Monika Hauser: “The development in Afghanistan is the bitterest pill I have had to swallow”

Thirty years ago, gynaecologist Monika Hauser founded the organisation medica mondiale, which campaigns for the rights and protection of women in conflict areas and supports survivors of sexualised violence. In 2008 she received the Right Livelihood Award for her tireless commitment in this field. Today, medica mondiale works in 13 countries in association with other women’s rights organisations, experts and activists who fight against gender-based violence on the ground. Monika Hauser spoke to Right Livelihood about the organisation’s early days as well as its current projects.

Right Livelihood: Dear Monika, you were pursuing specialist training as a gynaecologist and had already decided where you wanted to work in the future when the war in Bosnia changed everything.

Monika Hauser: Yes. I wanted to leave Germany and go to Cuba. On the one hand, I always wanted to work abroad. I did a clinical elective in Sri Lanka, for example. On the other, I couldn’t imagine working in a German hospital or practice.

RL: Why?

MH: It was clear to me from the beginning that my patients are a harmony of body and soul. My standard was always: How would I like to be treated myself? I was then quite shocked by the reality of hospitals. First, I worked in South Tirol and then I started specialist training at a German university hospital. The topic of sexualised violence against women was taboo everywhere; it was simply not talked about. When the police brought a woman to the clinic at night, I was horrified by how she was treated. It was a purely technical process. No one was trained to deal with this issue – neither the clinic staff nor the police. I quickly realised that women were being re-traumatised by such procedures and that something urgently needed to change.

RL: How did you go about it?

MH: I joined forces with similar-minded colleagues and developed holistic treatment approaches in pilot projects. We trained ourselves, so to speak. The patients taught me a lot, which I used in my later work.

RL: Then in 1992 the media reports about the mass rapes in Bosnia came out.

MH: That really infuriated me. The crimes themselves, of course, but also the sensationalised reporting. Many survivors were re-traumatised by it. These women showed great strength because, despite everything, they held their lives together and had the courage to tell the world what happened. But instead of honouring this strength and protecting the women from further exploitation, most media outlets were all about blood and tears. Unfortunately, this way of reporting is still evident today in conflict regions. Both then and now, no one is interested in how women fare in everyday patriarchal society. After all, violence does not only occur in war.

RL: You then left for Zagreb without further ado.

MH: Yes, I had the impulse to speak directly with the women’s organisations on the ground about how I could best support them. It turned out that a lot of aid projects had already begun in Croatia, but nothing was happening in Central Bosnia yet. I learned that there were about 120,000 refugees in and around the city of Zenica, many of them affected women who were not receiving any professional help. I knew I had to go there. At the end of December, I joined two pastors from Kassel who wanted to bring relief supplies to Zenica by car. Through a local contact, I quickly got to know the women who later became close co-workers, some of whom I am still close friends with today. With these 20 comrades-in-arms, who were all highly motivated, we built a specialised centre. Our team consisted of high school teachers who taught German and helped with translation, gynaecologists, anaesthetists, general practitioners, nurses, psychologists, administrative staff and many more.

RL: Was this set up as a volunteer project?

MH: No. I put together a budget very quickly and received donations from Germany.

RL: Were you able to move freely in the region?

MH: The Bosnian army supported our project and also took us to the front line so that we could reach the refugee camps that were further away and inform them about our work. The Bosnian Croat army and the paramilitary – unsurprisingly – kept giving us trouble. So I insisted to the UNHCR that we get the so-called Blue Card, which shows that we are UNHCR-associated. That gave us a certain level of protection. When we had to leave, UN tanks took us to Sarajevo to fly out from there, but otherwise, there was little support from the UN on the ground.

RL: Were you aware of the dangers you were facing or did you block them out?

MH: I was totally focused and didn’t let it get to me because we were able to achieve so much. It was tough, but at the same time, incredibly positive work, the likes of which I had never experienced before. We built up this centre together as a multi-ethnic and inter-faith team of women, overcoming obstacles and growing together professionally. In all the madness of war, our work had an encouraging ripple effect throughout the whole region.

