Rape seems to historically been employed as a weapon or tactic in warfare, but recent sexual violence in places such as Africa and the Mideast have put it in the spotlight.
In those parts of the world, women who have been raped not only have to deal with the shock and physical injury of the attack itself, but also with its repercussions. Those include not only stigmatization in their own countries, but mental problems such as post-traumatic stress disorder (PTSD) — as if they were soldiers trying to forget the horrors of battle — and also anxiety and depression.
The New England Journal of Medicine just published a study on what type of mental health care works best for victims of rape during warfare, particularly in Third World countries, as well as an article offering a perspective on the topic.
http://www.nejm.org/doi/full/10.1056/NEJMp1304712?query=TOC&\
As the article points out, reconstruction efforts after a conflict ceases typically focus on “security, health, physical infrastructure, and economic development: they have been less well-equipped to respond to or prevent sexual and other forms of violence against women.”
And while there are established protocols for post-rape counseling in high-income nations such as the United States, there hasn’t been much research done on whether that method works in nations that are poor, have few resources and have dramatically different cultures than developed nations.
In Africa, for example, there are high illiteracy rates and few mental-health specialist, the article points out. The journal said that there hadn’t been any assessments of what treatments worked best in the Third World, until a trial in the Democratic Republic of Congo (DRC). That trial found that using group processing cognitive therapy, which is typically 1 1/2 hour weekly sessions where rape victims talk about their experiences and work-through their emotions, was a promising treatment.
“The intervention, targeted at women who had either been raped or witnessed rape and who had symptoms indicative of depression, PTSD, and functional impairment, appeared to lead to great improvements in mental health than did provision of case management and individual support,” the article said.
A study done several years ago in the DRC found that 16 percent of women there had gone through sexual violence at some point of their lives. Even worse, these women seem to be part of a culture of violence. In the DRC, 35 percent of the women reported experiencing sexual violence from an intimate partner, the article said.
And in these culture, mental heath care practitioners must be sensitive to women’s fears about being shunned or abandoned because of what has happened to them.
The journal article acknowledged that there are questions about whether the Congo trial will work in other places, but that “these new results suggest it may be feasible to offer relatively specialized counseling services after sexual assault to women in low-resource, conflict-afflicted settings.”
And that’s good news for these innocent victims.
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