Psychological support for victims of sexual violence

Psychological support for victims of sexual violence

Sexual and gender-based violence remains a cause for concern in the DRC.

In the Ituri District, and in particular in Mambasa Territory, the situation is worrying.  The reason is the Simba rebels from the Morgan group who are still active. The most recent abuse took place on the 7th and 10th of February this year. Several cases of girls and women being abused were reported to us.

Serious consequences for both mind and body
Sexual violence such as this causes psychological instability with serious consequences for both mind and body. It requires the implementation of adequate psychosocial support. That is what I provide, supported by a team of accredited psychologists.

How can we help Survivors of Sexual Violence to recover psychologically?

We can start by implementing support structures (counselling centres) and training psychosocial assistants supervised by psychologists. Victims are sent to counselling centres via a referral system between other social protection agents (health workers, police, community relays) and trained community members

  1. Welcoming survivors: emphasis is put on the quality of care, which will determine the tone of the rest of the interview.
  2. Introducing the psychologist and promising to uphold the principles of confidentiality. The issue of medical support is raised immediately as the rest of the interview is based on it. Psychological support can only take place after medical support has been provided.
  3. The survivor’s story: this is the most crucial step. The psychologist has to show two indispensable qualities: empathy and active listening.
  4. Exploring the survivor’s experiences during and after the attack.
  5. Psychoeducation and normalisation of symptoms.  Up until this point, psychosocial assistants can take part, using brief and supportive therapies in those cases where the trauma has not affected higher mental functions.

Cases which go beyond the abilities of pychosocial assistants are referred to me. And that is when I move on to complex psychotherapy. It can be cognitive therapy, or behavioural, sometimes confronting the victim with the traumatic factor using the Fuilding technique. For example, some survivors who show signs of a phobia of uniformed men have been progressively introduced to soldiers for therapy sessions. These are the steps we take:

  1. Welcoming survivors: emphasis is put on the quality of care, which will determine the tone of the rest of the interview.
  2. Introducing the psychologist and promising to uphold the principles of confidentiality. The issue of medical support is raised immediately as the rest of the interview is based on it. Psychological support can only take place after medical support has been provided.
  3. The survivor’s story: this is the most crucial step. The psychologist has to show two indispensable qualities: empathy and active listening.
  4. Exploring the survivor’s experiences during and after the attack.
  5. Psychoeducation and normalisation of symptoms.  Up until this point, psychosocial assistants can take part, using brief and supportive therapies in those cases where the trauma has not affected higher mental functions.

So that’s a summary of the steps we carry out in our daily work. 

Alongside this schema, the psychotherapy we provide to survivors also consists of sociotherapy and group therapy through theatre performances, games, or even film showings.

Taking the stories recorded in intervention zones into account, whether from survivors themselves or members of their families, it becomes apparent that the psychosocial support we provide is of utmost importance for the reintegration of Survivors of Sexual Violence into their communities, including their households. (Familial, community mediation…)

After the support we provided, one woman said to me, “I thought that it was all over for me, but now I realise that there is still hope of having a normal life in my community “.

Vijitha, 13, places flowers in the sand, near the site where her mother died during the tsunami, on a beach in the fishing village of Thalanguda in the southern state of Tamil Nadu. She has come to the beach to pay her respects. [#3 IN SEQUENCE OF SIX] In November 2008 in India, the Viswanathan sisters, Vijitha, 13, and Vijyashree, 11, continue to adapt to changes in their lives following the death of their mother and younger brother during the 26 December 2004 tsunami. Their father Viswanathan also lost his livelihood as a fisherman in their coastal village of Thalanguda in the southern state of Tamil Nadu. The tsunami killed more than 10,000 Indians and displaced 400,000. Tamil Nadu State was among the worst-affected areas: some 480 children lost both parents to the tsunami, and many more lost one parent or other close relatives. Following the disaster, Viswanathan sent his daughters to live in the Government Home for Tsunami-Affected Children, an orphanage in the city of Cuddalore. After only a few days, however, both were homesick and returned to their father?s house, where they were cared for by a paternal aunt. In May 2005, Viswanathan received compensation from the Government for the death of his wife and son, and deposited half the amount in his daughters? names. In February 2006, he remarried; the sisters now also have a 23-month-old brother and a two-month-old sister. Vijitha and Vijyashree continue to keep the memory of their mother and brother alive, and their father has dedicated a puja (prayer) room, decorating it with images of his deceased wife and son.

Psychosocial support is accompanied by other kinds of support (access to justice, socio-economic reintegration etc.) via the referral system. From the fourth psychotherapy session, the survivor qualifies for socio-economic and educational reintegration.  Access to justice depends on the willingness of the survivor, who is made aware of the merits of this approach throughout the psychotherapeutic treatment.

Intervention problems

We need to make the country safe, to demobilise armed groups, to restore the state's authority
The main difficulty is the lack of security in intervention zones.  Our work requires many different resources: technical and financial resources, but also human resources. If you work in red zones, which means that lives are in danger there, and yours too.

The distance between support structures and survivors, and the near-absence of a psychological clinic which also makes use of psychiatry are also significant obstacles.

Psychologists also have to be monitored and supported

Here is the harrowing tale of a couple I cared for for over 3 months at the general referral hospital in Mandima:

My husband and I sell tea in the gold mine at Itembo. One morning in November 2013, some Morgan rebels arrived.  They demanded 250g of gold per person. We didn’t have any. Then they searched my vagina, first with their hands, then with a branch of a tree. They did the same with my husband in his anus. When they didn’t find anything, eleven of them raped me one after the other, then they forced my husband and I to sit on burning embers. We were burned everywhere. After they left, some good people drove us to the health centre and from there, we were referred to the hospital. 

Their story devastated me, and that day I left the consultation room feeling depressed. Luckily, a psychologist colleague of mine was looking after me a few hours later.

Photos: © UNICEF / Laurent Duvilliers – Sylva Vwiranda – Olivier Asselin – Tom Pietrasik

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Sylvie Vwiranda

Sylvie Vwiranda Spécialisée en psychologie clinique, Sylvie a grandi dans le Nord-Kivu. Aujourd’hui, elle offre une aide psycho-sociale aux victimes de violences sexuelles et travaille sur le bâtiment de la sensibilisation et la capacitation du personnel médical, mais aussi les autorités de l’État qui sont impliquées dans la lutte contre les violences sexuelles et l’aide aux victimes.

Sylvie Vwiranda A clinical psychologist, Sylvie grew up in North Kivu. Today, she provides psychosocial support to victims of sexual violence and works to increase awareness and capacitation among medical personnel and State authorities involved in fighting sexual violence and providing support to victims.

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