Congo's Wounds of War: More Vicious than Rape

The atrocity reports from eastern Congo were so hellish that Western medical experts refused to believe them—at first.

This is about fistulas—and rape, which in Congo has become the continuation of war by other means. Fistulas are a kind of damage that is seldom seen in the developed world. Many obstetricians have encountered the condition only in their medical texts, as a rare complication associated with difficult or abnormal childbirths: a rupture of the walls that separate the vagina and bladder or rectum. Where health care is poor, particularly where trained doctors or midwives are not available, fistulas are more of a risk. They are a major health concern in many parts of Africa.

In eastern Congo, however, the problem is practically an epidemic. When a truce was declared in the war there in 2003, so many cases began showing up that Western medical experts at first called it impossible—especially when local doctors declared that most of the fistulas they were seeing were the consequence of rapes. "No one wanted to believe it at first," says Lyn Lusi, manager of the HEAL Africa hospital (formerly called the Docs Hospital) in the eastern Congo city of Goma. "When our doctors first published their results, in 2003, this was unheard of."

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