MSF has set up a project to treat the victims of rape and sexual violence near Liberia's capital, Monrovia, in the wake of the drawn-out civil war that has decimated the country over the last 14 years. The project opened in the first week of October.
It is feared that a high proportion of woman and children suffered brutal sexual abuse or attacks during the course of the conflict, with women being taken from their families and used as 'sex slaves', and children as young as five being assaulted.
The project aims to encourage rape victims and their families to seek care after sexual attacks quickly, in order for them to receive essential medical attention as rapidly as possible.
The project is running in three camps just north of Monrovia which shelter around 16,000 displaced people who fled their homes during the fighting. MSF Liberian staff, many whom have also been victims of the war, work in the camps to spread the message that treatment is available and give rape survivors the confidence to come forward for treatment. In doing so, they have to tackle the cultural taboos and social shame that surrounds sexual violence in order to encourage women and girls to speak out about their experiences.
Women and children who report being raped are referred first to local health clinics and then to Redemption hospital in Monrovia for examination and treatment. It is important that a local member of staff stays with the patient throughout, to explain the different steps of the procedure. Patients are given a prophylaxis to prevent pregnancy if they come within five days of an sexual attack. This is not an abortive pill, but a 'morning after pill' which prevents a fertilized egg from implanting into the uterus.
Those who come for treatment within three days of being raped can be given "PEP" - a prophylaxis which reduces the risk of contracting the HIV virus if administered within 72 hours of intercourse. All those who seek treatment are also treated for other sexually transmitted illnesses such as gonorrhoea, chlamydia and syphilis and are vaccinated against hepatitis B and tetanus.
In the first two weeks of the project, the team has seen about 20 patients, which suggests the frequency of rape and sexual abuse to be very high.
According to Dr Nathalie Civet, who is co-ordinating the project, "Many of the patients the MSF team are seeing are reporting sexual attacks that happened back in June, when there was intense fighting between rebels and government troops in and around Monrovia. However, we have also been surprised by the high rate of intra-familial sexual abuse.
"We are sure that even after the emergency situation caused by the intense fighting has settled down, there will still be a significant need in Liberia for medical care for victims of sexual abuse and rape."
In the first two weeks of the project, the team saw about 20 patients, which suggests the frequency of rape and sexual abuse to be very high.