DRC: Reaching Survivors of Sexual Violence in Ituri

The region of Mambasa has many natural resources: gold and diamonds mines, loggers...
Natacha Buhler/MSF
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In response to high levels of sexual violence in the Ituri region of eastern Democratic Republic of Congo (DRC), Doctors Without Borders/Médecins Sans Frontières (MSF) has launched a project in Mambasa to provide medical and psychological care to survivors.

Driving along the red mud road, the MSF Land Cruiser passes through a cloud of white, yellow, and orange butterflies. On either side of the road is thick forest. The trees are packed so closely together  that visibility is limited to a couple of feet.

It is not far from the Okapi Wildlife Reserve, and among the trees are animals on the brink of extinction, elephants, and villages inhabited of pygmy people who are the original inhabitants of this region. The trees also hide gold and diamond mines, both official and unofficial; smugglers of hardwood; poachers; armed Mai-Mai militiamen; and many other men carrying weapons.

The MSF staff in the vehicle represent one of three medical teams circulating between the towns of Mambasa, Nia-Nia, Bella, and PK51. At each stop, they provide care for victims of sexual violence and people suffering from sexually transmitted diseases.

Learn More About MSF's Work With Survivor's of Sexual Violence

Their work is part of a project launched this past February. They have already been very busy. "In March alone, our teams took care of 123 victims of sexual violence and treated 907 people for sexually transmitted diseases," said Mame Anna Sane, MSF medical team leader.

"These are very big numbers. That is almost four people raped per day—and that is just the ones coming to health facilities. Rape is so taboo that many people don’t come for help, so the real numbers are likely much higher."

Each of the three MSF teams is made up of a nurse, a psychologist, and a health promoter. Together, they provide support to nine health facilities in the region by training local staff members in the provision of medical and psychological care for survivors of sexual violence.

The MSF teams also supply the necessary medicines and work with local communities to raise awareness about sexual violence, encouraging victims to seek medical care promptly. Rape survivors need to come for help within 72 hours of an assault for treatment to be effective. MSF teams also educate people about the symptoms of sexually transmitted infections so that people recognize them and come for treatment.

Taking Care of the Survivors

The work with local communities is showing results, and there is evidence that rape survivors are coming forward more promptly.

When an MSF team is visiting the Biakato health center, a 70-year-old woman who survived a gang rape is brought in by a group of relatives and neighbors. Two days earlier, she was asleep at home when three armed men broke down her door. They dragged her out of the house and into the forest, where they beat her and then raped her one by one.

They left her in the forest, naked and unconscious. At the health center, she will receive psychological support and treatment for HIV and other sexually transmitted diseases. Her daughter is with her—but not all patients have family members to support them.

Marie, 37, is in the maternity ward at Biakato health center. She has just given birth to a baby boy and she is alone. Almost two years ago, as she went to sell drinks in a mine near her home, Marie was kidnapped by a Mai-Mai group. They kept her prisoner for more than a year and raped her repeatedly.

She only managed to escape when the Congolese army attacked the camp where she was being held. She returned to her husband, but he rejected her because she was four months pregnant from one of the rapes.

A Medical Emergency

"Our work involves changing mentalities to get rid of the taboo around [reporting] sexual violence, and to be able to offer proper care to every victim. [This mean working on] the mentality of the local population, but also of the authorities," Sane said. "Of course there is a criminal and legal aspect to sexual violence, but for us, it’s first of all a medical emergency."

MSF’s project in Mambasa will last six months and then be reassessed. It is already clear, however, that the need for medical and psychological care for survivors of sexual violence in the Ituri region are far greater than expected.

The region of Mambasa has many natural resources: gold and diamonds mines, loggers...
Natacha Buhler/MSF
The region of Mambasa has many natural resources. Here red wood loggers bringing back their cargo to Mambasa.
Natacha Buhler/MSF
Villages on the road from Mambasa to Biakato.
Natacha Buhler/MSF
Marie (assumed name) is 37. She just delivered a baby boy that she named Alain. Marie had a small beverage business and she used to go the the gold and diamond mines in the forest where she could make a good sale profit. Once, on her way to the mines, she met with the Mai-Mai Simba who threaten to kill her with knives if she refused to be their "wife". She lived with them and other captives in the forest and had the opportunity to escape a year later during an attack of the Congolese army on the camp. She went back to her husband but was 4-months pregnant from the repeated rapes. Her husband repudiated her. She now lives with her older brother, but she is not sure that her sister-in-law will accept her new baby. She hopes to get some money to start a new business and rent a room for her and her baby, but she'll not return in the forest for anything in the world.
Natacha Buhler/MSF
Mame Anna Sane, medical team leader of the Mambasa project, discussing with the Chief medical officer (médecin chef de zone) in Mambasa Reference Hospital.
Natacha Buhler/MSF
MSF health promotor during a session on sexual violence and sexually transmitted infections (STI) in Molokai village. The original inhabitants of the region are pygmies people.
Natacha Buhler/MSF
Viviane, MSF team supervisor, and Jeam-Mari, nurse in charge of the Molokai health center during a consultation.
Natacha Buhler/MSF
Marguerite (assumed name) is 70. Two days ago she was sleeping at home next to her field when three armed men broke her door and dragged her into the forest. They beat and raped her. Her neighbors who heard the attack came looking for her and found her naked and unconscious body in the forest the following morning. They brought her to Biakato health center to receive emergency medical and psychological care.
Natacha Buhler/MSF
Husseni, assistant field coordinator, discussing with the Biakato's health center staff that MSF support.
Natacha Buhler/MSF
MSF car parked in front of the Molokai health center.
Natacha Buhler/MSF