The Silent Wounds: The Enduring Trauma of Female Survivors of Conflict-related Sexual Violence

Sexual violence in conflict zones is a profoundly devastating issue, primarily affecting women, and moderate men who are disproportionately targeted by armed militia groups. In the ongoing conflict in Goma by M23 rebels, for instance, 132 female inmates were raped and burnt alive in Munzenze during prison break on February 2025. Among the dead were at least 26 children , a veritable reminder of how sexual violence continues to be used as a weapon of war. While these acts leave undeniable physical scars, the psychological wounds are often more hidden but equally, more devastating. The trauma inflicted on the women is not only physical but deeply psychological, leading to long-term mental health challenges that can cripple survivors for the rest of their lives, if not addressed. The Goma jail break tragedy exposes the deep scars of war in the DR Congo, or any country at war where rape is weaponized against women and girls. In these circumstances, justice remains elusive, as survivors’ voices are silent. Urgent action is needed to protect victims, amplify their voices and bring an end to recurrence of such acts of impunity.

The Refugee Law Project's work with survivors of Conflict-Related Sexual Violence (CRSV) has highlighted the profound psychological challenges experienced by sexual violence survivors. CRSV refers to patterns of violent sexual acts including rape (rape with objects, gang rape), sexual slavery, forced nudity, forced pregnancy, forced prostitution, and other forms of sexual abuse that occur in the context of armed conflict. These acts are often used as weapons of war to intimidate, humiliate, and disproportionately disempower or even dehumanize survivors. Many survivors are left to battle psychological conditions such as depression, anxiety, Post Traumatic Stress Disorders(PTSD), and a sense of hopelessness, which impede their ability to lead productive and fulfilling lives. The trauma of sexual violence shatters self-perceptions and sense of self which often leave survivors struggling to find hope for the future. This psychological devastation, is often unaddressed and silent, and create a barrier to their healing, affecting not just the survivors, but their entire families and communities.

The UN Security Council’s Resolution 1820 in 2008 recognized sexual violence as a weapon of war, acknowledging its devastating impact not only on physical health but also on mental well-being. Sexual violence in conflict zones has long-lasting psychological consequences, including feelings of shame, fear, suicidal thoughts, anger, anxiety and isolation. One of the most disabling aspect of sexual violence is the shame and stigma associated with it imbedded in various deep socio-cultural norms. Survivors often carry the weight of their trauma in silence, fearing to disclose their ordeal and access support services. The silent wounds they carry prevent them from rebuilding their lives, limiting their opportunities and undermining their ability to thrive. This multifaceted nature of CRSV means that survivors are burdened with the trauma of both personal violation and collective victimization. The survivors often endure years of living with the haunting memories of their experiences, amidst a pervasive silence surrounding their suffering .

Through a decade of humanitarian work with refugees, undocumented migrants and asylum seekers, I have listened to numerous horrifying stories of conflict-related sexual violence experiences from both male and female survivors. Survivors of CRSV have suffered immeasurable pain for a long time. During the screening process, one survivor recounted a traumatic experience, I quote "Imagine the unimaginable pain of witnessing the brutal murder of my parents, their bodies left lifeless in the room, while I was also subjected to sexual violence by a rebel." This attests to the layers of trauma that leave survivors helpless.

In the shadows of conflict, where hope seems dim, survivors find themselves fighting battles no one can see. One Congolese survivor in Kampala recounted her ordeal, describing the pain and trauma she endured when she witnessed her father and two aunts being killed because her father refused to comply with the rebels' sexual demands of having sex with his sister. Following this, she was repeatedly raped and tortured by four armed men for a whole day and abandoned, leaving her emotionally scarred. At the time of sharing her story, she expressed significant emotional distress, frequently disassociating from those around her. She reported persistent feelings of worthlessness and hopelessness. Sexual violence leads to profound psychological changes, including emotional numbness, altered relationships, and disruptions in social interactions, all of which profoundly impact survivors’ abilities to connect with their families and sustain their overall well-being.

Through my work supporting survivors of sexual violence, I have observed that trauma profoundly affects self-perception, self-esteem, identity, emotional wellbeing, physical health, trust and, contributes to vulnerability and instability. A Congolese survivor living in Kiryandongo Refugee Settlement, for instance, recounted being abducted with his sister in North Kivu. He was forced by a commander to undress and dance before other rebels and then compelled to have sex with his sister. He remained in captivity for three weeks and due to the overwhelming shame of having had sexual intercourse with his sister and the forced nudity, he developed self-harming disorder as a way of coping with the shame and guilt of what he did to his sister.

After they were freed from the rebels, his sister tragically disappeared from home, unable to bear the shame and resentment she felt toward her brother. Survivors of such traumatic experiences often carry profound psychological wounds, which can manifest as intrusive thoughts, isolation, depression, and chronic emotional pain. These mental health challenges can persist long after physical violence has ended, highlighting the urgent need for comprehensive support and healing for survivors.

The situation for female survivors of conflict-related sexual violence remains critical, with the Multi-Sectoral Needs Index 2024 highlighting that single-female-headed refugee households and households led by individuals aged 59+ both face heightened vulnerability, with 95% and 96% respectively reporting significant needs, and 30% of both groups being in acute need. The vulnerabilities of these women, especially those with unresolved psychological trauma are further worsened by limited access to comprehensive mental health services. In Uganda, where most refugee families are headed by women, the responsibility burden intensifies as they struggle to care for children and meet basic needs, extending on their hardships and vulnerabilities.

