War-Related Sexual Violence in Sierra Leone A Population-Based Assessment AReport by Physicians for Human Rights With the Support of the United Nations Assistance Mission in Sierra Leone © 2002, Physicians for Human Rights All rights reserved. Printed in the United States of America ISBN: 1-879707-37-3 Cover and report Design: Glenn Ruga/Visual Communications Cover Photo: Kristina Hare Lyons Physicians for Human Rights Physicians for Human Rights (PHR) promotes health by protecting human rights. We believe that human rights are essential preconditions for the health and well-being of all people. Using medical and scientific methods, we investigate and expose violations of human rights worldwide and we work to stop them. We support institutions that hold perpetrators of human rights abuses, including health professionals, accountable for their actions. We educate health professionals and medical, public health and nursing students and organize them to become active in supporting a movement for human rights and creating a culture of human rights in the medical and scientific professions. Since 1986, PHR members have worked to stop torture, disappear- ances, and political killings by governments and opposition groups; to improve health and sanitary conditions in prisons and detention centers; to investigate the physical and psychological consequences of violations of humanitarian law in internal and international conflicts; to defend medical neutrality and the right of civilians and combatants to receive medical care during times of war; to protect health professionals who are victims of violations of human rights; and to prevent medical complicity in torture and other abuses. As one of the original steering committee members of the Interna- tional Campaign to Ban Landmines, PHR shared the 1997 Nobel Peace Prize. PHR currently serves as coordinator of the US Campaign to Ban Landmines. The President is Robert Lawrence, M.D.; Vice President is Holly Atkin- son, M.D.; the Executive Director is Leonard S. Rubenstein, J.D.; Deputy Director is Susannah Sirkin; Advocacy Director is Holly Burkhalter; Senior Program Associate is Doug Ford; Director of Communications is Barbara Ayotte; Director of Finance & Administration is Lori Maida; Director of Development is Dena Getzie; Director of Campaigns is Gina Cummings; William Haglund, Ph.D., is Director of the International Forensic Program; Senior Medical Consultant is Vincent Iacopino, M.D., Ph.D.; and the Fireman Health and Human Rights Fellow is Lynn L. Amowitz, M.D., M.S.P.H., M.Sc. Physicians for Human Rights Physicians for Human Rights 100 Boylston St., Suite 702 1156 15th St. NW, Suite 1001 Boston, MA 02116 Washington, DC 20005 Tel. (617) 695-0041 Tel. (202) 728-5335 Fax. (617) 695-0307 Fax. (202) 728-3053 Email: [email protected] Email: [email protected] Web: www.phrusa.org Web: www.phrusa.org iii UNAMSIL The United Nations Assistance Mission in Sierra Leone (UNAMSIL) was established by Security Council Resolution 1270 on October 22, 1999 with the broad based mandate of cooperating with the Government of Sierra Leone and other parties in implementing the Lome Peace Agree- ment and assisting in the implementation of the disarmament, demobi- lization and reintegration of the parties in conflict. On February 7, 2000, May 19, 2000 and March 30, 2001 the mandate and size of UNAMSIL were expanded. Its current troop strength exceeds 17,000, making it the United Nations’ largest peacekeeping mission. In pursuit of its mandate, UNAMSIL combines military and civilian personnel. The Human Rights Section is part of the civilian component of the mission and has a threefold approach to its activities. The first is to monitor the compliance by government and all parties to the conflict of human rights and international humanitarian law. Secondly, the Human Rights Section provides technical assistance in building the capacity of national institutions that can promote respect for the rule of law through a sustainable culture of human rights. Thirdly, the Section undertakes and supports human rights and peace awareness programs conducted in national languages as a means of building popular confidence in, and understanding of, the human rights principles and their role in peace- building efforts. The UNAMSIL Human Rights Section conducts specialist work with national institutions, the internally displaced and children. It also focuses on the rule of law and gender issues. The Human Rights Section currently has 16 international staff members and 4 national staff members deployed in its three offices in Freetown, Kenema and Makeni. UNAMSIL Mammy Yoko, Aberdeen P.O. Box 5 Freetown, Sierra Leone iv Foreword The subject of violence against women in Sierra Leone has until recently been overlooked. I welcome this report by Physicians for Human Rights, with the support of UNAMSIL, which helps to redefine the role that sex- ual violence played in the conflict. The findings and data are a clear indi- cation of the kinds of depravity that war can bring. I visited Sierra Leone on official mission in August 2001 to study the issue of violence against women committed during the conflict and to identify key measures and initiatives needed to ensure the rights of women in the aftermath of the conflict. In my work as Special Rapporteur on violence against women I have seen that it is often the need to understand clearly the specific nature of gender-based