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Out of the Shadows


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 the enemy.”

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 Nations estimate.

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 projects.

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 says.

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 human rights.”

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 a watershed.

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
the enemy.”

Boris Cyrulnik,
French neuro-
and expert on
trauma recovery



















Your turn

What should the Movement do to better respond to gender-based violence during conflict and other emergencies? Please send your opinions to: or join the discussion at:




















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 worker explained.
Photo: ©Pedram Yazdi/ICRC

In Cali, Colombia, this victim of
sexual abuse received a visit and assistance from the ICRC.
Christoph Von Toggenburg/ICRC

Silent suffering

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 violence.

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 adds.

“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 the problem.”

Marie-Servane Desjonquères, ICRC, Geneva

The Movement’s response

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 reported.

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 not sufficient.
Better equipped

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 and War, 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 spoken
to the ladies at the
listening house, and
they have shown
me that this could
have happened to
anyone, my heart is

Fanny, 43-year-old
rape victim in the
Democratic Republic
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 gender-based violence.
Photo: ©Damien Schumann/IFRC

Vulnerable after disaster

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

Meanwhile, 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 response.

“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


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