After entering the Democratic Republic of Congo (DRC), we dropped our bags at our hotel and headed for a women’s health clinic. Some of IntelliTect’s philanthropy has been supporting fistula surgeries at this clinic, many of which are caused by rape. Here we met with the head doctor and discussed with her the prevalence of gender-based violence (GBV) in the DRC. In the DRC:
- Over the course of their lives, 33% of women will face some form of gender-based violence (GBV).
- 51% of ever-partnered women aged 15-49 years experience intimate partner physical and/or sexual violence at least once in their lifetime.
For those of you who are unaware, untreated fistula problems can cause you to smell constantly as your bowels are perpetually leaking. Frequently in this part of the world, your husband will disown you. Furthermore, the cause is violence or child bearing (sometimes because of rape). Here are USAID’s and UNFPA’s descriptions (not for the faint of heart):
Traumatic fistula is a condition that can occur as the result of sexual violence, often in conflict and post conflict settings. There are no solid estimates of its prevalence, but traumatic gynecologic fistula can make up a significant part of the overall genital fistula caseload in places where sexual violence has been used as a weapon of war.
Rape, often aggravated by the thrusting of objects into the vagina, can result in a hole between a woman’s vagina and bladder or rectum, or both, resulting in the leaking of urine and/or feces. Survivors of sexual assault may have additional, severe physical injuries and are at an increased risk for unwanted pregnancy and sexually transmitted infections, including HIV. Survivors live not only with chronic incontinence, but also with the psychological trauma and stigma of rape.https://fistulacare.org/what-is-fistula/traumatic-fistula/
Obstetric fistula is one of the most serious and tragic childbirth injuries. A hole between the birth canal and bladder and/or rectum, it is caused by prolonged, obstructed labor without access to timely, high-quality medical treatment. It leaves women and girls leaking urine, feces or both, and often leads to chronic medical problems, depression, social isolation and deepening poverty. Half a million women and girls in sub-Saharan Africa, Asia, the Arab States region and Latin America and the Caribbean are estimated to be living with fistula, with new cases developing every year. Yet fistula is almost entirely preventable. Its persistence is a reminder of gross inequities, a sign of global inequality and an indication that health and social systems are failing to protect the health and human rights of the poorest and most vulnerable women and girls.https://www.unfpa.org/obstetric-fistula
We spoke with the doctor (in yellow below) at length and she was quite open about her experiences. She talked about how the surgery was not always sufficient because in many cases when the women leave the clinic they are going back to the same crappy circumstances in which they were abused in the first place. She talked about the never-ending line of patients but the limited resources that allowed them to be treated. It was a sobering meeting.
Also, while fistula surgeries are amazing for the patients, they are not reducing the frequency of cases caused by violence. In fact, most women here are stigmatized by the problem and do their best to keep it secret. Only when World Relief (the NGO we partner with in the DRC) meets the women and is able to get to know them, do they discover the problem and persuade the patient to seek medical attention.
Afterward, we were invited to go visit some of the patients – all of whom had given permission for photos and conversations. In addition, we got to see the surgery room.
Notice that these women are still caring for their children while they are in hospital – generally a stay of up to 21 days (14 in recovery and 7 in physical therapy). While we’ve had several sobering moments throughout our trip, this was one of the worst and most memorable.
Here are some more statistics regarding DRC poverty and injustice:
- 48% of women have to walk for more than an hour to reach a health facility.
- 37% of women aged 20 to 24 years were first married or in union before age 18.
- Child mortality (children dying before the age of 5) is a staggering 1 in 10
- 1 in 18 mothers are at risk of death during child birth.
- 19% of the population has access to electricity
- 8% (2014) of women ages 15-49 use modern contraceptive methods.
- 86% (2011) of 10-year-olds cannot read and understand a simple text by the end of primary school.
- Mean years of schooling for an adult is 6.8 years, however, factoring in what children actually learn, the expected years of school is only 4.5 years.
In the evening, we went out to dinner with the World Relief team and discussed the various ways they are fighting poverty in the DRC. It was a great conversation and I learned about all sorts of cool things they are doing.
Earlier in the Day
I confess, that my morning was an embarrassing contrast with the clinic visit. I awoke in time to get up and watch the sunrise. It wasn’t particularly spectacular, but I love that time in the morning and it was good to spend some quiet time pondering our experience so far.
Following breakfast, we threw our gear in the boat and headed back to the other side of the lake – stopping of course for a brief swim along the way. Once we made it back to our trusty Toyota Land Cruiser, we headed into town and purchased a SIM card and withdrew some money. I also befriended one of the youth I met on the street and connected with him on WhatsApp. Over the past few days we have had several interesting conversations about the Rwandan Genocide, but more about that when we return to Rwanda.