DR Congo: Savage sexual violence is a defining characteristic of the Congo war, writes Declan Walsh in Goma.
A pungent odour wafts through the room. Hands folded on her lap, Rosette, a 23-year-old with twists of black hair, waits patiently. The operation was the next day, she says. Surgery should get rid of the smell.
Rosette was waiting for doctors to rebuild her vagina. Two years earlier, a gang of armed men destroyed it. They stormed her village in eastern Congo, killing six men, including her husband, then they raped the women. For four days Rosette laid there, battered and unable to budge.
When help came, her rescuers followed a swarm of flies buzzing overhead.
Rosette suffers from vaginal fistula, a medical condition which has virtually disappeared in the developed world. It persists in some African countries where there is poor childbirth. In eastern Congo, however, a flood of new victims is emerging, marking the horrors of a barbaric conflict.
Aid workers call it the war against women. Normally resulting from childbirth complications, fistula in Congo is the product of particularly violent rape. Severe internal injuries cause immense pain and debilitating incontinence. Social ostracisation often follows.
Dozens await operations at a clinic in the eastern capital, Goma. Many have had objects - sticks, fingers, gun barrels - thrust inside them. Some have been shot in the vagina. One teenager has had her eyes poked out. For those treating them, the cruelty is incomprehensible.
"It numbs you. How can human beings do that to each other? They must be possessed," said Lyn Lusi of Doctors on Call for Service (DOCS), the US-funded charity running the clinic.
Along with the plunder of diamonds, gold and coltan, savage sexual violence has emerged as one of the defining characteristics of the five-year Congo war.
In the vast eastern forests, gunmen - rebels, local militia, armed refugees from Rwanda - rape with abandon. Sometimes the aim is to subjugate an entire community. Other times, it seems, they do it just because they can.
"They want to show power and strength, that they can do whatever they want to," says hospital worker Fred Kahunde.
In just six month this year, the DOCS clinic in Goma treated 1,000 women, 83 of whom required fistula operations. An older hospital to the south in Bukavu has healed hundreds more. The attacks in turn fuel the spread of HIV/AIDS - 12 per cent of women tested positive, many of whom had not been sexually active.
Patients wait in two large white tents donated by UNICEF, and eat rations from the World Food Programme.
Last week, Mwasi (18) stumbled through the flapping door. Her eyes had been beaten to a pulp. The gunmen also damaged her hearing, so doctors shouted questions into her ear.
Now she replies in a low whisper, nervously fingering the zip on her jacket. Tears continuously stream down one cheek. Staff are unsure whether it is a medical reaction or just sadness. "They killed my parents, then they beat us to show them where the food was," she says.
Her assailants were with the Interahamwe, the Hutu militia which fled Rwanda after leading 1994 genocide, she says.
Aid workers say all armed groups - including the main rebel group, RCD-Goma, the Mayi Mayi militia - are guilty. "They are all bad as each other," says Dr Abuka Longombe, a Congolese surgeon who carries out many of the operations.
The big, burly man reached into his drawer and pulled out a photo. It showed a woman whose lips were cut from her face. For a moment he was lost for words.
"My youngest patient was five, the eldest was 73. How can you do this to a grandma?" he asks, throwing his hands open. "I don't have an explanation, but one thing is sure: their goal was to destroy."
Dr Longombe has seen the worst of the Congo war. Last year he narrowly escaped the slaughter at Nyankunde, in north-eastern Ituri province, when Lendu fighters killed more than 1,000 people from the rival Hema tribe.
In the hospital where he was director, the militia hacked at least 40 patients to death in their beds. "Some were just after surgery, so they were still in traction. It was impossible to escape," he recalled.
Nyankunde was among the worst atrocities of the five-year war; some of the dead appeared to have been cannibalised. He believes a war crimes tribunal is necessary to end the culture of impunity.
Hopes for justice, though, are thin. Congo's judicial system is crumbling and rebel armies rarely discipline their soldiers. The RCD-Goma commander in North Kivu province, Brig-Gen Laurent Nkunda, denied his men committed mass rape.
"Yes there has been some rape," he shrugged, "but where there is war, there is abuse. War is not a recommendation."
A few days later, the UN under-secretary for Humanitarian Affairs, Jan Egeland, was visiting Goma. He said: "I have told the leaders the international community will hold people accountable for war crimes."
For now, though, the outside world is concentrating on cementing the fragile peace between President Joseph Kabila and his former rebel enemies.
A transitional government is sitting in the capital, Kinshasa, but in the east, fighting has slowed but not stopped and looting, murder and rape continue.
After her operation, Rosette recovered on a narrow bed in the white tent. Beside her, about 40 other women waited for their operations. Amid the talk of peace, their battle for survival continues.
Names of victims have been changed.