March 8, 2003
Program of the "Tika/Bika viol! I say no to rape!" Campaign

In February 2003, 300 silhouettes symbolizing the damage done on rape victims will be placed in the streets of Brazzaville as part of a campaign run by MSF. Photo ©Copyright Alain Fredaigue

Between March 2000 and December 2002, 548 victims (99.3% women) of sexual violence were admitted to the emergency ward at Makélékélé hospital in Brazzaville, the Republic of Congo. The ages of the victims ranged between 6 months and 69 years.

On March 8, 2003, Doctors Without Borders/Médecins Sans Frontières (MSF) will launch a campaign to raise awareness of the impact of rape on women and society in Brazzaville, where MSF runs a comprehensive program to aid rape victims that includes post-exposure prophylaxis to reduce the risk of HIV/AIDS infection.

Raising awareness in the streets of Brazzaville

March 8th, 2003

– 500 human-sized silhouettes made of wood will be installed in the streets of Brazzaville as symbols of the suffering endured by women victims of rape.

Brazzaville's taxis taking part in a campaign run by MSF to raise awareness on sexual violence. Photo ©Copyright Alain Fredaigue

– A Congolese troupe will stage a theatrical performance devised to raise awareness of the consequences of rape. The short plays will take place on a set built onto the back of a flat-bed truck, which will tour through the neighborhoods of Ouenze, Talangaï, Makélékélé, Bacongo, etc.

Around March 8th

– Bumper stickers, badges, pamphlets, posters, and advertising streamers bearing the slogan Tika/Bika viol, je dis non! (I say no to rape!) will be distributed throughout the city.

Let's Face Up to Rape!

Rape is a taboo topic, but we must not shy away from addressing it. Rape is a brutal attack on a woman's sense of integrity and a crime that too often goes unpunished. It is a crime that causes serious trauma, which leaves its victims with life-long consequences, and which has equally serious social repercussions.

The Severe Consequences of Rape

Women who have been raped suffer terrible consequences, even if many of these pass unnoticed: violation of the woman's sense of integrity, physical and psychological injury, HIV infection, unwanted pregnancy, and expulsion from the family unit.

– The most frequent

physical

–

Psychological

– On the

social

The physical effects of rape are usually the first consequences that drive the victim to seek help, especially at the stage when she is suffering complications from them, of which there are usually many: infectious diseases and/or sexually transmitted diseases, complications requiring surgery, and hemorrhaging. Many victims also fear that they have acquired HIV or fallen pregnant during the rape. While the physical traumas remain the most visible, they are invariably accompanied by psychological traumas that must be detected and treated. On the psychological level, we have encountered anxiety, depression, and post-traumatic stress syndrome. We have observed, among the patients we have treated in the Makélékélé hospital, a sense of shame and dishonor, humiliation, self-hate, and a feeling of being stained and physically damaged. – Thierry Baubet, psychiatrist, MSF

Crimes That Endure Beyond the War

Between May 3rd and December 31st 1999, almost 1200 women presented themselves to the emergency ward at Makélékélé hospital, saying that they had been raped. Most of the sexual violence perpetrated during the war took place on the road linking Kinkala with Brazzaville, given the moniker 'the corridor of death' by those who survived it.

Although less than it was in 1999, the incidence of sexual violence remains high. From the number of victims still being admitted to Makélékélé hospital, we know that the phenomenon of rape did anything but end with the war.

These crimes, which were perpetrated mainly by the military during the conflict and which continue to be perpetrated by 'men-at-arms' whenever trouble descends on Brazzaville, are now committed mainly by civilians. In 60% of cases, the victim is very well acquainted with the rapist. He is a neighbor, a family friend, sometimes even a father, uncle, or brother.

My sisters and I were returning from the fields when we ran into some soldiers. They were returning from the neighboring villages. I couldn't run with the others because of the heavy load on my head. The attackers grabbed me, undressed me, and raped me. I told all this at the Kindamba police station, but they didn't react. After the rape, my grandmother asked me to go to Brazzaville to seek treatment. Rape is a big problem in my village for women who go to fetch water from the fields either alone or in groups. –  P, 15 years old, raped by three soldiers in April 2002 in Kindamba I was playing in the next door lot with my cousins. Then the boys who live across the avenue came. They forced me to go to their house. There two of them bound my mouth and the others did silly things to me. – B, 5 year old victim We were returning from Kermesse with my sister when rain took us by surprise and forced us to seek shelter. Suddenly 12 men surrounded us and threatened to kill us, then raped us. – T, 11 years old

Impunity of the Aggressors

Despite the clear condemnation of rape in Congolese law, not a single verdict in a rape case was handed down in 2002. No rapist questioned is ever found guilty. Although rape is a crime, a friendly arrangement is often reached between those concerned. This notorious impunity clearly constitutes a very aggravating factor of the phenomenon.