Amidst the devastation, some stories are too raw to forget, and too powerful to ignore. Case in point is a 52-year-old Congolese survivor residing in Kampala who shared her horrifying experience of abduction and repeated sexual violence. While teaching at a school in the DR Congo, she was forcibly abducted by rebels and held captive for a year. During her abduction, she was repeatedly gang-raped, which led her to turn to drugs in an attempt to numb the intense physical and emotional pain she endured. As a result of the repeated assaults, she became pregnant and gave birth to a daughter in Goma, a child conceived through rape. Her ordeal came to an end when an ambush in the area allowed her to escape. She eventually sought refuge in Uganda, hoping to rebuild her life. However, her suffering did not end there. While struggling to survive in Kampala, she was raped again and subsequently gave birth to another child, also conceived through rape. Despite these unimaginable hardships, she continues to fight for a better life for herself and support her children as the head of the family.

At any rate, prolonged and repeated exposure to violent experiences such as sexual torture, gang rape, sexual slavery, and rape with objects can severely impact victims, often resulting in emotional numbing, depression, and other psychological issues if not properly diagnosed and treated and also worsens the life of survivors.

Despite the critical need for psychological support services, 77% of individuals experiencing psychological distress in the Kiryandongo Refugee Settlement reported being unable to access such care . Furthermore, 40% of refugee households indicated that family members in psychological distress were unable to obtain psychosocial support. This lack of access to support services worsens chronic post-traumatic stress disorder (PTSD) among survivors, with their needs often inadequately addressed. While some organizations offer basic humanitarian support, comprehensive support including local community interventions focusing on social coherence, engagements of survivors with psychiatrics, consistence with psychosocial standards of care among others, are frequently lacking or remain severely inadequate. The limited number of humanitarian partners and staff providing quality psychosocial and mental health support, particularly for survivors of sexual violence, highlights a significant gap in humanitarian interventions. Without prioritized efforts from governments, donors, and humanitarian partners, the survivors are at risk of degenerating into further mental health disorders.

Institutions such as the Refugee Law Project have made significant steps in supporting survivors of conflict-related sexual violence (CRSV) by facilitating access to essential services, including medical rehabilitation and psychosocial support. They have also led awareness campaigns on disclosure, sexual violence, and gender justice, advocating for policy reforms to promote gender equality alongside championing the discussion on males as survivors through the South-South Institute on Sexual Violence. Additionally, they have engaged in advocacy, capacity building, research, and dialogues with stakeholders on CRSV's impact. However, continued efforts are needed to further professionalize support systems within humanitarian agencies and address the ongoing needs of survivors in a comprehensive and sustained manner among refugee communities in Uganda.

There is an urgent need for a more robust humanitarian response system that facilitates better-integrated service delivery and a prompt assessment of the psychological needs of victims at individual and household levels within refugee settlements and urban settings. This includes improving tailored counseling services for victims, which are essential for their recovery and integration. Addressing these issues comprehensively will enhance the effectiveness of humanitarian efforts and support the trauma healing of survivors.

To effectively support survivors of sexual violence, a comprehensive and survivor-centered approach is necessary. This includes offering personalized case management where each survivor is linked to a dedicated professional who coordinates their medical, psychological, and other needs. Creating safe, accessible spaces for survivors, such as sustainable confidential counseling rooms or community centers, is crucial for privacy and emotional safety. Improvement in the food aid programming is also urgently needed, many have no food at household hold level nor do they have any sustainable livelihoods engagements which worsen the life of survivors and refugees in general. Long-term functional peer support networks led by survivors can also offer solidarity and support shared healing processes, while regular follow-up care ensures that survivors receive continuous support in their recovery journey. Overcoming barriers to access services, such as transportation or stigma disclosure conversations, through programs like mobile mental health clinics is essential to ensuring that services reach the most vulnerable. Additionally, ensuring that services are culturally sensitive and trauma-informed builds trust, which is fundamental in helping survivors feel comfortable to seek help and participate in their own healing processes and meaningfully engage in the social and economic lives of their local communities.

Further, psychological first aid to all humanitarian actors and immediate crisis interventions are necessary immediately following an assault. Such timely and prompt intervention ensures survivors are not left to cope alone in the aftermath of suffering sexual violence. Also, long-term recovery should include focus on economic empowerment, providing survivors with skills training or microloans to regain financial independence and autonomy. Community awareness campaigns remain essential in reducing stigma and fostering empathy, encouraging communities to offer support and create an environment where survivors can heal without fear of judgment.

Finally, localized survivor engagement for change can be achieved by involving survivors in community engagements, sharing their personal stories in safe, supportive settings like support groups. By amplifying survivor voices in local forums, such as community meetings or radio programs, their lived experiences can inspire collective action and drive lasting cultural behavioral changes towards supporting survivors of sexual violence in conflict. These combined efforts not only help survivors recover but also empower them to rebuild their lives with dignity, strength and hope.

Charity Immaculate, Refugee Law Project, SGBV Officer

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