Creation of a Care Centre for Victims of Sexual Violence

— Central African Republic —

BACKGROUND

The Central African Republic (CAR) is a landlocked country bordering Cameroon, Chad, Sudan, South Sudan, the Democratic Republic of Congo and the Republic of the Congo (Congo Brazzaville). Central Africans have a life expectancy of 53.5 years [1]. The country has 4.6 million inhabitants [2], 600,000 of whom live in the capital city of Bangui. The country’s security context is very unstable and humanitarian needs exceed available resources.

The CAR has seen conflicts for almost twenty years. In the early 2000s, tens of thousands of women and girls were victims of sexual violence during the civil war that ended with the peace agreements signed in 2007. Since 2012, the CAR has been experiencing one of the most serious political and security crises in its history. On 17 October 2018, the Office of the United Nations High Commissioner for Refugees (UNHCR) estimated that there were 636,489 internally displaced persons (IDPs) and 574,638 refugees.

In this context, gender-based violence (GBV) demands special attention. This violence takes different forms, including sexual violence (SV). Acts of sexual violence, already considerable prior to the crisis, are now used in this conflict as an instrument to terrorise and “punish” civilian populations, and rape – whether by gangs or individuals – and sexual slavery are now common practices among armed gangs. Furthermore, as happens in the majority of armed conflicts, gender-based violence, such as domestic violence, sexual exploitation and forced marriage, is on the rise. This means that the number of survivors continues to grow, including men and children. The statistics are all the more alarming because many of the survivors are not taken into account by virtue of their not having sought help due to fear of stigmatisation, lack of information on the initiatives available and insufficient financial means.

A comprehensive care plan for victims

Since 2017,  at the Bulenga Rural Hospital (DRC), the Fondation Pierre Fabre has been supporting the replication of the “one-stop centre” model developed by Dr Denis Mukwege, based on four key treatment areas – medical, psychological, legal and socio-economic – that address victims’ essential healing and empowerment needs. Faced with the situation in the Central African Republic, and with shared experience in the Democratic Republic of Congo, the Fondation Pierre Fabre, the Panzi Foundation DRC, the Dr Denis Mukwege Foundation and the Francophone Institute for Justice and Democracy have decided to again join forces, with financial support from the French Development Agency, to replicate Dr Mukwege’s holistic care model at a public hospital in Bangui (the Amitié Sino-Centrafricaine Teaching Hospital) and within the Association of Women Lawyers of Central African Republic, both already recognised as referral resources for victims of sexual and gender-based violence in the country.

In this programme co-funded by the French Development Agency in the amount of 3 million euros, the Fondation Pierre Fabre, at the helm of this group of partners, will contribute 1.2 million euros. The Foundation will also offer its medical and scientific expertise and will be in charge of the programme’s administrative and financial management.

This programme is slated to run for an initial four-year period and will give survivors of sexual and gender-based violence in Bangui and the provinces access to good-quality, holistic care dispensed in a complete, coordinated, controlled manner by virtue of the “one-stop” approach. This programme will also be involved in preventing sexual and gender-based violence in the country. With support from international partners, this programme relies on South-to-South skills transfer between Congolese and Central African entities. It will also strengthen the capacities of a public hospital and a recognised local association, both of which are already recognised as referral resources for victims of sexual and gender-based violence in the country.

[1] INED (French Institute for Demographic Studies) 2018 estimate
[2] INED 2018 estimate

KEY FACTS
_____

Area of intervention
Access to quality healthcare

Programme
Since 2020

Involvement
For this project, the Fondation Pierre Fabre is at the helm of this group of partners. It is providing a quarter of the funding, its medical and scientific expertise, and will be in charge of the programme’s administrative and financial management.

Action

  • medical care: create a referral system for victims, strengthen the technical platform and skills of the staff of the obstetrics/gynaecology and maternity department at the Amitié Sino-Centrafricaine Teaching Hospital
  • psychosocial care: strengthen the capacities of the psychiatric care unit and carry out awareness-raising campaigns for the general public
  • legal support: strengthen the skills and reception capacities of the Association of Women Lawyers, create a secure computerised file system and support victims in legal proceedings
  • social reintegration: strengthen skills and capacities for victim support (training in income-generating activities).

