Congo: 'Sexual terrorism' in South Kivu leaves HIV in its wake

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BUKAVU, 22 October (IRIN) - In 2004 the United Nation's World Health Organisation estimated there were 25,000 survivors of sexual violence in South Kivu, the Democratic Republic of Congo's eastern province, but those working to rebuild shattered lives consider this a fraction of the real number.

"I have no doubt that over 100,000 women have been raped in this province," said Christine Schuler-Deschryver, of the German Technical Corporation (GTZ), who remained in Bukavu, the provincial capital, during the war, and registered more than 14,000 rape survivors.

The people of South Kivu lived through 10 years of unfathomable violence inflicted by foreign rebel groups and Congolese militia as they fought each other. Most notorious are the Forces Démocratiques de Libération du Rwanda (FDLR), comprised mostly of Rwandan Hutu militiamen who fled across the border after the 1994 genocide in their country. Many local people blame them for spreading the virus.

"It was the Interahamwe [Rwandan Hutu génocidaires] that brought AIDS," said Honorata Zakumwilo, 54, who was raped and tortured by the Interahamwe for 14 months. "They would cry out 'A manger' [food time] but they weren't calling for dinner, they were calling for us." The sexual atrocities and humiliation Honorata was subjected to are hard to comprehend. "We were sexual slaves, but simply raping us wasn't enough."

Precise statistics are impossible to compile. An overwhelming sense of shame and guilt stops many women admitting to their ordeal, and areas in the province remain insecure.

Schuler-Deschryver is convinced that the widespread sexual violence committed across the eastern region has nothing to do with satisfying sexual needs. "People don't realise they are using rape as a weapon of destruction - it's sexual terrorism."

GTZ supports the local nongovernmental organisation, Commité de Rayon d'Action Femme (CRAF), in counselling known rape survivors who are reluctant to seek medical attention after the trauma of sexual abuse, and who may also have to face having contracted sexually transmitted diseases.

According to Aldegonde Kyakim, project director at CRAF, there has been a marked increase in HIV rates directly linked to rape.

"From the blood tests carried out on sexual violence victims, we see a prevalence rate varying from five to 15 percent," Kyakin said. She believed the fluctuation to be largely due to geographical location and the armed groups operating there.

"The highest prevalence rate of 15 percent is among women raped by the FNL [Forces nationales de liberation] from neighbouring Burundi, while those believed to have been raped by the Interhamwe have an estimated prevalence rate of 10 to 12 percent," she said.

Official 2005 figures from the National Programme for the Fight Against AIDS (PNLS) put the infection rate among South Kivu's rural population at 4.5 percent.

The conflict has directly contributed to the spread of HIV in South Kivu, said Dr Rebecca Adlington, a medical supervisor and HIV/AIDS specialist with Medécins Sans Frontieres (MSF) in Bukavu.

"In the South Kivu territory of Uvira, the sero-prevalence among blood donors in 1994 was five percent, yet by 1998 the prevalence rate among donors was up to 12 percent, so you have to ask yourself, 'why?'" Adlington said.

"This was not a sample group who considered themselves at risk. In general, they were relatives of those who needed blood. Something was spreading the virus, and it was more than likely the military and armed groups."

Women seeking medical help as a result of injuries sustained during rape, or found by organisations like CRAF, are taken to Panzi General Hospital, high in the hills outside Bukavu.

Many arrive suicidal, said Dr Cecile Kamwanya, head of the hospital's psychological support programme. "Marginalised by their family and community, raped women feel they have committed a wrong. A raped woman is worthless to her family. There's nothing worth living for in their eyes."

The hospital performs up to 100 operations a month on women in need of reconstructive surgery; each woman brought through the hospital doors receives trauma counselling and is encouraged to take an HIV test. "Nearly all accept," said Kamwanya. "It's even the first thing some demand when they arrive."

War has destroyed health services in South Kivu and prevented local and international organisations from running HIV/AIDS sensitisation programmes in rural areas. Tens of thousands of sexual violence survivors live unaware of the risks of infection and are unable to access the limited care and treatment programmes available in and around Bukavu.

The longer the province's health services remain woefully inadequate, health workers fear, the further HIV will embed itself in communities.

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