The global medical community appeals for peace and an end to the sexual aggression in the Congo

The open war in the East Democratic Republic of the Congo has been replaced by a low intensive but brutal campaign of sexual aggression towards its women and girls. At least half a million of them have to date been raped. Is it the curse of large numbers that allows for this terror to continue? The number represents every woman or girl in Stockholm, every other female in Paris, every third in London.
If we instead begin to imagine just one woman, that she is first raped in public and then forced to sit on burning coal until her entire genitalia are destroyed. Her husband, children and family are forced to witness the torture. Her father is forced to participate in the rape. The family´s fields are then torched. Let us then imagine that during the following days 242 other women are raped, something that occurred as recently as August this year, and then consider that this aggression has been on-going for more than a decade.

Should this particular woman survive her intestines, urinary organs and genitalia will be so damaged that she, even after repeated surgery, risks leaking urine uncontrollably, something that often results in her being ostracized from village. Villages that witness the public rape of their women lose their social cohesion. Male family members who powerless are forced to witness or participate in the aggression are stripped of their role as family providers and defenders; many men then abandon their families, not solely or primarily because of primitive conceptions of a woman´s own guilt and soiled status as rape victim, but for loss of identity, grief and shame. Children are born as a result of rape and are turned away from the communities. HIV and syphilis are quickly disseminated since the rape is performed in wounded genitalia. The social fabric of the community is in this way destroyed. Further, the plunder of goods deprives people of their self sufficiency; constant fear leads to stagnation of trade; rural areas are depleted and villages dispersed as many flee to the relative safety but absolute poverty of the urban cities.

Since eleven years back Dr Denis Mukwege at Panzi Hospital in Kivu Province of East RDC surgically treats women who have survived rape and torture, to date 30 000 women. The details that the hospital personnel routinely collect of the attacks have convinced them that the rapes are conducted in a systematic and premeditated fashion. An organized armed militia operating in the region often has its own characteristic method of torture that accompanies the rape. This cannot be emphasized enough: in their experience rape is followed by various forms of torture. One group make women to sit on burning coal or open fire, another forces up sharp objects, others fire ammunition up the vagina. One can thereby begin to distinguish one aggressor group from another. The militias elaborately interweave physical and psychological torture. Destroying a woman´s genitalia is a very palpable way of preventing the bearing and birth of children, but the devastating psychological consequences of the rape for the woman, her family and community are just as undeniable.

Sexual violence has become an integral part of the present conflict and serves the same long-term objective as conventional warfare: the conquest of resources and destruction of the population. Without economic or social structure a people are easily subjugated and in time annihilated. Rape in the RDC has become a more efficient weapon of war than directly killing people.

Our colleagues in the Kivu Province have repeatedly testified to the terror that the region´s women endure; despite their credible testimony the inferno is allowed to continue. Their resource-and time consuming medical and surgical treatment only reaches a small percentage of all afflicted women. The long-term solution lies not in medical treatment but in achieving peace in the region.

We, as part of the global medical community, endorse Dr Mukwege and his colleagues´ following demands to the international community:

• Demand of the DRC, Rwanda and Uganda that they take control over their regular and irregular militias that wreak destruction in the area. The economic interests that entertain the chaos of the region to a great extent explain these states seeming indifference faced with the indescribable suffering taking place.
• Extend and strengthen the mandate for the peace-keeping troops in the region to protect civil society.
• Encourage the creation and training of a Congolese policing unit to large part consisting of women with the purpose to protect civilian society.

These demands are reflected in the public statements made by Margot Wallström, Special on Representative to the UN on Women’s Situation in War. Her work must be prioritized and her words brought in to action. The massive killing in the DRC continues on the same scale as before but now occurs deceptively slow and through a drawn-out suffering. People die, as Denis Mukwege expresses it, “La Mort Douce”, Gradual Death. This brutality is on-going since more than ten years and in part by the same aggressors who raped and terrorized in Rwanda in 1994. The international community then delayed inexcusably long and has now, again, delayed inexcusably long.

Endorsed by:

The Swedish Society of Obstetrics and Gynecology (SFOG)
The Swedish Society of Medicine
The Swedish Medical Association
International Federation of Medical Students' Associations – Sweden
Medicine Studerandes Förbund, Sweden
World Medical Association
Nordic Federation of Obstetrics and Gynecology (NFOG)
Danish Society of Obstetrics and Gynaecology (DSOG)
Finnish Gynaecologic Association (FIK)
Norwegian Gynecological Association (NGF)
Icelandic Society of Obstetrics and Gynecology (FÍK)
The Society of Obstetricians and Gynaecologists of Canada (SOGC)
The Swedish Association of Midwives
AMOG- Associação Moçambicana de Obstetras e Ginecologistas, Mozambique
Canadian Association of Midwives
FIGO - the International Federation of Gynecology and Obstetrics
Association of Obstetricians and Gynaecologists of Ukraine (AOGU)
Scandinavian Doctors Sweden
Rotary Doctors Sweden
Lithuanian Society of Obstetricians and Gynaecologists suppot this statement.
Polish Gynecological Society supports the appeal.
Nicaraguan Society of Obstetrics and Gynecology
Lithuanian Society of Obstetricians and Gynaecologists
Groupement des Gynécologues Obstétriciens de Langue française de Belgique & Belgian Royal Society for Obstetrics and Gynaecology, Belgium
Royal College of Obstetricians and Gynaecologists, United Kingdom