Rwanda

Rwanda: Broken bodies, torn spirits - Living with genocide, rape and HIV/AIDS

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News and Press Release
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Originally published
A new 96-page report from African Rights, released on 15 April 2004
For the full significance of the national and international commemoration of the 1994 genocide in Rwanda on 7 April 2004 to be realized, African Rights believes we must all focus our thoughts upon the ongoing needs of genocide survivors and make firm commitments to their welfare and rehabilitation. In the past decade, there has been time to document thousands of genocide crimes and prosecute some of their perpetrators as well as to study the roots of the genocide. Buildings and systems have been restored. There has not, however, been enough thought and resources given to healing the wounds of survivors. Many say that for them it is as if time has stood still-their everyday lives are still dominated by the genocide. Much has been already said about the legitimacy of their case for compensation, but much more must urgently be done. We issue a special plea to the international community to recognize in particular the unbearable suffering endured by the survivors of genocide and rape and their immediate need of assistance. African Rights' latest report, Broken Bodies, Torn Spirits, Living with Genocide, Rape and HIV/AIDS provides detailed testimony of their condition; most are in ill health and any substantial endeavour to help them must begin now.

The Courage to Speak Out

For rape victims, reliving their assault and describing its consequences, as they do in Broken Bodies, Torn Spirits, is agony. Yet 201 of them were willing to speak out. There are many reasons why their testimonies are important. In particular, women offer insights into attitudes and emotions that must be taken into account if initiatives to combat sexually transmitted infections and HIV/AIDS are to succeed. They also reveal missed medical opportunities and humanitarian failures and explain the social and economic costs which can result from rape. Not least, they articulate the trauma and pain that, in Africa, most rape victims bear in silence; in so doing they challenge social constraints which allow rapists to benefit from impunity.

Women give courageous and informative accounts, but in reality they are speaking principally out of desperation, through poverty and illness. They need help, and unless they receive it, the inadequacy of human rights reporting in this context raises profound ethical questions.

This is not the first time African Rights has documented the plight of rape victims in Rwanda; several other organizations and individuals have also drawn attention to their situation. But awareness has not translated into comprehensive action. Admittedly, there has been no shortage of priorities for assistance in Central Africa in the years since the genocide. While recognizing the scale of human suffering across the region, we find that genocide rape victims in Rwanda lead a uniquely troubled existence and many feel their survival is "another form of martyrdom." After enduring ten years as a "living dead person", in the words of one victim, they are exhausted.

No one can revive the millions killed in genocide and conflict over the past decade in this region, but it is not, in our view, beyond the capacity of governments, international agencies and non-governmental organizations (NGOs), working together, to restore quality of life to these women, who make up a tiny percentage of Rwanda's population. African Rights' report identifies their problems and possibilities for addressing them.

Records of Rape

Rape was prevalent during the 1994 genocide in Rwanda-the youngest victim interviewed was just six in 1994, and the oldest was aged 71. Some were pregnant when raped and others became pregnant as a result. Many of the women were subject to repeated attacks. Moreover, rape was invariably one element in a succession of traumatic episodes, including other forms of abuse, terror, betrayal, bereavement and displacement. One woman, Josette, had gone to her home sector of Sahera in Butare, hoping it would be safer than Kibungo, where her husband had been murdered. But three days later, she and her sisters were raped. This was the beginning of a pattern of attacks, so frequent Josette can barely recall the details, let alone recognize the perpetrators. "They transformed their act of violence", she said, "into a habit, like drinking water." She tries not to think about this period of her life.

I was raped by a lot of people and at different times. I can't think how many times. Each time that the killers found me in the sorghum field or in the house, they did nothing but rape me.

Details of the abuses included in the report illustrate, in the most graphic manner, how conflict itself spreads sexually transmitted diseases and HIV/AIDS. Governments must show unwavering commitment to pursuing peaceful mechanisms for conflict resolution; to better education and training of their armed forces; and to bringing perpetrators of rape to justice.

The Physical Costs

HIV/AIDS

In the stories of HIV-positive women, there are several obvious examples of how the disease is spreading, not just through ignorance, but also through neglect. Looking at lives from the outside, it is apparent that mistakes have been made, both by the medical practitioners women have consulted in the years since the genocide, and by the women themselves. A series of pressures condition women's lives; the tragic reality is that most exist in a world empty of choices.

