Sexual violence has always been part of armed conflict. A few programmes offer
support for victims and serve as potential models for doing more.
“WE COULD HEAR the crude laughter and boots treading
the floor, the excitement among the officers. How many times
was each one raped that night? I was left with a body that
was torn and fragmented everywhere. There was not an inch
of my body that did not hurt.”
A victim from the former Yugoslavia of the 1990s? A quote
from today’s Democratic Republic of the Congo (DRC)?
No: these are the words of Jan, who was a 17-year-old Dutch ‘comfort
woman’ during the Japanese occupation of Indonesia
in 1944. But she could have been one of the Sabines abducted
by the Romans in antiquity, a victim of the Visigoths in
fifth century Europe, a Vietnamese girl during the war with
the United States, a German woman in Berlin in 1945.
As it could have been so many others.
“Rape in times of war has always been systematic,” notes
neuropsychiatrist Boris Cyrulnik, who is known for his writings
on the psychological resilience of trauma survivors. “Fighters
were ordered to kill and maim, and then they were let loose
to help themselves to food and to women.”
According to Cyrulnik, this violence with “a sexual
signification” has given way, over the past 30 to 40
years, to rape as a weapon of war. “This is ideological
rape, one that aims, like in Kosovo or [DR] Congo, to destroy
For many groups of people, few things go deeper than the ‘virtue’ (many
would say ‘honour’) of their mothers, daughters
and wives, so ‘staining’ them will destroy the
community more surely than killing a few of its members.
And all the more so when pregnancies follow the attack, burdening
the victim and her people with a child fathered by the enemy.
In extreme cases, rape equates murder — such as the
rapes with machetes perpetrated during the 1994 Rwanda genocide.
Men and boys are also victims. For example, castration,
which was practised by the Ku Klux Klan in the US south and
by the French in Algeria. Detention is particularly conducive
to abuse, aimed at humiliating and dehumanizing the other;
think of the infamous images of Abu Ghraib or of the thousands
of Muslim and Croat men abused during the war in Bosnia.
For Florence Tercier, a former women and war adviser at
the ICRC, violence against women is about “where the
power lies”. Already marginalized in peacetime, women
will be the victims of choice when normalcy collapses. Not
only wars, but also natural disasters and displacement may
lead to sexual and gender-based violence.
Frequently in such situations, people live in cramped, insecure
camps, with little if any privacy or police protection (see
box, Vulnerable after disaster). The men are uprooted and
unemployed, so there is often frustration, substance abuse
and domestic violence. “When emergency strikes, the
stress levels rise and so does the level of violence,” says
Vera Kremb, non-discrimination and gender coordinator for
the IFRC. “The same is true for sexual violence.”
This pressure can bring out the worst in otherwise non-violent
men. “He used to be a good husband before we fled to
this refugee camp in Malawi,” a Congolese woman recently
told an IFRC video crew, recounting how her husband threw
boiling water over her. In camp settings, girls risk being
raped when they go to wash or fetch wood.
Listening to the unspeakable
The world over, rape is a taboo, and it is the victims
who carry the stigma. Their family and their community may
reject them; they can be killed to ‘cleanse the family
honour’. The physical and psychological scars of
rape can last a lifetime. In the book Listening to the
Silences: Women and War, the former ‘comfort woman’ Jan,
who received no counselling for 50 years, speaks of how
the old fear still “burns me up”.
The trauma of rape can also lead to debilitating depression,
shame and anger which make it extremely difficult for the
victim to get back to a normal, productive life. Psychosocial
support is therefore a key part of the humanitarian response.
In the field, several approaches are being tried out that
could serve as models. In the DRC, the ICRC supports a series
of maisons d’écoute or listening houses, where
the counselling starts with a simple act: offering women
a safe place to tell their stories.
“When a victim of rape comes to our listening houses,
the first priority is to make the person feel secure, lower
her anxiety and ensure she gets proper medical treatment.