ACHIEVEMENTS AND FUTURE INITIATIVES

Future initiatives

Upgrade
the obstetrics/gynaecology and maternity department at the Amitié Sino-Centrafricaine Teaching Hospital

Guaranteeing
free access to high-quality, comprehensive treatment

Social and economic
Reintegration
for victims 

3,240
victims treated over four years

THE PARTNERS AND THEIR CONTRIBUTIONS

French Development Agency
The French Development Agency (Agence Française de Développement or AFD) group is a public entity that implements France’s development and international solidarity policies. Its staff members are involved in more than 4,000 projects having great social and environmental impact in the French Overseas Territories and 115 countries, on issues such as climate, biodiversity, peace, education, urban planning, health and governance. The AFD contributes to the commitment of France and the French people in supporting the Sustainable Development Goals (SDGs).

Dr Denis Mukwege Foundation
The Dr Denis Mukwege Foundation denounces the use of sexual violence during armed conflicts. Addressing the international community, it advocates for the establishment of a legally binding red line against rape as a weapon of war, to end impunity, increase states’ accountability and ensure justice for victims. It supports the treatment model established at the Panzi hospital and its replication in other war-torn areas.

In this programme, the Dr Denis Mukwege Foundation will provide its expertise in the comprehensive treatment model, support advocacy and help develop the survivors’ network.

Panzi Foundation DRC
The Panzi Foundation DRC was founded nearly a decade ago by Dr Denis Mukwege to support the hospital where thousands of rape victims are given treatment and other forms of assistance in the war-torn northeast of the Democratic Republic of the Congo. By implementing a comprehensive care model, the hospital and the Panzi Foundation DRC have earned a solid reputation in treating the gynaecological and psychological harm caused by sexual violence.

For this project, the Panzi Foundation DRC will share its experience and expertise in the realm of comprehensive care and treatment for GBV and SV victims, including training the medical staff at the Amitié Sino-Centrafricaine Teaching Hospital.

Amitié Sino-Centrafricaine Teaching Hospital
This hospital complex is one of five central referral hospitals. It has a strategic geographic location near PK5. The hospital was built in the 1980s by the Chinese cooperation and is already a referral establishment for victims of sexual violence. For this programme, the Amitié Sino-Centrafricaine Teaching Hospital will be one of the two gateways to the holistic treatment centre. Improving the quality of care in the gynaecology/obstetrics department will also benefit the entire population.

Francophone Institute for Justice and Democracy
The Institut Francophone pour la Justice et la Démocratie (IFJD), or the Francophone Institute for Justice and Democracy is a French association that pursues the activities of the Varenne University Institute and the Francophone Association of Transitional Justice. It is responsible for promoting the dissemination of knowledge in both academic and operational contexts. It has developed a substantial arm devoted to GBV and SV including publications and research, training, expertise and support for legal and judicial assistance, focusing mainly on the comprehensive victim aid model. Having both a scientific and an operational purpose, the IFJD promotes production and dissemination of knowledge, support for scientific and university research and initiatives in the field.

In this programme, the IFJD will contribute its expertise in both transitional justice in general and the specific concerns of sexual violence. The IFJD has been working alone or in partnership in the Central African Republic since November 2015. In the context of the holistic assistance centre in Bangui, it will be responsible for legal matters.

Association of Women Lawyers of the Central African Republic
The Association des Femmes Juristes de Centrafrique (AFJC), or the Association of Women Lawyers of the Central African Republic: This Bangui-based Central African association whose members are all women lawyers (respecting a minimum academic requirement) was established in 1992 by Ms Catherine Samba Panza to promote and defend human rights with specific initiatives with respect to women and children. The AFJC had originally created “legal clinics” to assist women victims of GBV and SV in filing complaints. Starting in 2010, however, in response to events that generated many more victims among women and children, support and counselling centres were created across the country, ten of which were at one time funded by UNICEF, but are currently inactive due to lack of funding. The AFJC is a well-known reception centre for GBV and SV victims. The association provides them with a minimum of psychosocial services (meals, listening/support, rest, etc.) and supports them in assembling their legal dossier.

Follow our action

Sexual violence in CAR: All stakeholders sign an agreement for comprehensive care programme

Training pharmacists in the Global South is a top public-health priority that the Fondation Pierre Fabre has chosen to support over the long term The Fondation Pierre Fabre, leader of this consortium of international partners, joined with all the project’s other Central African stakeholders in signing the agreements and memoranda of understanding, allowing this initiative to be actively implemented.

Our programmes