Rape in Darfur is not only used by the authorities in Sudan as a weapon of war but it is also indirectly used to attract more recruits and more irregular fighters who fight along the side of the government forces. In addition to this, religious leaders such as scholars and imams were also mobilized to research the religion and to identify verses and teachings that could suggest the legalization of rape of women captives during the war. Once they had managed to identify such teachings, there was a significant increase of rape cases committed during the conflict in Darfur. This sudden dramatic increase of conflict related sexual assaults has greatly impacted the provision of health care to rape survivors in Darfur.
According to the NGOs working on this in Darfur, sexually transmitted disease such as HIV-AIDS is the major threat faced by the survivors of rape. Being addicted to rape, which has become a religious obligation, perpetrators in Darfur are mostly prone to be carriers of HIV, hepatitis, gonorrhea and syphilis which they swear to disseminate to jeopardize the health of local innocent women and girls who fall captives after every war. As a response to this health challenge, the United Nations Population Fund (UNFPA) is the only UN entity fully established in Sudan and mandated to procure medical supplies such as post exposure prophylaxes (PEP) which, if administered within 72 hours aftermath of rape, is expected to prevent the infection from all sexually transmitted diseases including unwanted pregnancies.
Unfortunately, most rape survivors cannot access this medication for various reasons. For example in the community, where illiteracy is about 60%, there is ignorance about the availability of such services. Another reason is that the survivors, for reasons of stigma and shame, rarely report these cases at health or police stations fearing that their social life will be jeopardized as they are most likely to be divorced or abandoned by their partners or worse they might get punished by the family members by revealing such information in their community.
There is also fear and reluctance among the health service providers, especially NGOs, to render health care to rape survivors because authorities may expel them out of the country. For instance in 2008, thirteen NGOs specialized on clinical management of rape survivors were forced to leave Darfur and their properties were confiscated. Directors of NGOs interviewed (Medical Corp and Norwegian Church Aid) believe that providing health service to a rape survivor is a very difficult in Darfur because authorities fear that NGOs might prepare reports based on their program and will eventually bring the attention of the international community to these human rights violations. For this reason, these NGOs have huge obstacles to overcome in order to procure medicines such as PEP, and this has created a critical gap in the provision of health care to rape survivors.
Another challenge which prevents some rape survivors from accessing health care is the government policy that compels all rape survivors to fill a form called Form 8 at police stations before they move to health centers. In Form 8, the Police fills in all the necessary information of the incident, clearly assess the injuries and shows all the forensic evidence which can help the court to reach a verdict. Although Form 8 appears to support the rape survivors with forensic evidence which can assist the court to reach a verdict, rape survivors fear reporting the cases to the police stations, because they lose their confidentiality, privacy, and some are even accused of reporting false complaints and arrested.
In addition, some policemen who had been militarized during the peak of the conflict were very hostile against women and girls from certain ethnic groups and usually abused their power and prevented survivors from accessing Form 8, without which no health services could be provided. As a consequence of all these factors, survivors would be turned away by health service providers at health care centres. This is still a dilemma today.
In an attempt to solve these problems, in 2005 the Federal Ministry of Justice issued a decree and a circular making amendments to Form 8 allowing rape survivors to access health services at health centers without necessarily filling the form at police station. The amendment also advised that health service providers should keep with them sufficient copies of Form 8 so that survivors would not need to go to police stations to fill the form. In addition to this whatever the health providers might have documented should be taken to court as evidence. But in spite of all these positive changes, some survivors still face the problems where the police might not have been informed on the changes of the policy..
Because of the challenges of accessing confidential health services, rape survivors in Darfur continue to suffer lifelong health constraints. Besides being infected with HIV-AIDS, rape survivors continue to suffer: unsafe abortion, miscarriage, unwanted pregnancies, unary tract infections, genital irritation; vaginal bleedings and infections; fibrosis, pelvic pain and pain during intercourse. These worries have profound devastating mental health consequences and some of these include: suicidal thoughts; depression and generalized anxiety, reduced self- stem; and panic phobias. Some survivors also suffer post-traumatic stress disorders and increased risk of revictimisation.
To respond better to these lifelong threats UNFPA in Sudan should develop a program for screening rape survivors who still continue to battle the negative side effects of rape crimes committed mostly in 2003 during the peak of the conflict. Such a confidential screening will help in empowering women and girls who still continue suffering negative side effects of rape incidents.
By intentionally hindering health care to rape survivors, government authorities in Darfur violate a number of rights: the right to health care including reproductive related rights established at the World Population Conference convened in Cairo 1994, UN Security Resolution 1325 which among others calls for the protection of women and girls during the conflicts.