‘You say rape, I say hospitals. But whose voice is louder?’ Health, aid and decision-making in the Democratic Republic of Congo

Abstract

In the last decade, scholars and humanitarians have rightly drawn attention to the high rates of gender-based violence in the eastern Democratic Republic of Congo (DRC), which are associated with the high levels of conflict in the country since 1996. However, this focus detracts from the general health problems that stem from the deterioration of the health sector, which began long before the outbreak of war. This article analyses local perceptions of the determinants of maternal health and illness in eastern DRC, and identifies ways in which women cope with barriers to health care that derive from an inadequate and/or absent health-care system. The article demonstrates that in both urban and rural locations in all four provinces of eastern DRC, women have organised to address their own vulnerabilities, which, according to them, amount to more than exposure to gender-based violence. The existence of these informal systems demonstrates the need to reassess the image of Congolese women as primarily passive victims and/or targets of violence. The article suggests that these culturally rooted indigenous solutions be evaluated as worthy recipients of development funding, which is often exclusively offered to international organisations.[« Vous dites viol, je dis hôpitaux. Mais qui parle le plus fort ? » : La santé, l'aide et la prise de décision dans la République Démocratique du Congo]. Durant la dernière décennie, les érudits et les humanitaires ont correctement attiré l'attention sur les taux élevés de violence sur la seule base du genre dans l'est de la République Démocratique du Congo (RDC), qui sont en lien avec les hauts niveaux de conflit dans le pays depuis 1996. Pourtant, cette attention sur les violences sexuelles détourne l'attention qui devrait être portée aux problèmes sanitaires généraux qui sont dus à la détérioration du secteur de la santé, qui a commencé longtemps avant l'émergence de la guerre. Cet article examine les perceptions locales des déterminants de la santé maternelle et de la maladie dans l'est de la RDC et identifie les manières avec lesquelles les femmes s'adaptent aux difficultés d'accès aux soins de santé qui résultent d'un système de santé publique insuffisant et/ou absent. L'article montre que dans les zones tant urbaines que rurales et dans les quatre provinces de l'est de la RDC, les femmes se sont organisées pour faire face à leurs propres vulnérabilités, qui, selon elles, représentent un problème plus important que l'exposition à la violence fondée sur le genre. L'existence de ces systèmes informels démontre le besoin de reconsidérer l'image des femmes congolaises comme étant en premier lieu des victimes passives et/ou des objets de violences. L'article suggère que ces solutions culturellement enracinées dans le modèle local pourraient être évaluées

War rape survivors of the Second Congo War: A perspective from symbolic convergence theory

“…A recurring theme about rape as an illness in the eastern DRC indicates that Congolese women associate satanic glitches in health-care delivery with higher chances of getting STDs. Too many women do not realize that war rape itself can get them STDs (D'Errico et al 2013).…”

“…This has decreased the level of stigmas encountered by individuals through the development of organizations. These include Children's Voice in North Kivu, the Program for Promotion of Primary Health Care and the Support and Promotion of Women's Initiatives (D'Errico et al 2013). …”

“…The community's inhabitants have petitioned for United Nations' officials to manage rape perpetrators from the Democratic Forces for the Liberation of Rwanda so that soldiers can come and occupy the same residence. As such, Congolese women believe that if the community does its part in movements like constructing homes for soldiers, violence can be deterred as long as they confiscate their arms (D'Errico et al 2013).…”

Beyond the hype? The response to sexual violence in the Democratic Republic of the Congo in 2011 and 2014

“…Second, sexual violence overshadowed killing, maiming, torture, and all other conflict‐related traumas (Autesserre, ), and the crime was treated as the worst thing that could happen to a woman. Medical services often were restricted to sexual violence, disregarding other health needs among the population (D'Errico, Kalala, and Nzigire, ). Attention to sexual violence even obstructed the reorganisation of the armed forces and other institutions responsible for securing the rule of law and potentially preventing such action (Baaz and Stern, ).…”

Organizing Hypocrisy: Providing Legal Accountability for Human Rights Violations in Areas of Limited Statehood

“…For instance, there is a common perception that, in order to receive international funding, domestic organizations must have an SGBV component to their work. In some instances, this has led organizations to abandon other important development programs (such as those involving maternal mortality or access to healthcare—see D'Errico, Kalala, Bashige Nzigire, Maisha, and Malemo Kalisya ), and in others it has led to the alleged over‐reporting of rape statistics in efforts to attract additional funding (Douma and Hilhorst ; Heaton ). Moreover, the disproportionately high SGBV caseload in DR Congo's criminal courts devalues other crimes, sending the message that rape is the only crime taken seriously by law enforcement agencies.…”