The look on the patient's face, even weeks later, will haunt me. Her anguished eyes, avoiding contact with the men in the room, dart rapidly back and forth. She winces at every perceived movement. Her voice, barely audible, utters monosyllabic responses. Despite having worked in emergency medicine for over 20 years, I have never seen a patient display such unspoken suffering and torment.
I am in a medical clinic in the Congo (known as the DRC). The woman before me was held as a sexual hostage for the past year by Congolese rebels. Raped on a daily basis, she was recently liberated into the care of a saintly woman who houses over a hundred similar victims.
The patient, whose name is Amani, is HIV positive.
She is eleven years old.
Later that afternoon I visit H.E.A.L Africa, a medical clinic that specializes in surgical correction of victims of the sexual violence which has left thousands of women in central Africa with disabling fistulas (an abnormal communication between the vagina and rectum and bladder). Hospital stays can last months, and surgical failures are many. Their families accompany them to the HEAL compound — most women are without husbands, but children abound. I watched as they arose from their outdoor foam pads to plant vegetables, hang their tattered clothing on bushes to dry, and seek hope in the midst of despair.
A rich source of natural resources such as diamonds, timber and minerals, and home to the rare highland gorillas, this area was once known as the Switzerland of Africa with its beautiful hills, clean air, and temperate climate. Now it serves as a source of corruption, looting, and violence — particularly the utilization of rape as a weapon.
Amani and the HEAL patients are victims of an ongoing and minimally publicized conflict in the Congo known as Africa's "First World War." Recent estimates put the conflict's death toll at over five million people. It is the aftermath of the Rwandan genocide, when in 1994, the Rwandan Hutu majority murdered an estimated 800,000 minority Tutsis in the space of four months, while the United Nations and western world shamelessly refused to intervene. And although Rwanda has done an admirable job of restoring peace to their country through an amazing display of forgiveness and unification of its people, Congolese rebel forces continue the conflict across the border in the eastern DRC.
Such brutality is not new to the region. The original tribes had their share of violent encounters, but they paled in comparison to the horror inflicted upon the Congolese by King Leopold's Belgian colonization in the early 1900's. A Congo population of about twenty million was reduced to ten million within one or two decades. The slaughter was unbelievably cruel, leaving a legacy of devaluing human life and dignity. Conrad's novel, Heart of Darkness, exposed these horrors to the world. Sadly, in 2010, only the characters have changed.
(I must parenthetically state that such genocidal cleansing is certainly not limited to central Africa — consider Armenia, Bosnia, and the Holocaust, or, in our own country, our horrific treatment of African slaves and Native Americans. Ethnic hatred is, sadly, a universal behavior.)
When we approach the celebration of our own independence, we display gratitude for our amazing freedoms. Yet to honor those freedoms, we must be eternally vigilant as to what future path we choose to tread. For when we — as a nation or as individuals — judge someone based on their ethnic heritage, skin color, religion, or any other criteria except their individual character, we run the risk of descending down that same pathway of hatred and discrimination that has resulted in the untold deaths of millions of human beings around the world.
Let us continually speak out against bigotry and discrimination. Let us lobby our leaders to protect the defenseless. And let us, personally, in our interaction with others, step upwards onto a path of compassion and recognition of all humanity. As we do so, we can rescue the Amanis of tomorrow.
[Note: Dr. Sainsbury recently visited Rwanda and the Democratic Republic of the Congo as a volunteer for D.O.C.S. (Doctors On Call for Service), teaching emergency medicine to local physicians. Here he shares one experience there. This article was originally run in July 2010.]
