Full report - International Alert

41 • Women’s Bodies as a Battleground: Sexual Violence Against Women and Girls During the War in the Democratic Republic of CongoHIV 9%cervicitis 4%soft chancre 7%vaginitis 7%endometriosis 7%vaginal trichomonad 7%genital scabies 4%pubic tinea 9%gonorrhoea 31%syphilis 13%leucorrhoea 2%Graph 2: Medical problems diagnosed in 658 women rape victims who were patients at the Saint Paul health centre in UviraNine per cent of the women who were tested for HIV/AIDS turned out to be HIV-positive. These resultsare probably not an accurate reflection of the real situation, given that techniques for taking bloodsamples in the rural areas are not entirely reliable, and that the tests were carried out on the patients onlyonce, between December 2002 and February 2003. The incubation period for HIV can be as long as ayear and therefore the test ought to be carried out several times, the last test taking place one year afterthe suspect sexual contact. It is only at that point that a reliable diagnosis can be made.The majority of the rape victims – 70% of the women interviewed – had received no medical treatment at all.Some had decided not to go to a health centre, preferring not to reveal what had happened for fear of beingstigmatised. Others could not get access to treatment, either because there was no health centre in their area,of if there was, because it was too far from where they lived. The roads were unsafe, and many women wereunwilling to set out alone, for fear of being attacked and raped again. Some of the interviewees had beenrobbed and stripped of their belongings after being subjected to rape, and were totally without financial meansand incapable of meeting any medical expenses, or of getting themselves to a specialised clinic in a town.The destruction of much of the public health infrastructure poses many problems. A large number of hospitalsand rural health centres have been completely looted and ransacked and have had to close. Medical staff havequit their jobs because of the lack of security, rapes, abductions and pillaging. In the most remote rural areasthe lack of competent nursing staff means that victims have little chance of receiving proper medical care. Thefew health centres in the rural areas that are still functioning are not equipped to deal with the morecomplicated cases. In urban centres such as Bukavu the general hospital and the clinics are stretched beyondtheir capacity and are unable to properly deal with all the cases presented to them.More than half of all the medical facilities in South Kivu suffer from a dire shortage of medicines, to thepoint that they are no longer able to give their patients even basic primary care. Shabunda, for example,has 66 health centres, of which only 34 are functioning – and this only since 2001. There are only twogeneral practitioners in post for the whole area. The 34 functioning centres have experienced interruptionsin the supply of essential medicines since the outbreak of the war. Only ten of them receive emergencymedical support, from Médecins sans Frontières Holland.A number of local organisations also look after victims of sexual violence and 18.6% of the womeninterviewed had benefited from their support. These associations arrange first aid for the the victims