BOOK REVIEW

 

A review of: The Power of Women. A doctor's journey of hope and healing written by Denis Mukwege

 

 

Julie Whitlock

Occupational therapist at Work-Link, a vocational rehabilitation practice in Johannesburg, South Africa. ORCID: https://orcid.org/0009/0003-0065-9243; Contact details: whitlockjuliea@gmail.com; Declaration of bias: The reviewers have no bias to declare

 

 

Title of the book: The Power of Women. A doctor’s journey of hope and healing written by Denis Mukwege
Author: Denis Mukwege

 

 

Information on the author

The author of The POWER of WOMEN, Dr Denis Mukwege is a medical doctor who studied at the University of Bujumbura in Burundi and specialised in gynaecology and obstetrics in France. He returned to work in his home country, first at Lemera and then at Panzi Hospital, which he founded in 1999. Through his work with survivors of rape, he has become a campaigner for women's rights and has won a Nobel Peace Prize for his activism and work.

The setting for this book is the Democratic Republic of Congo (DRC), described as 'an area the size of Western Europe' and 'close to the middle of the world and the heart of Africa'. Although the author is of the opinion that the book is not autobiographical, it reads like an autobiography, with the history of the former Belgian Congo and the DRC interwoven with the author's personal and professional journey, and the lives of the women he is dedicated to healing. The book is interesting, and disconcerting, to read owing to the theme of rape, which runs through it. It is well-researched and detailed, and the reader must therefore digest it slowly. Dr Mukwege penned the book after he had spent two decades caring for and treating survivors of sexual violence, and had received a Nobel Peace Prize for his work. He describes the Congo as a "window into the extreme end of the global scourge of sexual violence". As per the 1955 census, life expectancy for women there was only 38 years, and childbearing was the main killer. In fact, the author's parents had both lost their own mothers in childbirth.

Mukwege was born in 1955 in a humble "shack" and grew up in Ba-kavu, a fishing village on the shores of Lake Kivu in what was then the Belgian Congo. In 1983 he began his career as a student medical doctor at the Swedish Mission in Lemera where, almost immediately, he had to assist the only other doctor on site with surgery, often by flashlight. He began specialising in obstetrics after witnessing the extent of the rape and maternal health crises in rural Congo and being inspired by the extraordinary women he encountered there. Describing the start of his journey, he says, "There was no prenatal care, all births were home births with no medical expertise". Also, "the hardships of life fell disproportionally upon women," who had no break from childcare, planting, cultivating, carrying of crops to markets and performing all domestic chores.

The author describes the consequences of "the neglect of women at the moment of childbirth where the design flaws of human anatomy forced them to risk their own lives to deliver new ones". Often, women in obstructive labour were carried to hospital through the jungle for days. Women were dying for lack access to a caesarian section, which caused birth complications like fistulae, incontinence, reproductive difficulties and then stigma and rejection. In Congolese society men are traditionally not involved in the childbirth process and there are societal sexist beliefs that perpetuate the problems described in the book. The author describes himself as an accidental feminist, a campaigner and advocate for women's rights, fighting the "deadly lottery of childbirth." His outrage at the violence inflicted on fellow human beings is evident in the book as is his deep appreciation for the opportunity he has had to "amplify the voices of those whose marginalization denies them opportunities to tell their stories".

Mukwege explores the influences of gender-based violence in the Congo, including the impact of the Belgian colonial system on the weakening of matriarchal roles, and the Congolese wars. He describes how rape became normalised during times of war and women were often subjected to destructive pelvic gunshot injuries. Victims of this violence also suffered from psychological disorders as a result the trauma and societal rejection, since they were often blamed for their medical conditions. The second half of the book describes the author's response to these atrocities. He becomes involved in establishing holistic care for women in the DRC and raising awareness internationally. He trains previous rape victims as grassroots workers, to mentor other survivors. Mukwege's case report of a teenage survivor of rape and obstructed child-birth and her journey from survival to healing and a purposeful, productive life is central to this book.

The author saw that the extreme violence and dislocation had a profound impact on many activities of daily living of survivors and concluded that this required redress through a holistic treatment approach and advocacy. In an action that will resonate strongly with occupational therapists, the author facilitates the setting up of small-scale activity and vocational training programmes for rape survivors, to promote physical and psychological healing and wellbeing through occupation. Rape survivors could graduate and, where possible, return to their villages and reintegrate and transform their communities.

The reviewers were intrigued by the author's exploration of the question: 'Why do men rape?' His research proposes and dissects a host of possible precipitating circumstances: the role of mineral exploitation and the links between violence against women and the manufacture of goods like the cars and mobile phones were two such examples. Dr Mukwege supports the view that positive masculinity prevents rape. He discusses how rape is prevalent in societies where there is a sense of male impunity due to judicial failings. In response, he set up a judicial clinic at Panzi Hospital, to assist women survivors in their legal rights and to train doctors in forensic medical reporting. Sadly, women and men who speak out about rape often pay a price for their bravery. Dr Mukwege was threatened by his own government when he attempted to make a speech about rape at the UN in 2011 and he survived an assassination attempt in 2012.

Although this book is not an easy read because of the brutality of the topic and the amount of detail the book contains, it is truly inspiring. The author's wholehearted advocacy for women and his practical efforts to deal ho-listically with the impact of rape and obstructed child-birth in women and girls in war torn central Africa, gives the reader a sense of hope that change can occur in Africa. The book is not only about Africa though; it contains insights and interventions useful to all communities and countries across the globe. Occupational therapists working throughout Africa, and especially those in rural settings, will greatly benefit from reading The POWER of WOMEN.

 

 

Submitted: October 2022
The book review was not peer reviewed
Accepted: November 2022
Published: August 2023