NOTE: I wrote this article about the conflict in the Congo without mentioning the reason behind it – multinational corporations fighting over natural resources that are used in cell phones. Please read this article from the October 20, 2009 issue of San Francisco BayView: Congo Week: an interview wit’ Kambale Musavuli, spokesman for Friends of the Congo
by Suzy Subways
APRIL 2007 • Issue 4
In New Orleans, an extraordinarily incompetent official response compounded Katrina’s brutal impact. In another October 2005 New England Journal of Medicine article about the response to Katrina, disaster relief experts observed that “ignorance of the lessons learned from managing similar crises in other countries” played an important role in the U.S. government’s insufficient response to Katrina. In the Democratic Republic of the Congo (DRC), destruction caused by governments and militias has created a humanitarian disaster of tsunami proportions. Living in the U.S. is very different from living in a developing country in Africa. But in both places, we can see how powerful forces sometimes worsen and even take advantage of catastrophe, while others with power do their best to help people whose lives have been shattered.
Healthcare: Another Casualty of War
Although the Second Congo War officially ended in 2003, violence continues, especially in the east. The conflict has directly involved eight African nations and 20 armed groups, and it continues to include the Hutu militia that took part in the 1994 genocide in Rwanda. Since 1998, nearly four million people have died—more than in any conflict since World War II. As in other violent conflicts, most of these deaths weren’t caused by bullets but by disease and malnutrition that could have been treated or prevented if not for the violence and its effects on healthcare, farming, and housing. As in Rwanda, the conflict has facilitated HIV transmission and made it far more difficult to deliver healthcare to the increasing number of people with HIV.
Rape as a Weapon of War
Historically, rape has been used against civilians as a weapon of war, although it’s relatively recently that feminists and humanitarian groups have been able to draw media and world attention to this atrocity. During the Second Congo War, rape was widespread, and this brutality continues today as violence persists in the east. Immaculee Birhaheka, director of a women’s rights group in Goma, a city in Kivu province in eastern Congo, told the Guardian in November 2006, “It is impossible to know how many women have been raped in the war, but it is hundreds of thousands.”
In the chaos, with no reliable government authorities to protect civilians or rebuild the already limited public health infrastructure, nongovernmental organizations have done their best to step in. HEAL Africa, a nonprofit started in 1994 by a Congolese doctor to improve rural health, provides continuing medical education to local physicians with support from international funders and medical schools. Joseph Ciza Nakamina, a Congolese nurse who runs HEAL Africa’s North Kivu sexual violence program Heal My People, presented preliminary research at the global AIDS conference in Toronto last summer, confirming that conflict increases the risk of HIV. Of the militiamen and armed gangs who commit most of the rapes in the region, 12 percent are HIV-positive, Nakamina reported.
A Community Takes Action
In March 2003, hundreds of women held a protest against rape in the center of Goma, demanding medical care for fistula, a severe resulting internal injury. Since then, trauma counselor and activist Mama Jeanne Banyere has brought women from remote areas to HEAL Africa’s Goma hospital, which offers surgery for fistula, HIV treatment, and post-exposure prophylaxis (PEP)—a short course of antiretrovirals used to prevent HIV infection immediately after exposure.
Ciza Nakamina recommended making PEP more accessible through trained nurses in places where doctors will not go due to safety concerns. Judy Anderson, a HEAL Africa consultant from the U.S., says, “There’s a huge need for help in getting the PEP kits out to the clinics in outlying areas—a virtually unlimited need, as there are not many others out there doing so.” The stigma of surviving rape can also be a barrier. “We are trying to get more PEP kits out there and inform the public of the treatment option—the difficulty is getting people to come forward within the 72 hours for PEP,” she says.
Nakamina also called for keeping the DRC conflict and gender-based violence on the world’s agenda. While global attention focuses on other conflicts, the war that’s over in name only continues to terrorize civilians and spread HIV. And as most Americans forget about the destruction of New Orleans, another preventable disaster whose impact continues to increase in many ways, Gulf Coast survivors still fight for their homes.
As AIDS activists and human beings, we can never forget to honor the dignity of all displaced and brutalized people in the U.S. and around the world, listening as communities define their own needs and offering our solidarity, rather than patronizing charity.