I can't stop thinking about Marie. She was 30 years old when I met her in 2015. Two years earlier, six fighters armed with rifles and machetes burst into her home in the capital of the Central African Republic, Bangui. Two of the fighters held her husband at gunpoint while the others pushed her to the ground. "Each of the four then raped me," she told me. "My husband was in the room, but they would not let him move."
Afterward, Marie didn't have the money for an HIV test or any medical care.
In 2015, the United Nations created the International Day for the Elimination of Sexual Violence in Conflict, recently marked on June 19, as a call to action. But every day should be a call to action: in crises from Myanmar to South Sudan to Syria, fighters carry out rape and sexual assault. The majority of reported survivors are women and girls, but men and boys are also victims. Few of them have access to help or justice. In the Central African Republic, these assets have been virtually nonexistent.
In May, the Central African government and the UN special rapporteur on sexual violence in conflict signed a new agreement pledging to tackle sexual violence by armed groups, including bringing attackers to justice and providing necessary services for survivors. But the test will be how well these promises are carried out. The latest UN report on conditions in the country includes information on continued acts of sexual violence by armed groups and "widespread rape" documented in one particular area.
For our 2017 report on sexual violence by armed groups in the Central African Republic, my colleague and I interviewed nearly 300 women and girls who had survived rape and sexual slavery. We found widespread and systematic use of rape as a tactic of war. Most of the incidents we documented were gang-rapes and many could be considered torture. Women were raped by multiple fighters while held for weeks in makeshift camps or forced to watch as armed men murdered their husbands or children before raping the women. Girls were captured while walking home from school, leaving them pregnant and afraid to return to class. Other research has documented similar violence against men and boys.
Fewer than half of the women and girls we met had obtained any medical care. Many who did hadn't disclosed the rapes to health personnel for fear of stigma and abandonment, so they didn't get essential post-rape treatment. Only about a fifth had received emotional or psychological support, despite symptoms consistent with depression and trauma, including suicidal thoughts. Only 11 of the almost 300 women and girls we interviewed had even attempted to seek justice.
None of this is surprising in one of the world's poorest countries, where a largely forgotten conflict has raged since 2013. Hopes are pinned on the latest peace agreement, signed in February, but it is precarious: violence broke out in March and again in May.
Meanwhile, armed groups are still using rape and other sexual violence against civilians. The medical aid group Médecins Sans Frontières (Doctors Without Borders) reported that its sexual violence clinic in Bangui treated nearly 800 patients -- mostly women -- between December 2017 and September 2018. Data collected from numerous aid agencies showed nearly 2,000 reported cases of sexual violence in 2018, though it's unclear how many were by members of armed groups.
Survivors of conflict-related sexual violence across the country require confidential, comprehensive medical care, including emergency contraception and safe abortion. They desperately need mental health care by trained providers, as well as socioeconomic assistance. They also need to know about these services and where to find them. And in a country where a $1 shared taxi ride can be prohibitive, they need access to transport or mobile services.
Most survivors we met had little faith that their attackers would be prosecuted, but many longed for it, including Marie. "I have thought about what these men did, and justice for myself," she said. "I want these men brought to justice and put in prison."
In the recent agreement, the Central African government said it would seek justice for victims of conflict-related sexual violence in the national justice system, including by supporting a special unit of police and gendarmes for sexual violence cases. The agreement also prohibits the government from allowing the attackers or their commanders from holding government office or receiving amnesties -- both sticking points in peace negotiations and essential to lasting peace as well as justice for survivors of the conflict's many atrocities.
The government and the UN should also ensure political and technical support for the Special Criminal Court, a new war-crimes body based in the domestic system that operates with international expert participation and assistance. For the court to adequately address sexual violence and other crimes, strong victim and witness protection programs will be essential. Continuing assistance from donor governments for these programs is also vital.
On June 19, I was thinking of Marie and the hundreds of women and girls I met in the Central African Republic, many of whom await the most basic measure of help: a doctor's visit, a counselor to talk to, the hope of seeing their attackers brought to justice. The Central African government, the UN and the international community should make sure the women and girls aren't still waiting this time next year.