On the occasion of the awarding of the Nobel Peace Prize to Denis Mukwege and Nadia Murad for their efforts to end the use of sexual violence as a weapon of war and armed conflict, CIVICUS speaks to Susannah Sirkin, director of policy and senior advisor with Physicians for Human Rights (PHR). Founded in 1986, PHR uses medicine and science to document and call attention to mass atrocities and severe human rights violations. PHR’s work focuses on the physical and psychological effects of torture and sexual violence, the forensic documentation of attacks on civilians, the unnecessary and excessive use of force during civil unrest, and the protection of medical institutions and health professionals working on the frontline of human rights crises. Susannah oversees PHR’s international policy engagement, including its work with the United Nations, domestic and international justice systems and human rights coalitions, and is also responsible for managing and multiplying PHR’s strategic partnerships globally.
Who are Nadia Murad and Denis Mukwege, and why were they awarded the Nobel Peace Prize?
Let me start with Denis Mukwege, whom I know personally. Dr Mukwege is an incredibly skilled and experienced gynaecologic surgeon from the Democratic Republic of the Congo (DRC). He is not only a clinician but also has a PhD in Medicine and has become, unfortunately due to the wars in the DRC, an expert in treating victims of mass sexual violence in the context of the decades of brutal conflict in his country. His medical specialty therefore became treating patients with traumatic fistula – women who were sexually assaulted so violently that various functions of their internal organs were damaged and destroyed, causing pain, incontinence and many other problems. In sum, Dr Mukwege’s surgical expertise is repairing fistulas and treating damage to the genital and reproductive organs in women and girls. In the course of treating hundreds of victims of mass rape in Eastern Congo, he started to speak out, as a doctor, against the atrocities and the culture of impunity that continued to be the norm in his country, and he began to analyse and denounce the use of mass rape as a weapon of war and to bring the voices of survivors to the fore in the global context.
Dr Mukwege is eloquent, courageous, creative and imaginative. He is equally capable of speaking to heads of state and the UN Security Council as he is of talking to the people of Panzi, the small town where his hospital is located in the South Kivu province of eastern DRC. He has also mentored dozens of young professionals working to support survivors in DRC and beyond. He is a huge advocate for a holistic model of treating survivors of sexual violence: he recognises that medical care is not just about the immediate needs of survivors or rape – which are many, including the prevention of sexually transmitted diseases and dealing with possible pregnancy and mental health trauma – but also about supporting access to justice and social and economic reintegration and, above all, about restoring dignity and ending the stigma and shame that has silenced so many survivors.
Nadia Murad is a young woman who was a victim herself - but she did not remain a victim and instead became a powerful and outspoken survivor. She comes from Sinjar, in northern Iraq, and belongs to the Yazidi people, a very small ethnic and religious minority that Islamic State (ISIS) targeted for extermination because they viewed them as pagans. In 2014 ISIS overran the area, rounded up people from her village, and committed unspeakable atrocities. They killed thousands of them, including six of Nadia’s brothers, and took the women into slavery. More than 6,000 Yazidi women were kidnapped by ISIS and held as sexual slaves, and more than 3,000 are still missing. So essentially, Nadia is a survivor of what was clearly a genocide - the deliberate destruction of a people’s culture and community, their homes, the killing of men and boys, mass abductions and disappearances, the sexual slavery of women and girls. In this case, as in the cases of most survivors of sexual violence in conflict contexts, rape is just one of the many horrific atrocities inflicted on them.
What is remarkable about Nadia is that she came out of captivity, which involved unbelievable suffering – beatings, burning, rape – as a leading voice describing and denouncing the plight that she experienced along with thousands of women, and bearing witness to the genocidal violence against her entire community. She overcame enormous trauma, transformed her brutal experience into witness, testimony and advocacy, and has become a voice for her people and against violence against women, and to demand accountability for the Yazidi genocide. Hers is also a call to look at survivors as whole persons and recognise their dignity as human beings and not just as victims of one crime or another. In fact, both she and Dr Mukwege, the survivor and the doctor, testify to this deep understanding of the whole person that demands our response. And they both call for addressing the continued global impunity for these crimes and ensuring that survivors not only have a voice, but they are respected and listened to, that they recover their dignity and eventually receive a full measure of justice – including reparation.
Do you think the Nobel Prize will make a difference in terms of the visibility of wartime sexual violence and holding perpetrators accountable?
This is the most visible and prestigious global prize for peace and human rights, and the eyes and ears of the world are focused on its announcement. The laureates get the opportunity to address the global community in their Nobel speeches delivered from Oslo on 10 December, International Human Rights Day. As long as the media captures these moments and focuses on these individuals, they have an extraordinary platform to speak to governments, to the international agencies doing work in conflict zones and to all of civil society. So this is a terrific opportunity for them to continue to raise the issue and to point policymakers and others in the direction of the concrete actions that are needed, because they are activists, they know their communities, and they know what needs to be done.
Additionally, the very fact that somebody like Nadia, who went through those experiences, can have a voice sends a powerful message to other survivors. Nadia was very young, and she was not a trained organiser or activist, but she was able to overcome trauma and become a global spokesperson so that people like her could have a voice. This is very validating not just for the Yazidi people, who have suffered unspeakably, but also for women and girls anywhere who have suffered assault. She specifically calls attention to the phenomenon of slavery – which includes rape but is not limited to it. And in her case, attention also focuses on the vicious, depraved crimes committed by ISIS.
