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War, Rape and Genocide: Never Again? Martin Donohoe.

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1 War, Rape and Genocide: Never Again? Martin Donohoe

2 Special Thanks To Vic Sidel and Barry Levy (War and Public Health, Terrorism and Public Health) Vic Sidel and Barry Levy (War and Public Health, Terrorism and Public Health) Photographers James Nachtwey, Sebastio Salgado, and others Photographers James Nachtwey, Sebastio Salgado, and others

3 Outline Sudanese genocide Sudanese genocide History of wartime violence against women in the 20 th Century History of wartime violence against women in the 20 th Century VAW in the U.S. military VAW in the U.S. military War and “Masculinity” War and “Masculinity” The Nature of Violence and Rape in War The Nature of Violence and Rape in War

4 Outline Health Consequences Health Consequences Refugee Camps Refugee Camps Human Rights Issues Human Rights Issues Role of Health Professionals Role of Health Professionals Conclusions and Recommendations Conclusions and Recommendations

5 Darfur, Sudan Between 180, ,000 deaths over last two years (most from disease) Between 180, ,000 deaths over last two years (most from disease) 5.5 million refugees and internally displaced persons; 2.7 million in refugee camps 5.5 million refugees and internally displaced persons; 2.7 million in refugee camps Government-supported, Islamic Janjaweed militias responsible for killing Black Africans Government-supported, Islamic Janjaweed militias responsible for killing Black Africans Arms sales to Sudan from China, Russia, France, Iran, Saudi Arabia, Belarus, Poland, Lithuania Arms sales to Sudan from China, Russia, France, Iran, Saudi Arabia, Belarus, Poland, Lithuania

6 Darfur, Sudan Bush administration called situation “genocide”, yet failed to act substantively Bush administration called situation “genocide”, yet failed to act substantively Bush administration relied on Sudan, which used to harbor Osama bin Laden, for military intelligence Bush administration relied on Sudan, which used to harbor Osama bin Laden, for military intelligence Obama administration has failed to act Obama administration has failed to act

7 Darfur, Sudan Bipartisan Congressional Research Service reports administration concerned that holding Sudanese officials accountable could “disrupt cooperation” Bipartisan Congressional Research Service reports administration concerned that holding Sudanese officials accountable could “disrupt cooperation” Nevertheless, mild economic sanctions and travel restrictions enacted in May, 2007 Nevertheless, mild economic sanctions and travel restrictions enacted in May, 2007 Formation of Southern Sudan in 2011 has failed to bring peace Formation of Southern Sudan in 2011 has failed to bring peace South Sudan oil South Sudan oil

8 Democratic Republic of the Congo (DRC) “Africa’s World War” “Africa’s World War” Between 700,000 and 3 million deaths Between 700,000 and 3 million deaths 2 million displaced 2 million displaced million women raped; million victims of IPV million women raped; million victims of IPV 2011: 48 rapes/hr 2011: 48 rapes/hr Unraveling of civil society Unraveling of civil society Life expectancy for those born in 2011 = 40 Life expectancy for those born in 2011 = 40

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11 History 250 wars in 20 th Century 250 wars in 20 th Century Most conflicts within and between small states Most conflicts within and between small states Many in sub-Saharan Africa Many in sub-Saharan Africa 85-90% of casualties among civilians 85-90% of casualties among civilians Opposite at end of 19 th Century Opposite at end of 19 th Century

12 Infamous Genocides China (under Mao), late 1950s – early 1970s: 30 million killed China (under Mao), late 1950s – early 1970s: 30 million killed USSR (mostly under Stalin), 1920 – mid 1950s: 20 million killed USSR (mostly under Stalin), 1920 – mid 1950s: 20 million killed Germany (under Nazis), mid 1930s – 1945: over 11 million killed Germany (under Nazis), mid 1930s – 1945: over 11 million killed Japan, late 1930s – mid 1940s: 10 million killed Japan, late 1930s – mid 1940s: 10 million killed

13 History Women considered spoils of war Women considered spoils of war Abduction of Helen of Troy Abduction of Helen of Troy Rape of the Sabine women Rape of the Sabine women Millions raped in 20 th Century conflicts Millions raped in 20 th Century conflicts

