: according to United Nations estimations, about 100,000 women were raped in 2008 alone. Often, the attacks even took place in public, and according to Venantie Bisima Nabintu of the Womens’ Network for Justice and Peace (RFDP), frequently the assaulted girls or women were violated by several men at a time. In some cases, the assailants even used bottles or wooden logs.

Some rapists are so brutal that the victims’ wounds actually have to be stitched up. Some women even become incontinent. Almost always, the victims are emotionally traumatised, and frequently they are infected with HIV or become pregnant. Moreover, they are often socially ostracised and expelled by their husbands, families and communities. “A raped girl automatically becomes an outcast,” says Somali peace activist Asha Haji Elmi.

Apparently, Isaksson’s statement also applies to other African regions of conflict: during the Rwanda genocide of 1994, approximately half a million women were raped; in Liberia, two out of three. In Sierra Leone, up to 94 % of refugee women were violated.

And victims tend to be younger and younger. Seventeen percent of those who received hospital treatment from Doctors Without Borders in conflict regions were children younger than 12. However, Africa is not the only place where sexual violence is part of everyday life in times of war: in the former Yugoslavia, between 20,000 and 60,000 women became victims of sexual abuse. After-care continues to this day.

In order to fight sexual violence in times of conflict, more female police officers should be trained and deployed. Furthermore, all security forces, including Blue Helmets, should be sensitised. According to Isaksson, this would not be too complicated an endeavour if serious attention were given to the integration of gender issues into training programmes. For this purpose, people should be addressed in a language they understand. “It is possible to make a change,” as the Scandinavian expert emphasises.

Recurrent suffering

Despite all changes in international law – especially last year’s decisive new UN-re­solutions (see info box) – assaults on women are likely to continue in regions of crisis. Stephen Rapp, Chief Prosecutor of the Special Court for Sierra Leone, agrees: “Sexual violence has always played a role in conflicts.”

Consequently, these women will have to be assisted, but, sadly, suitable aid concepts are often lacking. Selmin Çalıskan from the German Women’s Rights Organisation medica mondiale criticises the fact that most measures address only one aspect of the problem, resulting in a complex array of different instruments. She takes Afghanistan as an example, where all kinds of potential benefactors are active, yet none of them know what the others are doing. “Many women die because we don’t have a coherent approach,” Çalıskan says.

“Where women are destroyed, the future of an entire people is destroyed,” says the medical doctor and director of the NGO Heal Africa in Congo, Lusi Kasereka. Formerly, people believed it was enough to heal the physical damage of raped women and to treat the vaginal injuries. But women suffered much more from the experience of violence. In order to meet the complexity of the matter, an integral approach is necessary.

By means of its so-called “Healing Arts” projects, Heal Africa attempts to teach women basic manual skills such as sewing or baking bread. With these skills, they can activate their potential and make a living in a dignified way. Kasereka emphasises that in many cases, an entirely new livelihood has to be built up.

It is also essential to recognise the injustice experienced by the victims. The identities not of the women but of the perpetrators have to be made public. It must be made clear that it is not rape victims who deserve blame, but their tormentors. However, this cannot be taken for granted. “Rape is the only crime where the victims are being punished,” argues Ute Scheub, co-founder of the German Women’s Security Council. After all the atrocities the women have had to endure, they should
not be branded as eternal victims, but acknowledged and supported as active individuals.

According to Heidemarie Wieczorek-Zeul, German Minister for Economic Cooperation and Development, the health care system also has to face up to the matter of sexual violence. Ideally, there would be more hospitals offering rehabilitation measures to these women, including legal advice. The German Development Ministry is supporting such a hospital in Nigeria.

No matter where or under which circumstances women become victims of sexual violence, support has to be provided on a long-term basis – in all areas of life. All experts taking part in the Berlin conference on violence against women in conflicts organised by InWEnt and UNIFEM in Berlin on the International Women’s Day, March 8, strongly agreed on this.

Marijana Senjak, who has been working with rape victims in a Bosnian Women’s Therapy Centre for 16 years, underscored the importance of “rapidly creating new structures” in the work with traumatised persons. Beyond medical and legal considerations, the major challenges are professional education, reintegration and psychosocial tasks: “Trauma work always takes time.”

Media coverage also plays a considerable role, Senjak argues. It should not only inform about the incidents, but also elucidate the various reasons and consequences. It is therefore important that journalists understand their work as an educational duty.

Especially in poor and politically unstable countries it is often difficult to meet such requirements straight away. For instance, there are not enough trained specialists for the appropriate psychological care of people who have been traumatised by the experience of massive violence. Frank Neuner, a psychology professor in Bielefeld (Germany), reports that in Uganda there are only one or two psychiatrists and an equally small number of clinical psychologists. The same applies to Liberia and Congo. In cooperation with colleagues, Neuner has developed a special procedure of trauma therapy which he thinks even trained amateurs are capable of implementing. He takes a pragmatic approach: “If there is no other choice, we can’t but teach laypersons to treat the victims.”

The role of men also has to be given closer consideration – yet clichés have to be carefully avoided, Neuner warns. Muriel Volpellier from the International Rehabi­­li­tation Council for Torture Victims (IRCT) in Denmark points out the fundamental importance of involving men in violence prevention measures; but in order to do that, they have to be given the chance. And not only women are victims of sexual ­violence: approximately 10 % of traumatised people seeking her advice are actually men. Not only do they have to be treated for their own sake, but also because they carry their experiences into their families. Men who have been victims of rape are much more likely to become rapists themselves.