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The work of “Medica” Zenica with survivors of war rape and sexual violence in Bosnia and Herzegovina

About “Medica” Zenica(1)

Medica Zenica is the oldest specialized women’s non-governmental organization in Bosnia and Herzegovina (BiH), which, since April 1993 has been continuously providing comprehensive help, support and care to women and children survivors of war. Additionally, it also offers support to women and children suffering from post war violence, including survivors of war rape and other forms of war torture, sexual violence in general, survivors of domestic violence, as well as victims of trafficking in human beings. Medica Zenica is a leading organization addressing the issues of trauma and violence in BiH and during almost 23 years of work Medica Zenica has provided services to more than 450.000 survivors throughout the territory of BiH.

Our approach to women and children, survivors of war and post-war trauma and violence, through developed services, which are based on humanistic values, includes provision of services at the safe house/shelter, psychological counseling center, legal counseling center, and the unique telephone line 080 02 23 34. This helpline offers help and support to survivors of war rape and sexual violence and their family members (active 24/7 on the territory of BiH).

Medica Zenica also supports the SOS helpline for survivors of domestic violence, crisis intervention center and drop-in center for children at risk. Additionally, Medica Zenica runs economic empowerment programs in rural areas, and carries out outreach work, such as provision of psycho-social and medical assistance, legal support, as well as provision of assistance to men in psychological counseling centers. Furthermore, it engages in fieldwork, educational and awareness raising activities with the first informal network of women from rural areas, which was established by Medica Zenica.

Additionally, Medica Zenica implements a variety of educational, research, advocacy, and publishing projects focusing on the promotion and protection of human rights, prevention and rehabilitation from war trauma, sexual and domestic violence, establishment of referral mechanisms and institutional networks by using existing resources in the community, as well as combating trafficking in human beings.

Working with survivors of war rape and sexual violence

During times of raging war, Medica Zenica was established by the German gynecologist Dr. Monika Hauser and 20 local women professionals in response to the needs of many survivors of conflict-related sexual violence.

Everyday increasing numbers of women, girls and children who survived war rape and sexual violence needed adequate support and assistance, a safe place and someone to talk to without being judged and blamed for what had happened to them. One survivor, a beneficiary of Medica Zenica said: “The most I ever got was Medica. What you did for me, that psychological support. Material support, when people are hungry, is very welcome. And to me, I was hungry at that time, I was hungry for self-confidence, I was hungry for support so I could move on, so I could live. To give me strength, to tell me that what I thought was my fault actually was not my fault. When I heard that, it was worth to me. It meant everything to me, and it still does.”(2)

Rape and sexual violence were systematically used as a weapon and strategy of war. There is no exact number on how many women and girls survived war rape and sexual violence in BiH, but according to estimates between 20.000 and 50.000 women and girls were raped.(3) In those very difficult times, Medica Zenica opened its door to women, girls and children, embraced them, helped them and supported them according to their needs. The door of Medica Zenica remained open for survivors of sexual violence and war rape. After the war, Medica Zenica also started working with survivors of domestic violence, violence in the community, trafficking in human beings. Despite difficulties in securing funding, its doors have never been closed.

After the war, the problems of domestic violence and trafficking in human beings became burning issues in BiH and the attention of donors shifted away from war trauma to other issues. Medica Zenica experienced a huge economic crisis in 2007. Sabiha Husić, the current director of Medica Zenica, bravely took over the responsibility to lead Medica Zenica in 2007 and since then the work of the organization has carried on and been expanded.

It was a big challenge for Medica Zenica in those times to continue providing comprehensive help and support to survivors of war rape and sexual violence, because there were no donors to support our activities. Nevertheless, Medica Zenica continued to support survivors, being aware of their needs and the long-term consequences associated with war trauma, which were yet to come to the surface. The traumas affected survivors, their family members, their children but also society in general. For all those 23 years, Medica Zenica has been actively advocating for the social recognition of the rights of survivors of war rape and sexual violence, fighting against their stigmatization, lobbying for holding perpetrators to account, ending impunity of war criminals and finding sustainable responses to the needs of survivors.

In 2003, on its tenth anniversary, Medica Zenica organized a round table discussion entitled “Ten years after” and the idea of introducing survivors of war rape and sexual violence into the Law on Social Protection emerged. Soon after Medica Zenica together with other 20 nongovernmental organizations from BiH started the campaign “For dignity of survivors”. In 2006, NGOs, activists and female parliamentarians were finally successful in their efforts, when an amendment to the Law on Social Protection, Protection of Civilian Victims of War and Protection of Families with Children of the Federation of BiH(4) was formally adopted. Through this amendment, survivors of war rape and sexual violence in the Federation of BiH were recognized as a special category of civil victims of war entitled to monthly financial support and a variety of other socioeconomic rights. This was a historic moment as for the first time ever in the world, survivors received this kind of social recognition – yet problems persist.

