War, Rape and Genocide: Never Again?

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					War, Rape and
Never Again?
  Martin Donohoe
        Special Thanks To
    Sidel and Barry Levy (War and
 Vic
 Public Health)

 Photographers James Nachtwey,
 Sebastio Salgado, and others
 Sudanese genocide
 History of wartime violence against women
  in the 20th Century
 VAW in the U.S. military

 War and “Masculinity”

 The Nature of Violence and Rape in War
 Health Consequences
 Refugee Camps

 Human Rights Issues

 Role of Health Professionals

 Conclusions and Recommendations
             Darfur, Sudan
 As many as 300,000 - 450,000 deaths over
  last two years (most from disease)
 2.7 million in refugee camps
 Government-supported, Islamic Janjaweed
  militias responsible for killing Black
 Arms sales to Sudan from China, Russia,
  France, Iran, Saudi Arabia, Belarus, Poland,
                Darfur, Sudan
   Bush administration called situation “genocide”,
    yet failed to act substantively
   Bush administration relied on Sudan, which used
    to harbor Osama bin Laden, for military
   Obama administration has failed to act
    significantly, despite 2010 mass rape/indictment
    of warlord
            Darfur, Sudan
 Bipartisan Congressional Research Service
  reports administration concerned that
  holding Sudanese officials accountable
  could “disrupt cooperation”
 Nevertheless, mild economic sanctions and
  travel restrictions enacted in May, 2007
 Election to form Southern Sudan (1/11)
  may bring peace
        Democratic Republic of the
             Congo (DRC)
   “Africa’s World War”
   Between 700,000 and 3 million deaths
   2 million displaced
   1.7-1.8 million women raped; 3.1-3.4 million
    victims of IPV
       2011: 48 rapes/hr
   Unraveling of civil society
   Life expectancy for those born in 2011 = 40
 250 wars in 20th Century
 Most conflicts within and between small
 Many in sub-Saharan Africa

 85-90% of casualties among civilians

    Opposite at end of 19th Century
           Infamous Genocides
   China (under Mao), late 1950s – early 1970s: 30
    million killed
   USSR (mostly under Stalin), 1920 – mid 1950s:
    20 million killed
   Germany (under Nazis), mid 1930s – 1945: over
    11 million killed
   Japan, late 1930s – mid 1940s: 10 million killed
   Women considered spoils of war
     Abduction of Helen of Troy

     Rape of the Sabine women

   Hundreds of thousands raped in 20th
    Century conflicts
       History - World War II
 Rape widespread on most sides in World
  War II (Americans = least common
 Japanese soldiers forced between 100,000
  and 200,000 women into sexual slavery
  (“comfort women”)
    *Korea, Burma, China, Holland,
     Indonesia, Phillipines
         “Comfort Women”
 Some underwent forced hysterectomies to
  prevent menstruation, make them
  constantly “available”
 More than half died due to mistreatment
               “Comfort Women”
   3-5 year detention
   5-20 rapes per day
   For 3 yrs of enslavement, low estimate is 7500
    rapes per woman
   Japan has not compensated any victims
       Historical blindness to atrocities
 Vietnam War
    Perpetrators included U.S. soldiers

    Few brought to justice

 1971: Bangladesh War for Independence

    200,000 - 400,000 girls and women raped
     by Pakistani army
      25,000 pregnancies
   1994: Rwandan genocide
      At least 250,000 women raped

   1990s: ethnic cleansing in Bosnia
      >20,000 Moslem women raped

   Other 20th Century conflicts: civil wars in
    Liberia, Sierra Leone, Somalia, Egypt, Libya,
   2000s: Well-documented, credible allegations of sexual
    humiliation and rape against female detainees at US
    facilities in Afghanistan and Iraq
   Iraq’s Abu Ghraib prison: sexual humiliation, forced
    homosexual poses
   Guantanamo Bay prison: Muslims taunted with fake
    menstrual blood
   Amnesty International and Red Cross have condemned
Violence against women in the U.S.
   5 - 20 times more likely than other government
    employees to have suffered a completed or
    attempted sexual assault
   Higher rates of chronic pelvic pain,
    dysmenorrhea, abnormal periods, premenstrual
    syndrome, and dissatisfaction with sexual
      all correlate with a history of sexual trauma
       while in the military
Violence against women in the U.S.
 U.S.   military now 14% female
   While   racial epithets banned, terms
    like “bitch”, “pussy”, “dyke” still
   Pornography officially banned, but
    easily available
 Violence against women in the U.S.
 2007 Pentagon report: 2,085 sexual assaults
    But est. 60%-80% not reported

