'Our programs in Bangui are the only facilities in CAR delivering comprehensive treatment to victims of sexual violence. This medical and psychological care is vital for victims to hope that one day they’ll heal and overcome their trauma.'
Médecins Sans Frontières/Doctors Without Borders (MSF) clinical psychologist Hélène Thomas recently helped open a medical and psychological support program for victims of sexual violence (VSV) at the general hospital in Bangui, the capital city of Central African Republic (CAR). She was in CAR between April and December 2014. She discusses some of the cases she saw during that time below.
By Hélène Thomas
Sophie’s* story affected me the most. She seemed to be literally falling to pieces when she arrived at the hospital. She was only just 37 but looked more like 50. She had foot sores and malaria and was under-nourished. Traumatized, confused and disoriented, she was also suffering from Kaposi’s sarcoma, a disease that manifests itself as cutaneous lesions. What she had to say was truly shocking: "I don’t know if I’m alive or dead. My life is meaningless. Is there any dignity left for me? Am I still a human being?"
Sophie was on a bus going to the market in Boguila in northwest CAR when it was stopped by a group of armed men. They first separated the males from the females and then took the women into the bush. For two weeks, these women were gang-raped, drugged and forced to march barefoot on very little food. One day, some of the men left to attack a village and the women managed to escape.
Sophie was utterly shattered. She had no notion of the courage it had taken her and the other kidnapped women to escape, that they could have ended up alone in the bush or subjected to reprisals by armed groups. Villagers took them in, gave them first aid and protection and then they went home. But Sophie’s misery was far from over.
A victim in need of medical treatment
When she finally got home, her husband repudiated her and wouldn’t even allow her to see her nine-year old son. Her brother, however, had heard on the radio that MSF was opening a program for victims of sexual violence at Bangui general hospital, and suggested that she go.
When she arrived at our clinic, we began by reassuring her and calming her down. We took her statement in Songo (a language spoken in CAR) as she doesn’t speak French that well. Quite unusually, we had to admit her as an in-patient because she really was very ill and weak. We gave her a clinical and medical examination, and sadly we found that she had been infected with HIV. It was so hard for her. She said she wanted to kill herself. But fortunately, thanks to the medical treatment, psychological support and social interaction with people accompanying other patients, she gradually recovered. We kept her with us for about a month, until she felt strong enough to go back to her village.
Shocking levels of sexual violence
CAR is in a state of absolute chaos and what happened to Sophie is far from an isolated case. Between July and November 2014, we treated just at the general hospital 274 victims of sexual violence. 24 were minors — almost half not even eight years old — and seven were male.
I remember one lady who was 90. We had to go and get her at her home because she was wounded. And a three-year old little girl who was in a state of shock. It’s horrendous to see such suffering.
Victims mostly come because they, or somebody they know, have been informed and made aware of what we do through the outreach campaign we ran when we opened the program, and some are referred from other health facilities. And now the Bangui police, and more particularly the brigade for the protection of minors tasked with handling sexual assault cases, have started sending victims to us.
MSF and the treatment of sexual violence in CAR
Our program at the general hospital and the VSV unit managed by MSF at Castor health centre also in Bangui are the only facilities in CAR delivering comprehensive treatment to victims of sexual violence. This medical and psychological care is so vital for victims to hope that one day they’ll heal and overcome their trauma.
MSF started working in CAR in 1997. Since 2013, the organization has doubled medical assistance and increased programs to respond to the ongoing conflict in the country.
* The names in this article have been changed to protect victims of violence.