As for Dr Mukwege, it’s worth noting that this is a time of a possible, long-awaited transition in the DRC, where there may be long-delayed elections, and where dozens of unresolved mass atrocity cases await justice. The Nobel Prize to Dr Mukwege calls attention to the very critical role played by doctors who believe that you cannot just treat the victims of mass crimes but must also use your experience and expertise to bring about change and stop these crimes from happening in the first place. In the view of PHR, this transformation of Dr Mukwege from a doctor who treats each patient individually to a doctor who creates and advocates for peace and justice on the global stage is an extremely important model for doctors everywhere, and especially for those who are witnesses of human rights violations.
Can you tell us more about the work that PHR has done in partnership with Dr Mukwege as well as in northern Iraq, including the area where the violations against Yazidi people took place?
Over the past seven years, PHR has worked very closely with Dr Mukwege and his staff to build capacity for the forensic documentation of sexual attacks and to bring health professionals to work more closely with law enforcement, lawyers and judges, so that survivors can gain access to justice safely and with dignity. This is fundamental because unfortunately, it is still very common for medical humanitarian workers to feel that their job is limited to providing medical care, and as a result, they set up a firewall between medical care and justice, as if the two were in competition or even incompatible with each other. In the model we promoted along with Dr Mukwege, medical support to survivors includes forensic documentation and, if the survivor so wishes, also support towards and all the way through a justice process. This requires a multidisciplinary collaboration that in far too many contexts is currently still not happening.
In Iraq, as in the DRC, we are developing a model of multi-sectoral capacity building to support access to justice for survivors of sexual violence and torture. In Iraq, this was not restricted to the Yazidi people, as these human rights violations are taking place in the context of the various crises unfolding in Iraq. We are training doctors, nurses, psychologists, law enforcement officers, lawyers and judges on forensic documentation of sexual violence and torture, and we are working to help support greater communication and collaboration across these sectors so that survivors of these crimes have safe and dignified access to justice in the full sense of the term.
We are very concerned that to date the prosecutions and trials to hold ISIS accountable for mass crimes in Iraq, which have definitely not met any recognised international standards for fair trials and treatment of detainees, have also not involved any criminal charges related to sexual violence or sexual slavery. All the ISIS detainees are being prosecuted under anti-terror laws, not for the crimes of rape or sexual slavery. The justice system has so far not met the needs of the Yazidi people or any other victims of slavery and sexual violence.
In Iraq we are adapting the model used in the DRC, because there are legal as well as cultural differences between the two countries. A big difference is that DRC is a party to the Rome Statute - the International Criminal Court - and has incorporated it into domestic law, so we were able to use those standards, procedures and understandings of mass crimes within the Congolese legal system. That is not the case in Iraq, where there are no laws that recognise or allow for the prosecution of genocide or crimes against humanity. This huge legal gap makes it nearly impossible to prosecute genocide, mass rape and mass sexual slavery in Iraq.
Across the world, what needs to be done to ensure that sexual violence is recognised and treated as a major human rights violation?
There are things to be done at every step of the way. In too many places, everything conspires against victims coming forward. Sexual violence is often perpetrated by very powerful people who control a person’s physical, economic or social environment, their jobs and even their social standing in the community. In many parts of the world women who have been raped are considered unmarriageable. In sum, there are many factors conspiring against a victim coming forward or even seeking medical care, let alone justice.
In almost any country, the biggest initial obstacle is the lack of confidence that survivors have in the law enforcement and justice system. So first, there needs to be safe access to reporting. Opportunities need to be provided for reporting to a person who is well trained to respect the survivor’s physical and emotional needs, understand the trauma that that person has been exposed to and master all the technical aspects to ensure that the case is properly documented, both clinically and forensically, to facilitate access to justice. This also requires a support network to provide assurances of safety and confidentiality, as well as a context where the survivor is not judged or stigmatised, or has their integrity questioned. More often than not, it is the victim who ends being interrogated instead of the perpetrator.
Second, there are failures of the justice system to address, including delays, lack of proper procedures to allow survivors to tell their stories safely and confidentially, and an inadequate understanding of the ways trauma affects memory or even the ways in which someone presents in front of a court of law. A lot of our training seeks to address these issues. Third, there is the limited supply of the economic and psychosocial support that survivors need. And last but not least, at the highest international level, there is the failure to prosecute the worst perpetrators, which makes it much more difficult for survivors to deal with the day to day crimes of rape and sexual assault.
What further support does civil society need to combat wartime sexual violence, including from international civil society and the international community?
One of the biggest problems that we have is the insufficient communication and coordination among all the entities working on these issues. When there is a crisis – the Rohingya people in Bangladesh, Iraq, Syria – many organisations come in to do their very well-intentioned work, but they do so in a far too uncoordinated way. We hear constantly from the legal side that gathering testimonies without the proper training can actually harm the case, and we see that some survivors are interviewed way too many times by too many people without a clear purpose. In other words, two things that are critically needed are training and coordination.
The third thing we need is for the international community to be more intentional about referring cases to international justice mechanisms, and not just drop them if, say, the Security Council fails to refer some case to the International Criminal Court. We now have investigation mechanisms – for Iraq, for Myanmar, for Syria – but they don’t have any judicial authority. We need to address the fact that the system is broken: we are giving people hope, we tell them that if they report they might get justice - but that is in fact not happening.