"This thing of rape," said Colonel Edmond Ngarambe, shifting uneasily on his wooden bench high in the mountains of eastern Democratic Republic of Congo. "I can't deny that happens. We are human beings. But it's not just us. The Mai Mai, the government soldiers who are not paid, the Rastas do the same thing. And some people sent by our enemies do it to cause anger against us."
The colonel's words lay bare a brutal reality about the wretched use of rape as an instrument of war in the east of the Congo. The growing numbers of women who arrive daily at hospitals as a fresh bout of fighting engulfs the region often have no idea whether their attackers were from the Mai Mai traditional militia, renegade Tutsi soldiers or a group of deserters from an array of armed groups who wear dreadlocks, call themselves the Rastas and specialize in particularly brutal treatment of their victims.
Ngarambe's own men in the Democratic Forces for the Liberation of Rwanda (FDLR), which evolved out of the army and militia that fled into Congo after leading the 1994 genocide of Rwanda's Tutsis, have been named by human rights groups as among the worst offenders in the onslaught against women, hundreds of thousands of whom have been raped over the past decade of conflict.
Rape has been used to terrorize and punish civilians in Congo who support the "wrong side," and it is perhaps no coincidence that it was also a tool of genocide in the mass murder of the Tutsis.
Sexual violence is now so widespread that the medical aid charity, Medecins sans Frontieres (MSF), says that 75 percent of all the rape cases it deals with worldwide are in eastern Congo. Darfur is a distant second.
"The two places don't compare," said Augustin Augier, the MSF administrator at Rutshuru hospital, who was previously posted to Darfur. "There you have a lot of people in camps but here the insecurity is so much worse."
The numbers of women seeking treatment for rape at the hospital has risen as a conflict that has already left 4 million dead over the past decade has reignited.
Human rights groups described gang rapes as commonplace and often accompanied by "barbaric" acts of torture with victims beaten with clubs, cut with knives or sexually assaulted with guns. Many young women have been abducted into sexual slavery.
The largest UN peacekeeping force in the world of more than 17,000 troops has done little to stop it. Instead, the primary attempt to discourage sexual violence appears on hand-painted murals on walls across the region telling men that it is not manly to rape.
Some of the victims make their way to Rutshuru hospital where they are met by Esparance Kiakimwa, a 29-year-old nurse in its sexual violence unit.
"We treat women and children from many places, sometimes very far. Many others can't get the courage to walk so far so those who arrive often tell us that all the women in the village were raped but they are the only ones to make it to the hospital. The numbers that make it are only a small part of the total," she said.
"They arrive on the back of motorbikes and in cars but sometimes on foot, walking for days because they don't have any money for transport. They have all kinds of injuries like knife cuts and damage to the vagina. It's worse for the young girls. We have to take them immediately to surgery," she said.