crimes, through research and collection of data, that is required to mobilize civil society, governments and the international com- munity against such abuses. This report comprehensively documents the widespread nature of sexual violence in Sierra Leone during the conflict and is a valuable tool for those who have been fighting for women’s human rights to be put on the agenda as a matter of priority. Furthermore by documenting the wartime experiences of women in Sierra Leone this report will provide a valuable contribution in making the post- conflict needs of women and girls more apparent. Its findings should be taken into consideration in the formulation of repatriation and resettle- ment plans, as well as demobilization, rehabilitation, reintegration and post-conflict reconstruction programmes. I often see many situations involving gender-based violence—similar to the cases so carefully documented in this report—for which perpetrators go unpunished. Internationally there has been progress, at least in the area of legal sanction. Perpetrators of violence against women during wartime are being brought before the courts of justice. Their trial and punishment is a vindication of many years of effort by many groups and individuals who have been trying throughout the years to end the impunity of those who commit the most horrendous acts of brutality. In this regard, I wel- come the Foca judgment by The International Criminal Tribunal for the Former Yugoslavia, which sets out in detail, the international law and standards with regard to war crimes and crimes against humanity com- mitted against women and girls. The Tribunal found that these actions constituted rape as a crime against humanity, torture as a war crime and enslavement as a crime against humanity. Their strong judgment is wel- come and lays to rest all arguments that rape and sexual slavery during wartime does not constitute international customary law that is in fla- grant violation of international humanitarian law. The Foca judgement sets a context by which the wealth of information contained in this report should be analyzed. v The International Criminal Court, which was finalized in 1998, is also a major victory for those who have fought to make international justice an important part of modern international law. The Rome Statute makes explicit that rape and gender violence are among the most serious crimes of concern to the international community by specifically defining them as constituent acts of crimes against humanity and war crimes. According to the Statute, rape, sexual slavery, enforced prostitution, forced preg- nancy, enforced sterilization or any other form of sexual violence also constitutes a Grave Breach of the Geneva Convention. Similarly, the Statute defines crimes against humanity to include torture, as well as rape, sexual slavery, enforced prostitution, forced pregnancy, enforced steriliza- tion or any other form of sexual violence of comparable gravity when committed as part of a widespread or systematic attack directed against any civilian population. The Statute also provides that persecution on the basis of gender may constitute a crime against humanity. As a result of this Statute and the decisions of the international tri- bunals in the Hague and in Arusha, the world is slightly more just for women who have been the victims of sexual violence during wartime. It is my hope that the Truth and Reconciliation Commission and the Special Court in Sierra Leone will follow this example and ensure that cases involving violence against women are prosecuted and the perpetrators brought to justice. Rarely do human rights organizations undertake and publish such sub- stantial and detailed studies of sexual violence in conflict. It is in this light that this report will help the international community to understand the grave situation in Sierra Leone and the needs of all the conflicts’ sur- vivors. I encourage its wide dissemination, as this important and timely report will be of interest to all those who seek to understand or intervene in the rebuilding of Sierra Leone. Radhika Coomaraswamy United Nations Special Rapporteur on violence against women, its cause and consequences vi CONTENTS Acknowledgements ix Glossary xi I. Executive Summary 1 Purpose of Study 1 Findings 1 Methods of Investigation 4 Characteristics of Assistance Needs among Respondents 7 Reporting Sexual Violence Beliefs about Justice among Respondents Reporting Sexual Violence 8 Attitudes of Women's Human Rights and Women’s Roles in Society 9 Recommendations 10 II. Background 15 Population and Geography 15 Historical Overview 15 The Role of Diamonds in the Conflict 19 The Lome Peace Agreement 19 Demobilization Effort 22 The Status of Women in Sierra Leone 23 Human Rights Abuses During the War 25 The Humanitarian Situation 28 Health Care Delivery 30 Education 34 Impact of War on Women 35 III. The Prevalence of War-related Sexual Violence and Other Human Rights Abuses Among IDPs 37 Methods 37 Findings 41 Comments on Survey Findings 56 Limitations 61 vii IV. Qualitative Comments and Testimonies of Sierra Leonean Women and Girls 63 Case Examples from In-Depth Interviews 63 Women’s Attitudes about Punishment of Perpetrators 73 V. Application of Relevant International Law 83 Humanitarian Law 84 Human Rights Law 85 Non-State Actors 86 The Special Court for Sierra Leone 87 The Truth and Reconciliation Commission 88 VI. Responses to