At a second stage, we help rebuild her image of herself which
was shattered by the rape,” says Jacques Caron, an
ICRC psychologist in eastern DRC.
The lush hills of the Kivu, as the region is called, have
seen unspeakable horrors during the past 15 years of conflict.
Rapes, sometimes accompanied by extreme violence and targeting
all ages from babies to great-grandmothers, have affected
more than 150,000 women over this period according to a United
The listening houses were created in 2000 by Congolese women,
some of whom were rape victims. International support followed.
Starting in 2004, the ICRC trained the staff and now supports
40 of these structures.
The ICRC also makes post-rape kits available at the health
centres it supports. The kits include emergency contraception
to prevent unwanted pregnancies, anti-retroviral drugs to
prevent HIV transmission, treatments against sexually transmitted
infections and immunization against tetanus and hepatitis
B. If used at the most 72 hours after the attack, these kits
lessen the risk of contracting HIV.
Food and a bed are available for those unable or unwilling
to go home. Injured victims are referred to ICRC medical
facilities. A number of agencies, including the Red Cross
of the Democratic Republic of the Congo with help from the
IFRC, also assist women, particularly those rejected by their
husband after the rape, to start small income-generating
The results can be uplifting. Fanny,* 43, says she used “to
feel so dirty and disabled after what happened. But since
I have spoken to the ladies at the listening house, and they
have shown me that this could have happened to anyone, my
heart is lighter.”
Could the listening houses model be exported to other contexts
such as Haiti, where the epidemic level of rape in the camps
is putting the spotlight on the issue? Projects in Colombia,
Malawi and South Africa also offer potential models for integrating
sexual and gender-based violence issues into existing, long-term
efforts in the fight against HIV and AIDS, and in emergency
operations dealing with internally displaced persons.
Some within the Movement are also advocating for improved
preparedness and planning in the design of emergency shelters
and camps, i.e., better lighting, better siting of sanitation
services, privacy between the sexes, and provision of fuel
so women don’t need to search for firewood. Awareness
about rape should become more mainstream, they argue, along
with a general improvement in reproductive health services
for women during emergencies.
“Based on our mandate, we could play a much more prominent
role in fighting gender-based violence — through humanitarian
diplomacy, through our vast network of community volunteers
and by providing medical and psycho-social services for survivors
of sexual violence during emergencies,” says IFRC’s
Kremb, noting that teenage pregnancy, self-induced abortion
and HIV infection rates also rise in the wake of emergencies.
ICRC adviser on women and war, Nadine Puechguirbal, agrees. “Humanitarians
think as soon as the emergency passes they can organize camps
and integrate gender issues, but by then it’s too late,” she
A watershed in the 1990s
Despite the long history of rape in conflict, the humanitarian
response did not come until the mid-1990s. The triggers
were the conflict in Bosnia, with its litany of rapes,
and Rwanda, where the genocide shocked the world. Médecins
sans Frontières and the International Rescue Committee
were among the first to start gender-based violence programmes
in these contexts.
The evolution was due to a convergence of factors, explains
the historian Carol Harrington. “In World War II Berlin
or after the 1971 mass rapes in Bangladesh, victims were
provided with medical services, for abortion and venereal
diseases treatment. But this did not happen at every conflict.
“One of the biggest changes in the 1990s was the attention
given to the psychological trauma, following work by experts
who had previously linked rape to torture. Another important
factor was the work of feminists who were focusing on violence
against women, highlighting that women’s rights were
Rape had evolved from being a matter of ‘honour’ to
a matter of human rights, as well as a medical issue, one
with both visible and invisible wounds. Meanwhile, the ad
hoc international criminal tribunals in the 1990s — on
the former Yugoslavia, Rwanda and Sierra Leone — were
Their guiding statutes mention rape under crimes against
humanity which are in the ambit of the tribunals. Their jurisprudence
was groundbreaking, including, in the case of the former
Yugoslavia, for men-on-men violence.