 Veterans Administration study: 24% of
  female patients under age 50 reported
  domestic violence within the past year
 2008-2011: dramatic increase in reported
  sexual assaults
Violence against women in the U.S.
   Government Accountability Office Report, 2006
   Aggressive and duplicitous recruiting tactics on
      Including sexual harassment and rape

   2008: Defense Dept. granting more moral
    waivers, due to declining recruitment, thus
    enlisting more men with records of domestic
    and sexual violence
     Militarism and “Masculinity”
   Pervasive glorification of war and its
    acceptance as means of conflict resolution
      Linked to antiquated definitions of
       appropriate masculine behavior and
       coming-of-age rites
     Militarism and “Masculinity”
   Vocabulary and imagery laden with
    denigrations of the feminine and perverse
    phallic imagery of weapons as extensions
    of male generative organs
     weapons ads employ sexual imagery

     weapons described in terms of
      “hardness, penetration, and thrust”
       War and “Masculinity”
 Association of military bases with
    Tacitly accepted by commanders

 Men dominant decision-makers in
  pursuing militarization, fighting wars, and
  resolving international conflicts
       Violence and Rape in War
   Occurs against backdrop of ongoing individual
    and societal forms of violence against women
   Rape
      Individual acts of violence

      Genocide (to terrorize, subjugate, humiliate,
       and ethnically cleanse subjugated population)
       Violence and Rape in War
   Usually more sadistic and violent than rape
    outside of war

   Often committed in presence of woman’s
    husband and children, who are often then
     Violence and Rape in War
 Forced continuation of pregnancy
 1994 Rwandan genocide – 5000
    Enfants mauvais souvenir (“children of
     bad blood”)
    Difficulty caring for children

    Abandonment and infanticide
       Violence and Rape in War
   Male victims:
     Raped, forced to commit rape against
      other victims / perform sex acts on
      other prisoners and/or guards,
      castrations, forced circumcisions, other
      sexual mutilations
     All under threat of torture or death
    Health Consequences of Rape in
 Traumatic injuries, including fistulae
 STDs, including HIV

 Pregnancy

   Access to emergency contraception,
    abortion, and antibiotics often extremely
    Health Consequences of Rape in
   Short-term psychological sequelae:
       Fear, profound sense of helplessness and
   Long-term psychiatric sequelae:
       Depression, anxiety disorders (including PTSD),
        multiple somatic symptoms, flashbacks, difficulty
        reestablishing intimate relationships, shame,
        persistent fears, and blunted enjoyment of life
    Peacekeepers / Refugee Camps
   7,000 man African Union peacekeeping force in
    Darfur under investigation for raping and
    abusing local women and girls

   Refugees forced to endure rape at border
    crossings as “price of passage”
            Refugee Camps
 Guards rape women or force them into sex
  in return for protection from bandits or for
  basic goods, including food
 Presence of abusive guards inside camps,
  and bandits just outside, makes simple
  tasks such as going to the latrine or
  gathering water or firewood dangerous/life
           Human Rights Issues
   Violence against women and girls violates
    several principles enshrined in international and
    regional human rights law, including the right to
    life, equality, security, equal protection under the
    law, and freedom from torture and other cruel,
    inhumane, or degrading treatment
          Human Rights Issues
   Tokyo War Crimes Trial: rape first identified as
    a war crime
      Successful prosecution of some commanders

