Rwanda's civil war began in 1990. Between April and July 1994, genocide claimed the lives of an estimated 800,000 Rwandese, displaced nearly four million people, and had a devastating impact on national health infrastructure. In addition to severe limitations being placed on the ability of the Rwandan government to prevent and treat HIV/AIDS during the genocide, the International Criminal Tribunal for Rwanda noted the use of 'genocidal rape' as a weapon of war during this time, with between 250,000 and 500,000 women and girls being subjected to rape. Deliberate infection with HIV was observed as a pattern of warfare. The exact effect of these actions on HIV/AIDS prevalence is, however, not known.