Since the establishment of the International Criminal Tribunal for the Former Yugoslavia (ICTY) in 1993, brave women survivors of war and conflict related sexual violence from BiH found their courage and testified in cases of rape as a form of torture and sexual enslavement as a crime against humanity. The ICTY was the first international criminal tribunal based in Europe that passed convictions for rape as a crime against humanity, following a previous case adjudicated by the International Criminal Tribunal for Rwanda.(5) However, in 2005 the Prosecutor’s Office and the Court of BiH began simultaneously with the ICTY to prosecute war criminals and the problems for survivors commenced. Survivors and witnesses were not adequately prepared, nor supported and received no protection before and after testimonies. They felt betrayed because authorities violated their rights to privacy and adequate care was not provided for them.

One of the survivors said: “You are meant to be protected, and yet your name is published in the newspapers. It is affecting. I had an opportunity to go as a witness to The Hague, there is a huge, huge difference. Here, we are unprotected in the court, and everywhere else”.(6) This situation was the reason for Medica Zenica to initiate in 2010 the establishment of the first institutional networks for the support and assistance of survivors and survivor witnesses. The initiative addressed the needs of survivors of war crimes, sexual violence and other criminal offences, including domestic violence and human trafficking, before, during and after testimony. The networks, first of their kind in BiH and in the Balkans, brought together professionals from government institutions and NGOs to provide in a trauma sensitive manner, adequate, timely and effective support to survivors.

Medica Zenica established such institutional networks in Zenica Doboj, Una Sana Canton, Central Bosnia Canton, and Herzegovina Neretva Canton. In cooperation with United Women from Banja Luka an institutional network was established in Banja Luka, while the process has already begun in Livno Canton, Bosnia Podrinje Canton and Istočno Sarajevo. Since 2010 and up until now, the institutional networks proved to be sustainable and efficient mechanisms recognized as models of best practice. Currently they are being established throughout the whole territory of BiH.

During 2013 and 2014 Medica Zenica conducted a research on the long-term consequences of war rape and coping strategies of survivors in BiH entitled “We are still alive. We have been harmed but we are brave and strong“. This gave space for survivors to raise their voices and this study is one of the rare researches in the world on this topic. The following key facts emerged from the data analysis:

  1. The mental and overall health of survivors from the sample is of grave concern: 57% of participants are suffering from clinically relevant PTSD symptoms. Their general psychological distress is high and many show psychosomatic problems and anxiety symptoms. 70% of the participants state that the experience of rape completely affects their life today. 65% of the participants regularly take drugs; half of them for 20 years. Almost all of the participants take psychopharmacological medicine. Others also take cardio-vascular and hormonal regulation medication, which clearly shows the long-term impact of posttraumatic and post-war stress on women’s health. More than 58% of the participants reported the presence of four or more gynecological problems, and almost 11% reported cancer. The relationships with their families, especially husbands and children, are also highly affected and clear indications of transgenerational transmission of trauma were found.
  2. Despite the unique status of civilian victim of war, which 79% of the women in our sample have obtained, the participants overwhelmingly agree that governmental, cantonal and entity institutions are failing to adequately support survivors. Essential support is perceived as only being provided by NGOs. Ongoing stigmatization in communities, the lack of protection for witnesses, insensitivity towards survivors in institutions, and shortcomings in the implementation of the law clearly outweigh any positive role that the political mechanism of granting war rape survivors a special status could play.
  3. It was found that on average the most commonly used coping strategies amongst the participants can be classified as “adaptive”. Positive aspects of posttraumatic growth were reported by a considerably high number, roughly 68% of the survivors. These ways of coping might be attributed to Medica’s long-term therapeutic and social support. The complexity of these results shows that many survivors continue to suffer although, and this is no contradiction, most of them are at the same time coping as competently as they can. It is the level of destruction inflicted by war rape, probably exacerbated by other stressors and the ongoing stigmatization in communities and society, which makes it incredibly difficult for many survivors to cope “well”.
  4. This complex picture is complemented by the fact that the participants highly value Medica Zenica’s services. Findings show that general measures of support, such as care and availability, understanding and a safe space for sharing experiences are playing a major role in their recovery. They attribute Medica Zenica with a key role in their trajectory of coping.(7)

In March 2014, the Former British Foreign Secretary Mr. William Hague and the UNHCR Special Envoy Mrs. Angelina Jolie Pitt paid a historic visit to Medica Zenica. This visit to Medica Zenica and BiH was of great importance because it raised awareness of the problem of rape and sexual violence at the level of local authorities and donors. This period has been crucial in using the momentum and trying to find adequate solutions for the challenges faced by survivors.

