Population Matters

Grace Under Fire

June 10th, 2010

One of the films featured at this week’s Women Deliver conference in Washington was a new BBC documentary that takes a much needed look at women and reproductive health care in one of the most violent conflicts of the 21st century.  I saw it last week at a special viewing offered by the U.S. State Department.  It should be required viewing for anyone concerned about the welfare of women and children.

Produced by Dr. Grace Kodindo, OBGYN and professor of Population and Family Health at the Mailman School of Public Health at Columbia University, “Grace Under Fire,” is an emotionally compelling film about the severe lack of reproductive healthcare in the Democratic Republic of Congo (DRC).  The DRC has been torn apart by a horrific civil war fueled in part by its rich supply of natural resources.  In recent years, over 5 million people have died as a result of the conflict and related disease, many of them women and children.

The documentary follows Grace as she makes her dangerous journey from city to village to meet with women and health officials directly affected by the conflict in the DRC.  She visits local health facilities and talks directly with women who are willing to talk about their experiences.  In the DRC mass rape has become a weapon of war; it’s used to humiliate women and families and marauding troops use it to gain control over communities and spread terror.  Survivors fearing stigma and ostracism often do not speak out about it.  It’s heartbreaking to watch Grace as she talks to young women who have been raped and impregnated by soldiers.

Many of these women were forced to give birth on the road instead of in a hospital.  In assisting these women, some families had access to emergency birth kits consisting of a sterile plastic sheet, a razor blade, rubber gloves, soap, and medical tape.  The kit is no substitute for trained medical care, but it’s cheap, and in a country torn apart by violence, it can make the difference between life and death.

Grace also interviews a mother and father who have 12 children and don’t want any more, but like many parents in this region they lack access to family planning services.  She travels further west to Katsiru, visiting displaced people living in UN camps where she speaks to more women who have been raped.  The numbers are staggering. The United Nations High Commissioner for Refugees (UNHCR) says that at least 200,000 cases of sexual violence have been recorded in the DRC in the past decade.  Many of them live in the volatile North and South Kivu provinces, which are hosting 1.4 million internally displaced persons (IDP).

In Katsiru, Grace visits the only health facility, one that is trying to care for the 17,000 people living in Katsiru, along with three IDP camps.  It’s woefully ill-equipped. When there are complications during childbirth, the villagers must make a stretcher and carry the woman to another clinic over 12 miles away.  Though the facility treats an average of 20 reported rape victims a month, there are no rape kits, no emergency contraceptives, no antibiotics, no HIV tests, no rubber gloves, no emergency birthing kits, no midwives, and only three condoms.  It’s an eye-opening and depressing account of the need for family planning and reproductive health care in the DRC and other conflict zones.

At the end of the film we are shown a road side court martial of a group of soldiers accused of rape, who are sentenced to a lifetime of hard labor.  At least some of the perpetrators are being brought to justice, but women in the DRC continue to be raped, and continue to suffer from a health system that is unable to respond to their needs.  In this conflict as in many, women and children are the real victims, not the soldiers.

It’s important to remember that what’s happening in the DRC is also happening in some fashion in other war zones, like the Sudan.  What’s needed is a committed and coordinated international effort to bring reproductive health services into areas affected by conflict.  Earlier this week, the Gates Foundation pledged $1.5 billion for family planning, maternal health, and nutrition services in developing countries, and the issue of maternal health is high on the agenda for the upcoming G8 summit in Canada.  Maybe this documentary will help to stir the conscience of both foundations and donor nations.  The need is certainly there.

For more information on the film visit this site.

Posted by Emily Pontarelli, Program Associate

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