I’m not sure if it was the flashing Travel Advisory by the State Department or the stories of people being detained at the border, or maybe everything I had read about the Democratic Republic of the Congo (DRC) in the Spring semester as I had studied sexual violence in the Eastern region, but the air seemed to have a overt sense of explosion. The DRC has been embroiled in a horrible regional and civil war for the past decade that has cost the greatest number of lives since World War II. Currently a ‘ceasefire’ remains in place but as we quickly learned, words and signatures on an agreement are trivial in an environment where human life has little value.

Signs of the war were palpable as we toured the hospital grounds observing victims of gun shot wounds, burns, and rape. The fighting continues and the most horrific consequences fall on women. Rape has systematically been used as a weapon of war in the Eastern Congo in an effort to demoralize, deject and destroy communities. The violence has not subsided as over 2,000 women reported rape in North Kivu in the month of June alone (although the true figure is likely much higher as cultural stigma is assigned to the victims). Sexual violence continues on an unimaginable scale and women who survive such harrowing experiences can derive a traumatic fistula—a tear in the vagina from violent rape. Violent injuries like traumatic fistula are generally less common than obstetric fistula, which results from lack of access to maternal healthcare systems. In regions of war and instability, increased violence coincides with a complete break down of already dysfunctional systems and absolute catastrophe ensues.

My months of reading and research materialized as we walked through the doors of the female ward. An elderly woman shuffled around her bed, using the edge to support her frail body. When our eyes met, she stopped and I watched this poor woman hunched uncomfortably over her bed, every line in her deep brown skin and the faint light in her eyes conveyed a lifetime of hardship and tragedy. When Dr. Jo told us this eighty-four year-old woman had endured a violent rape only a few weeks earlier, my heart sank. I wondered how a human being could purposefully inflict so much pain and suffering on the life of another. This woman was waiting for a corrective surgery to repair the traumatic fistula that violent encounter left her. Despite appreciating the service HEAL Africa offered this woman, I felt heart broken that this grandmother in the twilight of her life should ever need such an intervention.

Some cases of fistula are not easily corrected and require multiple attempts at surgery. Around 10% can never be healed because so much tissue has been lost. HEAL Africa established a small commune of women with complicated or irreparable fistulas who live and work together several miles outside of Goma. The commune collectively produces soap and textiles to sell as well as raise rabbits for food and manages a large garden for vegetables. Some women have been there for weeks and others for years but they have all bonded like sisters and mothers, taking care of each other, giggling and gossiping. The community is called “Grounds for Hope” and the name lives up to the mood in this compound. Most of them are smiling and affectionate, which is encouraging to see when you consider the emotional trauma that lurks just below the surface.

While we were there a beautiful young woman was visiting Grounds for Hope. This young woman, lets call her “Rebecca,” had lived at the commune while she healed from her complicated fistula and wanted to come see her friends during her school break. Her story is disturbing. At 14, a rebel militia man courted her and when her family refused to give her hand in marriage, the militia responded by setting her home ablaze. She was not there, but several members of her family were trapped inside and burned. Rebecca continued to escape abduction until the rebels finally caught her and made this adolescent their slave in every sense of the word. By 17 she had survived rape, pregnancy, and a prolonged labor in the bush that left her with a fistula. Leaking urine, Rebecca had little worth to the militia and she escaped before they murdered her. She eventually found her remaining family and Heal Africa and returned to school – the only subject that really made her smile.

We had a chance to visit a school HEAL Africa created to accommodate young patients or the children of patients as they waited to recover. When we first walked in the small classroom, the scene in the class could have been a school house anywhere. The kids, obviously overjoyed to have visitors, sang welcoming songs and were eager to see where we came from on the map. After this very warm welcome, the teacher wanted to show us the affects war has on the children asking basic questions such as ‘what do you want to be when you grow up?’ The traumatic scars of the war emerged in their answers. One gregarious boy stood up and replied ‘NOT a soldier!’ as he recounted the night soldiers came into his home, beating his mother and stealing all of their belongings. In this brief encounter, we heard these children calmly recount unimaginable tragedies - for a child should see their father abducted or their sister raped and to recount it so unemotionally…its an unsettling experience.

Press reports and articles in magazines cannot fully capture the absolute chaos of the Congo. But in an environment where little provides hope, HEAL Africa is a wellspring sanctuary offering some note of redemption in such a destructive place.