Democratic Republic of Congo: HIV - the longest lasting scar of war

Date: 01/12/2004

Index: AFR 62/026/2004

The conflict in the Democratic Republic of Congo (DRC) that raged from 1996 to 2003 has left numerous scars on the people and infrastructure of the country. The widespread destruction of homes and hospitals, the mass killings and brutality that characterised this ugly conflict have left children without families, people without limbs and widespread sickness.

However, one dimension of the violence is likely to prove one of the most lasting and difficult to heal. The DRC conflict was particularly marked by the systematic use of rape as a weapon of war. While rape has, tragically, never been far from conflict in humanity's history, in the DRC it was clearly used by armed groups as one of the main weapons against their opponents and the civilian population. In eastern DRC, members of armed groups have raped tens of thousands of women, including young girls and the elderly, as well as a number of men and boys, in order to terrorize, humiliate and subjugate civilian populations.

Mass rape in the DRC has contributed to the spread of HIV, which is predicted to have a catastrophic future effect on the health of the country. The DRC National Aids Program estimates that the rate of infection has reached 20% in the eastern provinces and could threaten more than half of the population within the next ten years. Some experts believe that the HIV prevalence rate in the east may actually be much higher. In a country at the heart of a continent so decimated by Aids, this has stark implications for the ability of DRC to recover from its recent conflict-scarred history.

Aids disproportionately affects women; according to UNAIDS, young women are three times as likely to be living with HIV/Aids than young men. When Aids is a consequence of rape, the effect on women is catastrophic. Survivors of rape are frequently abandoned by their families and communities, forced to leave their homes and left in poverty. Rape survivors in the DRC frequently suffer other serious illnesses and injuries.

The healthcare infrastructure in the DRC has broken down completely, fighters deliberately targeted medical centres and hospitals; attacking, looting and destroying many, forcing the sick and injured to flee. The conditions in those that remain in operation are overcrowded, unhygienic, lacking basic means to sterilize equipment and often without water or electricity.

Twenty-five-year-old Judith (not her real name) fears she contracted HIV/Aids as a consequence of a rape by an armed group two years ago. "They came into the house, took all our belongings and raped the whole family -- my sister-in-law, their children, the uncles; men as well as women. All of us together... Since the rape, I have been very ill. I have constant stomach problems and diarrhoea... It's as if my legs don't work anymore."

For many victims like Judith, HIV infection amounts to an almost certain death sentence. State health facilities offer no treatment for HIV/Aids other than a voluntary test. For those who test positive, this is usually accompanied by only cursory counselling or advice. Only one international NGO in eastern DRC offers antiretroviral drugs that would increase the life-expectancy of those who have been infected -- it aims to treat just 150 people by 2005. This is just a drop in the ocean in terms of what's needed. Far more needs to be done to help rebuild the medical infrastructure of the country.

Changes are also needed on a social level in DRC. Before the war, women suffered economic, social and cultural discrimination that undermined their ability to protect themselves. A married woman needed her husband's permission to take a case to court, adultery laws punished women more than men, the management of wealth and property is entrusted to the husband -- all of which represent a culture where women were seen as second-class citizens -- a culture in which they were subsequently raped on a massive level as part of the conflict.

To truly heal the scars of the conflict, social change needs to come with development of medical systems and infrastructure. A more equal place in society would give women the opportunity to bring a permanent end to the conflict. A number of Congolese women’s, human rights, church and development organizations have mobilized themselves to respond to the needs of survivors. Women, who suffered so much through the conflict, have the determination to bring change and develop a society where health and well-being are a priority .