Responding to the attack on Dr. Mukwege, Panzi Hospital

In the wake of the attempted assassination of Dr. Denis Mukwege, Medical Director of Panzi Hopsital, and AIR Steering Committee member in October 2012, Jessica Horn and Leah Teklemariam reflect on the meaning of solidarity and the importance of both Dr. Mukwege and Panzi as African leadership.  The article was originally published on 18 March 2013 on the Our Africa platform of open Democracy 50:50.

Panzi hospital: a critical pulse for justice, peace and health

Congo’s women survivors, standing in solidarity with Dr Mukwege and his staff at Panzi hospital, have become donors to their own cause and catalysts for deep social change.  Who is standing alongside them and the hospital patients to ensure that their transformative work continues?

On the evening of 25 October 2012 a group of women from Bukavu mobilized and made their way on foot to the house of Dr. Mukwege.  They had heard rumors that he had been attacked, and their response was protective and immediate – they wanted to make sure that he and his family were safe.  These women are survivors of the horrific sexual violence that has become such a trademark strategy of the conflict in eastern Democratic Republic of the Congo.  They had come to know Dr. Mukwege when they were patients at the Panzi Hospital where he is the visionary founder and Medical Director.  They arrived at the hospital broken in both body and in spirit and with few options for survival.  Like the 30,000 other women who have been treated, cared for, and empowered at the Panzi Hospital since 1999, the healing they experienced was not just of their physical wounds but also of their emotional, psychological, and economic trauma.  These women found in Dr. Mukwege a man who sees what seems to be invisible to so many: that women – not minerals – are the DRC’s most precious and valuable resources. What moved them to begin their journey that October night was a testament to the impact of his philosophy and his action: that Congo’s women survivors are not passive victims, but catalysts for deep social transformation.  They are among Congo’s leaders – and they know that Dr. Mukwege is too.

When the women finally arrived at his home in Bukavu after the attack, they were weeping.  Once there, they heard the details.  A group of heavily armed men forced their way into Dr. Mukwege’s home and held his two daughters at gunpoint, waiting for him to return.  As Dr. Mukwege, himself, described to the New York Times:

I had gone to accompany a patient who had come to see me for medical advice, and when I returned I was met by heavily armed men who forced me out of my car.  They had been in my house and forced my children onto the sofa at gunpoint, which is how I saw them when I arrived.  I found myself with a gun to my head, and just as the gun was loaded and ready to shoot, a member of my staff, Joseph Bizmana, heroically intervened to save me.  He shouted and came running to jump on this armed intruder, who turned and shot him.  He fell down, I fell down, and I can’t really remember what happened after that.  I realized he was shot, and I saw him give his life for me.  The attackers then got in the car and left.

Although the headquarters of MONUSCO (currently the UN’s largest peacekeeping force in the world with about 20,000 troops) is but a few hundred metres from Dr. Mukwege’s front door, the first responders were about 20 of Dr. Mukwege’s friends, patients, neighbours, and colleagues who arrived at his home to keep watch.  They were driven by the truth that to threaten Dr. Mukwege was to threaten the very representation of hope for change in DRC.

The news of the attack spread quickly, both in Bukavu and around the world.  Within hours, offers of support came from North American and European governments.  Within days, Dr. Mukwege, his wife and daughters were on a plane to Belgium.  Not one African government offered either a statement of concern, or an offer of safety.

Dr. Mukwege remained abroad until his triumphant return to Bukavu on January 14, 2013, with assurances of security from the UN and local police.  The city, long since made weary by the intractable conflict, came alive in celebration.  Again his former patients walked to Dr. Mukwege, bearing gifts and necessities to ease his transition home.  To date, there has been no police investigation and the identities of the attackers remain unknown.

Why Panzi Hospital matters

When we speak of “Panzi” we know that it means more than a hospital and related NGO initiative.  We know its significance is deeper than service provision to a population brutalised as “elephants fight” in a complex political and economic conflict in the eastern Democratic Republic of Congo.

As a medical facility, Panzi Hospital is ground-breaking.  The team of gynecological surgeons, headed by Dr. Mukwege, have pioneered innovative techniques in obstetric surgery, particularly in repairing traumatic fistula.  They have literally pieced women’s bodies back together, reconstructing women’s bladders and mutilated genitalia. Put differently, Dr. Mukwege and his medical team, have made a hospital that sits at the end of an unpaved road and at the epicentre of persistent armed conflict – a focal point for teaching and innovation on obstetric and gynecological surgery.  This painful and reluctant expertise has developed as a result of the extremity of the violence that their patients experienced.  To Dr. Mukwege “the word rape or sexual violence cannot fully translate the horror I see hundreds of thousands of women living through in this part of the world.”  Today, the work of Panzi Hospital is a technical gem for an African region still facing deep challenges to providing quality medical care tailored to the limited infrastructure and resources that exists in both rural and urban contexts.