The 1998 Rome Statute of the International Criminal Court
(ICC) further grounded “rape, sexual slavery, enforced
prostitution, forced pregnancy, enforced sterilization, or
any other form of sexual violence of comparable gravity” as
a “crime against humanity”, under certain conditions.
The text speaks of “any civilian population”,
thus encompassing both sexes. The ICC has already issued
several indictments based on this article.
This 15-year-old in Obo, Haut-Mbomou Provence, Central African
Republic, was abducted when she was 13 by an armed group
and forced to become one of the commander’s many wives.
Photo: ©Marcus Bleasdale/VII
“This is ideological
rape, one that aims,
like in Kosovo or
Congo, to destroy
In Kiwanja, North Kivu province, DRC, at a listening house for victims of sexual
violence, a woman speaks with a psychosocial worker (right). “The listening
house is a refuge because when a person is raped, she cannot speak of it to
her neighbours and even less to her husband who might reject her,” the
Photo: ©Pedram Yazdi/ICRC
In Cali, Colombia, this victim of
sexual abuse received a visit and assistance
from the ICRC.
©Christoph Von Toggenburg/ICRC
In Colombia, instances of domestic and sexual violence
are frequent but mostly unreported. The issue is still largely
taboo, the signs of abuse are not always obvious, and most
of the victims remain anonymous. This is especially the case
when the crime is linked to armed conflict.
To get free state medical services, Colombian law requires
the victim to file an official complaint. But few victims
feel sufficiently safe to press charges. “Mostly, victims
sexually abused by an armed actor are too afraid to speak
out because they fear for their lives,” explains Tatiana
Florez, in charge of ICRC’s health programme in Colombia.
There, the ICRC works in partnership with a family planning
organization called Profamilia to assist victims of gender-based
But this is not a simple task. Victims themselves don’t
always see rape as their greatest trauma, or post-rape assistance
as their biggest need. “Rape is often seen as just
another crime, considered as relatively minor in the face
of the murder of a husband, the loss of all one’s belongings,
or the estrangement from one’s home,” Florez
“We orient people who wish to file a complaint towards
the appropriate agencies,” explains Luz Marina Tamayo,
the ICRC’s advisor for issues related to women facing
war. The ICRC offers free medical and psychological assistance
to those who prefer to not seek recourse through the state
system. In all cases, victims are assisted in complete confidentiality.
People with very sensitive cases are sometimes given aid
to relocate quickly.
Follow-up with victims is also extremely challenging. “When
first meeting a victim of sexual violence, one must always
have in one’s mind that it might be the only time you
will see this person,” explains Marina Alexandra Caicedo,
coordinator of a psychological programme for gender-based
violence victims for the Colombian Red Cross. “That’s
why we have trained our collaborators and our volunteers
to respond to this type of situation.”
It’s also important to go to where the victims are — in
Colombia that often means in dispersed, isolated communities.
The Colombian Red Cross, also present in many hard-to-access
regions by virtue of its mobile health units, directs people
to pertinent institutions for psychological or other support,
or to the ICRC and Profamilia.
In 2010, close to 180 people were assisted by the ICRC. “The
big challenge for us today is to raise awareness that sexual
violence is also a medical emergency, which requires intervention,
including HIV prophylaxis, within 72 hours,” concluded
Marie-José Sierro, the ICRC delegate in charge of
health in Bogota. “It’s also necessary that the
people know that they can come to the ICRC and speak about
Marie-Servane Desjonquères, ICRC,
Within the Movement, the 1990s were also a turning point.
There were related resolutions at two International Conferences
of the Red Cross and Red Crescent in 1996 and 1999. At the
latter, the ICRC pledged to better assess and respond to
the “needs of women and girl children affected by armed
conflict” and, among other things, to “actively
disseminate the prohibition of all forms of sexual violence
to parties to an armed conflict”.
