We have completed four mobile clinics in two villages, Ikoma and Mwirama, in the Walungu territory, about 45 km from Bukavu. This area has been tremendously impacted by the Interhamwe (Hutu Rebels) and military attacks on villages. The attacks have resulted in countless rapes, looting, burning homes, and murder.
The clinic provides free care to survivors of sexual violence. We are able to see 20 new clients and 10 follow-up clients at each clinic. We are finding that about 30% of the survivors have never seen a healthcare provider after the rape–mainly because of a lack of money to pay for care or transport to care, fear of stigma and abandonment. Women often come forward only when they are sick — we are treating STI, UTIs, malaria, and other endemic illnesses. But mostly we are finding a significant need for mediation and reintegration programs for survivors and their husbands that also includes trauma informed care for the couple, their family, and children.
Fortunately to date, we have not had a survivor test HIV positive … we start each clinic with a group class to village women and men about HIV and other STIs. This is important as we are providing information to survivors that will help them make the decision to take the HIV test. The education is done in Mashi, the language of the Bashi people who live in the area. One of our team’s physicians leads the education with a local nurse, and after the education, those who need care are organized to see one of our two doctor/nurse teams.
There is much going on with the clinic … when our research assistants grab a chair and head off to a private area to talk with survivors of rape (female and male), family members, community leaders, and health providers, we are working together to develop clinical protocols for survivors of rape as well as the components of a mediation and reintegration program for survivors. This also includes questions related to microfinance to help rebuild household income as a component of mediation and survivor reintegration to family and village.