by Dr Ilham Abdelhai,MD

05 March 2004

Maniema Province, DR Congo: Christine* is a 14-year old Congolese girl from Kindu, Maniema Province. When I met her, she was hospitalized for brutal injuries inflicted by a knife on her buttocks and thighs, after being raped by 5 militiamen, thought to belong to one of the Mai Mai factions, active in the area. She has miraculously survived her injuries which started to heal, however, she was still unable to sit or walk without pain.The story of Christine is a story lived by many women and girls in Congo, a post-conflict country where fighting between militias and factions has largely ceased but civilians became the consistent target for killing, rape, looting and an array of harassments.

In my work to disseminate information on HIV/AIDS, I have realized how HIV/AIDS intimately mingles with gender issues. I have observed how the low status of women, socially and economically, makes them have less control over their bodies, particularly over their sexuality. This fact, whether manifested as coercive prostitution or the inability to convince a male sexual partner to wear a condom, have a far-reaching impact on HIV/AIDS epidemic making women particularly vulnerable to contract the disease.

A recent trend in the epidemiology of HIV/AIDS in the region is the fact that since 2001, the number of infected women (among registered cases) outnumbered that of infected men. This trend has continued in the subsequent years. The lack of reliable information about the transmission of HIV/AIDS and risk behaviors among women further increase their vulnerability. Other factors related to HIV/ AIDS is the reality that people become sexually active at a very early age and along with polygamy, having multiple sexual partners is a common practice.

As a country in an armed conflict, sexual violence against women has been widely used as a weapon. Perpetrators have often been, as the case of Christine, members of police and military forces from the different fighting factions. Notoriously, rape is inflicted against women of a wider age range (from 3- to over 70 years of age). Not surprisingly, rape is not considered a major crime by many Congolese people, including educated people.

Teen pregnancy is a fairly common phenomenon in the region due to early marriage and women feeling socially pressured to conceive as quickly as possible after marriage. Many feel pressured to give birth to as many children as possible as this is directly related to the woman social status in the community. Antenatal and maternity services are primitive and women run serious health risks, both during pregnancy and delivery.

In Kananga, a city of about 1 million people, the only reliable antenatal care can be found in a private hospital 30 Km outside the town, where cost of treatment is well beyond the means of the majority of Congolese women in the town, and the same could be said about pediatric care. It should be noted that the DRC has one of the highest infant and maternal mortality rates worldwide, estimated as 129 per 1000 live births and 1300 per 100,000 live births, respectively.

In my opinion, these issues require an immediate national and international commitment, they desperately need consistent investment in education and prevention measures for HIV/AIDS & other sexually transmitted infections, teen pregnancy and maternal mortality.

The social tolerance to rape mentioned above could give an idea of how much is to be done. Working with and through the Congolese society, we can negotiate for more education and rights for women, improve access to health services, so that women could have the control over their sexuality and reproductive life.

* Not her real name