KASEREKA JO LUSI, MD: SURGEON HELPING WOMEN RAPED DURING CONGO WARS

Curtis Abraham

FROM MY ARCHIVES

Jo Lusi

Dr. Kasereka “Jo” Lusi has been an orthopedic surgeon in rural Congo for most of his adult life. He studied medicine at the University (formerly Louvanium) of Kinshasa, Democratic Republic of Congo (DRC), and the Royal Infirmary of Scotland and later did his orthopedics specialization in Belgium. After completing his studies, he returned to Nyankunde Mission Hospital, and worked there as an orthopedic surgeon for the next nineteen years.

In 1993 he joined MAP International in Nairobi as Regional Director of Health Development. In 1994 he returned to Goma, eastern Democratic Republic of Congo and later became the co-founder (with wife Lyn who passed away in 2012) of HEAL Africa. HEAL Africa has a 155-bed tertiary referral hospital is one of only three referral hospitals in the D.R. Congo. It’s funded by the British development agency Tearfund. It provides general surgery, orthopedics, obstetrics and gynecology (including fistula repair), pediatrics, and internal medicine. It also serves as a center for healthcare and research, and for training doctors and healthcare professionals. The hospital comprises roughly 20% of HEAL Africa’s work.

HEAL Africa is changing the lives of women who have been brutally raped, as well as mobilizing local churches and communities to build peace (a study carried out by researchers by the World Bank and International Food Policy Research Institute at Stony Brook University in New York, published in 2011, estimated that 1,152 women are raped in DRC every day).

The majority of HEAL Africa’s activities are focused on community development efforts. HEAL Africa supports 31 safe houses throughout North Kivu and the Maniema provinces, and partners with over 90 remote clinics and hospitals. Programs address gender-based violence, public health and health education, law and justice training, community development and rebuilding, spiritual development, and personal finance through micro-loans.

At one time he was the only orthopedic surgeon in eastern Congo for a population of 8 million people. In 2013, Dr. Lusi was widely tipped for the Nobel Prize for Peace.

The late Lyn Lusi with husband Jo

HAT IS A FISTULA?

Generally, a fistula is an abnormal connection between two tissue-lined organs or vessels. A vaginal fistula or tear can be caused by violent rape like what we see in war zones like eastern D.R.Congo. This can often leave them unable to have children. It also leaves the women unable to control their bladders. But this condition is also caused by childbirth; when a prolonged labor presses the unborn child tightly against the pelvis, cutting off blood flow to the vesicovaginal wall.

WHAT PSYCHOLOGICAL AND SOCIAL IMPACTS DO FISTULAS HAVE ON YOUR PATIENTS IN D.R. CONGO?

Many rape victims are rejected by their families and their communities. Even the husbands of these women and young girls turn their backs on them.

HOW DID THE HEAL AFRICA HOSPITAL COME ABOUT?

In 2000, my wife Lyn and I became concerned with the plight of women during the two civil wars and continued armed conflict in eastern Congo. It is the women who are paying the highest price during such violence. The severe injuries that are inflicted on these women’s bodies sometimes resemble the carnage when a lion is devouring its prey! We couldn’t stand by and do nothing, so we decided to do something and I continue this work in Lyn’s memory.

HAS THE END OF THE M23 REBELLION SEEN AN INCREASE OR DECREASE IN THE NUMBER OF WOMEN AND GIRLS REPORTING RAPE AND NEEDING RECONSTRUCTIVE SURGERY?

The end of the M23 rebellion has provided a window for us to see even worse atrocities than we had previously seen. We have been able to reach deep into forest villages and see more fistula cases. I can say that from 2010 until today the numbers have been increasing. But even though the war of the M23 rebels has ended, there are still 20 other militias such as the FDLR, who were the main perpetrators of the 1994 genocide in Rwanda, are still terrorizing people in the jungles of eastern D.R.Congo. Women are also being raped by soldiers of the Congolese army.

WHAT ARE SOME OF THE CHALLENGES OF DOING SURGERY IN AN AFRICAN WAR ZONE?

We medical people in Africa don’t have the experience of working for a lot of money, so one of the greatest challenges is not to expect anything in terms of financial rewards for the medical work you do. Another challenge is that you find yourself saving lives of vulnerable women and girls without much help from anywhere. I find myself repairing their fistulas with tears in my eyes. But you do it because you love people. It’s a labor of love.

WHY HAS RAPE BECOME A WEAPON OF WAR IN THE CONGO?

Sexual violence has been a consequence of the wars. In our tribal culture, if one tribe invades another tribe’s villages, rape was used as a method of humiliation, provocation, and

to make the other tribe feel victimized. It is a way of the victors to insult the vanquished; to show them you are more powerful than they are.

DO YOU THINK THIS BEHAVIOR IS ALSO A COLONIAL RELIC FROM THE DAYS OF BELGIAN IMPERIALISM WHEN CONGOLESE WOMEN WERE RAPED BY COLONIALIST ON RUBBER PLANTATIONS?

My father, a surgical nurse, grew up during colonial times but his generation taught us to treat women girls with respect; to treat them like princesses. Anybody who is my mother’s age I call my mother. My women patients I address them by calling them my sister or mama. So, it's a lack of social order because of endemic war.

