During the first and second conflicts in the Democratic Republic of the Congo (DRC), all armed parties to the conflict carried out a policy of genocidal rape, with the primary purpose being the total destruction of communities and families. Such was the violence directed at and carried out towards women that Human Rights Watch (HRW) described it as "a war within a war". HRW has reported that as of March 2013, civil conflict had reignited when the militia, March 23 Movement (M23), resumed hostilities following a ceasefire. Girls from the age of five to women aged eighty have been assaulted and sexually mutilated. Others were raped and their families forced to watch. By 2008 the United Nations (UN) had estimated that up to 200,000 females had suffered from some form of sexual violence. The brutality of the rapes have caused long-term health, social, familial, and psychological problems. There have been reports of infants aged one being raped, as well as women in their nineties. Médecins Sans Frontières (MSF) reported that over 50 percent of survivors believed that the use of rape was a deliberate tactic used for the extermination of the Congolese people. While females have been the primary victims of sexual violence, men and boys are also sexually assaulted. In 2009, several non-governmental organizations including HRW and Amnesty International (AI) reported that the rape of males in the DRC was systematic, and on the increase. The majority of the rapes have been carried out by militias, such as the Lord's Resistance Army, the Democratic Forces for the Liberation of Rwanda, the Mai-Mai and the Congrès national pour la défense du peuple. Since 2009, rapes, killings and human rights violations carried out by the armed forces (FARDC) of the DRC have increased. Rape as Genocide According to Amnesty International, the use of rape during times of war is not a by-product of conflicts, but a pre-planned and deliberate military strategy. In the last quarter of a century, the majority of conflicts have shifted from wars between nation states to communal and intrastate civil wars. During these conflicts the use of rape as a weapon against the civilian population by state and non-state actors has become more frequent. Journalists and human rights organizations have documented campaigns of genocidal rape during the conflicts in the Balkans, Sierra Leone, Rwanda, Liberia, Sudan, Uganda, and the DRC. The strategic aim of these mass rapes