Grâce from Tumba in Butare has to find treatment both for herself and her child. She explained how first she, then her 15-year-old daughter-also a victim of rape-came to take an HIV test and the consequences of the diagnosis. Grâce broke down during the interview and was unable to finish telling her story.

After the genocide, I often had difficulties with sinusitis, but I hadn't thought that I might have caught AIDS. Staff from AVEGA came and raised our awareness about the need for taking an HIV test. We asked to be tested. I hadn't really ever thought that the results would be positive. I was just taking the examination to show that I was heeding their advice. To my great surprise the results came back positive. I can't explain how I felt at the time. I then sent my daughter to be tested and she too was diagnosed as HIV positive. For the time being she's returned to school. She's working well in class, even though she's very ill.

Grâce's attitude to anti-retrovirals was instructive. She does not even see the point in seeking help.

I've never thought about taking anti-retroviral drugs. I don't even believe that they work. I'm convinced that there's no drug that can fight AIDS. In my case, only God, who knows that it wasn't my fault that I caught this virus, could perform a miracle and heal me. I find it totally inconceivable that I have AIDS and I avoid thinking about it a lot.

Even when women are aware of the issue, establishing their HIV status is not a straightforward matter, as Alodie's experiences illustrate. She sought treatment after the genocide. One of the worrying aspects of her story was the fact that although she felt very unwell and the doctor prescribed her drugs, she says she was never informed of his diagnosis. She went on to marry and have children, but her health continued to deteriorate. Soon they discovered her husband was ill, but again, she says, they were not told what to expect.

With my first pregnancy, I was still having gynaecological difficulties, but this time it was worse. I returned to the doctor and my husband went with me. They took a blood sample from my husband and told us that he had an illness, but again didn't say which one. The doctor prescribed us more medication. Throughout the pregnancy I was afraid of a miscarriage, right up until the time the child was born.

Whenever my husband and I had sexual relations, my illness would recur. I kept going back to my doctor, and he kept prescribing medication for me. My second and third pregnancies were the same.

Eventually, following the birth of her third child, both Alodie and her husband were tested for HIV/AIDS at Butare University Hospital. She described the process and its impact on their family life.

When we went to collect our results, the doctor asked me what I would do if I had contracted the AIDS virus. I replied that I would probably commit suicide. So the doctor said that the results weren't yet back. Two months passed by and I was none the wiser.

I was worried because my husband had got his results back, but had hidden the fact that he was HIV positive from me. I decided to get tested again in Kabutare. This time I got the results the same day. I was frightened, and I had every reason to be. The results proved positive. I passed out. When I regained consciousness I took a bike taxi and went home.

The means to help women find the emotional and physical strength to deal with HIV infection must be found, on behalf of individuals and African societies as a whole. Education about safer sex is important, but so is generating hope. HIV/AIDS is seen as a demonic force and at the moment people have no weapons to fight it. The result is suspicion, nihilism and denial. Broken Bodies, Torn Spirits echoes calls to provide cheap anti-retrovirals across the developing world. The prospect of treatment is the best means available to persuade people that there is a chance they can manage their illness. The argument that ultimately some individuals may not be candidates for anti-retroviral treatment, and that more limited palliative care may provide the best medical approach, should not be a distraction. Anti-retrovirals are a means to stimulate a collective mental shift, taking AIDS out of the supernatural and into the medical realm. Used properly, which includes ensuring a sufficient supply of nutritious food, they could have an impact well beyond the individual cases treated with the drugs.

In the Dark: Fear and Powerlessness

Almost all of the HIV-positive women interviewed were ill. It would be wrong, however, to assume that the rest are in a much better situation. Whether HIV positive, negative or unsure of their HIV status, the majority of women we spoke with felt unwell at the time of the interview. One woman after another described similar symptoms-stomach pains, discharge, repeated infections, urinary and gynaecological complications and skin eruptions. Even those who had tested negative for HIV saw the rape as the cause of their ill health and struggled on from day to day with little expectation of recovery.

Often women were aware of the risk that they may have contracted HIV/AIDS, but hesitated to take the test. Their reluctance stems mainly from the sense of powerlessness they feel in relation to all aspects of their lives, and particularly with regard to HIV/AIDS.