Despite this evolution, programming to combat gender-based
violence is still not fully integrated into the Movement’s
on-the-ground response in both conflict and natural disaster.
Some in the Movement who work on this issue argue that the
response is too episodic and situational and that more needs
to be done to integrate gender-based violence awareness and
programming in emergency preparedness, relief and recovery.
Still, a few programmes provide examples of what this integration
can look like. In southern Africa, programmes undertaken
as part of the Global Alliance on HIV, which encompasses
the IFRC, National Societies, volunteers and partners in
ten countries, weave gender-based violence programming in
prevention work that reaches deep into rural and urban communities.
Meanwhile, the Malawi Red Cross Society and the Office of
the UN High Commissioner for Refugees developed a comprehensive
approach to sexual violence in Dzaleka, a refugee camp of
10,000 people, which has now inspired similar efforts in
15 districts throughout the country. Community-based committees
lead sensitization and mediation. The police and the courts
are involved. Safe houses, as well as psychosocial counselling
and income-generating projects for abused women, are available.
One key outcome: an increasing number of cases are being
In major disasters, the response to gender-based violence
is also increasing. The Haiti earthquake, for example, marked
the first time that a gender focal person was part of the
rapid assessment team. It was also the first time the IFRC
hired a delegate specializing in programmes about gender-based
violence, sexual exploitation and abuse to be part of the
emergency response. After receiving some basic training,
Haitian Red Cross Society volunteers, who have unique access
to camp communities, are raising awareness and referring
women to locally available services.
But there are still gaps. While post-rape kits have been
made available in Haiti at all the basic health Emergency
Response Units and were offered by some National Societies,
the number of staff specifically trained to deal with the
unique psychological and medical needs of rape victims is
Similarly at the ICRC, the response to sexual violence
is not completely mainstreamed although there has been considerable
progress in the last ten years.
The comprehensive 2001 ICRC study, Women
Facing War, showed
that awareness about gender-based violence was already improving
but was still not sufficiently integrated into ICRC delegate
training and international humanitarian law (IHL) dissemination.
Part of a broader ICRC effort (also based on the 1999 pledge)
to better protect and assist women affected by armed violence,
the report concluded that conflict affects women differently
from men. Thus, the approach must be specific to those needs.
Since then, the ICRC has produced guidance documents (for
example, Addressing the needs of women affected by armed
conflict, 2004) and increasingly integrated the issue into
its general training and programme materials (Women
2008). Messages regarding the prohibition of sexual violence,
including direct dissemination to armed groups, are increasingly
part of the IHL repertoire. The ICRC also works with local
women to document cases of gender-based violence.
“Delegates today are far better equipped to respond
than ten years ago,” notes Charlotte Lindsey, author
of the 2001 report and now ICRC director of communication
and information management.
“Since I have
to the ladies at the
listening house, and
they have shown
me that this could
have happened to
anyone, my heart is
victim in the
of the Congo
“The situation here is bad, especially for young girls,” Malawi
Red Cross worker Janette Honore says of the Dzaleka refugee camp. “Many
women feel that they are forced to exchange sexual favours for basic items.” Along
with Jimmy Ndayishima, Honore is a member of the camp’s committee against
Photo: ©Damien Schumann/IFRC
25-year-old Nirva sits among a group of women and girls
at a camp for displaced people in Port-au-Prince. “You have rights, just like men,” she
tells them softly but firmly. “You don’t have to accept being victims.”
Three years ago, while walking home, Nirva was grabbed by
five men and gang-raped. Now she is a member of the grass-roots
organization KOFAVIV, and comes to this camp every Sunday
to tell the girls and women living here how to avoid a similar
fate — or what to do if they cannot.
Prior to the quake, action against gender-based violence
was increasing. But the quake erased that progress, killing
female leaders, destroying safe houses and permitting hardened
criminals to escape from prison.
