Restoring Trust in People and Life: The Mission of the Dr Denis Mukwege Foundation for Survivors of CRSV

The Dr Denis Mukwege Foundation initiated its operations in Ukraine before the large-scale Russian aggression. Catherine COPPENS, the Executive Director of the Dr Denis Mukwege Foundation joins us as we explore the support this international humanitarian organisation provides to survivors of conflict-related sexual violence and its collaborative efforts with the Government of Ukraine and civil society.

– When and how did the story of the Dr Denis Mukwege Foundation begin? What assistance does it provide?

– The Dr Denis Mukwege Foundation is an international organisation assisting survivors of conflict-related sexual violence (CRSV) worldwide. Founded in 2016 by Dr. Denis Mukwege, it promotes the Panzi model and philosophy of holistic care. This model aims to facilitate access for survivors of CRSV to medical, psychological, and social support, alongside access to justice on the local level, empowering them to effectively cope with the aftermath of their trauma.

Survivors of CRSV often face stigma and shame, frequently from their own families and communities and sometimes feeling guilty about what they have been through. Overcoming these challenges can be a lengthy process, sometimes extending over years. After providing support to individual survivors, Dr Mukwege and his team at Panzi Hospital in the Democratic Republic of Congo recognized that survivors benefit from coming together to openly discuss their experiences and share their journey towards healing, thus making the healing process less painful. This collective support among survivors strengthens them as they rebuild their lives.

The third component of the holistic care model relies on collaboration between government institutions and civil society organisations to provide effective assistance to CRSV survivors.

The Dr Denis Mukwege Foundation started uniting CRSV survivors by establishing the global movement of survivors called SEMA. Presently, SEMA is active in 26 countries, including Ukraine. SEMA-Ukraine is run by Iryna DOVHAN, who recognises the significance of survivor gatherings.

– Does the Dr Denis Mukwege Foundation provide assistance exclusively to female survivors, or also to male survivors?

– Dr Denis Mukwege, an obstetrician-gynecologist, practiced in the Democratic Republic of Congo to ensure safe childbirth and maternal survival, addressing a significant concern. However, his hospital also received women with severe vaginal injuries, initially without disclosure of the cause. Over time, the women shared that those injuries were the consequences of sexual violence, often perpetrated using sticks that inflicted severe internal damage to their organs. Initially, CRSV primarily affected women.

During the initial meeting of the worldwide SEMA movement, around 60 survivors from nearly 20 countries came together to discuss the possibility of including male survivors into the organisation. Some were hesitant, given their upbringing in patriarchal societies, concerned that male survivors might overshadow women. That was a few years ago. I believe, the network has since grown and proven resilient and has welcomed its first male members. Branches catering to male survivors have now emerged within national movements, including those in Colombia and the Democratic Republic of Congo.

In Ukraine, both the Dr Denis Mukwege Foundation and SEMA-Ukraine engage with and provide support to male survivors.

Are children affected by CRSV?

– In my opinion, the impact of CRSV on children varies depending on the country’s circumstances. It affects them in various ways. Firstly, children themselves can be survivors of sexual and gender-based violence. Secondly, they can also be unwilling witnesses when CRSV occurs to women or men in their families or communities. Witnessing their mother or sister experiencing sexual harm can be equally traumatic for them.

There is a third aspect to consider. Sometimes, mothers who have experienced CRSV may struggle to esume their previous roles. They might withdraw from their families, battle with depression, and face difficulties in caring for their children. As a result, the children may also be affected.

And the last but very important aspect. In many countries, we observe that women who have experienced sexual violence become pregnant and give birth to children. This experience can be extremely traumatic for the mother, and depending on how society responds, it can also be distressing for the child.

Children are indeed a significant part of CRSV survivors, and particularly in areas such as Congo and elsewhere, they are identified as a vulnerable population requiring appropriate support and aid.

– In which countries does the Dr Denis Mukwege Foundation operate?

