Sexual violence in the eastern DRC
"It is the first time I am telling my story because of the shame and dishonour I am feeling inside. At the time of the incident, I was living in a bivouac in the bush, hiding from the war. One day, I had gone to the fields to collect some food to eat. As I was cultivating, I heard someone screaming loudly and the next minute armed men appeared in front of me. I tried to escape, but one of the men pulled me by the hand and knocked me over. He told me if I moved, he would kill me. He took the clothes I was wearing and he started to hit me. Then he raped me. He also introduced his fingers inside of me and he told me if he had a machete, he would cut me. I cried so much and I was so distressed to be forced to do such a thing at my old age. I went home at night, hiding in the dark my nudity. Because I am so old, I felt a lot of pain in the vagina and the abdomen pelvis. But most of all I am angry and I cry whenever the whole incident flashes back to my mind." 70-year-old woman raped in January 2002
Fizi territory, in which Baraka is situated, is one of eight administrative territories that constitute the province of South Kivu in Eastern DRC. Located at the southeast of the province on the shore of Lake Tanganyika, it covers an area of 15,786 square kilometres with an estimated population of 275,000. The main economic activity used to be agriculture, with fishing in the coastal villages. The nearby Ubwari peninsula is known to be rich in mineral resources such as gold and coltan.
Even before what has been referred to as Africa's first "world war", tensions and fighting existed in the Baraka area between different ethnic groups supported by neighbouring countries. The armed groups were responsible for killings and massacres of the civilian population and many people fled to Tanzania.
With the dramatic increase in armed conflict after 1998, the whole of Eastern DRC descended into chaos with the civilians the main victims. In Baraka, during major clashes between two armed groups in early 2003, over 350 mortars were thrown over a period of 6 months.
National peace efforts in 2003 have resulted in agreements between the involved armed forces who have begun to integrate themselves into a national army in the DRC. Tensions still exist, however, and the Fizi area remains insecure with most ex-combatants still not demobilised.
Malnutrition and lack of health care
Against this background of a cycle of violence and intense armed conflict, the humanitarian consequences for the population have been horrific.
Insecurity, systematic pillaging, and constant displacement have made it impossible for people to cultivate their lands, making malnutrition a concern for many years.With less fighting, people can more easily return to work in their fields, but armed groups continue to loot crops and with the possible return of more than 100,000 refugees from Tanzania over the coming months the food situation may worsen.
"During the war there was a complete shortage of medicines in the health centres. To remedy this situation in Baraka the population clubbed together whenever possible to buy medicines in Uvira. The ones who contributed got their money back thanks to the cost recovery system, but when patients didn't have money they just gave away their "pagne"2, their shoes, or whatever else they had. However, when everybody was totally destitute, the population had no other option than seeking health care with "Bumba Phars" - people who sell medicines over stalls at the market. These people sell medicines with a prescription they themselves make up, although they are not even trained in nursing as all they want is to run their business. At this time the most frequent pathologies were malaria, anaemia and respiratory infections because people were living in the forest and were constantly exposed to mosquitoes and to the rain and the cold." Health worker, Baraka, November 2003
In Fizi there has been a lack of access to health care for a number of years with a complete collapse of the health system and widespread looting of medicines.
Until more Non Governmental Organisations (NGOs) started to work in the area in mid-2003, the civilian population was unable to access even the most basic of health services and epidemics of disease were widespread.
Currently only 26 of 33 health centres in Fizi health zone function with great difficulty. In most health centres, there is a total absence of medical equipment such as stethoscopes and microscopes. In the health centres not supported by NGOs, the medical supplies reportedly arrive only at random or - in most cases - not at all.
"One month ago, my older brother appeared in Baraka after having been unaccounted for seven years. I had lost track of him when forces stormed the Baraka area and in the panic, we both fled in different directions. Since then, he spent all his time living in the bush, fearful to come out in a territory controlled by different forces that could punish him for his disloyalty. Deprived of health care for many years in the bush he was terribly sick and died one week ago." Man, Baraka, November 2003
A major concern is reproductive health. According to a report by the WHO about 1,837 women per 100,000 die during childbirth in the DRC - over three times the average of other African nations.3 The risk of complicated pregnancies is made even more acute by pathologies such as malnutrition, anaemia, and malaria, which are exacerbated by food insecurity and displacement resulting from the war. The daily salary for a manual worker is about $2.5 dollars in the DRC.
A caesarean section - in many cases a live saving operation - may cost up to $40.4 Today it is believed that thousands of people are still living in the forest, totally deprived of proper health care.
Download the entire report here in PDF format.
2 A "pagne" is a piece of fabric that Congolese women use to dress.
3 DRC Health Up-date,World Health Organisation, July 2001
4 Costs in December 2003