Survivors Of Sexual And Gender-based Violence Research Articles

Encounters with kindness: everyday and extraordinary kind interventions in the lives of forced migrant survivors of SGBV

ABSTRACT While much attention is given to understanding the nature of the sexual and gender-based violence (SGBV) encountered by forced migrants, far less focus is placed on the actions and experiences that enable them to cope with violence. In this paper, we adopt a novel perspective examining forced migrants’ accounts of kind encounters with strangers who are not obligated to offer assistance. We draw on 166 semi-structured interviews with forced migrant SGBV survivors to examine the nature of kind encounters, the contexts in which they occur, and their reported outcomes. Our analysis reveals that kind encounters manifest across forced migration journeys and range from the extraordinary to the everyday. Kind encounters offer vital help and support and can connect people across cleavages while fostering resistance against degrading heteropatriarchal and bordering practices. The significance that respondents attach to such encounters underscores gaps in humanitarian protection and the normalization of cruelty towards forced migrants. We argue that kind encounters are inherently micropolitical, influencing social relations, and confronting gendered and racialized hierarchies. By uncovering the importance of kind encounters, we present a fresh perspective on the experiences of SGBV in forced migration with much potential in the study of migration.

Can reproductive health services be used to screen for sexual and gender-based violence in post-conflict Northern Uganda? – a pilot study

Background: Sexual and gender-based violence (SGBV), including rape and child sexual abuse, remains a significant challengein post-conflict northern Uganda. Many victims have never sought help. Consequently, the scale of the problem is not known,and SGBV victims’ injuries, both psychological and physical, remain hidden and unresolved. Objectives: We aimed to explore whether health workers in rural Reproductive Health Services (RHS), following specific training,could provide a valuable resource for SGBV screening and subsequent referral to targeted services. Methods: Our project had three elements. First, RHS workers were trained to use a questionnaire to screen subjects for pastSGBV. Second, the screening questionnaire was used by RHS workers over a 3-month period, and the data collected were analysedto explore whether the screening approach was an effective one in this setting, and to record the scale and nature of theproblem. Third, victims detected were offered referral as appropriate to hospital services or to a dedicated SGBV ActionAidshelter. Results: Of 1656 women screened, 778 (47%) had suffered SGBV: 123 rape, and 505 non-sexual violence. 1,254 (76%) had beendirectly or indirectly affected by conflict experiences; 1066 had lived in internally displaced persons camps. 145 (9%) requestedreferral to Gulu SGBV Shelter; 25 attended the shelter and received assistance, and 20 others received telephone counselling. Conclusion: Undetected SGBV remains a significant problem in post-conflict northern Uganda. RHS workers, following specifictraining, can effectively screen for and identify otherwise unrecognised survivors of SGBV. This matters because withoutongoing detection, survivors have no opportunity for resolution, healing or help. Keywords: SGBV; resource-poor setting; Screening.

Viable justice: survivors of sexual and gender-based violence and/or torture amongst South Sudanese refugees living in settlements in Northern Uganda