It is discouraging, from the perspective of the women interviewed, that there is a cost involved in HIV testing; that transport is usually needed to get to the right hospital or clinic; that there is a delay in collecting the results; and that more than one test is needed to confirm a negative result. These difficulties might in many cases be surmountable, were they not overshadowed by two fundamental deterrents-the stigma associated with HIV infection and the fact that treatment is inaccessible or inadequate. Until women are given a real sense of hope, that by taking an HIV test they will access treatment and support, it is understandable that some prefer to remain in the dark about their HIV status. Adèle was gang-raped during the genocide but has lost the will to try and fight her current illness.

I haven't gone for a medical examination. But I'm very unwell with a cough that won't go away. I am getting thinner from one day to the next. I've had enough of life. It means nothing to me.

Fragile Health

Numerous women still live under a constant shadow of pain or discomfort which reduces their capacity to work, look after and provide for their families. They are either not receiving treatment or have not been diagnosed and treated properly. Medical care for genocide rape victims in Rwanda can be summarized as "too little, too late." In particular, women found to be infected with a sexually transmitted infection (STI), at one time or another after the rape, had usually received treatment, yet continued to suffer the same symptoms.

Dévota was raped as a young child of seven; the direct consequences for her health have been debilitating. Reunited with her mother after the genocide, Dévota has been taken to the doctor regularly with the apparent lingering symptoms of an STI, despite treatment. She does not appear to have been informed of the specific cause of her illness. However, she has been tested and is not HIV positive. She is now in fifth year of primary school, having had to repeat several times due to frequent absence. Her mother is working and looks after her, but despite visits to the doctor Dévota remains unwell.

These pains even prevent me from sleeping. I cry out very loudly. So I have to consult a doctor.

I've hidden my story from the other children. I don't want them to make fun of me. They could say that I'm a woman. None of them went through the same thing.

The Emotional Costs

All the women included in this report are deeply traumatized and it is likely that most are clinically depressed. Some received limited counselling, but efforts to repair the emotional damage in the Rwandese context meet with a series of complexities, unique to genocidal rape.

Victims have to contend with their ongoing grief, fear, disappointments over the past decade and anger towards genocide perpetrators and those they consider their sympathizers. Rapists frequently insisted that they were "saving" women, by taking them as "wives." Some killers considered rape a profound torture and left women alive so that they would suffer enduring pain and loss. But a contrary view-that the victims of rape were fortunate to be spared-also prevails. On occasion women were offered a direct choice between death and rape, but even when they were not, they often feel confused emotions about their survival. Véronique was raped by so many men that she lost consciousness only to wake up and witness the killing of people around her at the commune office in Muhazi, Kibungo. She was beaten again, and then stayed among the corpses for three days.

Today I regret that I didn't die that day. Those men and women who died are now at peace whereas I am still here to suffer even more. I'm handicapped in the true sense of the word. I don't know how to explain it. I regret that I'm alive because I've lost my lust for life. We survivors are broken-hearted. We live in a situation which overwhelms us. Our wounds become deeper every day. We are constantly in mourning.

Shared Concerns

Whether young or old, infected by HIV/AIDS or not, the outlook shared by these women is bleak. They do not expect to live long and their greatest fears are for their children. Most of the women we spoke to were single mothers; many were also caring for orphans. They all fear for their children's future and those who are very ill or have tested HIV-positive worry intensely. Azelle, HIV positive and the sole carer for two children aged 15 and 12, cannot see a future either for herself or for them. They are in school but are neither fed nor dressed properly.

The children come home at midday, like the others, and return to school without having had anything to eat. How are they ever going to succeed in such a situation? It's very hard.

When the children talk to me about their life, it hurts me as I realize that I can't help them. I go to bed and cry, because I have no solution.

Women universally felt their children's prospects were grim-and not without reason. Terminally ill women need to be given help to plan for their children's life when they are gone.

Commonly, women believe that if they had a home to leave to their children they would be more secure, but most were in temporary, rented or shared accommodation. The predicament of displacement and insecurity they share is by no means unique to rape victims and is not directly related to the violation. But it contributes to their despair.

Rape victims have largely withdrawn from society and their isolation increases their vulnerability. Alongside their own hesitancy to get involved in their communities, and an important factor in shaping their attitude, is the hostility they have encountered from certain groups or individuals. This has been very destructive to their confidence and sense of well-being and, for some, it has seemed the final proof that there is no place for them in this world. Chantal admits being scared of her neighbours, though she recognizes that they also fear her.

We live together with our Hutu neighbours, but they don't trust us. They say that since they killed our people, we don't want them to live either. They say that if we don't kill them today, we will do so tomorrow. When they see anyone asking us questions, they're frightened that we're going to testify against them.

