Many of the girls, mothers and grandmothers who arrive at Dr Denis Mukwege’s hospital in Eastern Congo have suffered such extreme sexual violence that they are barely able to walk.
Dr Mukwege talks about Sarah, who was taken hostage, tied naked to a tree and gang-raped until she lost consciousness. She arrived at the hospital unable to stand, with severe internal injuries to her bowel, bladder and digestive system.
She is just one of more than 80,000 women who have arrived at Dr Mukwege’s treatment center since it opened in 1999, offering free medical care to the victims of rape who have been caught up in the ongoing battle between warring militias in the Democratic Republic of Congo.
Many of them will undergo long and complicated surgery, but some will be incontinent and infertile for the rest of their lives.
Worse still, perhaps, 40-60% of these women will never be able to return to their home communities. Sometimes that is because of the extent of their injuries. But most often it is because of the deep stigma that surrounds their plight.
Dr Mukwege at work: Post-rape surgery can last up to eight hours
Image: Mwangaza & Ukweli
In many societies, rape is a cause of deep shame, something that will leave victims isolated, rejected, or even vulnerable to being murdered.
But saying silent about sexual violence has handed impunity to the perpetrators - and led to the proliferation of rape.
“What is keeping rape in our society is silence. The silence [of women] is really a strong tool of rapists, so they can go on destroying girls and women," Dr Mukwege told the World Economic Forum Annual meeting in Davos.
"If she stays in silence, she can be raped again and again. And she can’t protect others."
Deep psychological damage
Having won the Nobel Peace Prize in 2018, Dr Mukwege has dedicated his life to fighting against both rape itself and the stigma surrounding it.
There are many Sarahs, Dr Mukwege says, in many other conflict-torn countries, citing Bosnia, Myanmar, Iraq, Colombia and the Central African Republic amongst others.
One of the implications of the silence concerning these sexual atrocities, however, is that there are extremely scarce facts to assess or even estimate the scale of the problem. It is a war crime that is largely undocumented.
Another major implication of the silence is that the perpetrators are never brought to justice, causing deep psychological damage to the victims, who must sometimes continue to live alongside their abusers.

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Even when the perpetrators have fled, true reparation requires the community to acknowledge what has happened, according to Dr Mukwege. Seemingly small gestures - such as a plaque or a small memorial in the village - can change the perception that these crimes must never be spoken about ever again, he explains.
A war against indifference
The silence surrounding rape as a weapon of war is also, to some extent, something that is being perpetuated internationally as well as locally.
“I call on the world to be a witness and urge you to join in order to put an end to this suffering that shames our common humanity,” Dr Mukwege said as he received his Nobel Peace Prize.
“Turning a blind eye to this tragedy is being complicit,” he said. “If there is a war to be waged, it is the war against the indifference which is eating away at our societies.”
Rape and harassment, albeit on a smaller scale, have also often remained secret in the developed world too, with some such crimes now coming to light decades later.
As the battle for gender equality continues, highlighted by International Women’s Day, Dr Mukwege is campaigning to raise awareness of the many thousands of women who have suffered unimaginable acts of sexual violence - and a life of rejection - as a byproduct of war.
He dreams of a day when women will be able to speak freely about what has happened to them, and the perpetrators will be the ones to feel lifelong shame. And he wants everyone to say ‘no’ to indifference.
“We all have the power to change the course of history when the beliefs we are fighting for are right,” Dr Mukwege says.