RL: How long were you on-site?

MH: All of 1993. I wanted to finish my medical degree in Cologne in 1994, even though I still had one leg in Zenica. That was quite a balancing act. In Germany, life just went on. Whenever I had to take time off for our project, there was little understanding from the clinic.

RL: You also set up your Cologne office and started working in other countries.

MH: First came Kosovo, then Afghanistan. In Afghanistan, we built up an organisation with 90 employees, initially with international staff, who then gradually handed over to local colleagues. Meanwhile, we began to focus more on cooperating with existing structures. This means that today, we no longer go directly into the crisis areas as an organisation, but support the work of local women’s rights organisations that are already active on the ground.

RL: What are medica mondiale’s areas of work?

MH: We have always had an interdisciplinary approach including medical, psychosocial and legal support amongst others – combined with political and social human rights advocacy work. Our first cooperation partner in Afghanistan was Sima Samar, by the way, who received the Right Livelihood Award in 2012. We have known each other for over 20 years now.

RL: Today, your focus regions include Southeast Europe, Iraq, and Central and West Africa. In the meantime, medica Afghanistan had to close and the staff evacuated…

MH: …now we support them here in Germany in different ways. And in Afghanistan, we continue to work with five organisations that, under the given conditions, try to organise psychosocial support for traumatised women, provide further training for law students who cannot continue their studies, and campaign for the protection of human rights defenders. The development in Afghanistan is the bitterest pill I have had to swallow in the 30 years since medica mondiale was founded. At the same time, I am very impressed by how courageously women on the ground continue to resist in creative ways. This is seen far too little internationally.

RL: You’ve seen a lot of horrific images over the years and you’ve had to witness horrendous stories. How do you manage all of it?

MH: In 1994, after my time in Bosnia, I had a serious breakdown. I had to pull the plug for three months and painfully learn that I also had to take care of myself if I wanted to continue doing this work. I then not only learned for myself how to do that, but we also directly made a project out of it. It’s called “mindful organisational culture” because it doesn’t just affect me, but also other colleagues.

RL: What do you do in everyday life to take care of yourself?

MH: Playing the saxophone, going for a run, doing yoga or nurturing my relationship with my husband. But finding the right balance here is a lifelong task. The most important thing is to stay in touch with yourself.

RL: In 2008 you received the Right Livelihood Award. How did that affect your work?

MH: Well, first of all, I had to give interviews for probably half a year. Many people became interested in our work who were not interested before. And it was also noticeable in the income from donations. So, the Right Livelihood Award gave us a big boost.

RL: What does your relationship with other Laureates look like?

MH: In November 2022, we collaborated with Denis Mukwege, to give a recent example. 30 of our colleagues from Germany, Bosnia, Kosovo, the Democratic Republic of Congo, Burundi, Uganda and Rwanda participated in the Mukwege Congress in Bukavu, which dealt with compensation mechanisms for survivors of sexualised violence, to share our work in Bosnia. Namely, together with Bosnian activists, we succeeded in getting a law passed in Bosnia in 2006 that guaranteed women who had been raped during the war a monthly pension and formally put them on an equal footing with veterans. The money protects against complete poverty and is enormously important, but equally important is the social recognition that this has countered the previous social stigmatisation.

RL: That is a great success that should set a precedent.

MH: Absolutely. Such laws are needed worldwide, but there is still a long way to go. In northern Iraq, where we have been working intensively since 2016, a little bit is happening in this respect. At the invitation of the government there, we have been training public health workers for a while in our stress- and trauma-sensitive approach. In 2022, we organised a delegation trip with Kurdish politicians and our Kurdish partners to travel to Zenica to learn about the Bosnian model. Talks on this will continue in northern Iraq this May.

RL: Learning from Bosnia also applies to a project you are currently running in Ukraine, right?

MH: Indeed. We regularly do online trainings for Ukrainian women’s rights activists as well as staff from women’s counselling centres and women’s shelters. And we conduct these trainings with Bosnian and Kosovar colleagues from our initial projects. In a way, we have just come full circle – albeit on a sad occasion.