The Great Lakes area of central Africa encompasses countries affected by past or acute present conflicts, such as DR Congo, Rwanda, Burundi and Uganda. The roots of these conflicts reach back to the colonial era and generally revolve around land and mineral resources. Ongoing migration and displacement, ethnic tensions, and innumerable rebel groupings and militia all keep the flames of conflict ablaze. The global trade in coltan, gold and cobalt all nourish a flourishing conflict economy, mainly to the benefit of politicians and military leaders. In plain view of the UN peacekeeping troops and international community, sexualised violence continues to be used as a weapon.

Eight facts on women's rights in the Great Lakes Region:

1. DR Congo: Conflict-related sexualised violence

In just one year, 2020, the UN peacekeeping mission MONUSCO documented 1,053 cases of sexualised wartime violence in the DR Congo. Of these, 700 were carried out by non-state armed groups and the rest by governmental security forces and soldiers. Women are frequently attacked and raped as they work the fields or fetch water. Survivors rarely have the opportunity to find medical, psychological or material help.

2. Rwanda: Sexualised wartime violence and trauma

Portrait of a woman in Rwanda

The UN estimates that between 250,000 and 500,000 women and girls were raped during the genocide in Rwanda. Thousands of children were born after being conceived during these brutal attacks. The social isolation and ostracism of the survivors and their children affect their whole family. They are often left living in poverty and desperation due to their health problems and traumatic stress.

3. Uganda: Cast out and marginalised

During the armed conflicts in Uganda since the early 1980s, innumerable young women and girls were kidnapped by rebels. They were held for months or even years, used as sex slaves, and repeatedly raped. Many of the survivors were left with unwanted pregnancies. In the eyes of their families they are “soiled“. Along with their children, they are then often cast out and socially marginalised.

4. Sexualised violence in everyday life

Suppression and violence also characterise the everyday life of many women in the region in times of peace. According to national healthcare surveys, some 44 per cent of all women of childbearing age in Rwanda, 47 per cent in Burundi, 58 per cent in the DR Congo, and 62 per cent in Uganda have been subjected to physical and/or sexualised violence. This ranges from rape, slavery or trafficking through to forced marriage and sexualised violence by their spouse.

5. Gender-based violence: Simply because they are girls

A group photo of Ugandan school girls

Girls are subject to a continuum of violence and disempowerment. For example, in Uganda almost half of all girls are married before they reach the age of 18 and the rate of teenage pregnancies is one of the highest in the world at 25 per cent. Those affected generally have to abandon their schooling and any chance of education. In the DR Congo, roughly one girl in five is forced by their teacher to engage in sexual activity in exchange for better grades. Orphans, street children and ethnic minorities are especially at risk.

6. Structural violence and repression

In the DR Congo and Burundi, family laws increase the discrimination of women and girls: in the eyes of the laws, they are inferior to men and subject to male conservatorship. Patriarchal values and resistance in Rwanda and Uganda have prevented the successful enforcement of reforms intended to ensure more equal rights and protection from violence. Corruption and a weak legal system obstruct attempts to bring perpetrators to justice and compensate survivors.

7. Restricted access to healthcare provision

In the wake of long years of conflicts, healthcare provision in the Great Lakes Region is inadequate. Especially in rural areas there is a shortage of clinics and staff. The injuries suffered during rape are so severe, the women and girls are often unable to reach the closest clinic afterwards. And even if they could, they would not be able to afford the costs of transport, medicines and treatment. Inadequate medical provision and risky abortions lead to high rates of maternal mortality and miscarriages.

8. Milestones in the fight against sexualised violence

The regional women’s rights organisations have brought the issue of sexualised violence into public awareness. It was their pressure which forced the countries in the region to accept important UN Resolutions on women, peace and security. Another important success was in 2006 as the International Conference on the Great Lakes Region agreed a Protocol on the Prevention and Suppression of Sexual Violence against Women and Children. The objectives of the Protocol include ending impunity, protection, and the provision of material and social assistance, including compensation, to survivors.

(Status of: 2021)

Practical Examples:

More than 1,100 women and girls affected by violence received integrated support in the South Kivu region of DR Congo.

