A Survivor-Centered and Holistic Ethics of Care: A Reflection on Ethics of Care in Practice and Within Survivor Groups
Author: Dominique Vidale-Plaza
One afternoon in 2015, I sat in a hotel conference room, in Goma, Democratic Republic of Congo, listening on as women activists and leaders from the Great Lakes Region discussed progress on the Women Peace and Security agenda. They had been brought together with financial support from a United Nations agency, as part of a regional platform of women leaders and peace-builders. Each of the women leaders and activists present had directly or indirectly experienced war. They had all been advocating for years, in different ways, for peace, security, and care for their communities.
On the final day of the conference, as the participants prepared their key recommendations for states in the African Great Lakes Region, donors, non-governmental organizations, and UN agencies, one woman stood and addressed the attendees. She proclaimed to the room that she was tired of these meetings and didn’t think she would be returning. She wondered aloud, why they were even asked to join these forums, year after year, to discuss women’s priorities for peace and security, only to have them return to their home countries and see nochangeinpeace,security, nor in the care for their peers– victims and survivors of war. She asked then, mostly to the representatives of the different Congolese governmental ministries and UN agencies present in the room, including myself, when would their recommendations materialize, when would their voices be heard? Her questions were returned with silence.
In the years to follow, in the course of my work in eastern DRC and later on in other countries affected by conflict, like Central African Republic, Colombia, Guinea-Conakry, Uganda and others, several survivors of war would echo similar sentiments to myself and others who would listen. Indeed, despite international policy attempts to render women andgirls more visible in post-conflict recovery efforts, not only as victims or beneficiaries, but also as agents of change, the “woman in conflict,” especially if she has survived sexual or other forms of gendered violence, still largely feels uncared for and unheard, her capacities and her priorities unheeded. One Congolese survivor of conflict-related sexual violence, an activist for care for children born of rape, told me before she began a virtual presentation in 2020, that she would again raise the needs of children born of conflict-related rape, but she knew it would not be for the last time. In 2018, women in remote Uganda, on the border with the DRC, swept their arms around to show me the vast distances they would have to traverse to seek basic care at a health-clinic, much less for making it to town, so they could participate in the meetings, where they themselves and their needs were being discussed. Survivors of conflict related sexual violence from around the world, not only from the African continent, have shared with me their frustrations with their states’ seeming inaction in the face of violence and their feeling that their cries for support fall on deaf ears– realities so different to the lofty words and statements shared in the gilded halls of international meeting rooms in New York and Geneva. I suggest that we should look to these women, rather than to their boardroom advocates, for models of how to realize more equitable, gender-just, and caring futures.
Since the adoption of UN Security Council Resolution 1325 in 2000, important policy strides have been made in recognizing the disproportionate effects of war on women and children. More attention is being paid globally by international media, donors, states, and humanitarian actors on the specific rights of survivors of conflict-related sexual and other gendered forms of violence, in healing, recovery, and the pursuit of justice. Rights-based approaches have been hailed as moving away from basic needs approaches, ostensibly transforming subjects of violence from “beneficiary” to “rights bearer” identities and relationships. However, rights-based approaches are not without their limitations and scholars have argued that over-emphasizing “needs” (language that persists even in rights-based policy guidance and tools) risks continuing to frame survivors as victims rather than agents of change. Survivors of war, and especially of conflict related sexual violence, themselves, together with scholars and practitioners, have emphasized a profound need for survivor-centred approaches.
In response to these calls, international actors, including the UN and other multilateral bodies, are adopting increasingly survivor-centred language and working to integrate this perspective in emergency and post-conflict recovery efforts. My experiences and discussions with victims and survivors of conflict-related sexual violence highlight, though, that these efforts often miss the mark of even meeting basic needs, much less for materializing the full ethos of survivor-centred approaches, as hoped for and expected by survivors themselves. While women and girls are increasingly visible in different peace and security related forums, and the voices of survivors of conflict-related sexual violence are more and more platformed in international and in some cases, national forums,– women and girls remain targets in war and their experiences accessing care, during and in the aftermath of war, are often less than favourable.
