Women and children are extremely vulnerable to sexual violence during times of conflict. Rape is frequently used by armed groups as a weapon of war, and in places where law and order have crumbled, vulnerable people simply have no recourse, leaving attackers to act with impunity. Such is the case in Central African Republic (CAR), where the brutal fighting continues.
Usually the result of complications during delivery, a fistula is an opening between the bladder and the vagina, or between the rectum and the vagina. Women become incontinent, and are often shunned from their societies and families as a result. They can also suffer additional medical consequences. Access to pre-natal care and interventions to assist with complicated labor, including C-sections are essential to preventing fistulas.
Their reality is grim – the thousands of migrants and refugees existing on the margins in South Africa. They lack access to proper health care and shelter and face physical and verbal abuse, police harassment and xenophobic attacks. For these migrants, proper legal status is often difficult to obtain, if not impossible. Gangs prey on them when they cross the border into South Africa and in the derelict buildings where they find temporary housing. As a result, many face further threats living in dangerous conditions, particularly in Johannesburg. Doctors Without Borders/Médecins Sans Frontières (MSF) is providing health care to these vulnerable people in Musina, a town on the border with Zimbabwe, and in Johannesburg.