All That Is Bitter and Sweet_ A Memoir - Ashley Judd [185]
His main work was in obstetrics, but every week he made home visits in the neighborhood to generate interest in modern family planning, birth spacing, and pre- and postnatal care. He told me that twenty to twenty-five new women showed up each month to access the clinic’s services. Although this number sounded small, he said it represented significant cultural change; men here generally want their women to produce as many babies as possible. Seeking to regulate their fertility was big news.
As he spoke, I tried to keep track of the litany of horrors he encountered in his daily work: The babies he delivered were often premature, and infant mortality here was the highest in the world. He treated women who were victims of sexual violence daily. Rape, including gang rape, has become an appallingly common occurrence in militia populated areas around Goma—meaning everywhere, as militias often roam. A frequent consequence of such rapes is fistula, when the wall between the rectum and vagina, or bladder and vagina, is torn open—and more. The doctor told us he had treated children, little girls as young as three and four, for rape-induced injuries. He also saw a lot of obstetric fistulas, caused when such tearing occurs in childbirth. It often happens because the mother herself is a child and her pelvis is not fully formed to accommodate childbirth, or as a result of other complications that in the United States would not have to cost a woman her health or her life. But when you try to give birth unattended, as 66 percent of African women do, fistula is a very real, life-destroying problem.
When I asked where this pervasive practice of rape came from, was it embedded in the culture, he said it was not cultural to begin with. He confirmed what I had heard from Zainab Salbi: Raping began here as a weapon of war, a way to dominate the enemy by terrorizing women, regarded as the backbone of the family, and destroying family structure. Now, gang rape was used by various armed groups, often on behalf of government and army officials and their proxies, in the artisanal mining of Congo’s extraordinary mineral wealth. The mass raping allowed groups to access the lucrative elements just under the soil without resistance, clearing out entire villages (hence the massive problem of forcibly displaced persons in eastern DRC). And now there had been violence and instability in this region for so long that war had become a way of life, and rape had become normalized—in the same way that poverty, lack of services, and hardship were the norm. Now, it was all generations knew.
There’s no way to sugarcoat it: Goma is a shithole. The stench is putrid. There is no sanitation. The water is unsafe. The rooms of the next clinic I visited were stuffed with malaria patients of all ages. They looked dazed and miserable, their bodies sagging, their eyelids heavy.
I sat on a few beds, making small talk about how to prevent the disease and, in my own hopeful way, introducing the possibility of each individual making a commitment to sleep under a mousquetaire—or mosquito net—at home.
It was a visiting day, so most patients had family in, grandmothers, other children, and siblings. Someone had brought a transistor radio that squawked out a tinny disco tune. My attention was drawn to one man who was feeding his small son. The boy was lethargic and mute, his nose ran, and an IV PICC line was taped awkwardly to his hand, which it dwarfed. The man fed him black beans from a tin plate, around which gnats flew.
This man was a hardened person, and our presence in the clinic that day seemed to irritate him. Unprompted, he started raging at the pregnant women who were given nets free of charge when they came to the clinic. The men still had to pay for theirs, although at highly subsidized prices. And the tough guy with the beans thought this was fundamentally wrong.
“Am I not a man?” he complained. “Should I not be given a net?