Abstract
BackgroundFollowing the declaration that President Mwai Kibaki was the winner of the Kenyan presidential election held on December 27, 2007, a period of post-election violence (PEV) took place. In this study, we aimed to identify whether the period of PEV in Kenya was associated with systematic changes in sexual assault case characteristics.Methods and FindingsMedical records of 1,615 patients diagnosed with sexual assault between 2007 and 2011 at healthcare facilities in Eldoret (n = 569), Naivasha (n = 534), and Nakuru (n = 512) were retrospectively reviewed to examine characteristics of sexual assault cases over time. Time series and linear regression were used to examine temporal variation in case characteristics relative to the period of post-election violence in Kenya. Key informant interviews with healthcare workers at the sites were employed to triangulate findings. The time series of sexual assault case characteristics at these facilities were examined, with a specific focus on the December 2007–February 2008 period of post-election violence. Prais-Winsten estimates indicated that the three-month period of post-election violence was associated with a 22 percentage-point increase in cases where survivors did not know the perpetrator, a 20 percentage-point increase in cases with more than one perpetrator, and a 4 percentage-point increase in cases that had evidence of abdominal injury. The post-election violence period was also associated with an 18 percentage-point increase in survivors waiting >1 month to report to a healthcare facility. Sensitivity analyses confirmed that these characteristics were specific to the post-election violence time period.ConclusionThese results demonstrate systematic patterns in sexual assault characteristics during the PEV period in Kenya.
Highlights
Recent armed conflicts have demonstrated the high incidence of sexual violence in modern warfare [1,2,3], which may occur due to opportunistic environmental conditions, strategies to terrorize, expel, or subjugate victims, and/or in settings where captives have been taken [4]
Using data derived from medical record reviews of sexual assault cases reporting to three health facilities located in the Rift Valley from 2007–2011, our objective was to identify whether the three-month post-election violence (PEV) time period was associated with systematic changes in sexual assault case characteristics using medical records from three healthcare facilities
Descriptive characteristics of the sample (Table 1) In total, 1,615 medical records were identified with sexual assault diagnoses, with 569 cases derived from Eldoret, 534 cases from Naivasha, 512 cases from Nakuru
Summary
Recent armed conflicts have demonstrated the high incidence of sexual violence in modern warfare [1,2,3], which may occur due to opportunistic environmental conditions, strategies to terrorize, expel, or subjugate victims, and/or in settings where captives have been taken [4]. Alterations in patterns of sexual assault during times of conflict may be indicative of, and/or characterize mass rape. Mean monthly prevalence in PEV monthsb Pc. Sexual Assault Time Series and Post-Election Violence in Kenya significant (p = .002) (Table 2), indicating that the PEV period was associated with a 22 percentage-point increase in cases where the survivor did not know the perpetrator. After adjusting for sex and lag between date of assault and presentation to the health facility, the Prais-Winsten estimate of the coefficient of the PEV period (beta = 0.20, SE = 0.06) was highly significant (p = 0.001) (Table 2), indicating that the PEV period was associated with a 20 percentage-point increase in cases where the survivor reported more than one perpetrator.
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