1. Latic, Ena BS

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Dear Editor,


This letter is in response to the January-March 2018 article "Genocide Rape Trauma Management: An Integrated Framework for Supporting Survivors." I found this article to be inspiring and beneficial because it contains important ideas that can empower women and possibly save lives. This article promotes emotional healing for women who have been brutally raped through medical care and women's support groups. However, as helpful as support groups can be, sometimes women do not want to talk about their feelings as it brings back traumatizing memories. As health care professionals, we need to empower women so that they feel a sense of control. We need to provide women with a sense of physical self-empowerment and such can be accomplished through self-defense training.


According to the article, over the past several years, Rwanda's Ministry of Health has partnered with major organizations and initiatives, such as Partners in Health and the Human Resources for Health Program, to improve access to and delivery of health care services, increase quality of their education, and empower Rwandan health services while decreasing dependence on foreign aid.1 As they are improving socioeconomically and politically, the women are still struggling with their mental health and well-being. Providing genocide rape victims with a self of physical empowerment may be the first step in improving their overall health and well-being.


As a Muslim refugee, my family and I escaped from the Yugoslavian War where there was genocide in Srebrenica as per the Bosnian Serb forces; they were sent out to ethnically cleanse our area. Although I personally did not experience or witness genocidal rape, I experienced fear and trauma from such an experience. I personally have experienced my own self-healing through self-defense training. I have been participating in the sport of karate and am presently a member of the US women's karate team.


Self-defense training teaches women to set healthy emotional and physical boundaries. Self-defense training is also linked to psychological benefits for survivors of sexual trauma.2 It is stated, "Genocide rape trauma was expressed in terms of unbearable moments, overwhelming feelings, a sense of hopelessness, somatic distress, negative self-image, and altered intimate relationships and social isolation. These psychological troubles are exacerbated by poor physical health."2(p49) In the article, there was a concept of self-help strategies that include writing in a journal or a prayer, but imagine how being in physical shape can benefit. Being in physical shape can benefit these women who have been through a lot, and they can use exercise and self-defense training to deal with posttraumatic stress disorder or depression. Incorporating physical movement to help the brain! Physical movement can stimulate the brain and increase dopamine and serotonin levels. Dopamine increases enjoyment, whereas serotonin improves willpower, motivation, and mood. In addition, self-defense training helps increase self-esteem, increase perceptions of internal control, and decreases perceptions of external control.2 Imagine being in control of your body, not feeling vulnerable, and feeling empowered because you know how to defend yourself physically? Being a part of the US national karate team, I am a firm believer that self-defense training is extremely important, especially because I am a woman. I travel the world not only doing the sport I love but also showing all the women out there you can express yourself with action and not with words or tears. Women who have experienced genocidal rape need to realize that their gender does not define who they are. They need to realize that they are in control of what they think and do with their body. Self-defense training is a catalyst to "preserve, protect, and promote human dignity."2(p44) As the nursing theory states, women should also be able to feel strong and confident in their own body. For those suffering from genocidal rape, a combination of both mental and physical empowerment would make for a more effective treatment approach.


-Ena Latic, BS


Health Studies


Utica College


Utica, New York




1. Mukamana D, Brysiewicz P, Collins A, Rosa W. Genocide rape trauma management: an integrated framework for supporting survivors. Adv Nurs Sci. 2017;41(1):41-56. doi:10.1097/ans.0000000000000177. [Context Link]


2. Pinciotti CM, Orcutt HK. Rape aggression defense: unique self-efficacy benefits for survivors of sexual trauma. Violence Against Women. 2017;24(5):528-544. doi:10.1177/1077801217708885. [Context Link]