WHAT IS ONE OF YOUR MOST MEMORABLE CASES?

It has always been Ekok. She was 13 years old when she was raped by three men on her way to school. Ekok became pregnant and was thrown out of the home by her family. She eventually lost her baby because her young body was not strong enough to deliver a child. She had torn her uterus; she had a vesicovaginal fistula meaning you cannot control your urine or bowel movements, so she was stigmatized because of her unhygienic condition. She tried to kill herself. Lynn sent a counselor to speak with her and she agreed to be operated on. We repaired her fistula after four or five operations. Today, she is promoting our cause. She went back to her village and spread the good news that for such rape victims there is hope. She is ready now to go to university and study law but she hasn’t gotten the scholarship yet.

DO YOU ALSO WITNESS MANY CASES OF DOMESTIC SEXUAL VIOLENCE AND DO THESE ALSO LEAD TO FISTUALAS?

Yes, everyday. In the DRC we have among the highest numbers of domestic sexual violence cases in the Great Lakes region. But these do not lead to fistulas. It is only the war-time rapes that lead to fistulas; where a foreign object is shoved violently into to the woman and damages their internal organs.

WHY HAS THE BIOGRAPHY OF WILLIAM WILBERFORCE BECOME SO IMPORTANT IN YOUR LIFE’S WORK?

I see William Wilberforce’s anti-slavery campaign of the 1840’s similar to that of our campaign against the rape of women and girls in eastern D.R. Congo. Women and girls we have treated have been enslaved by these rebel rapists. I tried to show William Haig, the British Foreign Secretary, that there is a big sexual slavery of women in eastern Congo when he and Angelina Jolie visited the hospital last year.

WHAT MOTIVATES YOU?

The first motivation occurred in 2002 when Lyn, and I met a woman called Sakina whose husband was killed. She ran away from her village to a neighboring village with her three children. But in this village, Sakina was brutally raped by five men. The rapists then inserted the barrel of a gun inside of her damaging her internally. I could not imagine a human being raping another human in such an inhumane and brutal way and so I decided to do something. She was my first fistula patient. Another motivation was Lyn. She was the driving force behind the hospital. She died of cancer but my inspiration comes from what she told me: “nobody is fit to live until they’ve discovered what is worth dying for”.

HAS YOUR WORK ENDANGERED YOUR OWN LIFE?

Yes, every day we need protection. In Goma, several policemen guard my house. When the civil war was going on, I heard about death threats on my life. I have even confronted those who want to kill me. The rebels say that I am talking negatively about them in international conferences. In addition to this, in 2003, as a senator in the transitional government of Congo, I lobbied for the recognition of sexual violence as a crime against humanity then I wrote Article 16 in our constitution which was adopted in our new constitution in 2006 and now gives a mandatory 25-year prison term for convicted rapists. Now my country has woken up to mass rape.

HOW ARE YOU AIMING TO RECONSTRUCT WAR-RAVAGED COMMUNITiES IN EASTERN CONGO?

HEAL AFRICA provides safe houses for rape victims and offer a system of support for treating the physical injuries of women who have been violently raped. We also offer legal counseling. While in hospital, the women can learn to read and write and other important skills. Over 1500 women with fistulas have been operated on at our hospital and restored to health and a total of about 16,000 women have been assisted by us. All the women affected are offered treatment for HIV/AIDS and Sexually Transmitted Infections (STI’s).

Then we started asking ourselves: how we can repair our fractured in our society? What we came up with is holistic care. We call it the Healing Arts Programme. It addresses the issues of poverty, inequality and illiteracy. Most women in the rural villages are illiterate. Africa can’t develop without the women. We also give micro-grants to help the women and their families start businesses. We also give them skills. They can make handicrafts like baskets they can sell and generate an income.

We cannot forget the men either because it’s the men who are the rapists. There is an attitude that to prove that you’re a man you have to rape a girl. This is wrong and we have to change this negative attitude of our men. In the rural areas we have 150 trained community counselors in six provinces whose job it is to listen and give comfort and advice.

WHAT IS YOUR OPINION OF RECENT ATTEMPTS AT GETTING SEXUAL VIOLENCE ADDRESSED ON THE WORLD STAGE?

I consider it a great victory for us that the international community is now focusing on sexual violence. I was crying the other day that Lyn did not live to see how our ideas have gone global. So I’m proud that the whole world now knows. But I am equally proud that it is also a domestic victory because we have woken up the government of the DRC and they have opened a ministry of women and family.

HOW ARE YOU PARTICIPATING IN THAT EFFORT?

In London, I have been attending some high level international conferences. Last year, I addressed a meeting of delegates from UN, the Department for International Development (DfID) and NGOs, which are seeking further international action to protect women and girls from violence and sexual exploitation after natural disasters and in conflict zones such as DRC.

I also got a chance to meet with some Hollywood-humanitarian-minded people like George Clooney and Angelina Jolie who are also anti-poverty campaigners and they get a chance to see our hospital and the good work we are doing. They also get to see the many challenges we face with limited funds and facilities. We are also spreading the news globally about our work using social media like Facebook and we are putting out and international newsletter. We have also forged closer ties with UN Secretary General Ban Ki-Moon and others.