   1993: UN Commission on Human Rights
    resolution calls rape a crime of war
             Human Rights Issues
   2001: International War Crimes Tribunal rules
    that rape in war is a crime against humanity
   1990s/2000s: successful prosecutions of rape as
    a war crime and act of genocide
   2009/2010: International Criminal Court issues
    warrants fro arrest of Sudanese President Omar
    al-Bashir for human rights abuses/genocide
       Al-Bashir still in power
       Human Rights Issues – Other
        International Agreements
   The Convention on the Elimination of all
    Forms of Discrimination Against Women
      adopted by UN General Assembly in 1979

      calls for equality of the sexes in political,
       social, cultural, civil, and other fields
      Ratified by 162 countries, but not U.S.
        Human Rights Issues – Other
         International Agreements
   UN Security Council Resolution 1325
     adopted in 2000
     mandates the protection of, and respect for, the
      human rights of women and girls
     calls on all parties to armed conflict to take specific
      measures to protect women and girls from gender-
      based violence, particularly rape and sexual violence
     U.S. has not signed
        Human Rights Issues – Other
         International Agreements
   International Criminal Court
     established by international treaty in 2002
     codifies accountability for gender-based crimes
      against women during military conflict by defining
      sexual and gender violence of all kinds as war crimes
     139 countries have signed on, U.S. has not
     Role of Health Professionals
   Document incidents of rape
   Use medical data to verify widespread rape
   Use techniques of medical science to validate
    victims’ testimonies
   Treat individual victims
    Management of victims of sexual
         violence during war
   Conduct a full history and physical examination
   Treat physical injuries and sexually-transmitted
   Offer emergency contraception and referral for
   Provide counseling and psychological support
    Management of victims of sexual
         violence during war
 Facilitate reporting to appropriate
 Gather forensic evidence

 Provide documentation of findings (in
  triplicate, with a copy for the victim, the
  United Nations High Commission of
  Refugees and the provider’s medical
    Management of victims of sexual
         violence during war
   Health exams should be conducted in a
    confidential manner by trained workers in
    a safe environment

   Female providers should be widely
    Management of victims of sexual
         violence during war
   In refugee camps:
     Place water collection points and latrines in central,
      well-lighted areas
     food distributed directly to women

     House female-headed groups and unaccompanied
      children in safe areas
   Women should be involved in designing and
    running the camps
Conclusions and Recommendations
   Each war represents a failure of our species to
    live in harmony, a waste of precious human
    capital, a further scourge on the environment,
    and a crime against all humanity
   Rape in war represents the malevolent nadir of
    human behavior
Conclusions and Recommendations
   Given the increasing spread of technology and
    materials for the construction of weapons of
    both small- and large-scale destruction, the
    enormity of the social and environmental
    problems facing humanity, and the realistic
    potential for the demise of the human species,
    rapid change is desperately needed
    U.S. Must Play Leadership Role
    Limiting consumption
    Cutting unnecessary military programs
    Increasing funds and using troops for
     international peacemaking (instead of making
    Building alliances with the UN to solve
     international disputes
    U.S. Must Play Leadership Role
   Vigorously investigate its own human rights
    abuses and fully prosecute those responsible
   Sign on to international agreements: CEDAW,
    UNSC Resolution 1325, ICC, the Convention
    on the Rights of the Child, the Convention on
    Economic, Social, and Cultural Rights, and the
    Convention for the Suppression of Traffic in
    Persons, others
    U.S. Must Play Leadership Role
   Pass International Violence Against Women Act
      Would require US government to prevent and
       respond to violence against women and girls as a
       part of US foreign policy and aid programs
      Stalled in Congress

   Join forces with international community to rapidly
    apply both economic and military pressure, including
    the protective use of military troops, to halt genocide
    and mass rape
 We failed to act to halt the genocide in the
  Sudan, just as we failed to act in Rwanda
 And yet we continue to say, “Never
 It is time for our nation’s policies to match
  this rhetoric
   Donohoe MT. Individual and societal forms of violence against
    women in the United States and the developing world: an
    overview. Curr Women’s Hlth Reports 2002;2(5):313-319.
   Donohoe MT. Violence and human rights abuses against women
    in the developing world. Medscape Ob/Gyn and Women’s
    Health 2003;8(2): posted 11/26/03.
   Donohoe MT. Violence against women: Partner abuse and
    sexual assault. Hospital Physician 2004;40(10):24-31. Available at
   Donohoe MT. War, rape and genocide: Never
    again? Medscape Ob/Gyn and Women’s Health
    2004;9(2): posted 10/22/04.
   Donohoe MT. Violence against women in the
    military. Medscape Ob/Gyn and Women’s
    Health 2005;10(2): posted 9/13/05. Available at
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