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18 History - World War II Rape widespread on most sides in World War II (Americans = least common perpetrators) Rape widespread on most sides in World War II (Americans = least common perpetrators) Japanese soldiers forced between 100,000 and 200,000 women into sexual slavery (“comfort women”) Japanese soldiers forced between 100,000 and 200,000 women into sexual slavery (“comfort women”) *Korea, Burma, China, Holland, Indonesia, Phillipines *Korea, Burma, China, Holland, Indonesia, Phillipines

19 “Comfort Women” Some underwent forced hysterectomies to prevent menstruation, make them constantly “available” Some underwent forced hysterectomies to prevent menstruation, make them constantly “available” More than half died due to mistreatment More than half died due to mistreatment

20 “Comfort Women” 3-5 year detention 3-5 year detention 5-20 rapes per day 5-20 rapes per day For 3 yrs of enslavement, low estimate is 7500 rapes per woman For 3 yrs of enslavement, low estimate is 7500 rapes per woman Japan has not compensated any victims Japan has not compensated any victims Historical blindness to atrocities Historical blindness to atrocities

21 History Vietnam War Vietnam War Perpetrators included U.S. soldiers Perpetrators included U.S. soldiers Few brought to justice Few brought to justice 1971: Bangladesh War for Independence 1971: Bangladesh War for Independence Estimated 200, ,000 girls and women raped by Pakistani army Estimated 200, ,000 girls and women raped by Pakistani army 25,000 pregnancies 25,000 pregnancies

22 History 1994: Rwandan genocide 1994: Rwandan genocide At least 250,000 women raped At least 250,000 women raped 1990s: ethnic cleansing in Bosnia 1990s: ethnic cleansing in Bosnia >20,000 Moslem women raped >20,000 Moslem women raped Other 20 th Century conflicts: civil wars in Liberia, Sierra Leone, Somalia, Egypt, Libya, Syria Other 20 th Century conflicts: civil wars in Liberia, Sierra Leone, Somalia, Egypt, Libya, Syria

23 History 2000s: Sexual humiliation and rape of female detainees at US facilities in Afghanistan and Iraq 2000s: Sexual humiliation and rape of female detainees at US facilities in Afghanistan and Iraq Iraq’s Abu Ghraib prison: sexual humiliation, forced homosexual poses Iraq’s Abu Ghraib prison: sexual humiliation, forced homosexual poses Guantanamo Bay prison: Muslims taunted with fake menstrual blood Guantanamo Bay prison: Muslims taunted with fake menstrual blood Amnesty International and Red Cross have condemned Amnesty International and Red Cross have condemned

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26 Violence against women in the U.S. military times more likely than other government employees to have suffered a completed or attempted sexual assault times more likely than other government employees to have suffered a completed or attempted sexual assault Higher rates of chronic pelvic pain, dysmenorrhea, abnormal periods, premenstrual syndrome, and dissatisfaction with sexual relations Higher rates of chronic pelvic pain, dysmenorrhea, abnormal periods, premenstrual syndrome, and dissatisfaction with sexual relations all correlate with a history of sexual trauma while in the military all correlate with a history of sexual trauma while in the military

27 Violence against women in the U.S. military U.S. military now 14% female U.S. military now 14% female While racial epithets banned, terms like “bitch”, “pussy”, “dyke” still common While racial epithets banned, terms like “bitch”, “pussy”, “dyke” still common Pornography officially banned, but easily available Pornography officially banned, but easily available

28 Violence against women in the U.S. military Recent increase in reported sexual assaults Recent increase in reported sexual assaults 3,374 sexual assaults reported to Pentagon (2012); 5,061 (2013) 3,374 sexual assaults reported to Pentagon (2012); 5,061 (2013) Estimated number about 7X higher Estimated number about 7X higher Veterans Administration study: 24% of female patients under age 50 reported domestic violence within the past year Veterans Administration study: 24% of female patients under age 50 reported domestic violence within the past year

29 Prosecution and Punishment Rare, Promotion not Uncommon for Perpetrators Since 1992, nearly 5000 accused sex offenders in the Army, including rapists, have avoided prosecution and the possibility of prison time Since 1992, nearly 5000 accused sex offenders in the Army, including rapists, have avoided prosecution and the possibility of prison time

