In the eastern forests of the Democratic Republic of Congo (DRC), there is a hidden war going on against women and girls. Abduction, rape, sexual slavery, torture and death have become an everyday reality for every woman. Three national armies, from the DRC, Rwanda and Uganda, long-entrenched rebel groups from three neighbouring countries, Uganda, Rwanda and Burundi, and proliferating local militias have made this part of the country the most militarised in Africa. And it is women who pay the price for this culture of violence.
A gynaecologist in Bukavu told Human Rights Watch how he felt that "if you are born a woman in this country, you are condemned at birth". The doctor said, in his many years of work, he had never before seen women and girls who had suffered atrocities like those committed against some of the women he had treated recently. One of his patients explained this, saying: "It is just hatred."
"There is real madness, with all this sexual violence linked to the war - another kind of attack on the Congolese people," said a counsellor in Bukavu.
HRW has just published a detailed report, The War Within the War. It documents dozens of appalling cases, including women who had parts of their genitals sliced off with a razor blade, women shot in the vagina after being raped, girls as young as five and women as old as 80 attacked.
Extreme cruelty is usually the response to any resistance. Monique was 20, and engaged to be married, when four soldiers broke into her parents' house and tried to rape her. Her mother told HRW how, when she resisted, they cut off her left breast and put it in her hand, asking if she still wanted to resist. When she said she'd rather die than give in, they cut off her genitals and held them to her face, before slitting her body open from the neck.
Women are attacked in their homes, in the forests where they go to make charcoal, in the fields where they work, on the roads going to market. Everything is then stolen, sometimes even the very clothes they are wearing. The rural economy has collapsed as a result of the terror.
North and South Kivu provinces, where HRW did its research, run along the borders of Uganda, Rwanda, and Burundi. Nominally, the Congolese rebel group Rassemblement Congolais pour la Democratie (RCD) controls the area, and has appointed governors and other officials; but the RCD has splintered many time, has little authority and its soldiers and officials are often themselves responsible for the attacks on women.
The health facilities in the region - like all state infrastructure in the Mobutu years - were rudimentary even before the war, which began here in 1993. Into this vacuum, an epidemic of HIV/Aids is expected that will be uncontrollable. Among the military, there are extremely high estimates of HIV infection. For women who have been seriously injured through being raped or sexually assaulted, there is little or no appropriate medical treatment. Many will never recover from the physical, psychological and social effects of these war crimes, which are invisible to a world indifferent to the DRC's long-running catastrophe.