the Sierra Leone Complex Emergency 91 Humanitarian Assistance 91 International Community Response to the Crisis in Sierra Leone 92 The United Nations 97 VII. The Future for Women in Sierra Leone 99 Responses to Sexual Violence in Sierra Leone 101 VIII. Appendices 103 viii Acknowledgements This report was written by Chen Reis, J.D., M.P.H., a consultant to Physicians for Human Rights (PHR); Lynn L. Amowitz, M.D., M.S.P.H., M.Sc., Fire- man Health and Human Rights Fellow, Physicians for Human Rights, and Instructor in Medicine, Division of General Medicine, Brigham and Women’s Hospital and Harvard Medical School; Kristina Hare Lyons, M.A.L.D., Program Associate for Physicians for Human Rights; and Vincent Iacopino, M.D., Ph.D., Senior Medical Consultant to Physicians for Human Rights. Holly Burkhalter, Advocacy Director for PHR con- tributed to the Executive Summary and Background sections of the report. Michele Heisler, M.D., Robert Wood Johnson Clinical Scholar, University of Michigan Health System, contributed to the chapter on qualitative comments and testimonies of women and girls. Kelly Askin, J.D., Fellow, Carr Center for Human Rights Policy, contributed to the chapter on Application of Relevant International Law. Ahunna Eziakonwas, Humanitarian Affairs Officer, UN Office for Coordination of Humanitarian Assistance, contributed to the recommen- dations. We are grateful to John Gay for his assistance with the presenta- tion of statistical analysis. The report is based on two research investigations. The first research trip was undertaken by PHR in March 2000 by Adyinka M. Akinsulure- Smith, Ph.D. and Deborah Dyson-Stocknoff P.A., M.P.S., from the Bellevue- NYU Program for Survivors of Torture, and Ms. Lyons. The second phase of research was undertaken by PHR together with the United Nations Assistance Mission in Sierra Leone (UNAMSIL) between January and February 2001. Ms. Lyons, Ms. Reis, Binta Mansaray, M.A., a consultant to UNAMSIL; Beth Vann, M.S.W., a consultant to PHR; Dr. Akinsulure- Smith; and Louise Taylor, M.B.A., LLM, UNAMSIL Human Rights Officer, composedthe PHR/UNAMSIL team. PHR especially thanks Maarit Kohonen, former Gender Specialist, UNAMSIL Human Rights Section; Mara Bustelo, Gender Coordinator, Office of the High Commissioner for Human Rights; Rodolfo Mattarollo, Chief of Human Rights Section, UNAMSIL; Patrice Vahard, Human Rights Section, UNAMSIL; Chris Mburu, former Acting Chief of UNAMSIL Human Rights Section, and Michael O’Flaherty, former UNAMSIL Human rights Section staff member, who helped initiate this project.We also are grateful to Memunatu Pratt for her assistance. The report was reviewed by Ms. Kohonen; Christina Saunders, Assis- tant to the Special Rapporteur of the Commission on Human Rights on Violence Against Women; Corinne Dufka, Researcher in Sierra Leone for Human Rights Watch; Ronald Waldman, M.D., M.P.H, Director, Pro- gram on Forced Migration and Health, Center for Population and Family Health, the Joseph L. Mailman School of Public Health, Columbia ix University, New York, NY; Leonard Rubenstein, J.D., PHR’s Executive Director; Susannah Sirkin, PHR’s Deputy Director; Barbara Ayotte, PHR’s Director of Communications; and Ms. Burkhalter. The authors are indebted to these people for their thoughtful comments and suggestions. Ms. Ayotte and Michelle Sachs, PHR’s Internet and Publications Coordi- nator, edited and prepared this document for production. Christina Deck, an intern at PHR, also assisted with report production. The authors are grateful to UNAMSIL and the UN agencies in Sierra Leone that provided information and support. The authors are also grate- ful to the organizations that provided referral services without which this study could not have been done including GOAL, the International Res- cue Committee, Médecins sans Frontières-Holland, Forum for African Women Educationalists (FAWE), Concern, Merlin, International Medical Corps (IMC) and Adventist Development and Relief Agency (ADRA) and to those which otherwise facilitated access to, and collection of informa- tion used in this study. We thank those individuals and organizations working in Sierra Leone who shared their time and insights with our research team including: for- mer United States Ambassador Joseph Melrose, Rabih Torbay of IMC, William Aldis of the World Health Organization (WHO), Glenis Taylor of UNICEF, the Campaign for Good Governance, Cooperazione Inter- nazional (COOPI), and The Council of Churches of Sierra Leone (CCSL). PHR is especially grateful to the women of Sierra Leone who participated in this study after years of suffering. PHR and UNAMSIL thank the team of dedicated researchers: Agnes Conteh, Isatu Fofana, Margaret Ganda, Fatmata Kabba, Joyce Kamara, Adama Koroma, Abigail Lebbie, Doris Lebbie, Erica Luke, Bondu Mani, Salley Mansaray, Laurel Mendenkia, Mary Quashie, Fatmata Salisu, Sia Sandy, Fatmata Sesay, Mariatu Songo-Kanu, Aminata Thorlie, Safiatu Turay, Mary Vandi, and Rose Vincent whose commitment to the project and perseverance under very difficult circumstances made this report pos- sible. The authors also thank Muctar Jalloh. This report is dedicated to Abigail Lebbie, who passed away in May, 2001. Abigail was a dedicated member of a team of Sierra Leonean field researchers. We wish to express our heartfelt condolence to her family and friends. May her soul rest in peace. x
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