– We operate on three different levels. In countries like Ukraine, Congo, CAR, and Burundi, we employ the comprehensive model of holistic care. In places like Iraq, our primary focus is on providing training. Additionally, in 10 countries including Bosnia and Herzegovina, Kosovo, Bangladesh, Myanmar, Colombia, Guatemala, Syria, Mali, South Africa, and Sudan, we support survivors by strengthening their national networks. We organize various events such as meetings and webinars to raise awareness about CRSV, discuss strategies for prevention, and foster global solidarity to address this issue.

– What is the purpose of your work in Ukraine? Have there been any adjustments to your approach since the commencement of the full-scale aggression by the Russian Federation?

– Even before the full-scale aggression, we extended support to SEMA-Ukraine, a group that brought together survivors of CRSV following the events in Donbas committed by Russia. However, our programme was quite constrained at that time. We focused on advocating for Ukrainian authorities to recognise these survivors and provide them with assistance.

After the full-scale invasion, we significantly stepped up our partnership with the Government of Ukraine, particularly with the Office of the Government Commissioner for Gender Policy led by Kateryna LEVCHENKO and the Office of the Deputy Prime Minister for European and Euro-Atlantic Integration run by Olha STEFANISHYNA. In the first months, a deep understanding emerged that the Russians were employing sexual violence as a weapon of terror, posing a high risk to many more civilians. We recognised the urgent need to leverage the expertise of Dr. Mukwege and our team in collaborating with professionals in Ukraine to offer the best possible support to survivors.

In April 2022, we and our fellow colleagues traveled to Ukraine for a meeting convened by Kateryna Levchenko, bringing together representatives from ministries, government agencies, and civil society organisations to chart our future course of action. During that time, Ukrainian authorities demonstrated sincere political will and commitment to collaborate in aiding survivors of CRSV.

The authorities were also deeply committed to investigating instances of CRSV, collecting evidence, and documenting them to substantiate the atrocities perpetrated by the Russian military. We even had some concerns about potential conflicts of interest due to the strong focus on survivors testifying to gather adequate evidence for investigating various CRSV cases. Nonetheless, it remained imperative for professionals like doctors, psychologists, and prosecutors to prioritize the interests of the survivors above anything else.

Ukrainian policy makers supported our position during the discussion, marking a highly valuable achievement.

Another advantageous aspect was that before the full-scale aggression Ukraine had a solid infrastructure for providing medical and other forms of assistance. This included facilities for safe childbirth, access to psychologists and psychiatrists, a functional justice system, and the Prosecutor General’s Office. With these services already in place, we did not have to create new infrastructure or deploy doctors or psychologists to the country. Instead, our efforts were directed towards enhancing existing facilities to ensure they operate smoothly and are fully equipped to provide effective assistance to survivors of CRSV.

Perhaps, some difficulties arose from an overly segmented assistance system. For instance, survivors seeking various medical services at healthcare facilities had to repeatedly narrate their experiences to each doctor, resulting in retraumatization. We provided training to show how assigning a dedicated social worker to each survivor could ensure they receive ongoing guidance and support throughout the system.

Another concern relates to funding. When individuals relocate from one region to another, they encounter numerous bureaucratic obstacles in accessing assistance. Some improvement is needed in this area.

– How do you assess the situation with CRSV in Ukraine?

– Sexual violence in Ukraine is primarily prevalent in the occupied territories and detention centers for prisoners of war, etc. Fortunately, the majority of the country remains unaffected by Russian aggression, and sexual violence is not as prevalent. It is different that, for example, in Sudan or Myanmar, where conflicts involve multiple parties. In Ukraine, the Ukrainian military confronts Russian occupying forces.

Moreover, all governmental institutions operate effectively here. For example, there has been no rise in violence against women in any region due to the absence of police.

We know that there are many CRSV survivors in Ukraine, and we realise that we are only scratching the surface, as many individuals in such circumstances find it extremely difficult to seek help. Nonetheless, both governmental agencies and non-governmental organisations such as SEMA-Ukraine are actively engaged in assisting these survivors, many of whom remain in occupied territories or are held captive. This represents a unique aspect of the situation in Ukraine.