30 Violence against women in the U.S. military Government Accountability Office Report, 2006 Government Accountability Office Report, 2006 Aggressive and duplicitous recruiting tactics on rise Aggressive and duplicitous recruiting tactics on rise Including sexual harassment and rape Including sexual harassment and rape

31 Violence against women in the U.S. military 2008: Defense Dept. granting more moral waivers, due to declining recruitment, thus enlisting more men with records of domestic and sexual violence 2008: Defense Dept. granting more moral waivers, due to declining recruitment, thus enlisting more men with records of domestic and sexual violence 2013: Branch Chief for Air Force’s Sexual Assault and Prevention Response Program charged with sexual battery 2013: Branch Chief for Air Force’s Sexual Assault and Prevention Response Program charged with sexual battery

32 Recent Developments DOD requires health care provider training on domestic violence DOD requires health care provider training on domestic violence Domestic violence advocates program and family support programs in place Domestic violence advocates program and family support programs in place Utilization still low Utilization still low

33 Recent Developments Civilian perpetrators barred from bases Civilian perpetrators barred from bases Military police to work with local law enforcement Military police to work with local law enforcement 2013: Branch Chief for Air Force’s Sexual Assault and Prevention Response Program charged with sexual battery 2013: Branch Chief for Air Force’s Sexual Assault and Prevention Response Program charged with sexual battery

34 Victim Assistance U.S. Army’s transitional compensation program provides financial and other benefits to the families of service members discharged for child or spouse maltreatment, including victim assistance and offender rehabilitation U.S. Army’s transitional compensation program provides financial and other benefits to the families of service members discharged for child or spouse maltreatment, including victim assistance and offender rehabilitation

35 Victim Assistance VA provides lifetime sexual assault victims’ counseling to all military veterans VA provides lifetime sexual assault victims’ counseling to all military veterans After one leaves the service After one leaves the service Most counseled patients are males, who suffer lower rates of sexual assault but make up a large majority of veterans Most counseled patients are males, who suffer lower rates of sexual assault but make up a large majority of veterans

36 Recent Developments Military Domestic Violence and Sexual Response Act Military Domestic Violence and Sexual Response Act Would reduce sexual assault and domestic violence involving members of the Armed Forces and their family members and partners through enhanced programs of prevention and deterrence, enhanced programs of victims services, and strengthened provisions for prosecution of assailants Would reduce sexual assault and domestic violence involving members of the Armed Forces and their family members and partners through enhanced programs of prevention and deterrence, enhanced programs of victims services, and strengthened provisions for prosecution of assailants In House and Senate subcommittees since mid 2009 In House and Senate subcommittees since mid 2009

37 Recent Developments H.R and S.B. 1018: Defense Sexual Trauma Response Oversight and Good Governance Act (Defense Strong Act) H.R and S.B. 1018: Defense Sexual Trauma Response Oversight and Good Governance Act (Defense Strong Act) Would guarantee access to military lawyer, allow victims to transfer from where assault occurred, ensure confidentiality, and institute rape prevention training for men and women Would guarantee access to military lawyer, allow victims to transfer from where assault occurred, ensure confidentiality, and institute rape prevention training for men and women In committees (2012) In committees (2012)

38 Recent Developments H.R. 1517: Holley Lynn James Act H.R. 1517: Holley Lynn James Act Would create system of independent oversight Would create system of independent oversight MST cases would automatically go to military court MST cases would automatically go to military court In committee (2012) In committee (2012)

39 Militarism and “Masculinity” Pervasive glorification of war and its acceptance as means of conflict resolution Pervasive glorification of war and its acceptance as means of conflict resolution Linked to antiquated definitions of appropriate masculine behavior and coming-of-age rites Linked to antiquated definitions of appropriate masculine behavior and coming-of-age rites

40 Militarism and “Masculinity” Vocabulary and imagery laden with denigrations of the feminine and perverse phallic imagery of weapons as extensions of male generative organs Vocabulary and imagery laden with denigrations of the feminine and perverse phallic imagery of weapons as extensions of male generative organs weapons ads employ sexual imagery weapons ads employ sexual imagery weapons described in terms of “hardness, penetration, and thrust” weapons described in terms of “hardness, penetration, and thrust”