For the hundreds of thousands of girls and women living
in camps for internally displaced people, sexual violence
is a daily threat. They sleep in tents that permit any intruder
to enter with the slash of a knife. Lighting is scarce, the
camps pitch black at night. Armed gangs roam undeterred.
Many husbands, fathers and brothers died in the quake, leaving
women to fend for themselves. And a majority of the camps
have no police presence or security.
“I sleep during the day and stay awake every night
to keep watch over my two girls,” says Evelyne Dennery,
a widow who lives in the Caradeux camp in Port-au-Prince.
Residents of this camp have formed an informal security patrol,
but without equipment as basic as flashlights or whistles
they can do little.
Children are also extremely vulnerable, says Jocie Philistin,
project coordinator of KOFAVIV. “People
now find themselves in a place where nobody knows anybody,
where a sense of community doesn’t exist, and where
women make up the labour force. They must leave the camp
to work, and the children are pretty much abandoned.”
The situation in some camps is better than that in others,
either because residents knew each other beforehand or because
the camps were set up with lighting and separate sanitary
facilities. “One of the lessons learned is that people
really need to be aware of these kinds of problems from the
beginning,” says Sian Evans, a programme officer for
the United Nations Population Fund who coordinates the gender-based
violence sub-cluster in Haiti.
By Amy Serafin
the number of ICRC projects specifically addressing gender-based
violence is small but growing. Apart from the DRC, the ICRC
offers programmes and services for victims of sexual violence
in Darfur and Colombia. There are also plans to begin programming
in Côte d’Ivoire, Haiti and Senegal.
In many of these areas, specific assistance for women (from
pre- and post-natal care to physical rehabilitation and help
finding missing family members) is already being provided.
In Iraq and Nepal, for example, there is particular emphasis
on economic security for widows left to provide for their
households. Women in these circumstances are often extremely
vulnerable to various forms of violence.
The debate continues, however, about the proper Movement
role and response to sexual violence and the specific needs
of women. Former women and war adviser Tercier notes that
there has been concern from some who saw gender-based violence
programming as a challenge to the ‘all-victims approach’.
Rooted in the Fundamental Principle of impartiality, this
approach is based on the idea that assistance is given comprehensively
and strictly on the basis of need.
In response, it is pointed out that developing a stronger
response does not alter the all-victims approach; rather
it reinforces the notion of a comprehensive response based
on a “better understanding of the needs and particular
vulnerabilities of certain categories of victims, in this
instance women”, according to the 2001 study.
There is also debate about whether rape falls outside the
strict mandate of emergency response because in certain contexts
it is ‘cultural’ or existed before the emergency.
But does that argument still hold when conflict or natural
disaster causes an extreme spike in gender-based violence?
There is one thing that most interviewed for this story
do agree on. Gender-based violence is a difficult problem
to address — particularly during crisis. Victims of
rape are hard to identify (see box, Silent suffering) and
often there are insufficient referral services, partner organizations,
safe houses or resources to respond properly.
Greater on-the-ground Movement action would require greater
commitment to volunteer and staff training, more investment
in psychosocial services, better preparation for medical
and security services for displaced people and resources
for delegations and volunteers already overwhelmed by crisis
“The progress made over these last years is impressive,
and this issue becomes more and more part of each of our
activities,” says Pierre Krähenbühl, director
of operations at the ICRC. He notes, however, that “we
still have a long way to go”.
By Iolanda Jaquemet
Iolanda Jaquemet is a freelance writer based in Nepal. She has reported on sexual
violence during conflicts in the Balkans, The Democratic Republic of the
Congo and elsewhere.
*Not her real name.
The systematic rape of women during the 1992-1995 war in the Balkans led to protests
demanding that allegations of rape be included as part of war crimes proceedings.
Below, two members of the Bosnian association “Women – Victims
of War” join protests in Sarajevo demanding justice for rape victims.
Photo: ©AP Photo/Hidajet Delic