Expert Report on Trauma Mental Health and Mass Rape: Prosecutor v. Bemba

The landmark judgment in the Prosecutor v. Bemba case before the International Criminal Court marks the first jurisprudence from the Court in a prosecution dedicated to redressing sexual and gender-based violence (SGBV) (see our coverage here and here).  The Human Rights in Trauma Mental Health Lab (“Lab”) at Stanford University submitted an experts’ brief in the sentencing phase of the case.  (Bemba was sentenced to 18 years’ imprisonment). My colleague Dr. Daryn Reicherter of the Stanford University Medical School Department of Psychiatry and the Behavioral Sciences testified in the case. A redacted version of the brief is now available here.

The Lab is an interdisciplinary program based at Stanford University comprising members of the Department of Psychiatry and Behavioral Sciences, the School of Law (yours truly), the Handa Center for Human Rights & International Justice, and the Palo Alto University Clinical Psychology program.  The lab faculty and staff include treating academic psychiatrists, professors of medicine, private treating psychotherapists and social workers, human rights lawyers, law professors, and graduate and undergraduate students. Lab members have thus amassed considerable expertise in trauma mental health from a range of disciplinary perspectives.

Our submission was based on our review of the evidence and trial record, including the expert reports and trial testimony of Dr. André Tabo and Dr. Adeyinka M. Akinsulure-Smith, PhD.  We situated this evidence within a comprehensive and comparative literature review on the psycho-social impact of sexual violence and other forms of extreme trauma on individuals, their families, and their communities.  In addition, we reviewed testimony from victims in the Bemba trial in order to show a direct connection between the literature, the expert testimony, and actual events in the Central African Republic (CAR). In particular, we relied upon our knowledge of empirical research that links trauma exposure with psychophysiological and neurobiological outcomes, thereby elucidating the mechanisms by which sexual violence and other forms of extreme trauma give rise to the psychosocial outcomes documented in the trial record.  The Report was informed by the Lab’s long experience treating, representing, and working with victims of severe trauma in communities wracked by massive human rights violations.  On a more hopeful note, the brief also discussed the prospects for healing, notwithstanding these grave impacts.

The Bemba trial record is replete with harrowing evidence of the scale of SGBV in the CAR in the timeframe under consideration. Women who took part in Dr. Tabo’s survey of women who presented at Bangui National Hospital, for example, described a staggering range of sexual violence at the hands of the troops under Bemba’s command and control.  These victims had been raped in their homes, while running away, and/or on their way to a relative’s home. Some victims were the target of gang rape, systematically committed.  In many cases, family and community member leaders were raped or forced to witness the rape.  All told, out of the 512 women surveyed, 408 (80%) were sexually or physically assaulted.

As discussed in more detail in the expert brief, the psychiatric literature predicts very poor functional outcomes for victims of sexual assault.  The resulting myriad of individual consequences includes psychiatric disorders such as post-traumatic stress disorder (PTSD), depression, and anxiety. Outside of these named mental health diagnoses, individuals suffer from abject feelings of hopelessness, spiritual degradation, heightened suspiciousness, persistent confusion, and fear. Victims of trauma can see themselves as vulnerable, view the world as lacking meaning, and view themselves as lacking worth.

The brief ends on an uplifting note, notwithstanding this empirical and cross-cultural research on the impact of SGBV on the human psyche. While very few men and women who are the victims of sexual violence remain unaffected by this experience, it is possible for survivors to go on to lead meaningful lives after a sexual assault with appropriate treatment and psycho-social rehabilitation.  The concept of post-traumatic growth (PTG) captures experiences of positive change that occur as a result of highly challenging or traumatic stressful life events.  PTG is a concept with roots in ancient philosophy regarding the potentially transformative power of suffering, but it has also been supported in current empirical research.  This possibility for the victims of Bemba’s subordinates underscores the importance of the current phase of the case devoted to reparations.  This will be the Court’s second reparations order; the first was issued in the Lubanga case.

Protection (from rape) or Freedom (to have sex)?

The debate in India surrounding  reforms to the sexual violence laws are a reflection of the changing mores in Indian society.   With economic liberalization in 1991, a strong middle class with access to new goods, movies, and ideas has emerged.   As a result of the mass protests in the aftermath of the brutal gang rape and death of Jyoti Singh Pandey, the President signed an Ordinance reforming the sexual violence laws on February 3, 2013. (The Ordinance took some provisions from an amendment to the Indian penal code that was pending in Parliament prior to the gang rape and adopted some provisions suggested by the Verma Committee report, but rejected other important provisions from that committee.  The Verma Committee was formed by the government after international and national attention focused on the issue of gender-based violence).  Article 123 of the Indian Constitution permits the President to put into place laws that have the weight of an act of Parliament when Parliament is in recess.  But the Ordinance expires on April 4 unless Parliament adopts it or an amended version of it.  The real deadline they are racing against is March 22 because Parliament is in recess again after that.

Key areas of disagreement such as the marital rape exemption and the availability of the death penalty in some cases of rape remain.  Yesterday The New York Times India blog highlighted one issue of debate — whether the age of consent for purposes of the statutory rape provision should be 18 or 16. The Ordinance placed the age at 18 but prior to that it was 16. The new bill that is being considered seems to have lowered the age of consent to 16.

It is some prominent feminist lawyers that have argued in favor of lowering the age of consent.  Indira Jaising points out that “[i]t is quite normal for people to have sexual relations at 16 or 17 years of age. . . . How can we make illegal what is normal?”  Additionally, Flavia Agnes pointed out in an article that appeared in Asian Age on December 23, 2012 that “one-third of all rape cases are filed by parents against boys when their daughter exercises her sexual choice and elopes.”  Thus, if the age of consent was increased, it would give parents more opportunities to mis-use the law. Continue reading