According to a report released this month by Human Rights Watch, armed milita groups in the Central African Republic have used rape and sexual slavery against civilians as a tactic of war. The report sheds light on the horrific violence that has been inflicted on women and children in the Central African Republic since conflict broke out in the country in late 2012.

The report identified 305 cases of rape and sexual slavery carried out against 296 women and girls by members of armed groups between early 2013 and mid-2017. While these numbers are concerning, the human rights group says the documented cases likely only represent “a small proportion” of all sexual violence incidents that have been committed in the Central African Republic during this period. As a result of the stigma surrounding the issue, there are security-related restrictions on research on the issue, and significant under-reporting by survivors of sexual assaults in the country.

For this report, Human Rights Watch interviewed 296 survivors of sexual violence, 52 of whom were girls at the time of the attacks. They also interviewed policemen, government officials, medical personnel, United Nations officials, and other members of the public. These interviews led the report to conclude that not only was sexual violence against civilians extremely prolific in the Central African Republic, but it was also frequently being used by fighters as a tool to punish women and girls – often along sectarian lines.

According to the findings, armed groups have not simply committed sexual violence as a byproduct of fighting, but have, in many cases, purposefully employed it as a “tactic of war.” Researchers found that the two main parties to the conflict had both engaged in sexual violence against civilians, using it as a means to punish those they perceived as supporting “the other side.” The Séléka coalition, a predominantly Muslim militia, was found to have targeted women and girls from Christian communities, while members of the Anti-Balaka militia, a primarily Christian group, targeted Muslim women and girls. Commanders from both parties tolerated sexual violence by their forces and, in some cases, appear to have ordered it and further committed it themselves.

Many of the women and girls interviewed in the report were attacked as they carried out daily tasks, such as making their way to school or work, going to the markets, or harvesting crops. Others reported being attacked in their homes during door-to-door raids by fighters searching for their male relatives, or as they tried to flee attacks on their towns. In the majority of sexual violence cases documented in the report, survivors were attacked by multiple perpetrators. In some cases, they were even tortured or held as slaves for extended periods of time. Human Rights Watch claims that select incidents of sexual violence documented in the report are so severe that they likely constitute war crimes or crimes against humanity.

These horrific cases of sexual violence left survivors with significant physical injuries, from broken bones to head trauma. Thirteen of the women and girls interviewed said they became pregnant from the rapes, while others are believed to have contracted HIV. In addition to physical injuries, many survivors continue to deal with the psychological effects of the attacks. Regardless, few survivors received medical or mental health care after their attacks, due to the lack of medical facilities, high costs of transportation to the facilities and of medical services themselves, and misconceptions about available treatment. Stigma and rejection from their families and local communities also acted as significant deterrents to survivors seeking treatment or disclosing the rapes at all.

Despite the severity of the crimes being committed, there are numerous barriers to justice for survivors of sexual violence in the Central African Republic. “In a country where the justice system is largely dysfunctional—with only a handful of operational courts, few lawyers and judges, and minimal capacity to investigate sexual violence or detain perpetrators—survivors have little or no opportunity to seek redress,” the authors of the report explained. In fact, only 11 of the 296 survivors interviewed by Human Rights Watch said they tried to file a criminal complaint. Death threats, physical attacks, and stigma were powerful deterrents to seeking justice, they said. Those who did contact authorities said they faced victim-blaming, failure to properly investigate, and demands to present their own perpetrators for arrest. To date, no member of either armed group has been arrested or tried in the Central African Republic for committing an act of rape or sexual slavery.

Recognising the dire situation facing women and girls in conflict zones in the Central African Republic, Human Rights Watch concluded its report with a series of recommendations to assist survivors of sexual violence and prevent further violence in the future. These recommendations include implementing a national strategy to combat sexual violence, providing free health and psychological services to survivors, and training police on how to better respond to sexual violence incidents. Furthermore, it is imperative that the government of the Central African Republic works with the international community to develop strategies against sexual violence and to strengthen the country’s justice system. This includes ongoing financial, logistical, and political support for the recently established Special Criminal Court, that will hopefully help combat the country’s entrenched impunity for serious sexual crimes. In addition, the group recommends that the U.N. Security Council impose targeted sanctions against Séléka and Anti-Balaka commanders responsible for sexual violence.

“There needs to be a strong and urgent message in the Central African Republic that rape as a weapon of war is intolerable, that rapists will be punished, and that survivors will get the support they desperately need,” says Hillary Margolis, a researcher in the Human Rights Watch’s Women’s Rights Division and co-author of the report. “Even in a conflict zone,” she says, “the government and international institutions can and should work to make services available to all rape survivors now, and put rapists on the path to accountability.”

This report by Human Rights Watch provides an important insight into the suffering of civilians in a crisis that receives little mainstream media attention. It should be noted that the researchers focused on cases of sexual violence against women and girls in the Central African Republic, and did not investigate reports of sexual violence against male civilians or allegations of sexual abuse by peacekeepers. As such, the problem of sexual violence in the Central African Republic is likely more widespread than reported in this document, and thus will require concerted and sustained domestic and international efforts if it is to be combatted.