In 1984,at the age of 29, Dr Denis Mukwege moved to France from the Democratic Republic of the Congo to complete his training as a junior obstetrician. It was his first trip to Europe, and he had spent half his life savings on the air fare. The city of Angers was to be his home for five years, but he struggled to make it one. He would arrange to view flats and on arrival would be told that they had just been let. It took him a while to figure out that it was his skin colour that was making apartments disappear. He finally found a home in a houseshare with other students.
When he took up his training position, he was astonished at how well staffed and equipped the hospital was compared with the one he had come from in the DRC, which delivered the same number of babies annually with just two doctors, as opposed to 30. Mukwege was already far more experienced than his peers in France. He had gained expertise beyond his years working in a small, under-resourced hospital where he operated on women and girls by torchlight and often broke away, mid-surgery, to consult medical literature for instructions.
Assisting in a caesarean section, he surprised a French professor who, puzzled by Mukwege’s skill, asked him if he had done this before. “About 500 times,” Mukwege said.
“Then why are you here?” the professor asked.
After his training, Mukwege would return to the DRC and embark on a career that would save thousands of lives and galvanise doctors and activists globally. He became not only a surgeon, treating victims of rape as a weapon of war, but also an advocate, a champion of women in the DRC and across the world.
He understood early on that his medical work would have limited impact until the root causes of sexual violence were eliminated. So he ran his surgeries, but also challenged different armed groups, and his own government, for their complicity in sexual war crimes, inviting threats to his own life.
This has made him an inspiration to feminists the world over. Michaela Coel called him a “real hero”. Jill Biden said that “beyond healer to these women and girls, he is hope”. The author V (formerly Eve Ensler), after meeting Mukwege in 2008, forged a personal friendship with him, as well as a professional partnership to raise funds and awareness with him. This culminated in the construction of the City of Joy in Bukavu, Mukwege’s birth town in eastern DRC, “a safe space for raped women that offers protection, education, and inspiration for its residents”. Mukwege has been clearing those safe spaces for women since the first day he stepped into a small rural hospital in the DRC in 1983. Thirty-five years later, he found himself in Norway, accepting a Nobel Peace prize for his efforts to end the use of sexual violence as a weapon of war and armed conflict.
Today, Mukwege is talking to me on a video call from a hotel room in Paris, where he is on a whistle-stop tour prior to the French publication of his book, The Power of Women: A Doctor’s Journey of Hope and Healing. His accent is unmistakably French, as is his outfit: a dark suit, a white shirt, and a colourful silk cravat tucked into his collar. His body language, the way he leans into the screen, ear first, calls to mind a doctor listening before he can give an opinion.
After I tell him that his book resonated with me, an African woman with a difficult obstetric experience in the past, and whose grandmother who lost multiple children shortly after birth, he won’t let me move on. “You have to talk about these things,” he says. In many parts of Africa, he explains, there is too much hidden trauma that people carry around. “We need to get people healthy so that they can have this capacity to think about the future. But when we have all this trauma, it can be hard.”
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Mukwege’s path to medicine started early, when he was a child in 1960s Bukavu, touring the homes of sick children with his pastor father. But it was the tenacity of his mother that explains why he’s here today. It wasn’t until he was an adult that he learned how close he came to death in the days after he was born. “I discovered that my mother fought for my life,” he says.
Baby Denis was born at home, like his other siblings. His father was away and a neighbour doubled as a midwife. Her only qualification was the ownership of a sharp razor. His umbilical cord wasn’t cut correctly and the resulting septicaemia would have claimed him in hours. His mother was alone but acted fast, bundling him into a cloth wrapped across her back. A Swedish missionary nurse intervened at the 11th hour and arranged for treatment. Mukwege still speaks with awe about the lengths to which his mother, and women like her, have gone to save their children. “I am so grateful for what she did,” he says.
He was unaware of his own brush with death when, at eight, he resolved to become a paediatrician. “When my father was praying for a child, I saw how weak he was.” His father explained to him why he was powerless. “He told me, ‘I am not a doctor.’ So my impression was, if my father can’t do it, I will do it. So we can be a team.” The two made a pact. Mukwege would become a doctor. He would heal, and his father would pray.
The Power of Women is not a read for the faint-hearted. In it, Mukwege writes of how he arrived as a newly qualified doctor in a hospital in the village of Lemera, in a remote eastern province of the DRC. By the end, his intention to become a paediatrician had evaporated. The extent of the maternal health crisis in a country where women gave birth at home in a cruel lottery (both his grandmothers died in childbirth) overpowered him. Women were dying from treatable infections and birth obstructions. They would appear at the steps of the hospital after travelling for miles on foot, sometimes with their dead babies still inside them.