– Why do Russians resort to CRSV?

– Responding to such a question is always challenging because the motivations stem from the minds of those perpetrating CRSV or those who allow it to happen. In any conflict, sexual violence can be employed as a weapon of terror. Regrettably, it serves as a convenient tactic of warfare for instilling fear and horror. The reports from Bucha have instilled fear in many people. Violence is often wielded by a group against individuals to assert dominance and authority. It serves as a means of exerting control. If they seek control and encounter resistance, resorting to violence is common.

When talking about CRSV against prisoners, it also serves as a method of torture, stripping individuals of their dignity and humanity, particularly men.

– What are your main approaches to working with CRSV survivors?

– We always place the needs of the survivor at the forefront. They often feel helpless and desperate, losing control over their own lives. As I mentioned earlier, victim blaming is common in many societies. Therefore, our efforts extend beyond aiding the individual to addressing social perceptions and biases, so the community firmly declares: what you have experienced is dreadful, but it is not your fault! We stand by you! This aspect holds immense importance.

Any form of torture is horrifying, but the added burden of shame and stigma makes CRSV much more difficult for both the survivor and their family. In some instances, men may abandon their wives following incidents of sexual violence. This is why we often engage with the families of survivors to ensure they receive ongoing support.

Respecting the decisions made by the survivors is paramount. If they choose not to involve the police, it is okay. If they choose not to testify, it is okay. If they choose not to discuss their experiences, it is okay. Survivors should not face any pressure, whether from law enforcement pursuing legal action or journalists seeking media coverage. We do not support anything that could potentially harm survivors. Only a survivor-centered approach will help wounded people regain trust in others and in life.

– What assistance do you think CRSV survivors in Ukraine need the most?

– Survivors need a comprehensive array of support services to aid in their recovery. This encompasses medical assistance, particularly gynecological care. Often, sexual violence is accompanied by physical injuries such as tooth loss, broken noses, or leg injuries, necessitating medical care to address these issues.

Additionally, social and economic support is crucial. When someone has been displaced from their home, responsible for caring for three young children, and facing uncertainty about basic needs like food and shelter, their primary concern may not be their own psychological well-being.

Similarly, they may not always prioritise seeking justice immediately, as even if the perpetrator is brought to trial, their day-to-day circumstances may not significantly improve. For many survivors of conflict-related sexual violence, the pursuit of justice is future perspective.

Additionally, there are concerns regarding reparations. It is crucial for the state to recognise that the harm inflicted to you is not your fault and that you deserve to be compensated. Therefore, it is not just about punishing and imprisoning the perpetrator. Not all offenders involved in crimes committed by the Russian military will face imprisonment, at least not right away.

– The Verkhovna Rada of Ukraine is deliberating on a draft law regarding survivor status for CRSV survivors and the provision of immediate interim reparations. What do you think of the lawmakers’ intentions, and how do you anticipate this law will impact your future endeavors in Ukraine?

–  Reparations hold great significance for both victims and society. They serve to shift blame away from the survivors and allow for the provision of comprehensive assistance, including socio-economic support. It is not about charity; it is about recognising the harm endured and holding the state responsible for compensating for this harm. It is particularly noteworthy that the Government of Ukraine is addressing these issues amidst ongoing conflict, setting a commendable example for other nations. This demonstrates that even during times of armed aggression, governments can fulfill international obligations and prioritise the well-being of one of the most vulnerable populations – CRSV survivors. This initiative is undeniably essential.

Volodymyr DOBROTA,

National Press Club “Ukrainian Perspective”

The material presented herein was prepared as part of the Project “RESILIENT TOGETHER: Improving the system of response to Conflict-Related Sexual Violence (CRSV)”. The Project is funded by the European Union and implemented by the Ukrainian Women Fund in partnership with the Civil Society Organization La Strada-Ukraine” and the Ukrainian Lawyers Association “JurFem”, as well as the Office of the Vice Prime Minister for European and Euro-Atlantic Integration of Ukraine and the Government Commissioner on Gender Equality Policy.