MASS RAPE: A SOCIAL WELFARE PROBLEM?

The National Association of Social Workers (NASW) lists service, social justice, dignity and worth of the person, importance of human relationships, integrity, and competence as its core ethical values. Social workers are encouraged to aspire to these ideals as detailed in the Code of Ethics (NASW, 2007). The first social work principle is service. NASW states that Social workers' primary goal is to “help people in need and to address social problems” (NASW, 2007). In the aftermath of mass rape, survivors display psychosocial as well as physical problems that need to be addressed.

Social justice, and a commitment to challenge injustice, is another core social work principle (NASW, 2007). Genocide and mass rape are the polar opposite of social justice and human rights, and it is one of social work’s imperatives to advocate for the latter principles. Social workers “pursue social change, particularly with and on behalf of vulnerable and oppressed individuals and groups of people” (NASW, 2007). Survivors and witnesses of mass rape are certainly “vulnerable and oppressed,” so the imperatives of social justice for these populations supports a social work response to the problem of mass rape. NASW principles state that social workers “strive to ensure access” to needed services for people experiencing social injustice. The principles of service and social justice have drawn the field’s attention to the social problems caused by mass rape campaigns. NASW has responded to the current crisis in Darfur with advocacy for humanitarian and peace-keeping intervention in the region (NASW, 2006).

Social workers value the dignity and worth of the person as well as human relationships. Sexual violence can cause the loss of personal dignity, integrity, and self-determination (Heise, 1998). Rape can be considered the most severe attack on a woman’s embodied identity, especially in the context of genocide (Seifert, 1994) The struggle for dignity and self-determination is rooted in the control of one’s own body and physical access to one’s own body; these important social work and human rights values are demolished through mass rape (Heise, 1998; Seifert, 1994). The social work profession’s estimation of the inherent worth of human life and the value of human dignity should compel individuals, agencies, and organizations within the social welfare community to respond to these crises. Further research, advocacy, and service development/provision are needed to effectively intervene with survivors and witnesses of mass rape.

The destruction of human relationships, human dignity, and human rights in the aftermath of mass rape is staggering. A social work response to these crises, featuring a relational, strengths-based, systems approach could offer hope for psychosocial recovery and reconstruction of the social structures that sustain individuals, families, and communities. Judith Herman, an expert in the field of violence and trauma, stated “recovery [from psychological trauma] is based on the empowerment of the survivor and the creation of new connections. Recovery can take place only in the context of relationships” (Herman, 1992, p. 133).

Since social workers “seek to strengthen relationships among people in a purposeful effort to promote, restore, maintain, and enhance the well-being of individuals, families, social groups, organizations, and communities,” the social work profession seems ideally suited to respond to the psychosocial needs of traumatized populations left in the wake of mass rape (NASW, 2007). An historic and defining feature of social work is the profession's focus on individual well-being in a social context and the well-being of society, a useful approach when individual lives, families, social and community structures must be rebuilt (Code of Ethics, NASW, 2007).

The social work principle of integrity can be interpreted to mean a refusal to engage in behavior that evades responsibility. NASW explicitly states, “Social workers are continually aware of the profession's mission, values, ethical principles, and ethical standards and practice in a manner consistent with them” (NASW, 2007). The integrity of the social work profession and its members is strengthened by the commitment to the ethical principles and standards delineated in the NASW Code of ethics. The principles and core values of the social work profession dictate that the problem of mass rape is within the scope of the field. In order to uphold the commitment to these core values and preserve the profession’s integrity, an active response of social workers in the provision of services to mass rape survivors is necessary.

In typical practice, social workers regularly respond to incidences of rape and sexual violence. Rape survivors may contact a social worker through a crisis hotline, emergency room, forensic interviewing center, psychiatric or mental health service, gynecological or abortion clinic, women’s center, domestic violence or homeless shelter, HIV testing facility, or counseling agency. The field of social work responds to rape through practice, policy, and research as well as through its advocacy on behalf of survivors, victims, and their families. Social workers may also be involved with treatment or interventions for perpetrators of sexual violence, or with rape prevention programs.

Thus, the “social problem of rape” is easily considered within the realm of social work practice, research, theory, policy, and advocacy. The “social problem of mass rape” falls similarly within the purview of social welfare. Scholars are calling for increased contribution by the field of social welfare to prevention of and response to mass rape, particularly in the context of ethnic conflict and genocide (Alenkin, 2006).

RESPONSE TO THE PROBLEM OF MASS RAPE

Although social workers are involved at the individual or micro level with local interventions for rape such as rape crisis response or counseling, it is important for the field to expand the scope of its response to the problem of mass rape. According to the NASW principle of competence, social workers must “practice within the scope of their abilities and seek to develop and enhance their expertise,” so the field should prepare itself to provide competent services to these populations (NASW, 2007). There must be further development of social work interventions to ensure the delivery of psychosocial services to survivors and witnesses of mass rape. Research and training are essential to the development of a social work response to the problem of mass rape.

Due to the scope of the physical and emotional devastation left in the wake of genocidal rape campaigns, treatment interventions that victims receive are often only marginally available, accessible, or effective. (Arcel et al, 1995; Frljak et al., 1997; Human Rights Watch, 1996; Kozaric-Kovacic, 1995). Timely, appropriate, and decently funded intervention by the United Nations (UN) or other forces (such as individual countries, coalitions, or independent aid organizations) is the best way to protect civilian women from becoming victims during a mass rape campaign. Many organizations provide treatment and intervention for rape trauma tend to survivors’ basic safety and physical needs, which is essential for their physical survival and their mental health (Arcel et al, 1995; Richters, 1997).

