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Journal Article

Citation

Mannell J. BMJ 2022; 377: o1016.

Copyright

(Copyright © 2022, BMJ Publishing Group)

DOI

10.1136/bmj.o1016

PMID

35459705

Abstract

A devastating war crime with far reaching consequences

On 24 February 2022, Russia launched a military invasion of Ukraine. Reports of sexual violence against women and girls began to emerge less than two months later. Multiple perpetrator rape, sexual assault at gunpoint, and rape in front of children have been reported to non-governmental and human rights organisations in Russian controlled areas.1 Research on the use of rape as a weapon of war in other armed conflicts around the world tells us that we should not be surprised.

The use of sexual violence against civilians during armed conflict is widespread and is now recognised as a war crime by the International Criminal Court. Yet, the reasons why men commit conflict related sexual violence vary. Most rapes committed by armed groups in the Democratic Republic of Congo (DRC), for example, were intended to terrorise civilians to gain control over land and other resources.2 By contrast, the rape and sexual slavery of Tutsi women during the Rwandan genocide in 1994 was a means of stripping an entire ethnic group of its humanity.3 In former Yugoslavia, sexual violence by the Serbian authorities was part of a government sanctioned strategy to destroy the lives and reproductive abilities of Bosnian Muslim women and their communities.4 The underlying motivations for the sexual violence against Ukrainian women and children will eventually become clear.

What we do know is that sexual violence has long term consequences. Women and girls' experiences of sexual violence are associated with significant increases in the rate of severe mental health problems, including post-traumatic stress disorder, depression, and thoughts of suicide.5 Past experiences of sexual violence also increase the likelihood that women and girls will experience other forms of violence later in life, including intimate partner violence,6 in ways that further exacerbate their poor mental health.7

Less well recognised is the potential for conflict related sexual violence to destroy communities, cultural identities, and social networks in Ukraine and elsewhere. Nearly 30 years after the Rwandan genocide, unwanted pregnancies from conflict related sexual violence has led to widespread loss of identity, fraught relationships with families, and the stigmatisation of an entire generation.8 A large qualitative study of community perceptions of sexual violence after a decade of conflict in the DRC highlighted the extensive isolation and shame experienced by violence survivors.9 In these ways, conflict related sexual violence has the power to undermine the stability of entire societies.

Although ensuring systems of accountability and punishment for perpetrators is the key to prevention and social change in the long term, a swift and effective international response to the survivors of sexual violence in Ukraine is critical now. But what should be done?


Language: en

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