Abstract
BackgroundDespite the signing of international peace agreements, a deadly war continues in the Democratic Republic of Congo (DRC) and sexual violence is a prominent modus operandi of many military groups operating in the region.MethodsRetrospective cohort study of women who presented to Panzi Hospital in 2006 requesting post-sexual violence care. Data was extracted and analyzed to describe the patterns of sexual violence.ResultsA total of 1,021 medical records were reviewed. A majority of attacks occurred in individual homes (56.5%), with the fields (18.4%) and the forest (14.3%) also being frequent locations of attack. In total, 58.9% of all attacks occurred at night. Of the four primary types of sexual violence, gang rape predominated (59.3%) and rape Not Otherwise Specified (NOS) was also common (21.5%). Sexual slavery was described by 4.9% of the survivors and a combination of gang rape and sexual slavery was described by 11.7%. The mean number of assailants per attack was 2.5 with a range of one to > 15. There were several demographic predictors for sexual slavery. Controlling for age, education level and occupation, a marital status of "single" increased the risk of sexual slavery (OR = 2.97, 95% CI = 1.12-7.85). Similarly, after controlling for other variables, age was a significant predictor of sexual slavery with older women being at a slightly reduced risk (OR = 0.96, 95% CI = 0.92-0.99). Women who experienced sexual slavery were 37 times more likely to have a resultant pregnancy in comparison to those who reported other types of sexual violence (OR = 37.50, 95% CI = 14.57-99.33).ConclusionsAmong sexual violence survivors presenting to Panzi Hospital in 2006, the majority of attacks occurred in women's own homes, often at night. This represents a pattern of violence that differs from other conflict settings and has important implications regarding protection strategies. Sexual violence in South Kivu was also marked with a predominance of gang rape, thus increasing the risk of serious injury as well as the likelihood of an individual woman contracting a sexually transmitted infection (STI). Sexual slavery was noted to be more common among young, single women and was found to have a high rate of resultant pregnancy.
Highlights
Despite the signing of international peace agreements, a deadly war continues in the Democratic Republic of Congo (DRC) and sexual violence is a prominent modus operandi of many military groups operating in the region
This pattern of sexual violence differs from that which has been reported in other conflict areas and has important implications regarding protection strategies
The United Nations (UN) and other humanitarian organizations implementing protection programs in Eastern DRC should consider strategizing with local women and community leaders to devise new protection protocols specific to the attack patterns within the region
Summary
Despite the signing of international peace agreements, a deadly war continues in the Democratic Republic of Congo (DRC) and sexual violence is a prominent modus operandi of many military groups operating in the region. Sexual violence in the Democratic Republic of the Congo (DRC) has been one of the most devastating aspects of the armed conflict that began in 1996 [1,2,3,4,5,6,7,8]. Sexual violence has been employed by militia groups to intimidate and punish communities and to control territory. After the Rwandan civil war and genocide in 1994, a massive influx of refugees from Rwanda flowed into Eastern Zaire ( the DRC).
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