DRC: Hospital's tale reveals missing children, brutalized women

Long after fighting in the Ituri region of the Democratic Republic of Congo (DRC) has largely subsided, civilian populations there continue to face high levels of violence from all sides, according to the global humanitarian group Doctors Without Borders/Médecins Sans Frontières (MSF). The five-year conflict that raged in the country between government forces and various rebel groups has claimed an estimated three million lives. Despite a peace deal and the formation of a transitional government in 2003, the threat of civil war remains. MSF reports persistent sexual violence, as well as humanitarian consequences from military operations in 2007 to disarm militias in the region, according to a report released on Oct. 24 titled "Ituri: Civilians Still the First Victims". Christian Captier, executive director of MSF, Switzerland, told IPS that civilians pay a heavy toll for these pacification operations. "They are accused by each warring group of supporting the other side and are therefore the victims of indiscriminate retaliation or punitive actions," he said. The report is based on data gathered over four years of providing medical assistance in the region, during which time MSF has treated 7,400 rape victims at the Bon Marché hospital in the capital, Bunia -- more than one-third admitted over the last 18 months. Most of the victims are women and girls, but 2-4 percent are men and boys. Despite an overall easing of the violence in Ituri over the last three years, MSF says that its health care workers continue to see 15 to 120 people a month who have suffered from sexual violence. "Other forms of violence are also associated with these sexual assaults, notably acts of humiliation and torture. One patient in five affirms having been held captive between two days and several years," said MSF Director of Operations Bruno Jochum. In May 2003, in the midst of violent fighting between militias, MSF set up the Bon Marché hospital to perform emergency surgery and offer inpatient and outpatient health care for women and children. In the last four years, the hospital has performed a total of 198,072 outpatient consultations, including 96,874 for children under the age of five. During the same period, staff at Bon Marché Hospital admitted 42,405 inpatients, performed more than 24,900 surgical operations and delivered 7,090 babies. The report is based on this medical data gathered by MSF since 2003. "With this report, MSF hopes to create an understanding of this alarming problem. There is a tendency for people to say that things have gone back to normal. But we do not want people to forget that the needs of the people are still not covered. We don't want this region to be forgotten and abandoned," MSF says that military operations linked to the disarmament process are still a source of direct violence against civilian populations, including rapes, brutality, home destruction, looting, and displacement. In Laudjo village, 85 percent of the houses were destroyed during military offensives in early 2007. Violence is the main cause of death for people there over five years of age. In the Djugu territory of Ituri, the violence has provoked the flight of tens of thousands of people who are now simply trying to survive. Today in Ituri, 150,000 internally displaced people (IDPs) are still unable to go home. In a state of utter destitution, they remain vulnerable to exploitation and assaults, and are heavily dependant on humanitarian aid until conditions are set for a safe return to their place of origin. In the Laudjo area, a study conducted by Epicentre, the epidemiological research arm of MSF, found that one-third of children between zero and four years of age were missing, reflecting the disastrous effects of several years of armed conflict and the disruption of health services. Extending health care and social services through adapted medical and mental care is an absolute necessity in Ituri, the report says. Faced with populations living in acute distress, local authorities must do everything in their power to ensure the end of all types of violence, as the relapse of heavy fighting in Kivu, just south of Ituri, illustrates the great instability that reigns in the east of the country. With regard to the violence perpetrated by the different armed groups, MSF says it is the direct responsibility of the Congolese government and the indirect responsibility of the countries that support it to take necessary measures to reduce the number of incidents and protect the country's citizens. Although the number of rapes committed by armed men went down in 2007, the report warned that the drop could simply reflect a reduction in the intensity of military activity rather than an improvement in their behaviour during periods of fighting. Since 2003, MSF medical teams at Bon Marché Hospital have repeatedly alerted the international community to the situation facing people in the region and the difficulties in providing them with humanitarian assistance. "Through this report we hope to create awareness and response which will help the country in building its own capacity," said Captier. "Our first job is to heal wounds of course, but we also listen to the stories of people. Behind every number is a dreadful story." The report is interspersed with personal accounts of victims as recorded by MSF staff. "I was on my way to (place X) in Bunia, where my father lives. When I got to (place Y), three boys came out of the bush and dragged me back into the bush," a 16-year-old girl assaulted by a former militiaman this year recalls in the report. "One covered my mouth as two people undressed me. Then the second person held me down while the third raped me vaginally. The three of them took turns on top of me, then two of them asked me if I knew who they were, and I told them I didn't. One of them took me to his uncle's house (place Z), where he raped me every day for two weeks." "One of the three boys had some guns, but the one who held me captive had a knife. My father came to get me yesterday and brought me to the health center."