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Weapon of war

Sylvie is a Central African midwife; Agnes, a French psychologist. Together they care for victims of sexual violence in a specialised clinic established by Médecins Sans Frontières in Bangui General Hospital, in the capital of Central African Republic (CAR). Here they describe the suffering experienced by the women, the omnipresence of violence in CAR since December 2013, and the efforts to provide care and comfort within the clinic.

Trigger Warning: this story contains information about sexual assault and/or violence which may be triggering to people who have similar experiences.

"One day Fatou a young mother of three children, came to us. She had been working in the fields, her small children alongside her, when a group of armed men appeared. Everyone fled but the men caught Fatou, and raped her. That was 2013. Then in September 2015 she was at home when her house was attacked. She was taken with some other women and children to another house, where the attackers killed the men and raped the women. Later she managed to escape and was able to reach Bangui, where she was referred to us”, explains Sylvie. Sylvie and her colleague Agnes are too often witness to stories like these, of women raped several times during their lifetime, and of terrorised and traumatised children.

The assaults occur in situations of extreme violence

Says Sylvie, "Here, in the context of armed conflict, rape is less an issue of sexual impulse than it is a weapon of war. The assaults happen in full view of the community, the family, and the children, in between the murders and the houses set alight." Médecins Sans Frontières opened its sexual violence care program in Bangui General Hospital in July 2014 to kick-start a response to the needs of victims, where there was none. The medical team also undertakes outreach activities in health centres in PK5 district and M’Poko and Castor camps. A free ambulance service has also been established.

"Here, in the context of armed conflict, rape is less an issue of sexual impulse than it is a weapon of war. The assaults happen in full view of the community, the family, and the children, in between the murders and the houses set alight."

Sylvie
Midwife

Since the clinic opened, the medical team has cared for 1,087 victims, almost exclusively women, 18.5 per cent of them minors. Only 158 of the 1,087 arrived within 72 hours after the assault. Delays in seeking a consultation are most often explained by poverty, which means it is not always possible to find transport; lack of knowledge about the free services offered by Médecins Sans Frontières; and insecurity which makes it hard to get around.

Prevention and protection activities including awareness-raising have also sometimes had to be reduced; and the insecurity has also had an impact on the capacity for judicial support to the victims. “Our Central African staff are exposed to potential reprisals by the perpetrators of the violence. So it is the international staff who respond to the summons to Court,” explains Agnes. Protection of the victims is a huge challenge for Médecins Sans Frontières’ team, to try to avoid letting them return to the same situation and the same environment that led to their rape.

Agnes and Sylvie hope that the democratic and institutional transition underway in CAR will calm the political situation, break the cycle of violence, and help expand preventive, treatment and protection services for the victims of sexual violence.