Once he had completed his five years of training in Angers, he returned to Lemera in 1989 as the first trained obstetrician-gynaecologist in the region. It was the start of a career that would save an incalculable number of lives.
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In the mid-90s, Mukwege and his hospital were caught in the political and tribal crossfires of the Congo’s first and second war. Ethnic tensions in the region had boiled over, leading to the 1994 Rwandan genocide, where Hutu slaughtered Tutsi wherever they found them. Two years later, the Tutsi-led Rwandan army invaded eastern DRC (then Zaire) to hunt down Hutu groups who had fled into the country, and made common cause with the Congolese rebels there. Mukwege’s hospital in Lemera, near the Burundi and Rwanda borders, became engulfed in the chaos. Mukwege went from treating women who simply didn’t have adequate care to women who had been gang-raped, and then shot or stabbed in their vaginas. He tried hard to maintain neutrality, refusing to allow government troops to dictate to him who he should and should not treat. Lemera was eventually overrun by Tutsi forces. He was away at the time, but scores of patients and several members of his staff were killed. In 1997 Mukwege fled to Kenya. That year, rebel leader Laurent-Désiré Kabila was installed as president.
A year later Mukwege returned to the DRC with his wife, Madeleine, and his three daughters, and started again. In 1999 he began to build a hospital in Panzi, a suburb of Bukavu, a maternal and sexual health facility that came to specialise in treating the sexual violence inflicted by various troops and rebel groups since the early 90s. Mukwege discovered that he was up against not just the physical effects of violence against women, but an entire patriarchy and justice system that ensured these crimes would continue. “I realised I wasn’t doing enough,” he says, and so he began to campaign, speak at conferences and implore the United Nations to do more. He had to get used to the global stage.
The new government, he says, fought him at every turn. His work was seen as a form of political dissidence, a rebuke to authorities who had abandoned women; “a way to challenge them, to ask them to do what they are supposed to do. This didn’t create a good relationship.” In 2011, he was delivered a death threat by a Congolese minister in a mafia-like meeting in New York. Mukwege was told that if he wanted to return to the DRC and live, he would have to cancel a speech on sexual violence which he was scheduled to make at the UN. Bewildered, Mukwege relented.
As Panzi hospital took in more victims (to date the hospital has treated 60,000), Mukwege was beginning to struggle psychologically, so horrific were the sexual injuries he saw on women, girls, even toddlers. His experience has taught him that the mind is slower to heal than the body. “I think that the reality is, you can’t work for a long time with all these women who are so traumatised without yourself being affected,” he says. “If you are not affected, you are not human.” Because he applied perfectionist standards during procedures, he would be paralysed by an internal monologue. He would ask himself: “What if this happened to my daughter, to my wife? But very quickly I understood that I could not go on that way.” Procedures that should have taken one hour were taking three, “because I was just thinking about all the questions that I get. When a girl of 14 asks you: ‘Doctor, do you think I will be able to have sex?’ But her vagina is completely destroyed. ‘Doctor, I hope that with this operation, I will not be incontinent.’ And you can’t reassure.” He shakes his head. “I decided to get a psychologist to support me.” Today, he manages to practise without taking on the burden of his patients’ turmoil. “Many of my staff, especially the psychologists, really burn out. It’s a very traumatising situation and you need to find a way to go on doing the job, without yourself falling down.”
Mukwege, who is also a Pentecostal pastor, finds comfort in his faith, too. He preaches in a small local church in the same parish his father covered in Bukavu. I ask him how he can reconcile the horrors he has seen with his faith. “I believe that we are created to be good, but at any moment we have a choice. The God I believe in calls us to love others, and this is a decision. It’s a responsibility. It’s not a matter of God – it’s a matter of ourselves.”
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Mukwege’s book is barely a memoir. His story is told more in stories of the women he has met along the way, who, in extreme distress, found deeper wells of resilience. There is the young woman he treated after she escaped a gang of rapist soldiers, only to leave the hospital and return a few years later with HIV. There is the girl he attended to when she was raped and pregnant, who returned a little over a decade later with a daughter, herself pregnant as a result of rape. And there is the elderly woman who told him that she wanted an apology from the authorities for the fact that she had been gang-raped by a group of soldiers young enough to be her grandchildren.