PurposeThe study aimed to listen to refugee survivors of sexual and gender-based violence (SGBV) and/or torture and explore what justice meant to them in exile. This study argues that what the survivors who participated in this research wanted was “viable justice”. The research was funded by the British Academy and Leverhulme Trust.Design/methodology/approachUsing a survivor-focussed justice lens combined with a trauma-informed approach, narrative interviews were held with 41 women and 20 men refugee survivors living in refugee settlements in Northern Uganda. The researchers also conducted semi-structured interviews with 37 key informants including refugee welfare councils, the UN, civil society, non-government and government organisations. Thematic analysis of the data resulted in the following themes being identified: no hope of formal justice for atrocities that occurred in South Sudan; insecurity; lack of confidence in transitional justice processes in Ugandan refugee settlements; abuse and loss of freedom in refugee settlements; and lack of access to health and justice services in refugee settlements.FindingsThis study argues that what the survivors who participated in this research wanted was “viable justice”. That is justice that is survivor-centred and includes elements of traditional and transitional justice, underpinned by social justice. By including the voices of both men and women survivors of SGBV and/or torture and getting the views of service providers and other stakeholders, this paper offers an alternative form of justice to the internationally accepted types of justice, which offer little relevance or restitution to refugees, particularly where the crime has been committed in a different country and where there is little chance that perpetrators will be prosecuted in a formal court of law.Research limitations/implicationsThe research findings are based on a small sample of South Sudanese refugees living in three refugee settlements in Northern Uganda. Thus, wider conclusions should not be drawn. However, the research does suggest that a “viable justice” approach should be implemented that is gender and culturally sensitive and which could also be trialled in different refugee contexts.Practical implicationsImprovements in refugee survivors’ dignity, resilience and recovery are dependent upon the active engagement of refugees themselves using a “survivor-focussed approach” which combines formal and community-based health services with traditional and transitional justice responses.Social implicationsThe provision of a “viable justice approach” ensures those who have experienced SGBV and/or torture, and their families, feel validated. It will assist them to use their internal, cultural and traditional resilience and agency in the process of recovery.Originality/valueThe research findings are original in that data was collected from men and women survivors of SGBV and/or torture and service providers. The empirical evidence supports this study’s recommendation for an approach that combines both formal and survivor-focussed approaches towards health and viable justice services to meet the needs of refugees living in refugee settlements. This is a response that listens to and responds to the needs of refugee survivors in a way that continues to build their resilience and agency and restores their dignity.

Health Providers' Response to Female Adolescent Survivors of Sexual and Gender-Based Violence and Demand Side Barriers in the Utilization of Support Services in Urban Low-Income Communities of Nigeria.

Survivors of sexual and gender-based violence (SGBV) are often hindered in their quest to access quality healthcare. This has a significant effect towards the achievement of Sustainable Development Goal SDG Target 3.7. to ensure universal access to sexual and reproductive healthcare services. This study is focused on identifying some of the demand side barriers in accessing health care services, particularly among young girls who are survivors of SGBV within intimate relationships in poor urban areas in Nigeria. The study used an ethnographic approach to solicit information from health providers, adolescents, and young women (AYW) in 10 low-income communities in two major cities in Nigeria, Ibadan and Lagos. Findings showed that there are structural limitations within the primary health care (PHC) system that posed a great challenge for survivors of SGBV to access services. Some of these include non-existing counseling services, a lack of rehabilitation centers, poor referral, and a lack of training for health providers in handling survivors of SGBV. There is also a lack of skills among health service providers that have negative influence on support services to survivors of SGBV. On the demand side, poor knowledge of possible health seeking pathways, a lack of education, and social support are barriers to accessing appropriate services among adolescent and young SGBV survivors. The study concluded that integrated services at the PHC level should include adequate and timely treatment for survivors of SGBV and targeted intervention to upscale skills and knowledge of health care providers.

Health professionals’ perspectives on the impact of COVID-19 on sexual and gender-based violence (SGBV) and SGBV services in Rohingya refugee communities in Bangladesh

