Put yourself in the flipflops of a guerrilla fighter in Congo and you see the value of rape. A form of booty in a land with not much left to pillage, it is also a weapon, a tool of war.
Even when drunk or stoned there is method in the way marauding bands of armed men use sexual assaults to shatter the morale and family structure of rival ethnic and tribal groups.
"The woman is humiliated, but also the tribe," said Justine Dikanza, who runs Basadi, a non-governmental organisation for displaced people in the eastern town of Bunia. "It sends a message that they are nothing. They are reduced, ridiculed. Husbands feel contaminated."
Women often try to keep the assaults secret lest they be disowned by their families. Now that fighting has abated and former conflict zones have been opened to relief groups, some stories are emerging.
Discreetly, thousands of girls and women are seeking treatment for ruptured organs, sexually transmitted infections and mental trauma.
Typical of them is Cecilia, a 44-year-old mother of seven who was abducted from the village of Mongwalu last year and repeatedly raped before finding refuge with other displaced people in a field of muddy tents outside Bunia.
"People here don't know the truth. If they did they would mock her as being a woman of the other tribe," said Ms Dikanza, whose NGO is supported by Médecins Sans Frontières.
Cecilia agreed to be photographed on condition that pictures were also taken of her neighbours, so that they did not wonder why she had been singled out. "It's not easy here," she said. Her neighbours nodded, assuming Cecilia was referring to the malnutrition and malaria.
Of all atrocities in the Congo's five-year war, sexual assault is perhaps the least documented. But there is little doubt that those seeking treatment represent a tiny fraction of the total.
The MSF hospital in Bunia has registered 560 cases since June, the women's ages ranging from four to 85. There is an average of one new case a day.
Some women arrive months or even years after the assaults, too late to avert unwanted pregnancies or HIV but not for antibiotics to treat infections. The violence of attacks - bayonets, bottles and gun barrels have been used - and botched deliveries of babies by rapists-turned-midwives in the bush can leave victims suffering incontinence due to a fistula (opening) forming between the anus and the vagina. Faeces comes out of the vagina, the smell is unpleasant, the humiliation total. "They are often rejected by their families, so I counsel them," said Henri Namisira, a psychologist at a Swedish missionary hospital in Bukavu, south of Bunia.
Since March, 1,029 women have come to the hospital for treatment after sexual assault, but many are still hiding in the forest, unsure the peace will hold, according to one doctor, Heikko Reinikainen, a Finn.
His Congolese colleague, Denis Mukwege, a specialist in repairing ruptured organs, had operated on four women with fistulas that day, one of them 16 years old.
Next to the operating theatre was a bungalow ward housing 51 girls and women, all his patients. Lying under a grey blanket, Justine Shrire, 25, was recovering from an operation two weeks earlier. She would take months to heal, but after six years of incontinence that was a small price.
She was smiling. Her husband, Christoph Kateo, had stood by her. "I feel things will get better now," she said.
Surgery
Another patient, Apolinne Mbila, 20, had been raped last year. She was waiting for surgery to determine whether she would be able to have children again after the butchery of an induced birth in the bush, which killed her baby.
On arrival many patients were silent, but that changed with the solidarity of other patients and promise of surgery, said Corry Kik, MSF's project coordinator in Bukavu, whose Aids centre treats these women when it can.
In the capital of neighbouring Burundi, another war-torn country edging towards peace, an MSF centre for victims of sexual violence opened in September. Some were so young that they, rather than their infants, played with the doll in the psychologist's office.
Under a mango tree, a 15-year-old called Maria cradled her eight-month-old son, the product of a rape at knife-point by soldiers who had broken into her home.
Maria's family stopped sending her to school and told her to stay at home because she was unlikely to find a husband. She said she was determined to resume her education, "maybe to become a doctor". She named her son Ngabirano, which means gift from God.
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