"Rape can be used as a weapon to undermine the whole social structure," says Wilhelmine Ntakebuka, the head of the Vico centre for victims of sexual violence in Bakuvu and Walungu. Sexual violence is often used to weaken any opposition in the population."

The centre provides psycho-social support and training in literacy, sewing and embroidery as well as material assistance to victims. Most of the women have come to Bukavu for treatment from small villages near the forests that provide refuge for various armed groups.

"Before, sexual violence was isolated and hidden," says Ntakebuka, known as Mama Vico to her protégés. "Now it is done in front of everyone: the victim's husband, her children, the whole community. No one can pretend it didn't happen.”

Because of high unemployment in the region, the women are in many cases the economic mainstay of their families, she adds. "Often the woman thinks she is marginalized, of no use. She no longer has the courage to go about her daily work or even assume her role within the family."

Marnie Lloydd, an ICRC delegate in South Kivu, says: "After a rape, there is the initial trauma and need for medical treatment. But there are longer term medical issues such as infections or HIV. Some of the attacks are so brutal, they leave serious or even permanent internal damage.

Psychological damage

“There is also long term psychological trauma. In addition, the victim may no longer be accepted by her community or even by her husband, and hence be separated from her children."

The ICRC is helping victims by supporting Mama Vico’s Walungu centre and by providing medication. It also gives post-rape PEP kits – with treatment intended to help stop the transmission of disease – to health centres in the regions concerned (these kits are intended for victims who have managed to obtain care within 72 hours of being raped). It has trained health care workers in psycho-social care and it supports several counselling centres and homes for victims. It also makes female-led households a priority for assistance.

In the small village of Bunyakiri, four hours’ drive north of Bukavu, representatives of 15 associations that provide support for the victims of sexual violence are meeting with the ICRC representatives at the local hospital. One of the issues they are discussing is the reluctance of many victims to come forward because they fear stigmatization.

Namungaaga Babika, vice-president of one of the associations, says: "We tell women not to hide rape cases and to come to the hospital as soon as possible. We also try to convince them they are still important and they can continue to help their families economically. We help them and we show them how to help themselves and their families."

André Munyali, president of another association, adds: "About 500 women have been treated here at the hospital. But a number of victims do not come for treatment because of shame, so they hide themselves.

"Rape in our society is considered dirty," he says. "The woman is sometimes rejected by her family; she becomes helpless and cannot help them, because they do not want to be assisted by someone who is “dirty”. Rape affects the woman and the whole family."

One of the women attending the meeting adds: "They deliberately rape in front of the husbands and fathers. The objective is to destroy the woman and to destroy the family, to break the ties between mother, father and children…”