This denial of justice affects the victims and allows this crime to become an everyday fact of life. It aggravates the violent criminalization of society. – Francoise Bouchet-Saulnier, lawyer, MSF When I was taken to meet a few of these rapists, I asked myself, 'why does a man commit rape?' He does it for revenge following a rejection, and to display his strength, virility, and power. In the Congo, rape is also an act of war and repression. It's an act in keeping with the pervading climate of violence, the anarchic and lawless atmosphere. Rape is commonplace in the Congo. While the victim's experience is universal, the crime itself is discounted here, made relative by the authorities, and isn't a priority. Now, I ask myself what is the status of women in the Congo? Rape is a symbolic act that sullies the image of the mother. I've learned that clans often rape one another's children to humiliate and weaken their rivals. –  Dr Grégoire, psychiatrist, Program Head

Victims Too Often Forgotten

Rape spares no one. One rape in two involves a minor: children, sometimes even babies. Boys as well as girls are raped. Nor are the elderly, pregnant women, or mothers spared. Every social category is affected.

Between March 2000 and December 2002, a total of 548 victims of sexual violence were admitted to Makélékélé hospital (99.3% were women), aged between 6 months and 69 years old.

The age brackets most affected are:
• Between 13 and 17 years old: 32.4%
• Between 18 and 27 years old: 24.6%

When a child is raped, the parents also suffer, but they express it awkwardly, often directing their anger against the child for not having been careful enough, for not having heeded them. We must help them recover. Like all parents, they love their children. – Francoise Bouchet-Saulnier, lawyer, MSF

The Médecins Sans Frontières Program

Since March 2000, Doctors Without Borders/Médecins Sans Frontières (MSF) has run an aid program for rape victims. MSF's goal is to offer a comprehensive, high quality service consisting of medical and psychological assistance as much as administrative and social aid. The service is entirely free and anonymous. The program is part of the National Program of Aid to Victims of Sexual Violence.

MSF teams receive rape victims at the Makélékélé hospital. In the last few weeks, they have also begun receiving them at the Talangaï hospital.

Comprehensive Medical Assistance

Free medical consultations are offered to women. The service begins with urgent medical treatment for the injuries sustained during the rape. A preventative treatment for sexually transmitted diseases (STD's) is then administered, and a voluntary screening for HIV is offered to the victims.

Victims who present themselves within 72 hours of the rape are offered the possibility of taking the morning-after pill to reduce the risk of pregnancy, as well as a post-exposure prophylaxis treatment to reduce the risk of infection with AIDS.

Both the woman victim of rape who carries an undesired pregnancy to term and her child receive free medical help throughout her pregnancy and for the months following the birth.

For the anti-HIV prophylactic treatment to be effective, and to avoid unwanted pregnancies, it is imperative that victims present themselves at the hospital within 72 hours of being raped.

Unfortunately, almost 50% of victims come to us too late, when there's not much we can do medically. It is absolutely essential that they come to the Makélékélé hospital with 72 hours. If they come within that window, we can prescribe them the morning-after pill to avoid pregnancy and give them a prophylaxis against STD's, most notably AIDS. –  Dr Jeanne, Program Assistant Coordinator

Psychological Treatment and Follow-up

Given the extreme gravity of the trauma endured and the need to prevent all psychiatric and psychological complications, MSF, as a follow-up to its medical services, offers psychological treatment, taking into account the psychological trauma suffered by rape victims. A psychiatrist is made available to them, and tries to alleviate their suffering with psychotherapy. If needed, the psychiatrist can prescribe psychoactive drugs. Particular attention is paid to the mother-child relationship to prevent any burgeoning troubles the child may face, as well as any problems a mother might have accepting a child born of rape.

One can never forget or heal from a rape. The most one can do is learn to live with it, to develop one's capacity to manage it, to put it aside. One can work at it so that it no longer handicaps one's everyday life. I know that I've done my job when I see signs of the gradual progress being made during session: a smile returning, a more relaxed mood or manner of speaking. The therapy continues for as long as I am dissatisfied with the results. The day that the victim has made progress, has returned to her daily life, and has begun to venture out alone to come and see us, then things have improved. – Dr Grégoire, psychiatrist, Program Head

Administrative Aid

Victims of rape also benefit from social aid with administrative procedures. Very often, victims find themselves marginalized from those around them and excluded from the family or social structures. This only adds to their suffering. Unfortunately, in a country where the voluntary cessation of pregnancy is forbidden even to rape victims, many women have had to carry through their pregnancies and have been marginalized as a result. For thirty of them, MSF has initiated a project of professional reintegration, offering them a three-month training program in the techniques of hat and bag weaving. This type of positive initiative encourages the victims to take action and to resume their professional lives. Additionally, social workers visit the victims' homes to check on the medical follow-up and to encourage the victims to pay regular visits to the psychologist at the hospital.

Almost 600 people have been thus received into the Makélékélé program since its inception three years ago. An identical program has been set up at the Talangaï hospital.

Necessary Prevention

These actions have restored a bit of hope and dignity to a few women and children, albeit only a few of the many rape victims in the Congo. But treating them isn't enough. Above all, we must prevent these rapes from happening in the first place. When we are faced with the limits of medicine, when we are confronted with horror, our duty is to bear witness on behalf of the victims whom we treat and listen to.

MSF has launched the "Tika/Bika viol! I say no to rape!" campaign to raise awareness among all Brazzavilleans and to urge them to fight this scourge.

© 2013 Doctors Without Borders/Médecins Sans Frontières (MSF)