U.S. Troops Deploy to Central Africa to Fight Sexual Violence

Restoring stability could increase access to critical health care in the region
The U.S. government is deploying 100 troops to Central Africa to help fight the Lord’s Resistance Army (LRA), a decades-old organization notorious for rape, sex slavery, and other forms of violence against women. The troops will be armed for self-defense but will primarily advise regional military forces in hunting down the leader of the LRA, Joseph Kony, who became the International Criminal Court’s first indictee for war crimes about 10 years ago.

Since 1987, the LRA has terrorized civilian populations throughout the central African region, including parts of Democratic Republic of the Congo, northern Uganda, South Sudan, and the Central African Republic. Over the years, tens of thousands of children have been abducted to serve as child soldiers, women and girls were enslaved for sex, while tens of thousands more were disfigured or killed. Those who have been displaced by the violence continue to live in refugee and displacement camps with little opportunity for education, work, or proper health care.

While it will inevitably take time, restoring stability in the region is a prerequisite for improving physical security and developing roads and other critical infrastructure that are key to expanding people’s access to medical care. This includes access to quality reproductive health care, a goal that EngenderHealth works to achieve in both Uganda, the DRC, and throughout Africa. EngenderHealth’s Fistula Care project supports health centers in both Uganda, where the LRA originated, and the DRC, where the group continues to operate today. The project focuses on providing treatment for women living with fistula resulting from both obstetric and traumatic injury. Read a story about EngenderHealth-trained fistula surgeons in the DRC.

Some consider President Barack Obama’s deployment decision to be a positive sign that the United States will not tolerate sexual violence in Africa. The decision to deploy is consistent with legislation in Congress, the “International Violence Against Women Act” (IVAWA), which aims to establish gender-based violence as a top priority for U.S. foreign policy. IVAWA passed in the Senate Foreign Relations Committee in December 2010 but failed to pass in the U.S. House of Representatives.

Fistula in the Congo: A Response to Nick Kristof's Feb. 7 Column

It’s shocking what’s happening every day in the D.R. Congo. The sexual violence is shattering to both women and their communities. But people like Dr. Mukwege prove that we are not powerless and something can be done about it. It’s so important to support health facilities like Panzi Hospital and doctors like Denis Mukwege—who are beacons of light in a tremendously bleak environment.

EngenderHealth supports Panzi Hospital and another hospital in the Congo, HEAL Africa, through the Fistula Care project, funded by USAID. These two facilities are centers of excellence for fistula repair, drawing women from all over the country and region in need of treatment.

With USAID support, doctors and nurses at Panzi and HEAL Africa have been trained to strengthen maternal health and fistula repair services—dedicated, local professionals who will be there for the long haul. In addition, the project ensures that women have transportation to the hospital for treatment and helps them reintegrate back into their communities once they have had surgery.

Obstetric fistula also occurs when women can’t access timely emergency obstetric care—namely, cesarean sections—during long or obstructed labors. With better maternal health care, obstetric fistula cases (which still make up the majority of fistula cases in the Congo) could be averted altogether. To prevent such fistula cases in Congo and elsewhere, we work with doctors, nurses, and midwives to help them better manage complicated pregnancies and births. At the community level, the project helps rural health workers refer pregnant women with complications to hospitals that can provide comprehensive care.

Strengthening health systems by building on existing resources is the best way to both treat women with fistula and prevent new obstetric fistulas cases. And a holistic approach that improves fistula prevention—by improving maternal health care and reducing sexual violence—is crucial. In terms of providing surgical repair, it’s important to keep in mind that the vast majority of fistula surgeons live and work in the developing world. Seeing fistula cases on a daily basis, local health providers should be supported to treat and prevent fistula. It makes sense to enhance the capacity of in-country health care professionals like Dr. Mukwege who can make lasting changes, both in their country’s health system and in the lives of women and their families.


Bethany Cole
Senior Program Associate
EngenderHealth

(This post appeared February 11 as a comment in response to Nick Kristof's column in the New York Times.)