41 War and “Masculinity” Association of military bases with prostitution Association of military bases with prostitution Tacitly accepted by commanders Tacitly accepted by commanders Men dominant decision-makers in pursuing militarization, fighting wars, and resolving international conflicts Men dominant decision-makers in pursuing militarization, fighting wars, and resolving international conflicts

42 Violence and Rape in War Occurs against backdrop of ongoing individual and societal forms of violence against women Occurs against backdrop of ongoing individual and societal forms of violence against women Rape Rape Individual acts of violence Individual acts of violence Genocide (to terrorize, subjugate, humiliate, and ethnically cleanse subjugated population) Genocide (to terrorize, subjugate, humiliate, and ethnically cleanse subjugated population) Societal or Structural Violence Societal or Structural Violence Legal, educational, social, and political marginalization Legal, educational, social, and political marginalization Impaired access to reproductive health services Impaired access to reproductive health services

43 Violence and Rape in War Usually more sadistic and violent than rape outside of war Usually more sadistic and violent than rape outside of war Often committed in presence of woman’s husband and children, who are often then killed Often committed in presence of woman’s husband and children, who are often then killed

44 Violence and Rape in War Forced continuation of pregnancy Forced continuation of pregnancy 1994 Rwandan genocide – 5000 pregnancies 1994 Rwandan genocide – 5000 pregnancies Enfants mauvais souvenir (“children of bad blood”) Enfants mauvais souvenir (“children of bad blood”) Mothers experience difficulty caring for children Mothers experience difficulty caring for children Abandonment and infanticide Abandonment and infanticide

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48 Violence and Rape in War Male victims: Male victims: Raped, forced to commit rape against other victims / perform sex acts on other prisoners and/or guards, castrations, forced circumcisions, other sexual mutilations Raped, forced to commit rape against other victims / perform sex acts on other prisoners and/or guards, castrations, forced circumcisions, other sexual mutilations All under threat of torture or death All under threat of torture or death

49 Health Consequences of Rape in War Traumatic injuries, including fistulae Traumatic injuries, including fistulae STDs, including HIV STDs, including HIV Pregnancy Pregnancy Access to emergency contraception, abortion, and antibiotics often extremely limited Access to emergency contraception, abortion, and antibiotics often extremely limited

50 Health Consequences of Rape in War Short-term psychological sequelae: Short-term psychological sequelae: Fear, profound sense of helplessness and desperation Fear, profound sense of helplessness and desperation Long-term psychiatric sequelae: Long-term psychiatric sequelae: Depression, anxiety disorders (including PTSD), multiple somatic symptoms, flashbacks, difficulty reestablishing intimate relationships, shame, persistent fears, and blunted enjoyment of life Depression, anxiety disorders (including PTSD), multiple somatic symptoms, flashbacks, difficulty reestablishing intimate relationships, shame, persistent fears, and blunted enjoyment of life

51 Peacekeepers / Refugee Camps 7,000 man African Union peacekeeping force in Darfur under investigation for raping and abusing local women and girls in ,000 man African Union peacekeeping force in Darfur under investigation for raping and abusing local women and girls in 2010 Refugees forced to endure rape at border crossings as “price of passage” Refugees forced to endure rape at border crossings as “price of passage”

52 Refugee Camps Guards rape women or force them into sex in return for protection from bandits or for basic goods, including food Guards rape women or force them into sex in return for protection from bandits or for basic goods, including food Presence of abusive guards inside camps, and bandits just outside, makes simple tasks such as going to the latrine or gathering water or firewood dangerous/life threatening Presence of abusive guards inside camps, and bandits just outside, makes simple tasks such as going to the latrine or gathering water or firewood dangerous/life threatening

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59 Human Rights Issues Violence against women and girls violates several principles enshrined in international and regional human rights law, including the right to life, equality, security, equal protection under the law, and freedom from torture and other cruel, inhumane, or degrading treatment Violence against women and girls violates several principles enshrined in international and regional human rights law, including the right to life, equality, security, equal protection under the law, and freedom from torture and other cruel, inhumane, or degrading treatment

