War, Rape and Genocide: Never Again? Martin Donohoe Special Thanks To  Vic Sidel and Barry Levy (War and Public Health, Terrorism and Public Health)  Photographers James Nachtwey, Sebastio.

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Transcript War, Rape and Genocide: Never Again? Martin Donohoe Special Thanks To  Vic Sidel and Barry Levy (War and Public Health, Terrorism and Public Health)  Photographers James Nachtwey, Sebastio.

War, Rape and
Genocide:
Never Again?
Martin Donohoe
Special Thanks To
 Vic
Sidel and Barry Levy (War and
Public Health, Terrorism and Public
Health)
 Photographers
James Nachtwey,
Sebastio Salgado, and others
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

Outline
Health Consequences
 Refugee Camps
 Human Rights Issues
 Role of Health Professionals
 Conclusions and Recommendations

Darfur, Sudan


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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
Darfur, Sudan


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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
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
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
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

Infamous Genocides


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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
History

Women considered spoils of war
 Abduction of Helen of Troy
 Rape of the Sabine women

Millions raped in 20th Century conflicts
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

“Comfort Women”
Some underwent forced hysterectomies to
prevent menstruation, make them
constantly “available”
 More than half died due to mistreatment

“Comfort Women”
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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
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

History
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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
History
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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
Violence against women in the U.S.
military
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
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
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
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)
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Estimated number about 7X higher
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

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

Government Accountability Office Report,
2006

Aggressive and duplicitous recruiting
tactics on rise
 Including sexual harassment and rape
Violence against women in the
U.S. military
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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
Recent Developments

DOD requires health care provider training on
domestic violence

Domestic violence advocates program and
family support programs in place

Utilization still low
Recent Developments
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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
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
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
Recent Developments

Military Domestic Violence and Sexual Response Act
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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

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)

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)

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
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”
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

Violence and Rape in War


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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
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
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

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
 All under threat of torture or death
Health Consequences of Rape in
War
Traumatic injuries, including fistulae
 STDs, including HIV
 Pregnancy

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Access to emergency contraception,
abortion, and antibiotics often extremely
limited
Health Consequences of Rape in
War
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Short-term psychological sequelae:
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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
Peacekeepers / Refugee Camps

7,000 man African Union peacekeeping force in
Darfur under investigation for raping and
abusing local women and girls in 2010

Refugees forced to endure rape at border
crossings as “price of passage”
Refugee Camps
Guards rape women or force them into sex
in return for protection from bandits or for
basic goods, including food
 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
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Human Rights Issues

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

Tokyo War Crimes Trial: rape first identified as
a war crime
 Successful prosecution of some commanders

1993: UN Commission on Human Rights
resolution calls rape a crime of war
Human Rights Issues
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2001: International War Crimes Tribunal rules
that rape in war is a crime against humanity
1990s/2000s: successful prosecutions of rape as
a war crime and act of genocide
2009/2010: International Criminal Court issues
warrants for arrest of Sudanese President Omar
al-Bashir for human rights abuses/genocide

Al-Bashir still in power
Human Rights Issues – Other
International Agreements

The Convention on the Elimination of all
Forms of Discrimination Against Women
(CEDAW)
 adopted by UN General Assembly in 1979
 calls for equality of the sexes in political,
social, cultural, civil, and other fields
 Ratified by 162 countries, but not U.S.
Human Rights Issues – Other
International Agreements

UN Security Council Resolution 1325
adopted in 2000
 mandates the protection of, and respect for, the
human rights of women and girls
 calls on all parties to armed conflict to take specific
measures to protect women and girls from genderbased violence, particularly rape and sexual violence
 U.S. has not signed

Human Rights Issues – Other
International Agreements

International Criminal Court
established by international treaty in 2002
 codifies accountability for gender-based crimes
against women during military conflict by defining
sexual and gender violence of all kinds as war crimes
 139 countries have signed on, U.S. has not

Role of Health Professionals
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Document incidents of rape
Use medical data to verify widespread rape
Use techniques of medical science to validate
victims’ testimonies
Treat individual victims
Management of victims of sexual
violence during war
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Conduct a full history and physical examination
Treat physical injuries and sexually-transmitted
diseases
Offer emergency contraception and referral for
abortion
Provide counseling and psychological support
Management of victims of sexual
violence during war
Facilitate reporting to appropriate
authorities
 Gather forensic evidence
 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

Health exams should be conducted in a
confidential manner by trained workers in
a safe environment

Female providers should be widely
available
Management of victims of sexual
violence during war

In refugee camps:
Place water collection points and latrines in central,
well-lighted areas
 food distributed directly to women
 House female-headed groups and unaccompanied
children in safe areas


Women should be involved in designing and
running the camps
Conclusions and Recommendations

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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
Rape in war represents the malevolent nadir of
human behavior
Conclusions and Recommendations

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
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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
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
U.S. Must Play Leadership Role

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Resurrect the International Violence Against Women
Act
 Would require US government to prevent and
respond to violence against women and girls as a
part of US foreign policy and aid programs
 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
We failed to act to halt the genocide in the
Sudan, just as we failed to act in Rwanda
 And yet we continue to say, “Never
again”……….
 It is time for our nation’s policies to match
this rhetoric

References



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):24-31. Available at
http://www.turnerwhite.com/memberfile.php?PubCode=hp_oct04_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/491147
Donohoe MT. Violence against women in the
military. Medscape Ob/Gyn and Women’s
Health 2005;10(2): posted 9/13/05. Available at
http://www.medscape.com/viewarticle/512380
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