- About HHR
[Editor’s note: This is a guest post written by Ms. Katherine Moloney.]
Sexual violence against civilian populations during armed conflict is recognized as a deliberate tactic of war, the gravity of which determines whether it is considered a war crime, a crime against humanity, or an element of genocide [see Statute of the International Criminal Court art 7.1(g) and art 8.2(b)(xxii); Security Council Resolution 1325 on women, peace and security (SCR 1325) para 11; Security Council Resolution 1820 on widespread or systematic violence in armed conflict paras 1, 4]. The widespread and systematic rape, sexual slavery, forced prostitution, and recruitment and kidnapping of civilians is at pandemic proportions in the Democratic Republic of the Congo (DRC). The majority of victims are children. By November 2008, World Vision spokesperson, Kevin Cook, and Save the Children spokesperson, George Graham, considered the DRC to be potentially the world’s worst place to be a child. The Congolese army is the single biggest perpetrator of sexual abuses according to a Human Rights Watch report published in July. This is despite commitments from both the government and the military that those found guilty of such human rights abuses would be punished. However, sexual violence offenses extend beyond the Congolese army to rebel groups, armed actors, and even UN personnel.
The deadliest war since World War II, the forgotten conflict in the DRC as been particularly devastating for women and children, who remain targets of sexual violence. These attacks are frequently exceptionally brutal, including gang rape, rape with a weapon, and rape accompanied by serious bodily harm. The medical consequences include death from injuries, contraction of HIV, pregnancy, or the development of a fistula. The psychosocial impact can be just as serious. Victims face stigma and familial and social rejection or ostracism. This can restrict their access to education or marriage and leave them displaced and at risk of further abuse.
In March 2009, a Comprehensive Strategy on Combating Sexual Violence in the DRC was finalized by the UN Office of the Senior Advisor and Coordinator on Sexual Violence after consultation with key stakeholders. The four strategic components are the following:
- Combating impunity for cases of sexual violence;
- Prevention of sexual violence and protection of victims;
- Security sector reform; and
- A multi-sectoral response for survivors of sexual violence
Further, the Sexual Violence Research Initiative, an initiative of the Global Forum for Health Research, facilitated its first conference, SVRI Forum 2009: Coordinated evidence-based responses to end sexual violence, earlier this month. Held in Johannesburg, South Africa, the global event assembled 200 experts for the purpose of endorsing research, highlighting good practice in program design, and fostering increased partnership and network building in the field of sexual violence.
Internationally, there is a need to redress the inadequacy with which sexual violence is addressed. The degree to which sexual violence is a gross human rights violation and public health concern is frequently downplayed. This has limited the development of empirically based policy and public health prevention programs and response services.
It is important, therefore, to substantiate the legitimacy of sexual violence as a major public health concern for policymakers, researchers, and programmers by raising the profile of this frequently taboo subject and bringing it into the public arena. Public health scholars and human rights advocates, thus, have a key role to play in directing the research agenda and contributing to institutional capacity building.
Strategies require a systematic, coordinated effort to address sexual violence through increased information exchange, enhanced partnership formation, and further engagement in multi-disciplinary actions. The Interagency Standing Committee Taskforce on Gender and Humanitarian Assistance consisting of over 20 key stakeholders within the UN and NGOs developed cross-cutting minimum intervention guidelines to prevent and respond to sexual violence in humanitarian settings.
Of necessity is the focus on cross-cultural sensitivity in the design and implementation of interventions. Different socio-cultural conceptualizations of mental health and well-being need to be recognized so that measures are directed in a culturally meaningful manner. Ideally, rather than transpose an existing model from a locality with a different value system, programs should foster participatory programming that incorporates indigenous healing principles and existing systems and structures. Furthermore, it is important to focus on inclusion of stakeholders (both male and female) and empowerment. An illustrative example includes the indigenous healing practices utilized for war-affected children in Angola and Mozambique. Purification or cleansing rituals of former child soldiers attended by family and community mark the transition from the “contamination” of war and death to acceptance and validation. These symbolic healing methods address the local conceptualization of psychosocial well-being in terms of appeasing the spirits in a culturally meaningful manner.
An article in the current WHO Bulletin highlights the intrinsic difficulties in developing a national framework and implementing a multi-sectoral program (psychological well-being, physical health, and justice measures) to respond to sexual assault victims. The lesson from the field contextualizes the problem in the resource-poor, horizontal primary health care system present in Kenya. It presents challenges and lessons learned that can be used to inform policy. It is through the dissemination and sharing of such research that the issue of sexual violence receives greater visibility. Increasingly, researchers will be able to build on the body of literature to evaluate, shape, and deliver better services for survivors of sexual violence. It is from such initiatives that activists and researchers can advance sexual violence research, policy, and programs that will translate to meaningful changes in the lives of those affected.
Selected links for additional reading:
Letter to the Editor: The Rule of Law as a Social Determinant of Health
O.B. K. Dingake
Letter to the Editor: Refusal to Treat Patients Does Not Work in Any Country – Even if Misleadingly Labelled Conscientious Objection
Christian Fiala and Joyce H. Arthur
Letter to the Editor Response: Much to Debate about Conscientious Objection
Wendy Chavkin, Laurel Swerdlow, and Jocelyn Fifield
Papers in Press
The Cholera Epidemic in Zimbabwe, 2008-2009; A Review and Critique of the Evidence
C. Nicholas Cuneo, Richard Sollom, and Chris Beyrer
Letter to the Editor: Human Rights, TB, Legislation and Jurisprudence
O. B. K. Dingake
UNstoppable: How Advocates Persevered in the Fight for Justice for Haitian Cholera Victims
HIV Criminalization Laws and the Right to Health
Canada’s Mining Industry in Guatemala and the Right to Health of Indigenous Peoples