Patricia Gray

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Country: USA
Background:
Research Project: Outcomes of interventions for rape survivors from the war in Sierra Leone: Memories of hospital visits and counselling sessions

BACKGROUND: Rape has long been an expected part of war, sometimes an accepted part of war. In past and present conflict zones such as Chechnya, Sierra Leone, Bangladesh, Myanmar, Liberia, Democratic Republic of Congo, the Balkan region, and Rwanda high rates of women are reported to have been raped as a tactic of war (Shanks et al, 2000). Despite the widespread prevalence of rape during war, the first significant attention to the issue was during the conflicts in Yugoslavia and Rwanda in 1994. Furthermore, it was not until the 1990s that the UN and other organizations began to call attention to and request redress for rape survivors in any setting (Bosmans, 2007). Thus, little time has passed since studies commenced on psychological effects of sexual violence for females in conflict or non-conflict zones.

Sierra Leone was in a state of civil war from 1991 to 2002. During the conflict, 9% of the population in Sierra Leone reported rape (Amowitz et al, 2002) and one-third of women experienced sexual assault (Bernath, 2007). Amnesty International (2000) and Human Rights Watch (1999) report having testimonies from an even higher percentage of the population. MSF sent doctors to Sierra
Leone to address the growing health concerns but upon arrival found little to no services for mental health which resulted in the establishment of temporary counseling centre’s (Jong et al, 2007). Between 1999 and 2002, the FAWE also provided counseling to survivors of rape in Sierra Leone (Amnesty International, 2000). Despite the availability of counseling and other services established for survivors, many women who were raped did not seek services because of shame or having to admit more than one rape occurred (Amnesty International, 2007). The consequence for acknowledging the rape ranged from acceptance by peers and family to condemnation by the community to husband abandonment (Amnesty International, 2007). At the end of the war, many support agencies left, ending most of the counseling services.

METHODOLOGY: In order to determine if services for women raped during war were effective, semi-structured in-depth interviews were conducted in three areas of Freetown: Lumley, Myakene/Calaba Town and Grafton. Participants were questioned about hospital visits and counseling sessions.

RESULTS: While discussing counseling and hospital visits with participants, the main themes that arose were: coping strategies, sex work and sexual exploitation, attending vocational school, and pregnancy as a result of rape. Counseling tended to ignore providing survivors with coping mechanisms. The most common coping strategies were praying and taking pills. Participants expressed that they would inform others in their position that they are not alone but in turn, feared telling friends because they may “throw it back in your face.”

CONCLUSION: Overall, this study showed that interventions need to have four components to effectively provide a foundation for a healthy life post war: (i) hospital visits that include speaking to the survivor about effects from rape and provide treatment, (ii) counseling that includes listening and working with the survivor on coping mechanisms that can be used in a time of crisis, (iii) vocational schools that allow survivors to learn a trade for economic livelihood and as a means to live life beyond war, and (iv) community interventions that address the need to accept women who were raped.

Keywords: Sierra Leone, rape, counseling, coping strategies, interventions