Intervention should include the provision of basic amenities, such as food, water, shelter and security, as well as stationary and mobile health and mental health services. Provision of food, clean water, decent housing or shelter, and reasonable protection from further harm have been established as important components of successful recovery; it is widely agreed that little psychological comforting can be accomplished in the absence of “three hots and a cot” (Arcel et al, 1995; Kozaric-Kovacic, 1993; Sharipova, 1997). The provision of relative security in a war zone or recently demilitarized zone can be complicated, and may require partnering with governmental or other organizations that can provide for the basic security of workers and clients, such as the United Nations.

Survivors often have both health and mental health needs, but they are more likely to seek assistance for physical health problems. In order to reach a greater number of survivors in need of social work services, it will be important to partner with health care providers. Frequently, raped women will seek medical care if it is available to them, but they may not disclose their abuse despite obvious trauma to the genitalia or other clear signs of sexual assault (Fischman, 1996; Swiss & Giller, 1993). Women should be sought out for treatment in ways that are not embarrassing because they are not likely to come forward on their own. In a study of over 100 Ugandan victims of wartime rape, “only half told anyone about the rape despite the fact that they all still had problems related to the rape when they finally spoke of it” (Swiss & Giller, 1993, p. 612). Confidentiality should be strictly observed, and all possible efforts to protect and restore the victim’s pride, self-respect, and image in the community should be made.

Because health care is virtually absent in war and is denied to victims of genocidal rape by virtue of the fact that they are intended to suffer and die, mobile and stationary rape crisis centers with teams able to respond to acute and severe trauma should be mobilized in these areas. The services provided should include physical health care and emergency services including transportation, mental health counseling, abortion, pain management, and evidence collection for later use at trials. Reports of sexual violence should be collected in a more systematic manner, keeping in mind the need for privacy and sensitivity in order to obtain testimony from rape victims. (Human Rights Watch, 1996). Women health care professionals should be included on the teams, because rape survivors overwhelmingly report that they would disclose their abuse to a female, but not a male, examiner or counselor (Human Rights Watch, 1996). These teams would need military or police protection that was trustworthy in order to protect the safety of rape crisis workers in the field. And even then, there is no guarantee of safety for workers in general, and females in particular.

In the aftermath of a genocidal rape campaign, physical and mental health care for victims must be a priority. Victims of sexual abuse during the genocide suffer persistent health problems and generally only receive intermittent, partial or temporary assistance for persistent, all embracing and potentially terminal problems (Frljak et al., 1997; Human Rights Watch, 1996; Kozaric-Kovacic, et al., 1995). Unfortunately the stigma surrounding sexual abuse often dissuades women from seeking the medical assistance they need. Interventions must be made accessible to women in a way that is not perceived as shameful to women and does not call attention to the sexual nature of the crime. Clinics must be established in such a way that it is not obvious what a woman is going in for (i.e. it should not be called a “rape crisis center” and only treat people for that type of problem; it should be a women’s medical facility that also provides quality treatment to survivors of sexual violence). It is essential that mental health service providers collaborate with providers of physical health care for survivors.

Mental health counseling should be available to rape survivors on an ongoing basis for as long as they need it. Survivors of the Rwandan genocide in 1994 reported utilizing rape-counseling services, if the counselor was a woman, and if the services were available to them (African Rights, 2004). In a ten-year follow-up study, survivors accessing mental health counseling had better overall outcomes than those who did not get counseling (there was no difference in access to health care services between the women who has received counseling and those who had not) (African Rights, 2004). Following a mass rape campaign, social work services may be provided to the victimized population, and these services can be extremely varied in terms of scope, focus, and theoretical framework. Individual, small group, large group, and family psychotherapy may be employed (Arcel, 1995; Pierotti, 1997; Webb, 2004). Counseling services may rely upon different theoretical frameworks, including empowerment or client-centered, psychoanalytic, cognitive-behavioral, mixed, or other paradigms (Arcel et al, 1995). In the field of mass crisis response, often counseling focuses on practical strategies for coping with the trauma that they have suffered and moving on with their lives (Arcel et al, 1995; Webb, 2004).

It is especially important to advocate for strengths based services, because of the humiliation and demoralization that genocidal rape survivors face. When staggering numbers of women are severely traumatized at once through mass rape campaigns, the strengths approach is particularly appropriate because it highlights existing abilities, beneficial qualities, and other positive factors that may assist in the recovery process. Social welfare is a leader among other professions, fields, and disciplines in the application of a strengths perspective to problem solving. Social workers help their clients solve problems, reach psychosocial goals, and facilitate positive human relationships through a strengths approach. A direct social work response to mass rape could provide valuable assistance to survivors as they rebuild their mental health, social networks, economic stability, and return to their lives.

The social work profession is uniquely suited to respond to the problems of mass rape because of historic, ideological, and pragmatic factors. The field is well versed in the psychology, sociology, and the politics of rape, as well as medical, psychiatric, and forensic responses to sexual violence. The strengths perspective combined with the pragmatism of social work’s approach to understanding and solving problems could be applied in the aftermath of mass rape to aid in the recovery of traumatized individuals, families, and communities.