International staff: 31
National staff: 287 MSF has been working in Republic of Congo since 1997
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Tika Bika Viol – I say no to Rape! A simple
slogan, a shattering subject. The grassroots
campaign Tika Bika Viol!, led by MSF,
transformed the streets of the Congolese
capital Brazzaville for a week in March 2003,
in response to the sexual violence that has
altered the lives of untold thousands of
women in Congo for many years.
The vast public education drive attacked
the lack of public awareness of rape that
has served to hide, and sometimes abet,
the persistent problem in the country. Tika
Bika Viol! grew out of MSF's ongoing work
providing medical care and psychological
support to rape victims in the capital city.
While MSF also has other types of projects
in the country – emergency assistance for
people displaced by con. ict in the south and
treatment for those suffering from sleeping
sickness – it was the rape care and prevention
work that took center stage in early 2003.
"To rape someone is to kill someone,"
B., 19-year-old victim
"Rape? Men like it." The phrase rings
out in the warm air of the Nkeoua market
neighborhood on the outskirts of Brazzaville.
A theater group sets up a simple set on a
flatbed truck; members of the MSF team
begin discussions with small groups of
men. The subject is provocative, but the
uncomfortable glances and silences also
speak of the weight of oppression young
women bear after nightfall. On the improvised
stage, the actors play out the terrible – yet
everyday – story of a young girl who meets
the wrong man. Facing the inevitable, the
young actress cries and pleads. The crowd
groans, the tension is palpable and the rape
scene is harsh. Everyone in the audience tries
to direct the difficult sequence. Laughter,
cries, shouts of rage – then jaws clench and
eyes turn away. The young woman is left
alone with her humiliation.
The silence reveals a collective discomfort.
Instinctively, women approach the truck in
small groups to support the young actress,
who struggles to recover. They know this
story all too well.
This street play proved to be the most
powerful part of Tika Bika Viol!. The
campaign touched the raw nerve of rape
that is one of the country's grim not-so-secrets.
Although it involved an international
colloquium attended by a variety of national
and international organizations, as well as
first lady Madame Antoinette Sassou, the
heart of Tika Bika Viol! was its grassroots
education. Over 300 life-size wooden figures
of women haunted the streets; street theater, banners and buttons promoted discussion of
the taboo subject. Taxis sported bumper
stickers and helped get the message to outof-
the-way spots and filling stations around
the city. The campaign helped put a taboo
topic out in the open and fostered discussion
of the devastating consequences of this
unfortunately common occurrence.
A disturbing phenomenon, encouraged by
impunity
In Congo, crimes of sexual violence,
including rape, were often perpetrated by
fighters from all sides during the country's
civil war, which flared up between 1998
and 2000. They continue to be carried out
by armed men during times of upheaval in
Brazzaville. But now these crimes are mainly
committed by civilians, with 60% of victims
being very well acquainted with their rapist.
Women, children and the elderly are at risk
of being raped in their homes, on the street,
and when carrying out daily activities such as
fetching water. To make matters worse, rape
goes virtually unpunished in the country: not
a single rapist was convicted in 2002.
The Tika Bika Viol! campaign was
the natural outgrowth of MSF's sexual
violence program, begun in March 2000
at Makélékélé hospital in Brazzaville. MSF
provides emergency medical care for rape
victims, including treatment for injuries
sustained during rape, medication to prevent pregnancy and preventive treatment
for sexually transmitted diseases including
HIV. To prevent unwanted pregnancy and
to block the spread of HIV, women should
receive medical attention within 72 hours. In
addition to medical assistance, MSF national
and international staff provide psychological
treatment and follow-up, essential for
traumatized survivors. More
than 600 people have been treated in the
sexual violence program in Makélékélé. In
January 2003, the project was expanded
to Talangaï hospital in the northern part of
Brazzaville.
Many victims of sexual violence are
unaware of the free services provided by
MSF and the urgency of receiving treatment.
Tika Bika Viol! helped spread the word about
both the problem and the MSF program.
Three weeks after the Tika Bika Viol!
campaign, the 300 wooden silhouettes
installed on all of Brazzaville's main roads
were still standing. Not a single one had
been stolen, and neighborhood residents
had put them back in place if they fell over.
The determined-looking women had been
transformed from an image of the rape
problem itself into a symbol of the rejection
of sexual violence.
Other programs: helping those affected by
displacement and disease
A year of armed conflict between government
forces and Ninja rebel factions was followed by
a ceasefire in March 2003. Beginning in October
2002, tens of thousands of people displaced by
the con. ict were trapped outside the city of
Brazzaville, pinned between the conflict zone
and government barricades; many others
remained unreachable in the forest of the Pool
region. MSF intervened with health clinics and a
supplementary feeding program. In May 2003,
MSF gained access to the Pool region and began
surgical, medical and nutritional programs at
the reference hospital in Kinkala, along with
measles vaccinations in outlying villages. In
June, MSF started mobile clinics, nutritional
assistance and support to Mindouli hospital,
also in Pool. As of July 2003, aid to displaced
people still waiting to go home continued.
MSF continued assistance to refugees
from Democratic Republic of the Congo
as well as local residents in the northeast
town of Bétou; in addition to providing basic
medical care, MSF has also constructed a
new operating room and outpatient ward
in Bétou's health center. MSF provides
artemisinin-containing combination therapy
(ACT) to malaria patients in the region.
MSF has also been actively fighting human
African Trypanosomiasis in Congo since 2000,
supporting treatment centers in Plateaux and
more recently Bouenza and Cuvette Est provinces,
conducting mass screening and researching
new protocols. Commonly known as sleeping
sickness, this neurological disease is caused by
a parasite transmitted by the tsetse fly and is
fatal if left untreated. It is endemic in 36 African
countries and affects an estimated 500,000
people. The Plateaux project closed in May 2003,
having screened 58,417 people and treated 913.
Since opening in September 2002, the Bouenza
project has screened 45,125 and treated 575.
Work in Cuvette Est began in June 2003.
In February 2003, an outbreak of the Ebola
virus in Cuvette caused the death of more than
120 people. Ebola hemorrhagic fever is deadly in
50-90% of cases. In collaboration with the World
Health Organization and the national Ministry of
Health, MSF provided essential medical supplies
such as isolation kits. A similar outbreak in the
region last year killed 66 people.
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