60 Human Rights Issues Tokyo War Crimes Trial: rape first identified as a war crime Tokyo War Crimes Trial: rape first identified as a war crime Successful prosecution of some commanders Successful prosecution of some commanders 1993: UN Commission on Human Rights resolution calls rape a crime of war 1993: UN Commission on Human Rights resolution calls rape a crime of war

61 Human Rights Issues 2001: International War Crimes Tribunal rules that rape in war is a crime against humanity 2001: International War Crimes Tribunal rules that rape in war is a crime against humanity 1990s/2000s: successful prosecutions of rape as a war crime and act of genocide 1990s/2000s: successful prosecutions of rape as a war crime and act of genocide 2009/2010: International Criminal Court issues warrants for arrest of Sudanese President Omar al-Bashir for human rights abuses/genocide 2009/2010: International Criminal Court issues warrants for arrest of Sudanese President Omar al-Bashir for human rights abuses/genocide Al-Bashir still in power Al-Bashir still in power

62 Human Rights Issues – Other International Agreements The Convention on the Elimination of all Forms of Discrimination Against Women (CEDAW) The Convention on the Elimination of all Forms of Discrimination Against Women (CEDAW) adopted by UN General Assembly in 1979 adopted by UN General Assembly in 1979 calls for equality of the sexes in political, social, cultural, civil, and other fields calls for equality of the sexes in political, social, cultural, civil, and other fields Ratified by 162 countries, but not U.S. Ratified by 162 countries, but not U.S.

63 Human Rights Issues – Other International Agreements UN Security Council Resolution 1325 UN Security Council Resolution 1325 adopted in 2000 adopted in 2000 mandates the protection of, and respect for, the human rights of women and girls mandates the protection of, and respect for, the human rights of women and girls calls on all parties to armed conflict to take specific measures to protect women and girls from gender- based violence, particularly rape and sexual violence calls on all parties to armed conflict to take specific measures to protect women and girls from gender- based violence, particularly rape and sexual violence U.S. has not signed U.S. has not signed

64 Human Rights Issues – Other International Agreements International Criminal Court International Criminal Court established by international treaty in 2002 established by international treaty in 2002 codifies accountability for gender-based crimes against women during military conflict by defining sexual and gender violence of all kinds as war crimes codifies accountability for gender-based crimes against women during military conflict by defining sexual and gender violence of all kinds as war crimes 139 countries have signed on, U.S. has not 139 countries have signed on, U.S. has not

65 Role of Health Professionals Document incidents of rape Document incidents of rape Use medical data to verify widespread rape Use medical data to verify widespread rape Use techniques of medical science to validate victims’ testimonies Use techniques of medical science to validate victims’ testimonies Treat individual victims Treat individual victims

66 Management of victims of sexual violence during war Conduct a full history and physical examination Conduct a full history and physical examination Treat physical injuries and sexually-transmitted diseases Treat physical injuries and sexually-transmitted diseases Offer emergency contraception and referral for abortion Offer emergency contraception and referral for abortion Provide counseling and psychological support Provide counseling and psychological support

67 Management of victims of sexual violence during war Facilitate reporting to appropriate authorities Facilitate reporting to appropriate authorities Gather forensic evidence Gather forensic evidence Provide documentation of findings (in triplicate, with a copy for the victim, the United Nations High Commission of Refugees and the provider’s medical agency) Provide documentation of findings (in triplicate, with a copy for the victim, the United Nations High Commission of Refugees and the provider’s medical agency)

68 Management of victims of sexual violence during war Health exams should be conducted in a confidential manner by trained workers in a safe environment Health exams should be conducted in a confidential manner by trained workers in a safe environment Female providers should be widely available Female providers should be widely available

69 Management of victims of sexual violence during war In refugee camps: In refugee camps: Place water collection points and latrines in central, well-lighted areas Place water collection points and latrines in central, well-lighted areas food distributed directly to women food distributed directly to women House female-headed groups and unaccompanied children in safe areas House female-headed groups and unaccompanied children in safe areas Women should be involved in designing and running the camps Women should be involved in designing and running the camps

70 Conclusions and Recommendations Each war represents a failure of our species to live in harmony, a waste of precious human capital, a further scourge on the environment, and a crime against all humanity Each war represents a failure of our species to live in harmony, a waste of precious human capital, a further scourge on the environment, and a crime against all humanity Rape in war represents the malevolent nadir of human behavior Rape in war represents the malevolent nadir of human behavior