Panzi Hospital’s work is holistic, and goes beyond the concept of medicine as ‘fixing bodies’ to considering how the hospital can contribute to integrated healing.  Women and girls that come to the hospital with crises related to physical and sexual violence also carry other concerns.  Many are living with HIV as a result of the violation. All manage the complex emotional scars left by attempts to dehumanize them and their communities in the conflict.  In the social double-standards that persist, women survivors also carry the stigma of having been raped and face difficulties in reintegrating into their communities.  The skilled team of doctors, nurses, counselors, social workers, lab technicians, HIV outreach workers and midwives take on these challenges.  They view the urgent physical needs of their patients as an entry-point to address longer-term holistic needs such as livelihoods, mental and emotional health, shelter, and education for their children.  They have a comprehensive income generation programme where women develop skills which translate into earning a meaningful income; they offer legal support to assist survivors to seek justice; they provide school fees to ensure that children can thrive.  They respond rapidly, always with an abundance of compassion and resourcefulness, compensating for painfully insufficient human and financial resources.  In doing so, Panzi Hospital stands as part of a dignified tradition of activist medicine- activist in the sense of contributing to deep social transformation, and understanding the role that medical practitioners play as agents of change.

A catalytic man

Dr. Mukwege undeniably lies at the heart of Panzi’s work and as a critical pulse in its vision of a more just, peaceful and healthy Democratic Republic of Congo.  Indeed so legendary are his medical skills that children in one community where Panzi Foundation works composed a song that they sang, dancing and clapping into a gathering we attended that says “We are going to dance, and dance, and dance until our bodies break, and then we will go to Dr. Mukwege who will put us back together again”.  As doctor and surgeon he possess an expertise that is invaluable for his patients but also for the African region.  However it is his capacity as a strategic thinker and as an advocate willing to speak truth to opaque and disruptive power – that is Dr. Mukwege’s gift, and ultimately what has exposed him to attack. His own words reveal the calibre of his ethical vision. Speaking before the United Nations a few weeks before the attack, he warned “We cannot silence the truth as it is persistent”.

What will we do?

As Dr. Mukwege returns to his work and advocacy back in Bukavu after his exile abroad, the conflict again ebbs and flows in the DRC.  In November, 2012, the world watched Goma (the provincial capital of North Kivu, DRC) fall into the hands of the M23, a militia group, and waited to see if their threats to continue onto Bukavu, and perhaps even Kinshasa would materialize.  While the M23 withdrew from Goma in December 2012 the situation remains volatile. Many remain skeptical that the regional peace deal signed on 25 February, 2013, between government parties will bring a lasting end to the rebel violence.  It feels like the world is watching, engaging military effort but in many ways not putting a full heart behind it.

And yet, watching and waiting is not something that the women of the eastern Congo do.  Despite the fact that it is their bodies upon which this conflict is being fought, they are rising up and taking action.  It is these women for whom Dr. Mukwege both risks and devotes his life.  As he stated in his recent address to the UN in September of this year “My honour is to be with these courageous women victims of violence, these women who resist, these women who despite all remain standing.”

So what will we do as Africans on the continent and in its Diaspora to match our heartfelt support for Dr. Muwekege and the work of Panzi Hospital?  As journalist Musa Okwonga expressed at the time of the attack, we refuse to see Dr. Mukwege become yet another “great African martyr”, dying before his time because we were not brave enough to stand up in defense.  Perhaps the best lesson is gleaned from the women in eastern Congo.  In Bukavu, from the very first news of his attack, Dr. Mukwege’s patients responded, bringing produce from their fields and offering them to hospital staff to sell so that they could fund Dr. Mukwege’s return ticket back home.  This “civilian peacekeeping force” understood their mandate of protection and direct response, and began their own form of philanthropy – they have become donors to their own cause.

In the longer-term, a durable response is also necessarily political.  As Dr. Mukwege has argued “we cannot put a peacekeeper behind every woman who goes to the field, what is needed is complete reform of the Congolese security system”.  This requires governmental actors involved to navigate the complex economics and regional geopolitics, and to stand firmly on ethical ground in saying no to the brutalisation of everyday Africans in the name of profit and political power.  African governments need to take a firmer stand.  What is happening in DRC has and can easily be replicated in other African contexts where weak states, the lure of natural resources, and unchecked military power form a literally deadly environment for people attempting to make a life for themselves and their families.

In the wake of a fight against colonial power in Mozambique, liberation leader Samora Machel offered “solidarity is not an act of charity but an act of unity between allies fighting on different terrains toward the same objectives”.  Solidarity with Panzi Hospital, in word, but critically also in deed, is an act of unity with the women of eastern Congo, with Dr. Mukwege and with the team at Panzi Hospital whose objective is clear – dignity and peace. It is an affirmation of the belief in a DR Congo and, more broadly, an African continent where people can live hopeful of the future rather than managing the impacts of the compromises of the past, and the all too violent present.