The first time I met Dr. Denis Mukwege, he was tired. Tired of men. Of governments. Of his fellow humans for not recognizing the tremendous suffering and horrific violence against women in the Democratic Republic of Congo. But he was particularly tired of men.

“We should do more,” Mukwege told me in New York in 2012. He spoke in a soft voice, but just beneath it was a shimmer of rage. “We are men, and we know where we come from, all of us. Why we can just be silent when our origin is trying to be destroyed and kept silent? We are born all from women. Maybe I’ve lost my way—I’m in a world I don’t understand.”

Bitterly thumping his chest, he said: “When people have just the impression that it’s ‘just’ women, it’s there that all my sorrow starts. When people say it was ‘only’ women, it was a ‘sexual relation’—no.”

Mukwege, the 2018 winner of the Nobel Peace Prize, along with Yazidi survivor Nadia Murad, founded a gynecological and obstetric hospital named Panzi in 1999 in a city called Bukavu, in South Kivu province, which is in the war-ridden east of Congo. Over the past 20 years, he has operated on tens of thousands of women—more than 15,000 of whom have been survivors of conflict-related rape (and particularly disturbing forms of it at that: Rape in DRC often involves multiple men, is carried out in front of family members, and involves the insertion of sticks, bayonets, and other objects). And he has reached a point in which he is operating on the daughters of rape for rape.

“I think that today I have lost all my words,” he told me. “I don’t have enough words to explain the brutality I’m watching.”

For 20 years now, the country’s complex internal conflict (mixed with extraordinary misogyny) has destroyed women’s bodies in particular for so many reasons—to humiliate them and their male relatives, to help take control over communities, to “protect” soldiers (many of whom believe there is magic power to gain by raping a woman), to express soldiers’ own misery at being impoverished, hungry, and even feeling unloved by their wives, among others. While DRC is tremendously rich in resources—with an estimated $24 trillion worth of untapped minerals (such as diamonds, cobalt, and zinc) in the ground, according to the United Nations—most of the country’s population of 83 million people live in desperate poverty, with the annual per capita GDP less than half of Haiti’s. War has continued for so long in part because of this desperation, and in part because of corruption by the DRC’s leader, President Joseph Kabila, who has continued to hold office despite reaching his term limits in 2016. In a country this inherently wealthy, control of resources has been a constant driver of war, with women bearing much of the brunt of the fight for wealth.

And within this nightmare, there are few activists or leaders who are able to speak out unpunished. The past two years has seen increased violence by the government because of protests against Kabila, with police shooting and killing demonstrators.

Mukwege has been DRC’s most prominent voice calling out the government on its need for democracy and its failure to end the ongoing conflict and prevent violence. He is “the epicenter of resistance,” said Stephen Lewis, co-founder of the Stephen Lewis Foundation, which works to fight HIV/AIDS in Africa, and a supporter of Panzi Hospital. Mukwege’s outspokenness has angered the government.

“He makes them look bad by existing,” said Naama Haviv, the former executive director of the Panzi Foundation USA, which raises funds for the hospital. “He’s showing that Congolese leaders can lead with integrity.” But he, too, has faced consequences.

In 2014, the government unilaterally froze all of Panzi Hospital’s bank accounts, claiming that it owed back taxes, despite the fact that it is a public hospital. It seized about $50,000, a large chunk of Panzi’s money. Nobody got paid that December as the hospital tried to take the government to court. The night before the trial was set to begin, the judge was found dead. All of this happened a couple months after Mukwege won the prestigious Sakharov Prize.

But, before all this, in 2012, someone tried to kill him.

The attempt came just weeks after Mukwege spoke at the UN, calling for those responsible for DRC’s violence to be brought to justice.

“I would have liked to say, ‘I have the honor of representing my country,’ but I cannot,” he told the audience. “In effect, how can one be proud of belonging to a nation without defense, fighting itself, completely pillaged and powerless in the face of 500,000 of its girls raped during 16 years; 6 million of its sons and daughters killed during 16 years without any lasting solution in sight?”

Having just arrived home to Bukavu from a trip to Europe, he was set upon by gunmen, who fired shots at him and his close friend and bodyguard Joseph Bizimana. Bizimana was killed. Mukwege then fled the country with his family, hiding in a secret location, unsure whether he would ever go home.

What happened next demonstrates exactly how much Mukwege is beloved by women in DRC.

Hundreds of survivors he had treated began writing him letters, asking him to come back. From within the gated Panzi compound, which turns to mud like the rest of Bukavu during the rainy season, they said things like, “If the government can’t protect you, then we will. You helped us with these bodies and we’ll use these bodies to protect you,” according to Haviv. The women began selling extra cassava and other produce at the markets and gathering whatever small amounts of money they could. They were going to buy Mukwege a ticket home.

The women got through to him. Who am I to stay here when these women are willing to give up and sell everything? was Mukwege’s thinking, said Haviv. He returned to Bukavu, to Panzi, to the brutality he was used to seeing up close every single day.

With his own government failing to stop the country’s conflict, Mukwege has long expressed befuddlement at the lack of intervention by the global community. “I have an impression, seeing the way Congolese women and children are treated now, I wonder if we have the same humanity,” he said of his colleagues versus the rest of the world. “I think if it were happening somewhere else, [the international community] should have found a solution.” He points to how the world stepped up to help Bosnia in the mid-1990s. I asked him once if he thinks the inaction is due to race, and he just sadly smiled.

The one thing every person who works with Mukwege or knows him well emphasizes, beyond his eloquence and steadfastness, is his integrity. It is not false or exaggerated. I once watched him at work in Panzi. He silently witnessed morning prayer and song, which was attended by dozens of women in brightly patterned dresses. He listened to his patients and the staff he oversees. He was ever-present in his white coat, and often looked exhausted. Yet he was, and is, always willing to discuss what he’s witnessed, feeling a moral imperative to speak out.

“He is acutely aware of his stirring eloquence and towering presence, as he regularly translates the brutality and suffering in the DRC and beyond into a powerful narrative that shakes the conscience and provokes a response,” said Susannah Sirkin, the director of international policy and partnerships at Physicians for Human Rights, who has known and worked with Mukwege for a decade.

These can be painful ideas to translate. When I visited the darkened halls of Panzi in 2016, there was a 3-year-old, a 5-year old, and a 6-year-old in the rape ward. All of them had been gang-raped. “When I treat a child with all her bladder and abdomen destroyed, I think, This is really not something I want to do with my life,” Mukwege said at the time. Yet he has endured.

On October 5, Mukwege was mid-operation when he received the news about the Nobel Prize. In his public statement after receiving the award, Mukwege said: “To the survivors from all over the world, I would like to tell you that through this prize, the world is listening to you and refusing to remain indifferent. The world refuses to sit idly in the face of your suffering.”

The honor felt overdue to many who have known Mukwege for a long time. Regardless, they are thrilled. “At this particular moment in history, when the backlash against women standing up against violence is so intense, the Nobel Committee could not have made a better decision,” said Jody Williams, winner of the 1997 Nobel Prize for her campaign to ban land mines. Years ago, back in New York, I asked Mukwege how he manages to stay sane, considering the terror of his work. “I don’t know how I’m doing it,” he said, laughing. “I can say that today I’m just wondering for how long I can go on with this question.”

The Nobel Committee, it seems, just gave him much-needed fuel to carry on.