Sep 14, 2006

Batwa: Sexual Violence, Lack of Healthcare Spreads HIV/AIDS

British medical journal published a paper arguing that the Batwa had worse access to healthcare than any other communities in a country which witnessed rapes as weapons of war.

CHOMBO, 13 September (IRIN) - The forest people of the Democratic Republic of Congo (DRC), marginalised at the best of times, were easy targets for the marauding soldiers and militiamen that reduced the eastern provinces to one of the world's bloodiest war zones.

Rape was a weapon of war in the decade-long conflict, with the local civilian population the overwhelming victims of the fighting and chaos that sucked in combatants from throughout the region.

Over a million Congolese are HIV-positive, according to the United Nation's Children's Fund (Unicef), but there is next to no data on the country's isolated pygmy communities. The minority rights group, Refugees International, estimated in 2000 that there were about 80,000 pygmies, also known as the Batwa.

The pygmies of South Kivu Province say there was little, if any, HIV/AIDS in their community before the war. HIV prevalence is still believed to be lower among them than in the wider Congolese society, but their poverty, social isolation and lack of healthcare services means little help is available for those who contract the virus.

Kahuzi-Biega National Park with its world-famous silver-backed gorillas, once home to the pygmies' forefathers, has now become the base of the Interahamwe militia who perpetrated the 1994 Rwandan genocide and are one of the main groups vying for control of eastern DRC's mineral and logging wealth.

Over the years the villagers of Chombo, a Batwa village set in lush green banana groves downhill from the park, have come to know, and fear, the Interahamwe's demands for food, labour or sex.

The militia came upon Chiza Mwemdena, 36, and a mother of three, when she was tilling the fields near the village in 2002. "I looked up, saw them and ran as fast I could, but they caught me," she said.

"There were about 50 soldiers and I think about 30 took it in turns to rape me. It happened to all the women who were stolen." The Interahamwe kept her for two weeks before she managed to escape. When she returned to the village her husband abandoned her, ashamed of his wife's fate.

"It was four years after the rape that I started to feel very strange," Mwemdena said, stroking her bony arms. "My urine was different; my stomach was very painful and I had no energy in my limbs. I used to be very big but now look at me, I am so thin."

Mwemdena was tested for HIV in 2004 by a local nongovernmental organisation, Union Pour l'Emancipation de la Femme Autochtones (UEFA). She was positive, and she is not alone. According to Salome Ndavuma, 28, four Chombo villagers have died since May, three of them women raped by the Interahamwe.

One of them was Mwemdena's sister. "It's an awful way to die. We know when it's AIDS; all the parts of the body stop working. We are very worried about what might happen to the village if it spreads, but what can we do?"

British medical journal The Lancet published a paper in June arguing that the Batwa had consistently worse access to healthcare than neighbouring communities, in a country the size of Western Europe.

"Even where healthcare facilities exist, many people do not use them because they cannot pay for consultations and medicines, do not have the documents and identity cards needed to travel or obtain hospital treatment, or are subjected to humiliating and discriminatory treatment," it said.

Antiretroviral (ARV) drugs are a rare find for any HIV-positive Congolese, but The Lancet's evidence suggests that if ARV provision is ever to reach Batwa communities, special outreach measures will be required.

For those who contract HIV, Chombo is not a good place to be. Landless after being evicted from their ancestral forests to make way for the national park, most villagers are undernourished, and poor hygiene gives opportunistic infections lots of scope.

"AIDS is a sickness that costs lots of money," said UEFA's Esperance Binyke. "You need good food. The pygmies eat once a day - if that - and that means that they die very quickly."

Access to healthcare is also very poor. Chiza Mwemdena was given medication, but only until the local UEFA's funding ran out, and soon her stomach cramps returned. The nearest free ARV programme is run by the international medical charity, Medecins Sans Frontieres, but that is a prohibitive 25km walk and taxi ride from Chombo.

Marhegane Lukhera, a Chombo elder, believes the first villager contracted HIV in 1998, probably from visiting a sex worker, and died in 2002. Now, he says, villagers are more prepared to openly discuss the problem of HIV.

"We teach the children from 12 years old not to have sex; we teach the girls not to take money for sex," he said in the village's only classroom. "The chief gathers us men together and advises us to stay with our wives, and his wife counsels women not to go outside with other men."

"I think we realise that it's important for everyone here to become aware of AIDS," Lukhera added. "We need to educate our children and test the adults."