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War, Rape and
Genocide:
Never Again?
Martin Donohoe
Special Thanks To
Sidel and Barry Levy (War and
Vic
Public Health)
Photographers James Nachtwey,
Sebastio Salgado, and others
Outline
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
Outline
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
Africans
Arms sales to Sudan from China, Russia,
France, Iran, Saudi Arabia, Belarus, Poland,
Lithuania
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
intelligence
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
History
250 wars in 20th Century
Most conflicts within and between small
states
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
History
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
perpetrators)
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
History
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
History
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,
Syria
History
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.
military
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
relations
all correlate with a history of sexual trauma
while in the military
Violence against women in the U.S.
military
U.S. military now 14% female
While racial epithets banned, terms
like “bitch”, “pussy”, “dyke” still
common
Pornography officially banned, but
easily available
Violence against women in the U.S.
military
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.
military
Government Accountability Office Report, 2006
Aggressive and duplicitous recruiting tactics on
rise
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
prostitution
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
killed
Violence and Rape in War
Forced continuation of pregnancy
1994 Rwandan genocide – 5000
pregnancies
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
War
Traumatic injuries, including fistulae
STDs, including HIV
Pregnancy
Access to emergency contraception,
abortion, and antibiotics often extremely
limited
Health Consequences of Rape in
War
Short-term psychological sequelae:
Fear, profound sense of helplessness and
desperation
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
threatening
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
(CEDAW)
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
diseases
Offer emergency contraception and referral for
abortion
Provide counseling and psychological support
Management of victims of sexual
violence during war
Facilitate reporting to appropriate
authorities
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
agency)
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
available
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
war)
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
Conclusions
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
again”……….
It is time for our nation’s policies to match
this rhetoric
References
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.
http://www.medscape.com/viewarticle/464255
Donohoe MT. Violence against women: Partner abuse and
sexual assault. Hospital Physician 2004;40(10):24-31. Available at
http://www.turner-
white.com/memberfile.php?PubCode=hp_oct04_partner.pdf
References
Donohoe MT. War, rape and genocide: Never
again? Medscape Ob/Gyn and Women’s Health
2004;9(2): posted 10/22/04.
http://www.medscape.com/viewarticle/491147
Donohoe MT. Violence against women in the
military. Medscape Ob/Gyn and Women’s
Health 2005;10(2): posted 9/13/05. Available at
http://www.medscape.com/viewarticle/512380
Contact Information
Public Health and Social Justice Website
http://www.phsj.org
martindonohoe@phsj.org
