Sexual violence has serious consequences for the mental health of survivors in the Central African Republic (CAR).
One of these consequences is stigma, which is a thorny problem in our society because of the socio-cultural weight it carries. Stigma affects the psyche of survivors and can result in the following:
- Social exclusion: which manifests itself in the survivor and the people around them being rejected in their community
- Individual isolation: particularly if they’ve been rejected by the community, some survivors decide to withdraw from their everyday lives because the trauma is difficult to overcome. This social isolation can lead a survivor to depression and thoughts of suicide.
- The downward spiral: in this stage, the survivor sinks closer and closer to ending their life. Because for him or her, this feels like the best solution to overcome their problem.
A place in society
"I no longer have self-esteem. I cannot get married after this assault because the people in my village do not consider me a worthy woman," felt one teenage survivor.
This young girl is immersed in deep sadness and a sense of hopelessness because she has become the object of mockery in her village. Her parents were forced to move to avoid this stigma.
She no longer goes to school because of shame, she does not talk to anyone, she only cries
"I can't go to school anymore or walk around like I did,” she explained.
“People made up songs in my name and are pointing fingers at me because of the traumatic event I went through."
The pain of this young girl has a cultural meaning because, in the Central African Republic, beliefs can be an obstacle to people being able to lead their life as it was before the attack.
For example, in certain ethnic groups, girls or women who have been assaulted have lost their “worth” after the event. On the other hand, for men who have been assaulted, they no longer have any honour and are rejected by the community.
These survivors then see themselves as people who no longer have a place in society.
I had been focusing on active listening, but now I replied, saying this:
"Miss, I congratulate you on your confidence and your courage in sharing with me your feelings and your suffering that you have never expressed to anyone outside of your family."
For this girl, the stigma prevents her from moving forward in her life and she is blocked: she no longer goes to school because of shame, she does not talk to anyone, she only cries.
I reassured the survivor that her suffering was real and that I valued her courage
The social aspect of this has had that much of an influence on her wellbeing.
Sexual assault causes many situations of distress, suffering and changes for survivors and their families, even beyond the trauma of the assault itself.
This can include social change, forced displacement, dropping out of school, destroyed homes, loss of property and loved ones. That’s why people need support to help alleviate these emotions and overcome this situation.
At the end of our session, I reassured the survivor that her suffering was real and that I valued her courage in telling me about her experience despite her sadness.
I comforted her by telling her that I was here to help her, that everything she told me would be kept confidential and that we are there to listen to her in a kind way – to support her psychologically and to help reduce the burden she is carrying.
Psychologists and psychosocial counsellors provide emotional support to survivors of sexual violence during the treatment and care, helping them to rebuild their lives through talking about their suffering and emotions during our sessions together.
Although we help many survivors within our project, we always wonder about the fate of all those who experience an assault but who, for whatever reason, have not been able to benefit from psychological follow-up or a kind listening ear.
MSF launched "Tongolo" in 2017, a project based in Bangui, providing medical and psychological care to survivors of sexual violence at the Community Hospital and Bédé Combattant Health Centre.
In order to strengthen the holistic aspect of care for survivors, the Tongolo centre was then opened on July 31, 2020, in the Batignolles district of the city.
More than 6,000 survivors of sexual violence have benefited from medical, psychological and psychosocial care delivered by MSF teams since the launch of the project.