Victims are seeking justice and their bitterness at its limitations is profound. In Rwanda, there has been a serious and concerted attempt to eradicate impunity for rape crimes. But, even in this receptive atmosphere, rape is a uniquely difficult crime to prosecute. Many cannot identify the men who tormented them, and in the process they may be subject to further humiliation and pain. Women spoke about their attempts to bring prosecutions, not only for the crimes committed against them personally, but also against their immediate family. Most were disappointed-several expressed anger about recent prisoner releases-and some had become targets as a result of their determination to pursue justice. Adèle, for instance, is still subject to threats and condemnation.

The neighbours wouldn't even give me water because I denounced their husbands to the judicial authorities. They always threaten me, saying that they're going to throw stones at my house and that if I ever cried for help, they would say that I'm mad.

Assistance

For many women, survival depends upon piecing together shreds of assistance from various sources, with few consistencies and constant uncertainty. Cécile's example is typical; she rents out her family fields, which brings in a small income and neighbours assisted her in putting up a makeshift home, the roof made of tent canvas. But given the importance of providing housing, food and education for the children and looking after her own health, Cécile finds it impossible to make ends meet.

Avega [Association of the Widows of the Genocide] gave me 20,000 francs in 2000, and pastor Jean Gakwandi, who works for the Solace Ministries of the Episcopal Church, donated goats to some of us. Kanyarwanda helps us too; the first time they gave us five kilos of rice and sugar, the second time 10 kilos of sugar, one kilo of milk, 10 kilos of maize flour, 10 kilos of sosoma, 10 packs of washing powder and one litre of oil. The third time I was ill so I didn't participate in the meeting.

What I'd like is to have a house, medicines to ease the damaging effects of AIDS, clothes for the three orphan children that I look after and money for their school fees. I also need something to help me make a living.

Women's associations are, at present, the main source of assistance for rape victims and women living with HIV/AIDS; both in Rwanda and Burundi they have proven their value. In terms of education and moral support they provide a critical link between women and services and must be encouraged and facilitated. Over the last few years, organizations such as Avega and the Society of Women Against Aids in Africa (SWAA), which exists in both Rwanda and Burundi, have gradually developed and strengthened programmes aimed specifically at rape victims, particularly as their own members began showing the signs of HIV/AIDS infection. Women draw strength from their relationships with other victims. As they find it so hard to relate to other people, these networks introduce essential constructive and positive aspects to their lives.

The results are generally commendable, both at a practical and emotional level, although not all programmes have been equally successful. Among the weaknesses are that women in rural areas are the least likely to receive help and there is an overall lack of consistency; both are usually related to financial constraints. Women have generally only received intermittent, partial or temporary assistance for persistent, all embracing and terminal problems.

Recommendations

There is reason to hope for imminent improvements in the arena of HIV/AIDS education, care and treatment in Rwanda, although without further and dramatic reductions in the cost of anti-retroviral drugs, these will struggle to keep pace with the spread of the disease. A comprehensive national approach is essential, and the Government of Rwanda has expressed its commitment to tackling the crisis openly, while new initiatives on the part of the international community demonstrate their increased concern about this issue. But while the programmes for People Living with HIV/AIDS will scale up, the assistance available to genocide survivors as a sector of Rwandese society is unlikely to do the same without a corresponding resolve.

The comments and experiences of most genocide rape victims suggest that they will never feel comfortable in groups where there is a possibility of meeting relatives of the men who raped them, or simply of exposing themselves to a community they believe betrayed them. Assistance needs to be targeted specifically and separately at these women. This recommendation is not contrary to the promotion of tolerance and unity, nor should it be considered discriminatory towards others. Genocide rape victims include both Tutsis and many Hutu widows, persecuted along with their Tutsi husbands. Providing effective and appropriate support systems for these survivors is an essential gesture of respect to people stripped of all else.

African Rights' research offers a strong endorsement of the work of women's associations for genocide rape victims. Future programmes for HIV/AIDS sufferers in Rwanda should work with these groups to address the crisis within the communities they serve. There is undoubtedly scope to build on existing associations and to form new ones in outlying areas. We can only hope that this report will help stimulate action to alleviate the economic and emotional deprivation of rape victims in Rwanda and in the Great Lakes region.

To receive a PDF copy of the complete report, please contact African Rights' office in Kigali.