War Rape and Genocide Never Again Martin Donohoe

War, Rape and Genocide: Never Again? Martin Donohoe

Special Thanks To n Vic Sidel and Barry Levy (War and Public Health, Terrorism and Public Health) n Photographers James Nachtwey, Sebastio Salgado, and others

Outline n Sudanese genocide n History of wartime violence against women in the 20 th Century n VAW in the U. S. military n War and “Masculinity” n The Nature of Violence and Rape in War

Outline n Health Consequences n Refugee Camps n Human Rights Issues n Role of Health Professionals n Conclusions and Recommendations

Darfur, Sudan Between 180, 000 - 460, 000 deaths over last two years (most from disease) n 5. 5 million refugees and internally displaced persons; 2. 7 million in refugee camps n Government-supported, Islamic Janjaweed militias responsible for killing Black Africans n Arms sales to Sudan from China, Russia, France, Iran, Saudi Arabia, Belarus, Poland, Lithuania n

Darfur, Sudan Bush administration called situation “genocide”, yet failed to act substantively n Bush administration relied on Sudan, which used to harbor Osama bin Laden, for military intelligence n Obama administration has failed to act n

Darfur, Sudan Bipartisan Congressional Research Service reports administration concerned that holding Sudanese officials accountable could “disrupt cooperation” n Nevertheless, mild economic sanctions and travel restrictions enacted in May, 2007 n Formation of Southern Sudan in 2011 has failed to bring peace n n South Sudan oil

Democratic Republic of the Congo (DRC) “Africa’s World War” n Between 700, 000 and 3 million deaths n 2 million displaced n 1. 7 -1. 8 million women raped; 3. 1 -3. 4 million victims of IPV n n 2011: 48 rapes/hr Unraveling of civil society n Life expectancy for those born in 2011 = 40 n

History n 250 wars in 20 th Century n Most conflicts within and between small states n Many in sub-Saharan Africa n 85 -90% of casualties among civilians n Opposite at end of 19 th Century

Infamous Genocides China (under Mao), late 1950 s – early 1970 s: 30 million killed n USSR (mostly under Stalin), 1920 – mid 1950 s: 20 million killed n Germany (under Nazis), mid 1930 s – 1945: over 11 million killed n Japan, late 1930 s – mid 1940 s: 10 million killed n

History n Women considered spoils of war n Abduction of Helen of Troy n Rape of the Sabine women n Millions raped in 20 th Century conflicts

History - World War II n Rape widespread on most sides in World War II (Americans = least common perpetrators) n Japanese soldiers forced between 100, 000 and 200, 000 women into sexual slavery (“comfort women”) n *Korea, Burma, China, Holland, Indonesia, Phillipines

“Comfort Women” n Some underwent forced hysterectomies to prevent menstruation, make them constantly “available” n More than half died due to mistreatment

“Comfort Women” 3 -5 year detention n 5 -20 rapes per day n For 3 yrs of enslavement, low estimate is 7500 rapes per woman n Japan has not compensated any victims n n Historical blindness to atrocities

History n Vietnam War n Perpetrators included U. S. soldiers n Few brought to justice n 1971: Bangladesh War for Independence n Estimated 200, 000 - 400, 000 girls and women raped by Pakistani army

History 1994: Rwandan genocide n At least 250, 000 women raped n 1990 s: ethnic cleansing in Bosnia n >20, 000 Moslem women raped n Other 20 th Century conflicts: civil wars in Liberia, Sierra Leone, Somalia, Egypt, Libya, Syria n

History n n 2000 s: Sexual humiliation and rape of female detainees at US facilities in Afghanistan and 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 n Higher rates of chronic pelvic pain, dysmenorrhea, abnormal periods, premenstrual syndrome, and dissatisfaction with sexual relations n all correlate with a history of sexual trauma while in the military n

Violence against women in the U. S. military n U. S. military now 14% female n While racial epithets banned, terms like “bitch”, “pussy”, “dyke” still common n Pornography officially banned, but easily available

Violence against women in the U. S. military n Recent increase in reported sexual assaults n 3, 374 sexual assaults reported to Pentagon (2012); 5, 061 (2013) n Estimated number about 7 X higher n Veterans Administration study: 24% of female patients under age 50 reported domestic violence within the past year

Prosecution and Punishment Rare, Promotion not Uncommon for Perpetrators n Since 1992, nearly 5000 accused sex offenders in the Army, including rapists, have avoided prosecution and the possibility of prison time

Violence against women in the U. S. military n Government Accountability Office Report, 2006 n Aggressive and duplicitous recruiting tactics on rise n Including sexual harassment and rape

Violence against women in the U. S. military 2008: Defense Dept. granting more moral waivers, due to declining recruitment, thus enlisting more men with records of domestic and sexual violence n 2013: Branch Chief for Air Force’s Sexual Assault and Prevention Response Program charged with sexual battery n

Recent Developments n DOD requires health care provider training on domestic violence n Domestic violence advocates program and family support programs in place n Utilization still low

Recent Developments Civilian perpetrators barred from bases n Military police to work with local law enforcement n n 2013: Branch Chief for Air Force’s Sexual Assault and Prevention Response Program charged with sexual battery

Victim Assistance n U. S. Army’s transitional compensation program provides financial and other benefits to the families of service members discharged for child or spouse maltreatment, including victim assistance and offender rehabilitation

Victim Assistance n VA provides lifetime sexual assault victims’ counseling to all military veterans n After one leaves the service n Most counseled patients are males, who suffer lower rates of sexual assault but make up a large majority of veterans

Recent Developments n Military Domestic Violence and Sexual Response Act n n Would reduce sexual assault and domestic violence involving members of the Armed Forces and their family members and partners through enhanced programs of prevention and deterrence, enhanced programs of victims services, and strengthened provisions for prosecution of assailants In House and Senate subcommittees since mid 2009

