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The women at the hospital in Goma come from all over Congo seeking surgery, sustenance, and emotional support. One woman walked 700 kilometers while seriously injured to arrive at the hospital. Other groups of women are fl own there in aircrafts provided by the German government.

The HEAL Africa hospital is divided into two compounds by a lava-paved road. The newer compound, still under construction, houses the hospital’s HIV/AIDS programs. The lava field outside the building serves multiple purposes. Some patients and families use the fi eld as an unoffi cial waiting room. Patients who have been at the hospital for a long time use the fi eld to wash clothes, laying their garments out to dry on chunks of black rock. Across the street, the number of women in need of surgery overwhelms the hospital facilities. On the far side of the pre-op ward, the hospital has pitched three UN relief tents that lend the entire compound the air of a refugee camp. Inside the tents, more women wait. Some feed their children or talk. Others stare dejectedly at the white tarp roof. All hope that the hospital will be able to restore some semblance of normality to their broken lives.

The doctors who care for these women face daunting medical challenges. The internal damage from rape often requires complicated surgeries. Many women must undergo multiple rounds under the knife. Sometimes, physical damage is so extreme that women no longer have enough tissue to reconstruct vaginal and rectal cavities. Even when they have the resources to make several attempts, doctors do not always succeed in repairing fi stulas. Despite these challenges, the hospital has treated almost 10,000 women and performed over 1000 successful corrective fi stula surgeries since 1996.

Even when surgery fails, HEAL Africa’s holistic approach to healing can still succeed. The hospital recently started a program called Grounds For Hope, which aims to provide a sheltered living community for women who cannot or do not want to return to their villages. Women with fi stulas that surgeons were unable to repair remain in the Grounds for Hope community. Each receives a small house, a plot for gardening, and access to education.

When doctors are able to repair fi stulas, women often fi nd that returning to their old communities is extraordinarily challenging. To ease the process of re-integration, HEAL Africa employs a network of counselors who are trained in family mediation. When a woman returns her village, a counselor accompanies her and negotiates with the family to try to insure a safe, peaceful homecoming. Through the assistance of Veterinarians Without Borders and the World Food Program, the hospital provides each returning woman with a goat, a new hoe, some seeds, and food. The material goods that women bring with them entice their husbands to take them back. Goats and seeds have saved more than a few marriages in Congo.

HEAL Africa employs counselors not only to facilitate the social re-integration of patients, but also to promote change in the wider Congolese society. Describing the hospital’s approach to medicine, Judy Anderson explains, “we cannot isolate what happens in a medical sphere from the trauma that possibly caused it and the social conditions that lead to the trauma.” To address these social conditions, HEAL Africa has more than 130 trained counselors working in the provinces of North Kivu and Maniema. These employees aim to raise rape awareness, to educate women, and to change cultural attitudes about the value of women. In addition, the hospital has set up four safe houses in villages around North Kivu where women can go if they feel threatened. Each house has a few beds, a listening room, and meeting rooms. The houses also host classes for women.

Despite HEAL Africa’s attempts to turn the cultural tide against sexual violence, the rapes continue. Increasingly, civilians, not soldiers, are the perpetrators. The question remains: in fi fteen years, will Seraphine still have to worry about the sexual violence that brought her there? Will her daughters and sisters have to cope with the devastating impact of brutal rape? Tellingly, the HEAL Africa hospital rests atop ten feet of lava. When Mount Nyiragongo erupted outside of Goma in 2002, a river of lava spilled down into the city and destroyed everything in its wake. On that foundation of destruction, HEAL Africa built a powerful symbol of change. It is time for the entire country to use the lessons learned from a decade of destruction to build the foundation for a brighter future.

Some names and personal details have been changed.