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Sexual violence: the healing imperative

How far do our post-conflict reconstruction efforts go when it comes to addressing the trauma and loss that women and girls experience during conflict? Jessica Horn reports ahead of the Nobel Women’s Initiative conference on ending sexual violence in conflict

“The context is the scar” once reflected Guatemalan Nobel Women’s Laureate Rigoberta Menchú Tum. Her enigmatic words have haunted me as I have listened to testimonies of women survivors of conflict in West and Central Africa over the past four years; testimonies that give witness to the truism that conflict does not end when warring factions agree to lay down their arms. The residues of violence, trauma and unimaginable loss remain in the bodies and minds of women and girls who continue to live in contexts where many of the elements of conflict- interpersonal violence, disrupted economies and poor or absent public services- persist.

Traces of trauma line accounts like that of a Liberian woman who was forced by rebels to watch her family being sexually assaulted and killed and then cook the remains for the rebels to cannibalise, and of a Ugandan woman who became HIV+ after a gang rape by soldiers, was chased away from her husband’s house and eventually made a home in a disused anthill. These details are not to shock but rather to underscore a blunt question- how far do our post-conflict reconstruction efforts go when it comes to the unimaginable trauma that women and girls experience during conflict? How deep are our interventions when it comes to complex terrain of mental health and emotional well-being? Amidst all of the investments that the international community and relief and development organisations place in the infrastructure and governance of fragile states, to what extent do we consider the “fragile states” of women’s hearts?  Can any community truly either reconcile or be reconstructed without excavating the fraught well of despair that conflict digs?

As civil society and governmental actors alike, how do we balance the individual, often diverse support needs of women survivors of sexual and other violence, with our predefined strategies and timelines for transition? We talk healing, but I have a sneaking feeling that many of us wish survivors would just “move on”. And indeed people who have survived conflict often do just that. As Sierra Leoneans love to joke- “we are all Managers here! We just have to manage”.

How deep do we go?

It is a triumph that sexual violence in conflict is finally not only legally recognised as a tool of war and a crime against humanity, but now deemed a ‘legitimate’ topic of debate in the UN Security Council. A women’s lobby around the International Criminal Court is working to ensure that those who bear the greatest responsibility for war crimes are tried for gender-based crimes; while women’s rights activists across the world continue to press for full resourcing and implementation of UN Security Council Resolutions around women, peace and security. Activists also continue to call for a complex analysis of the impacts of sexual violence- for example the intersection with HIV/AIDS.

From the ‘ground’ view however and despite the emerging political will, it seems that the architects of many large-scale reconstruction interventions are still at a collective loss as to what to do with the human impacts of the “aftermath”. In the many testimonies of women survivors that I have heard, the process of emotional transformation is almost always told through two moments- one is of another woman befriending them and giving them strength to live, and the other is the process of being born again as a Christian. Although anecdotal, this begs the question of why it is that we then fail to adequately resource women’s community-based responses, and whether religious institutions are standing alone in the organised response to women’s trauma, at least on a mass scale. 

There are some notable examples of quality work done around sexual violence-related trauma – the most striking in my experience is the work of the Uganda-based international women’s organisation Isis-Wicce. While documenting testimonies of conflict-affected women, Isis-Wicce’s staff felt that they could not just stand by in passive witness- something needed to be done to address the direct impact of the violence experienced by the women they were interviewing. Out of this they have developed an integrated model which combines gathering rigorous statistical documentation of violations with psychological and gynaecological assessments, and a follow-up process of advocacy, providing direct services, and training health providers to carry on the mental health support. This is fantastic work, done on a miniscule budget.

The difficulty of course, from an NGO perspective, is that healing from violation is a long and complex process-  something that can take a lifetime, and often requires ongoing support, not least for the fact that survivors may go on to experience new traumas as violence continues or amplifies in ‘peacetime’.  Indeed, in some respects the challenge of responding to trauma and the aftermath of conflict-related sexual violence is comparable to the HIV/AIDS epidemic in Africa, with community care givers- typically women and often grandmothers - picking up the typically unpaid daily work of sustaining individual and community well-being, while ‘high level’ debates and resources flow to large-scale policy and services. 

A question of methods

We know that depression, suicidal thoughts, self –harming and self-neglect are all among the expected and common experiences of women and girls who have survived violence. And in response, psycho-social support is typically included in the list of best practice methods for addressing sexual violence. On the ground there are scant resources to conduct this healing work, both in terms of funding and in the sense of professionals trained in appropriate, holistic and dare we say it, women-centred methods of psychological support. 

In framing healing through the lens of mental health alone, we of course run the risk of over-medicalising and over-individualising issues which may in fact have non-medical and community solutions. For example, an innovative funding initiative by the Urgent Action Fund-Africa, a Nairobi based women’s fund, proved that restoring women’s economic independence and ability to earn a living is a key element of enabling women to regain their sense of self and status as ‘productive’ members of the community, and to confront HIV and rape-related stigma. The initiative provided direct financial support to organisations of conflict-affected HIV+ women in Uganda, Kenya, Liberia and Zimbabwe.

Deep healing

I am a firm believer in supporting people’s own capacity to confront the injustices and violence in their lives, rather than imposing efforts and models which people might politely accept but ultimately fail to lead to meaningful change. In that light, is critical that we give greater value to women’s community-based efforts to recreate community, and provide support and solace. It is equally vital that we work with the small but critical community of mental health, counselling and “barefoot psychology” practitioners to strengthen understandings of what healing from sexual violence means for women in conflict-affected contexts, and how to better support this vital work. Indeed, echoing Irish Nobel Laureate Mairead Maguire’s call to engage deep democracy, it seems that we need to start making more serious investments in the process of deep healing, simultaneously providing tools and spaces for people to work through their trauma, while addressing the ongoing traumas of the ‘context’, including ongoing threats and impunity around violence against women and girls.

I will be reporting next week from the Nobel Women’s Initiative’ conference on “Women Forging a New Security: Ending Sexual Violence in Conflict”.  I look forward to threads of discussion around engaging the scars in the internal landscapes of individual survivors of sexual violence, and, critically, ways we can intervene to prevent the underlying wounds in the first place.

To read openDemocracy's full coverage of the conference click here


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