"A nation is not conquered until the women's hearts lay on the ground." -- Cheyenne Indian saying
During war, atrocities such as rape are often committed against civilian women. Rape occurs in areas under attack and in refugee camps. In war, rape is an assault on both the individual woman and her family and community. Many hundreds of thousands of women have been raped in wars in this century alone, as reported in areas as diverse as Korea, Bangladesh, Liberia, Southeast Asia, and Uganda. Bosnian refugees have described how, in the former Yugoslavia, military forces publicly raped women to systematically force families to flee their villages, contributing to the goal of "ethnic cleansing." Assaults are often gang-related and sadistic, including other forms of physical torture. These women may also experience loss of home and community, dislocation, injury, and untreated illness, and these women may witness the murder, injury, or rape of loved ones. The effects of these types of trauma are immeasurable, long lasting, and shattering to both inner and outer worlds.
The situation can be worsened by the cultural attitudes surrounding rape. In Muslim culture, for example, the honor of the woman reflects upon the entire family, and rape is very stigmatizing and shameful. A woman who is raped might fear being expelled from her husband's family or never finding a husband (1). Some rape victims might also believe that the rape is a punishment for some sin that they have committed. Even if they do not blame themselves, they may feel such a strong cultural responsibility to protect their family that they often remain silent about the trauma. Many of the Bosnian rape victims told no one about what happened to them. Stigma and injustice have surrounded the rape of women for as long as time. In fact, rape was not considered a crime against humanity or war crime until the 1990s (2).
Conservative estimates of the number of women raped during the Bosnian war are between 20,000 and 50,000 (3). Estimates of sexual assault rates range from 3% to 6% in Bosnian refugee women, and posttraumatic stress symptoms were found in up to 75% of Bosnian refugees. In Darfur, rates of rape are difficult to establish; however, some estimate that 10,000 girls and women have been raped each year since 2003 (4).
Rape is the type of trauma most commonly associated with PTSD (5). For more information on working with sexual assault survivors, go to our section on Other Types of Trauma.