their rights. Through awareness-raising activities, the centres provided information on where to go to receive assistance and claim these rights. In Burundi, Rwanda and the DRC, information on the national laws on Sexual and Gender-Based Violence (SGBV) was made available, and linkages with existing programmes were facilitated. “Due to my health condition I was informed by local authorities to attend an awareness raising event on torture and gender based violence organised by ARAMA in my community. When I attended, I really felt it was time to find a voice and seek help. ARAMA staff listened to me and helped me understand my situation and break the silence on my desperation and revealed my pain. It was through this process that I was invited to ARAMA’s centre in Kibungo, I was counselled and was referred to Kibungo district referral hospital for treatment. It is through ARAMA that I can regain life”. A.M., Rwanda “As a result of their involvement in the project, many women were elected as presidents of social counselling groups and income generating activity groups, which are recognised and registered by local authorities. Some of our beneficiaries are now members of local mediation committees, elected by all members of the community, while others are members of the National Women’s Council. Former women victims have now reached a status and a position to represent and advocate on behalf of others.” Jules Gahamanyi, Executive Director, ARAMA, Rwanda Creating pathways and partnerships: The medical referral system “They approached me in order to refer complicated cases of physical violence, including sexual violence. In July 2013, we signed a cooperation agreement. Until now, SAP-GL has transferred 45 cases, including 32 cases of torture and 13 of sexual violence. All cases needed reparatory surgery. Our cooperation proved to be extremely fruitful. Because of this project, patients receive full care. Moreover, while working with SAPGL we realised the importance of psychological and psychosocial support. Thanks to SAP-GL, two hospital employees participated in a training on community-based social counselling, and we created a psychosocial follow-up unit at the hospital.” In the Ngoma district in Rwanda for example, close cooperation with the One-Stop Center for SGBV resulted in the establishment of a 24/7 toll-free number so victims could have immediate access to mental and physical care and legal protection. In Burundi, increased co-operation with local authorities facilitated women survivor associations to report cases of SGBV to the police. When confronted with cases of SGBV, these survivor associations are often asked by police officials to conduct family visits and integrate victims in community-based social counselling. In addition, every training supported through the Great Lakes Project had a gender aspect. For example, trainings on income generating activities included micro-project management and leadership. By training women in how to provide for their family and gain independence, they were empowered and shown that they can have an impact and provide leadership at community-level and beyond. 12 IRCT Great Lakes Project Dr. Ernest Kilunga, Head surgeon and gynaecologist, Rushubi Hospital, Burundi Access to appropriate medical care is an ongoing challenge for many torture victims in the Great Lakes Region. In numerous parts of the three countries, and especially in rural areas, the care victims need is simply not available. As previously mentioned, other barriers to victims accessing rehabilitation services include poverty, incorrect diagnosis and victims’ reluctance to seek care. Furthermore, existing medical structures do not always provide the necessary services or the required quality of services. Even if higher quality services are available, there is often no capacity to cope with the large number of victims. This is especially the case for victims suffering from psychotrauma or psychosomatic disorders. Symptom-based medical diagnosis may not be adequate for these severe and complex conditions. As a result, torture victims can slip through the cracks in the medical system. The Great Lakes Project sought to address this bleak reality by introducing an effective medical referral system, co-ordinated by the centres. Through the referral system almost 3,000 torture victims in Rwanda, Burundi and the DRC received medical treatment. The project targeted remote and rural communities, developing and strengthening relations with community workers, victim associations, local and international NGO’s, as well as local authorities. The referral system increased the number of victims in need who were identified by these services. By developing community-based services and ensuring that regular follow-up visits were made to victims who had previously benefitted from the medical referral system, the centres gained credibility. This led to increased co-operation with local communities and greater access to information about new cases. The Project also trained centres in how to engage with the mass media. This proved extremely useful in facilitating community outreach and, ultimately, achieving better access to medical care by victims. As an example, the REMAK centre launched a radio spot in June 2014 in Mwenga, South Kivu, (DRC) to inform the population about the services they provide. Following REMAK’s radio spot, the number of victims of sexual torture from remote villages seeking medical care at the centre grew exponentially. Where REMAK received less than 10 cases from the remote Bisembe — Mulombozi area before June 2014, it received 74 cases from that area in July and August 2014 alone. IRCT Great Lakes Project 13