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19 May 2015

“We have been harmed but we are brave and strong.” – medica mondiale presents the results of a study on long-term consequences of sexualised violence

Press Release: Cologne, May 19, 2015. Survivors of sexualised violence have an urgent need for ongoing support, advice and therapy. This is demonstrated by the results of a study from the women’s rights organisation medica mondiale. Together with its Bosnian partner organisation Medica Zenica, between June 2013 and February 2014, it interviewed former clients in Bosnia and Herzegovina (BiH) to discover how they are coping 20 years after the wartime rapes. Psychological stress, gynaecological complaints and a generally alarming state of health all shape their everyday life. “Their experiences are still a burden today, yet they are coping with their lives,” explains Monika Hauser, founder of medica mondiale, upon publication of the study’s results in Germany. “There is a real lack of systematic research on this issue. So we are filling part of that gap with ‘We have been harmed but we are brave and strong. A study on the long-term consequences of wartime rape and the coping strategies of survivors in Bosnia-Herzegovina.’”

Based on the results, the two women’s rights organisations are making the following appeal: In BiH, general awareness needs to be significantly improved regarding the situation of the survivors of sexualised wartime violence. This should include a public discussion of the stigma which currently leads to social exclusion of the survivors, not the perpetrators. One respondent puts it bluntly: “Perpetrators have more rights than survivors.” According to Sabiha Husić, Director of Medica Zenica, it is essential to ensure both judicial and social acknowledgement of the injustice these women experienced, as well as punishment of the perpetrators. Furthermore, Medica Zenica and medica mondiale recommend long-term funding for psychosocial, medical, legal and economic support for survivors and their families. A trauma-sensitive approach also needs to be established in all of these offers of assistance, whether carried out by the state or NGOs. Throughout BiH networks are needed to ensure and coordinate comprehensive support for survivors. Additionally, the government and non-governmental organisations need to work together more closely.

After publishing the results of the study in Bosnia-Herzegovina in autumn 2014, tangible positive effects have already been achieved: Medica Zenica set up a new, free telephone hotline for survivors throughout BiH, including the Serb Republic (Republika Srpska). “New networks have been established and finally there is public discussion of violence against women, which could bring about peace in our society,” reports Ms Husić.

Research results in detail

51 women aged between 33 and 81 were surveyed regarding four topics. The first topic was how the violence the women suffered is influencing their everyday lives. Secondly, they were asked how Bosnian society treats survivors. The third point of interest was the mechanisms they use to cope. In the last part, the women were asked to evaluate how helpful they found the offers of assistance from the women's therapy centre Medica Zenica.

Alarming health situation

Over 93% of the women are still suffering from gynaecological complaints. 76% describe sleep disturbances and 57% are suffering from post-traumatic stress disorder. More than 70% of the surveyed women indicated that the rapes were still dominating their life, above all in the form of stressful, recurring flashbacks, nervousness and problems in close relationships. Over a quarter of the women report that the lives of their children have been “completely affected” by them passing on the unresolved traumas. These results attest the destructive long-term effects of wartime rape.

No social recognition

In BiH, survivors of sexualised wartime violence have been able to apply for the status of ‘civilian war victim’ since 2006. This entitles them to a monthly pension of around €275, as well as further training and assistance when searching for employment or accommodation. So far, only around 1000 have applied for this status, although 20,000 to 50,000 women and girls were raped. The reasons for this named in this study include the poor information policy of the Bosnian government, the amount of bureaucracy necessary, and the degrading procedure involved, during which the women repeatedly have to describe what happened to them. Nonetheless, 76% of the women surveyed by the study did successfully claim the status, helped in part by Medica Zenica. However, only 8% of them take advantage of the programmes on work, training and accommodation which they would be entitled to.

Talking helps

The coping strategy most frequently named is “diverting attention”. 60% of the surveyed women regularly use psychopharmacological medicines to alleviate their nervousness and to enable them to cope with everyday life. The women explained that the most important factors contributing to their stabilisation were the sharing, exchange and emotional support to experience among similar women, as well as hobbies and spirituality. In response to the question, "Does time heal?", 40% responded positively. Equal numbers of participants (28% each) felt that it is as difficult or even more difficult to cope with the experience now as it was immediately after the war. The remaining 4% did not make a clear statement in this regard.

Sharing experiences

Respondents described the services provided by Medica Zenica as either “considerably” or “very” helpful. More than 80% reported having received psychological support, medical assistance, food and clothing. The safe house organised by Medica Zenica provided shelter for around 50% of the respondents for a certain period of time. The figures for women who took advantage of religious support, financial support or support with childcare ranged between 40% and 25%. 24% attended vocational training programmes and 14% attended computer or English language courses. 16% of the respondents said that the Medica Zenica staff helped them with their court procedures. Survivors particularly valued the opportunity to talk to someone and share their experiences with others who had experienced something similar. They reported how important it was for them to have the security offered by the safe house: somewhere for them to stay in the middle of war. Many of the respondents are still using the psychosocial and medical assistance provided by Medica Zenica today.

Trauma research on war and rape

During the war in Bosnia-Herzegovina from 1992 to 1995, between 20,000 and 50,000 women and girls were systematically raped and subjected to sexualised violence in concentration camps. International trauma research shows that war and rape count as two of the most destructive traumatic experiences. So it can be expected that wartime rape, which combines both of these, leads to massive suffering for the survivor, with lasting impacts on their psychological and physiological health as well as their relationships to other people. There are very few studies on the issues of wartime rape and its long-term consequences or the coping strategies of survivors. For this reason, medica mondiale and Medica Zenica carried out a study with 51 women between June 2013 and February 2014. All of the participants had taken advantage of support on offer from Medica Zenica during or after the war. One of the problems faced by research into sexualised (wartime) violence is the fact that the feelings of shame and extreme stress among the survivors can lead to ‘sources of error’ in the research process. These include the desire to suppress painful memories or the tendency to respond with answers influenced by feelings of shame. In order to avoid this, staff at Medica Zenica were asked to carry out the surveys with their former clients and to ensure that the interviews could take place in an atmosphere of trust and security.


A summary of the study's results can be found in our Media Centre. An English video also presents the most important results in a concise way.