71 Conclusions and Recommendations Given the increasing spread of technology and materials for the construction of weapons of both small- and large-scale destruction, the enormity of the social and environmental problems facing humanity, and the realistic potential for the demise of the human species, rapid change is desperately needed Given the increasing spread of technology and materials for the construction of weapons of both small- and large-scale destruction, the enormity of the social and environmental problems facing humanity, and the realistic potential for the demise of the human species, rapid change is desperately needed

72 U.S. Must Play Leadership Role Limiting consumption Limiting consumption Cutting unnecessary military programs Cutting unnecessary military programs Increasing funds and using troops for international peacemaking (instead of making war) Increasing funds and using troops for international peacemaking (instead of making war) Building alliances with the UN to solve international disputes Building alliances with the UN to solve international disputes

73 U.S. Must Play Leadership Role Vigorously investigate its own human rights abuses and fully prosecute those responsible Vigorously investigate its own human rights abuses and fully prosecute those responsible Sign on to international agreements: CEDAW, UNSC Resolution 1325, ICC, the Convention on the Rights of the Child, the Convention on Economic, Social, and Cultural Rights, and the Convention for the Suppression of Traffic in Persons, others Sign on to international agreements: CEDAW, UNSC Resolution 1325, ICC, the Convention on the Rights of the Child, the Convention on Economic, Social, and Cultural Rights, and the Convention for the Suppression of Traffic in Persons, others

74 U.S. Must Play Leadership Role Resurrect the International Violence Against Women Act Resurrect the International Violence Against Women Act Would require US government to prevent and respond to violence against women and girls as a part of US foreign policy and aid programs Would require US government to prevent and respond to violence against women and girls as a part of US foreign policy and aid programs Stalled in Congress Stalled in Congress Join forces with international community to rapidly apply both economic and military pressure, including the protective use of military troops, to halt genocide and mass rape Join forces with international community to rapidly apply both economic and military pressure, including the protective use of military troops, to halt genocide and mass rape

75 Conclusions We failed to act to halt the genocide in the Sudan, just as we failed to act in Rwanda We failed to act to halt the genocide in the Sudan, just as we failed to act in Rwanda And yet we continue to say, “Never again”………. And yet we continue to say, “Never again”………. It is time for our nation’s policies to match this rhetoric It is time for our nation’s policies to match this rhetoric

76 References Donohoe MT. Individual and societal forms of violence against women in the United States and the developing world: an overview. Curr Women’s Hlth Reports 2002;2(5): Donohoe MT. Individual and societal forms of violence against women in the United States and the developing world: an overview. Curr Women’s Hlth Reports 2002;2(5): Donohoe MT. Violence and human rights abuses against women in the developing world. Medscape Ob/Gyn and Women’s Health 2003;8(2): posted 11/26/03. Donohoe MT. Violence and human rights abuses against women in the developing world. Medscape Ob/Gyn and Women’s Health 2003;8(2): posted 11/26/03. Donohoe MT. Violence against women: Partner abuse and sexual assault. Hospital Physician 2004;40(10): Available at white.com/memberfile.php?PubCode=hp_oct04_partner.pdf Donohoe MT. Violence against women: Partner abuse and sexual assault. Hospital Physician 2004;40(10): Available at white.com/memberfile.php?PubCode=hp_oct04_partner.pdf white.com/memberfile.php?PubCode=hp_oct04_partner.pdf white.com/memberfile.php?PubCode=hp_oct04_partner.pdf

77 References Donohoe MT. War, rape and genocide: Never again? Medscape Ob/Gyn and Women’s Health 2004;9(2): posted 10/22/04. Donohoe MT. War, rape and genocide: Never again? Medscape Ob/Gyn and Women’s Health 2004;9(2): posted 10/22/04. Donohoe MT. Violence against women in the military. Medscape Ob/Gyn and Women’s Health 2005;10(2): posted 9/13/05. Available at Donohoe MT. Violence against women in the military. Medscape Ob/Gyn and Women’s Health 2005;10(2): posted 9/13/05. Available at

78 Contact Information Public Health and Social Justice Website


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