War, Rape and Genocide: Never Again?

1. War, Rape and Genocide:Never Again? Martin Donohoe

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

3. 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

4. Outline • Health Consequences • Refugee Camps • Human Rights Issues • Role of Health Professionals • Conclusions and Recommendations

5. Darfur, Sudan • Between 180,000 - 460,000 deaths over last two years (most from disease) • 5.5 million refugees and internally displaced persons; 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

6. 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

7. 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 • Formation of Southern Sudan in 2011 has failed to bring peace • South Sudan oil

8. 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

11. 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

12. 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

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

18. 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

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

20. “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

21. History • Vietnam War • Perpetrators included U.S. soldiers • Few brought to justice • 1971: Bangladesh War for Independence • Estimated 200,000 - 400,000 girls and women raped by Pakistani army • 25,000 pregnancies

22. 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

23. History • 2000s: Sexual humiliation and rape of 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

26. 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

27. 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

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

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

30. 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

31. 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 2013: Branch Chief for Air Force’s Sexual Assault and Prevention Response Program charged with sexual battery

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

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

34. Victim Assistance 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

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

36. Recent Developments • Military Domestic Violence and Sexual Response Act • 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

37. Recent Developments • 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 • In committees (2012)

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

39. 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

40. 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”

41. 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

42. 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) • Societal or Structural Violence • Legal, educational, social, and political marginalization • Impaired access to reproductive health services

43. 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

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

48. 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, humiliation (e.g., Abu Ghraib) • All under threat of torture or death • Most unreported • Rarely mentioned by NGOs

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

50. 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