Entering DRC (East Africa Day 7: 2022-04-19)

April 19, 2022

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:

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:

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.


Gender-Based Violence, an in Person Encounter in Uganda

April 17, 2022

In 2020, “Uganda reported the highest number of Gender-Based Violence (GBV) cases in East, Central and Western Africa with 60% of girls and young women aged between 13 to 24 years having experienced one or more types of violence in childhood.  In the same report, 72% of Uganda’s young population (aged 18–24 years) have also experienced one or more types of violence before the age of 18 while 25% of young women in Eastern Africa justify a husband beating up his wife” – Increasing cases of Gender-Based Violence in East Africa.

I want to confess at the start I’m afraid to share this story. There were numerous immediate judgement calls throughout the encounter and I don’t know that we always made the right choice. However, if nothing else, it speaks to the prevalence of the problem and for that I’m choosing a little bravery at the risk of potential criticism. I’m not saying our actions were correct, or that we shouldn’t have done more, just describing the situation as we experienced it. Please know that it was difficult and no doubt you, dear reader, would have chosen better in the moment but I’m sharing anyway.

It was after 10 PM with no moon. We (Sean, Phil, and I) were about 30 minutes from the Bwindi Impenetrable Forest when we drove past a couple when the woman, somewhat quietly, pleaded for help through our open car window. Sean heard the plea and asked if she was okay. She was around 18 and the man holding her was perhaps in his early 20s. We hesitated but soon stopped the car and stepped out requesting the man to let her go. He refused, claiming she was his wife and wouldn’t let go. (Obviously being her husband doesn’t give any right to forcibly hold her like he was, but the man was drunk and there was a huge language barrier between us.) The couple crossed the dirt road and we stepped toward them. However, the man would not let go. We tried talking but there was essentially no communication due to the apparent language barrier. We suggested he just stop and let her go so we could talk, but he refused. There was more struggling and us peacefully but physically trying to free her. Everything we tried verbally was completely ignored.

The couple backed up to a wood hut and Sean took one arm while I took the other in the hopes of freeing her. However, his grip on her purse was relentless and she wouldn’t let her purse go. Shortly afterwards, additional men appeared and he seemed to be insinuating to them that we were stealing his wife. Yikes!! What is going on? Dang-it, I don’t speak the language. The man then told us that we could have her but it would be 3,000,000 UGX (about 900 USD). What? Are they seriously implying that we are trying to steal her?

We backed away trying to avoid anyone really getting hurt and she freed herself and ran behind Phil. However, the “husband” grabbed her again and wouldn’t let go this time. There were now a total of five men, all in the low 20s, and drunk. A couple of them grabbed tree branches and stripped off the shoots to create poles which they started swinging at us wildly, occasionally connecting with a hit or a kick.

With the threatening sticks we ended up separated, with the men and the woman on the other side from us. I tried taking one of them aside and talking with him but regardless of what I said, he replied with “go away.” The situation was degrading fast. I so wish the woman had run once she got free but how was she to know that?

The “husband” said something to the woman about knowing that the woman’s stuff was in his house? (Why was this in English? Did he understand more than he let on?) Even if we could free her, what happens tomorrow or the day after? Is she going to be punished worse because we were involved?

They started moving away and a couple of them took the upper road, looking down on us. They started hurtling rocks. They loudly hit the tin roof of the hut or skidded on the road, but they were all wild throws – not surprisingly given their inebriated stated.

With rocks flying past we decided to get in the car. But as we headed in the direction, the man held the woman’s body while two of his buddies lifted her legs and carried her back up the road. Stink! There is no circumstance where that behavior is okay. With the two other men guarding with additional rocks, what were we supposed to do? Should we do everything in our power even if it involves violence or bodily harm? If they are using physical force, does that justify it for us given their violence against the woman? After all, from everything we can tell, she is being forcibly held against her will, but we are also being accused of stealing her.

We drove down the hill, mostly in silence. We felt horrible not knowing what might happen. Even if we could help, would it make it worse in the long run? I don’t know. It’s so frustrating that we don’t speak the language.

15 minutes later, at the bottom of the hill, we reached a road block and spoke with a military guard who called the police. However, the police didn’t have a vehicle and would take more than an hour to reach the location. The guard eventually agree that we give him a ride to the location. Of course, after 30 minutes, the chance of finding them at night was miniscule, exacerbated because we were in very steep and dense terrain. Regardless, the hope seemed worth the attempt.

Once we returned there was no one associated with the events in sight. We went up the road 200 ft. and the guard asked those milling around if they had seen anything, but the response was in the negative. Briefly we saw someone hiding in the bushes and the guard (who was carrying a rifle) lunged at him but the man disappeared into the bush down a steep embankment. So frustrating!!!!!

In the end all we could do was take the guard back to his post and hope that there would be follow up in the morning and the real truth would be told, not some story about us trying to steal the woman.

April 23 Update:

Sean chose to take a detour towards the same area rather than drive directly to Kampala. He had some contacts in security and reached out to them for help. Even though it is almost a week later, here’s what he had to report:

“People talk – so believe it or not – it looks like the police here are gonna find the guys. This cheeky old man I came across had heard all about it and connected me with the police (their place is 1 km up the other road) and provided two of their names and locations. Anyways, more progress than I expected. I’ll keep you posted.
I pulled off and this Mzee (older man) came walking past me – spoke good English so I chatted with him. He is the main guy’s neighbor and overheard them when they got back that night and the next morning. Knew all the details. The guys were all hiding in the bushes and saw us with the soldier when we came back. The woman got taken back to the house, but left the next morning.

The Mzee is going to communicate with her and help her make a statement. I have all the numbers of the police and will follow up.
It was a long shot, but I’m stoked I was able to get the wheels turning to hopefully provide some protection for her moving forward.”

In the end, could we have done better? I’ve gone over it a thousand times and there isn’t a clearly better approach that I can think of. Suggestions? Perhaps if we had more swiftly freed her before others arrived but we were still trying to find a peaceful solution.