An emergent framework for more effectively and justly addressing the limits of both rights- and needs-based approaches is survivor-centred holistic care. By survivor-centred holistic care, I mean care that is agile, comprehensive, person-centred yet socio-ecologically rooted, responsive, participatorily-led, and ultimately, transformative. I understand care as going beyond service-delivery and certainly beyond the minimum standards of humanitarian jargon. I see radical care as having the capacity to articulate, signify, rearrange, and create new worlds. I am encouraged by theorists like Fritz de Lange, who describes care as “ubiquitous, fragile, dangerous, inevitable, necessary.” My own practical experiences have led me to believe that a survivor-centred and holistic ethics of care can provide a prism through which we can re-vision states’ engagement on survivors of conflict and societies’ needs for peace, security, and justice, in ways that are “liberating, effective, sensitive and responsible.”
After now ten years since I first began working on modelling survivor-centred holistic care, though I would not have known to identify it as such back then, I am convinced that this model cannot be delivered through traditional means of organizing care, in neither post-conflict settings nor during so-called peace-time, without drastic change to these traditional approaches and the foundations upon which they are based. I, alongside other practitioners, am confronted daily with existential and also very practical obstacles in making sense of this model and working to put it into practice. Ultimately, the same traditional approaches, practices, and frameworks employed in post-conflict recovery efforts, including humanitarian and development aid mechanisms, siloed ministerial departments, obsolete legislative provisions, top-down approaches to governance, and deindividualized, sweeping approaches to care in institutions, are not only limited in their capacities to convey and materialize the full ethos of survivor-centred holistic care; they may also constrain or even co-opt the radical potentialities of both survivor-centredness and holistic care. Traditional regimes of care, including international institutions, state bodies and mechanisms, legal regimes, military and police are based on normative rules and duties, and may consider care as being outside of their moral scope. Ethicist and feminist, Carol Gilligan highlights that an ethics of care is diametrically opposed to traditional dominant and ultimately, heteropatriarchal, moral theories.
I hope to use this reflection piece as a sense-making exercise, to unpack a survivor-centred holistic ethics of care and explore the potential of these ethics of care in rethinking and rearranging worlds, specifically in terms of politics and governance. I present the Panzi One Stop Centre (OSC) holistic care model and philosophy as an analytical framework for a set of survivor-centred, holistic ethics of care. Frustrated with institutionalized attempts to translate what I believe to be truly radical concepts into programmes, countless working groups, still more guidance documents, and more and more coordination mechanisms, I will also reflect on my experiences with survivors themselves, and their groups: associations, movements, and networks from conflict-affected communities around the world. I will illustrate how survivors, especially within their groups, collectively embody holistic care ethics, whether via the practical work of care and caring or through their situated understandings of relationality, interdependency, and vulnerability. In line with the work of different scholars, I centre survivor groups as sites of care and caring, wherein the ethics of care are constantly being defined, embodied, and materialized. Drawing from practice-based knowledge and scholarly work on the feminist underpinnings of care ethics, I will demonstrate how, especially through the lens of survivors and their groups, the ethics of survivor-centred holistic care are feminist and therefore, have radical transformative potential, leading us to question traditional, dominant orders about how care (and our world) is organized.
I will firstly reflect briefly on my practical experience working “on” care in different conflict-affected contexts around the world, and within different regimes of care. I will describe actors’ within these traditional regimes struggles to translate into practice, “survivor-centred approaches” as detailed in international policy. I will then introduce the Panzi One Stop Centre (OSC) holistic care model and philosophy. I will not focus on the model’s specific pillars, but will rather unpack some of its key principles and ethics. I will then use illustrative examples of how survivors and survivor groups from countries like CAR, Colombia, DRC, Guinea-Conakry, Uganda, embody and materialize a holistic ethics of care, linked to, but not constrained by, the ethics of the Panzi OSC care model. Following in the tradition of feminist scholars and care-ethicists, I reflect on the potential of the ethics of survivor-centred holistic care to radically influence and change our world. I posit that tacking on the language of “survivor-centred holistic care” into existing structures, mechanisms, and institutions will not bring about the desired effects, and while post-conflict recovery settings present important opportunities to “Build Back Better,” rebuilding on the same old foundations is like building beautiful sand castles at high tide.
I am convinced that this and similar reflections are critical and urgent, if we are to get any closer to creating a more gender-just, equitable, and caring world.
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