Therefore, Medica Zenica obtained permission in 2014 from the Federal Ministry to issue certificates to survivors of war rape and sexual violence, one of the documents necessary for obtaining the status of civil victim of war. Many survivors pointed out that they had encountered many problems and obstacles in the process of obtaining this status.

Nevertheless, by the end of 2014 approximately 800 survivors had obtained it.

At that point Medica Zenica established the first unique telephone line for help and support to survivors of war rape and sexual violence and their family members. The line is free of charge and provides counseling as well as information to survivors about their socio-economic rights and resources available in their respective communities.

At the end of 2014, Sabiha Husić was presented with the award “Woman of the World” in recognition of her extraordinary leadership and unwavering commitment in helping women and children survivors of war rape and post-war violence in BiH.

Following the increasing needs of our target groups, we recently finished constructing the new office building of Medica Zenica and officially opened the resource and counseling centre “Maya” Medica Zenica.(8) This enabled us to increase the capacities of the safe house and bring all our services(9) together at the same location with the educational center and safe house.

Despite significant progress and many achievements, a lot of work remains to be done in the future. The progress but also problems and ongoing challenges for survivors were also presented to Baroness Anelay, British FCO Minister of State and the Prime Minister’s Special Representative on Preventing Sexual Violence in Conflict, during her visit to Medica Zenica. On that occasion she also met survivors and representatives of NGOs working with survivors. At the end of her visit the Baroness said: „I am glad that the UK supports the work of these organizations which have been successful in their jobs for years. We have to work a lot on this problem in the future and we have to be conscious that behind everything there is a human being who needs help. Bosnia and Herzegovina has a horrible past regarding this problem but, I believe that this country has a great future ahead with the help of organizations like these.“(10)

What has to be done in the future for survivors of war rape and sexual violence:

  1. Ensure equal rights for survivors of war trauma and torture throughout the whole territory of BiH
  2. Implement a trauma sensitive approach in all support services in the following areas:
    – Health
    – Psychosocial field
    – Education
    – Criminal justice system
  3. Provide specialized psychosocial support to survivors and their families
  4. Protect survivors when these are testifying in national courts and ensure the ongoing prosecution of perpetrators
  5. Stop stigmatization
  6. Take positive action towards the social acknowledgement of survivors
  7. BREAK THE SILENCE

 

By Sabiha Husić, director of “Medica” Zenica & PhD candidate University of Sarajevo, and Irma Šiljak, program assistant of “Medica” Zenica. Bosnia and Herzegovina.

Sabiha Husić and her team at “Medica” Zenica will continue their devoted and committed work with survivors of war rape and sexual violence. Support our struggle for survivors of sexual violence in Bosnia and Herzegovina and worldwide.

Photo by Rosie Fraser on Unsplash

 

Sources

(1) Website: http://www.medicazenica.org/ (last accessed on 21 Nov. 2015) and Facebook: Medica Zenica

(2) Research on the long-term consequences of war rape and coping strategies of survivors in Bosnia and Herzegovina – “We are still alive. We have been harmed but we are brave and strong.” Second revised edition. (November 2014). Medica Zenica & medica mondiale. Zenica, Bosnia and Herzegovina, 2014 pp. 13 -14, & p. 133

(3) United Nations – http://www.un.org/en/globalissues/briefingpapers/endviol/ (last accessed on 21 Nov. 2015)

(4) “Zakon o izmjenama i dopunama Zakona o osnovama socijalnezaštite, zaštite civilnih žrtava rata i zaštite porodice sa djecom FBiH” published in the Official Gazette of the Federation of Bosnia and Herzegovina, no.39/06; available at: http://www.fbihvlada.gov.ba/bosanski/zakoni/index.php (last accessed on 21 Nov. 2015)

(5) http://www.icty.org/en/in-focus/crimes-sexual-violence (last accessed on 21 Nov. 2015)

(6) Research on the long-term consequences of war rape and coping strategies of survivors in Bosnia and Herzegovina – “We are still alive. We have been harmed but we are brave and strong.” Second revised edition. (November 2014). Medica Zenica & medica mondiale. Zenica, Bosnia and Herzegovina, 2014, p. 109

(7) Research on the long-term consequences of war rape and coping strategies of survivors in Bosnia and Herzegovina – “We are still alive. We have been harmed but we are brave and strong.” Second revised edition. (November 2014). Medica Zenica & medica mondiale. Zenica, Bosnia and Herzegovina, 2014 pp. 13 -14

(8) This is the offical name of the centre

(9) Our services include: psychological counseling center, legal aid center, drop-in center for children, counseling via SOS telephone line for survivors of domestic violence and unique telephone line for survivors of war rape and sexual violence and their family members

(10) http://medicazenica.org/uk/index.php?option=com_content&view=article&id=173:baroness-joyce-anelay-visited-medica-zenica&catid=1:latest-news (last accessed on 21 Nov. 2015)