These women, he says, “don’t have many possibilities, they don’t have many means, but they still fight to save lives, to save their children. They try to give their children food, education. I am so grateful for African women – they are doing a lot for our humanity.”
He sees them not as extreme cases that illustrate some African pathology, but examples of what happens anywhere in times of societal breakdown. In his book, he traces a broad sweep, from sexual violence in the wake of Hurricane Katrina, to the war in the former Yugoslavia, through Yazidi women enslaved by Islamic State, and Japanese “comfort women” forced into sexual slavery during the second world war, to show that women are the first victims when things fall apart. Mukwege believes that challenging misogyny in peacetime is paramount, in order to fortify society in moments of conflict. The first things to confront are silence and shame used “to keep women under control of men”. He adds: “When I talk in the west, I am always telling them: ‘What I am showing you, it’s happening even here, in your country.’”
Mukwege sees feminism as a straightforward matter of striving for the good of women, not a state of political enlightenment. “Feminist,” he says, “is a word that found me doing what I was supposed to do for humanity. I know many women in Africa who are fighting daily for the rights of women, and they are not saying that they are feminists.” During our conversation, he returns, again and again, to the humbling tenacity he sees in these unwitting African feminists.
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In 2012, Mukwege survived the most serious assassination attempt yet, one in which a friend gave his own life to save him. As Mukwege was driving into his compound, five armed men jumped into his car. A man in the front seat jabbed a machine gun to Mukwege’s torso; from behind, another pressed a pistol to his temple. Mukwege stepped on the accelerator. The men were thrown briefly. Then he hit the brakes and swiftly opened the door of the car, seeing that the entrance of his own home was within reach. But he was too slow. The Kalashnikov that was held at his belly was now in front of him. Mukwege braced himself for death.
At that moment, his friend and employee Joseph came running, shouting: “Papa! They are going to kill you!” Joseph had already been tied up by the assassins, but managed to free himself. Mukwege can’t quite remember what happened next. Shots were fired. He collapsed in a pool of blood. The assassins fled. When he came to, he realised the blood wasn’t his. Joseph, lying dead next to him, had drawn the gunfire.
“I can’t explain how I am still alive,” he says. “When I was attacked in my house, and my friend was killed, the red line was drawn.” He reported the attack to the police, who were lethargic in their response. To this day he does not know who the assassins were. His responsibilities as a parent and husband took over, and he fled to the US. But a few weeks later, he received word that a group of women from the island of Idjwi in Lake Kivu, a few hours from Bukavu by boat, had written to then-President Kabila demanding that the government bring Mukwege back to the DRC, and provide him with security. The women then wrote to the UN secretary general, turned up at Panzi hospital, and pledged that, if money was the issue, they would sell fruit and vegetables to pay for his and his family’s plane tickets. “This really disarmed me. I could not resist,” he says. Only three months after he left the country, he returned.
His reception was overwhelming. Women lined the roads for hours, celebrating and singing, as the authorities received him tersely, shamed by the spontaneous gathering. “It was 30km of women on the roads,” he says, beaming. “They were there just to say, ‘We are here and we want to support you. We want our doctor back, and we want to protect him.’” They followed him from the airport to Panzi hospital. “I did a small speech,” he says, after which one woman addressed the regional governor and the police chief. “She told him, ‘We will get 25 women who will do the security for the doctor, so he can treat other victims. We will feed him, we will protect him, and if someone wants to kill him, he will have to kill 25 women before they reach him.’”
If there was any question that he would stop his work, it was settled. Now, he intends to stay in the DRC until “we can end violence on women in Congo, or bring justice – so women can feel that they are protected by a system.” He sounds determined, but also resigned, as if he no longer has a choice in the matter. The government continues to face challenges from rebel groups, and innocent civilians are again in the crossfire, while eastern DRC remains volatile and lawless. Mukwege has moved permanently into the Panzi hospital compound, and he has round-the-clock protection by armed guards and UN peacekeepers.
But he also feels shielded by the power of women. “Sometimes I have this question: am I afraid? And my answer is yes. I don’t want to be a hero. But I have this feeling that there are these invisible forces around me.” Now, he says, “the ones who are trying to attempt on my life” might think twice. “They know that the women are there.”
• The Power of Women, by Dr Denis Mukwege, is published by Short Books at £20. To support the Guardian and Observer, order your copy at guardianbookshop.com. Delivery charges may apply.
Denis Mukwege will be in conversation with Annie Kelly for a Guardian Live online event on Tuesday 16 November. Book tickets here