Recent Developments n H. R. 1529 and S. B. 1018: Defense Sexual Trauma Response Oversight and Good Governance Act (Defense Strong Act) Would guarantee access to military lawyer, allow victims to transfer from where assault occurred, ensure confidentiality, and institute rape prevention training for men and women n In committees (2012) n

Recent Developments n H. R. 1517: Holley Lynn James Act Would create system of independent oversight n MST cases would automatically go to military court n In committee (2012) n

Militarism and “Masculinity” n Pervasive glorification of war and its acceptance as means of conflict resolution n Linked to antiquated definitions of appropriate masculine behavior and coming-of-age rites

Militarism and “Masculinity” n Vocabulary and imagery laden with denigrations of the feminine and perverse phallic imagery of weapons as extensions of male generative organs n weapons ads employ sexual imagery n weapons described in terms of “hardness, penetration, and thrust”

War and “Masculinity” n Association of military bases with prostitution n Tacitly accepted by commanders n Men dominant decision-makers in pursuing militarization, fighting wars, and resolving international conflicts

Violence and Rape in War n n n Occurs against backdrop of ongoing individual and societal forms of violence against women Rape n Individual acts of violence n Genocide (to terrorize, subjugate, humiliate, and ethnically cleanse subjugated population) Societal or Structural Violence n Legal, educational, social, and political marginalization n Impaired access to reproductive health services

Violence and Rape in War n Usually more sadistic and violent than rape outside of war n Often committed in presence of woman’s husband children, who are often then killed

Violence and Rape in War n Forced continuation of pregnancy n 1994 Rwandan genocide – 5000 pregnancies n Enfants mauvais souvenir (“children of bad blood”) n Mothers experience difficulty caring for children n Abandonment and infanticide

Violence and Rape in War n Male victims: n Raped, forced to commit rape against other victims / perform sex acts on other prisoners and/or guards, castrations, forced circumcisions, other sexual mutilations, humiliation (e. g. , Abu Ghraib) n All under threat of torture or death n Most unreported n Rarely mentioned by NGOs

Health Consequences of Rape in War n Traumatic injuries, including fistulae n STDs, including HIV n Pregnancy n Access to emergency contraception, abortion, and antibiotics often extremely limited

Health Consequences of Rape in War n Short-term psychological sequelae: n n Fear, profound sense of helplessness and desperation Long-term psychiatric sequelae: n Depression, anxiety disorders (including PTSD), multiple somatic symptoms, flashbacks, difficulty reestablishing intimate relationships, shame, persistent fears, and blunted enjoyment of life

Peacekeepers / Refugee Camps n 7, 000 man African Union peacekeeping force in Darfur under investigation for raping and abusing local women and girls in 2010 n Refugees forced to endure rape at border crossings as “price of passage”

Refugee Camps n Guards rape women or force them into sex in return for protection from bandits or for basic goods, including food n 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 n 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 n Tokyo War Crimes Trial: rape first identified as a war crime n Successful prosecution of some commanders n 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 n 1990 s/2000 s: successful prosecutions of rape as a war crime and act of genocide n 2009/2010: International Criminal Court issues warrants for arrest of Sudanese President Omar al-Bashir for human rights abuses/genocide n n Al-Bashir still in power

Human Rights Issues – Other International Agreements n The Convention on the Elimination of all Forms of Discrimination Against Women (CEDAW) n adopted by UN General Assembly in 1979 n calls for equality of the sexes in political, social, cultural, civil, and other fields n Ratified by 162 countries, but not U. S.

Human Rights Issues – Other International Agreements n UN Security Council Resolution 1325 adopted in 2000 n mandates the protection of, and respect for, the human rights of women and girls n 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 n U. S. has not signed n

Human Rights Issues – Other International Agreements n International Criminal Court established by international treaty in 2002 n codifies accountability for gender-based crimes against women during military conflict by defining sexual and gender violence of all kinds as war crimes n 139 countries have signed on, U. S. has not n

Role of Health Professionals Document incidents of rape n Use medical data to verify widespread rape n Use techniques of medical science to validate victims’ testimonies n Treat individual victims n

Management of victims of sexual violence during war Conduct a full history and physical examination n Treat physical injuries and sexuallytransmitted diseases n Offer emergency contraception and referral for abortion n Provide counseling and psychological support n

Management of victims of sexual violence during war n Facilitate reporting to appropriate authorities n Gather forensic evidence n 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 n Health exams should be conducted in a confidential manner by trained workers in a safe environment n Female providers should be widely available

Management of victims of sexual violence during war n In refugee camps: Place water collection points and latrines in central, well-lighted areas n food distributed directly to women n House female-headed groups and unaccompanied children in safe areas n n 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 n Rape in war represents the malevolent nadir of human behavior n

Conclusions and Recommendations n 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 n n 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 n 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 n

U. S. Must Play Leadership Role n n Resurrect the International Violence Against Women Act n Would require US government to prevent and respond to violence against women and girls as a part of US foreign policy and aid programs n 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 n We failed to act to halt the genocide in the Sudan, just as we failed to act in Rwanda n And yet we continue to say, “Never again”………. n It is time for our nation’s policies to match this rhetoric

References n n n 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): 2431. Available at http: //www. turnerwhite. com/memberfile. php? Pub. Code=hp_oct 04_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/491 147 n Donohoe MT. Violence against women in the military. Medscape Ob/Gyn and Women’s Health 2005; 10(2): posted 9/13/05. Available at n

Contact Information Public Health and Social Justice Website http: //www. phsj. org martindonohoe@phsj. org