About 90 women in South Kivu benefitted from income-generating measures.

In Burundi, more than 6,000 people were informed about sexualised violence and preventive measures as part of the “Twiteho Amagara” program.

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Partner organisations:

  • Burundi: Association NTURENGAHO, Dushirehamwe, MUKENYEZI MENYA
  • DR Congo: AFPDE, EPF, HAM, La Floraison, PAIF, RAPI, RFDP
  • Rwanda: Solidarité pour l‘Epanouissement des Veuves et des Orphelins (SEVOTA)
  • Uganda: FOWAC, Mentoring and Empowerment Programme for Young Women (MEMPROW)

Project priorities:

  • integrated support for survivors of sexualised violence and their children
  • community work against violence within the family
  • organisational development for women’s rights organisations

Funding and funders:
German Federal Ministry for Economic Cooperation and Development (BMZ)
Sigrid Rausing Trust
Fondation Smartpeace
Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ GmbH)
Medicor Foundation
Leoppold Bachmann Foundation
EU/HNTPO
Foundation Anne-Marie Schindler
Own resources

Source: Annual Report 2020

Overview of all partner organisations of medica mondiale

1. Networking and strengthening women’s organisations

Five members of a women’s group that receives support from our partner organisations in the Eastern Congo.

An end to violence against women and girls needs long-term changes in society. Progress towards this often fails because of a lack of political will and involvement. medica mondiale is committed to bringing together women’s organisations in the region, so they can work together to eliminate violence. Three cross-border programs offer the partners funding and expertise, but also space to share their own experiences and learn from each other.

2. Breaking the cycles of violence

The cycles of violence cannot be broken unless both the causes and consequences of violence are tackled. So prevention of violence and support for women and girls affected by violence are both essential components of our projects in Great Lakes Region. Our primary aim in supporting women and girls is to strengthen their self-confidence and their social status, in turn empowering them to actively rise up against violence and patriarchal ways of thinking.

3. Integrated assistance

Portrait photo of a women at a sewing machine.

The partner organisations of medica mondiale are often the first points of contact for survivors of sexualised violence. They offer integrated support and where necessary refer the survivors on to clinics or lawyers. In 2020 in the South Kivu province alone, some 500 women and girls were provided with psychosocial assistance and 200 received medical care. Income-generating measures such as agricultural training or micro-credits also enhance the women’s economic independence.

4. Training the stress- and trauma-sensitive approach (STA)

For our partner organisations, their work with survivors of violence can often be stressful and challenging. So self-care is an important aspect of project work with them. Regular supervision and training sessions help staff to guard against stress and deal with it better when it does occur. Since 2021, experts from the region have also been training specialist staff in healthcare institutions in Burundi and DR Congo on how to adopt the stress- and trauma-sensitive approach (STA). In this way, we hope to create an environment where survivors receive integrated support and are able to stabilise.

5. SASA!: Eliminate violence against women now

The gathering of a parents’ group in Uganda.

In Burundi our partner organisations are taking new paths in violence prevention. By adopting the approach of SASA! in Uganda, they intend to draw attention to inequality in power structures, and the opportunities to change these. This involves mobilising key actors, such as village elders, women’s groups, parents, and teachers, to become active within their communities and commit themselves to equal rights and the protection of women and girls. One example of how this can begin is the gender-equal sharing of household chores such as fetching water.

6. Advocacy and PR work

Several women sitting in a public group discussion.

PR and advocacy work are important approaches for our partner organisations as they work to ensure the rights and protection of women and girls. For example, in Eastern Congo they train local authority and government agency staff, as well as managers, on how to implement measures that protect against sexualised and gender-based violence. They are also conducting a lobby campaign to bring about structural change against corruption and illegal court costs. In Uganda, MEMPROW is calling on the government to increase the resources available for programmes to empower women and girls.

7. Feminist action

Working in a feminist way means working together. So medica mondiale is committed to exchange and networking. Each year, a symposium brings together stakeholders and partners from the whole region. Together they discuss effective measures, such as psychosocial work. In 2019, a main topic was feminist approaches to preventing violence. By offering feminist leadership training, we also empower women in management positions within civil society and government structures.

(Status of: 2021)