BackgroundThe COVID-19 pandemic has acutely affected Rohingya refugees living in camps in Cox’s Bazar, Bangladesh. Reported increases in sexual and gender-based violence (SGBV) were attributed in part to pandemic-related public health measures. In addition, the Government of Bangladesh’s restrictions to prevent the spread of COVID-19 have impacted the provision of comprehensive care for survivors of sexual violence. This study sought to understand how the COVID-19 pandemic affected SGBV and the provision of services for Rohingya survivors in Bangladesh.MethodsInterviews were conducted with 13 professionals who provided or managed health care or related services for Rohingya refugees after the onset of the COVID-19 pandemic in March 2020.ResultsAt the outset of the COVID-19 pandemic, organizations observed an increase in the incidences of SGBV. However, health care workers noted that the overall number of survivors formally reporting or accessing services decreased. The pandemic produced multiple challenges that affected health workers’ ability to provide essential care and services to Rohingya survivors, including access to the camps, initial designation of SGBV-related services as non-essential, communications and telehealth, difficulty maintaining confidentiality, and donor pressure. Some emerging best practices were also reported, including engaging Rohingya volunteers to continue services and adapting programming modalities and content to the COVID-19 context.ConclusionsComprehensive SGBV services being deemed non-essential by the Government of Bangladesh was a key barrier to providing services to Rohingya survivors. Government restrictions adversely affected the ability of service providers to ensure that comprehensive SGBV care and services were available and accessible. The Government of Bangladesh has not been alone in struggling to balance the needs of displaced populations with the necessary precautions to prevent the spread of COVID-19 and its response can provide lessons to others overseeing the provision of services during epidemics and pandemics in other humanitarian settings. The designation of comprehensive services for survivors of SGBV as essential is vital and should be done early in establishing disease prevention and mitigation strategies.

Reporting of sexual and gender-based violence and associated factors among survivors in Mayuge, Uganda.

Reporting of Sexual and Gender-Based Violence (SGBV) allows survivors to access support services to minimize the impact of the violence on their lives. However, research shows that most SGBV survivors do not report. We aimed to determine the proportion of survivors of SGBV in Mayuge District, Uganda, who report SGBV and the factors associated with reporting. Using a cross-sectional study design, we analyzed data of SGBV survivors in eight villages in Mayuge district collected in a baseline survey of a larger experimental study. Data were analysed using Modified Poisson Regression. Of the 723 participants, 65% were female. Only 31.9% had reported the SGBV experienced. Reporting was 43% lower among survivors aged 45 years and older (p-value = 0.003), and 41% lower among survivors with higher than a primary school education (p-value = 0.005). Likewise, reporting was 37% lower among survivors who relied on financial support from their partners (p-value = 0.001). Female survivors were also 63% more likely to report (p-value = 0.001), while survivors who were separated/widowed were 185% more likely to report than those who were never married (p-value = 0.006). Reporting of SGBV by survivors in Mayuge was found to below.

The potential role of network-oriented interventions for survivors of sexual and gender-based violence among asylum seekers in Belgium

BackgroundSocial support and social network members have been identified as an important factor in mitigating the effects of sexual and gender-based violence (SGBV) and improving the coping process for many survivors. Network oriented strategies have been advocated for among domestic violence survivors, as they help build on improving social support and addressing factors that alleviate repeat victimization. There are opportunities to implement such strategies among asylum seekers who are survivors of SGBV in asylum centres, however, this has not been fully explored. This study sought to identify key strategies and opportunities for developing peer-led and network-oriented strategies for mitigating the effects of SGBV among asylum seekers at these centres.MethodsTwenty-seven interviews, were conducted with service providers (n = 14) / asylum seekers (n = 13) at three asylum centres in Belgium. A theoretical model developed by the research team from a literature review and discussions with experts and stakeholders, was used as a theoretical framework to analyse the data. An abduction approach with qualitative content analysis was used by the two researchers to analyse the data. Data triangulation was done with findings from observations at these centres over a period of a year.ResultsMany of the asylum seekers presented with PTSD or psychosomatic symptoms, because of different forms of SGBV, including intimate partner violence, or other trauma experienced during migration. Peer and family support were very influential in mitigating the effects and social costs of violence among the asylum seekers by providing emotional and material support. Social assistants were viewed as an information resource that was essential for most of the asylum seekers. Peer-peer support was identified as a potential tool for mitigating the effects of SGBV.ConclusionInterventions involving asylum seekers and members of their network (especially peers), have the potential for improving physical and mental health outcomes of asylum seekers who are SGBV survivors.

Sexual and gender-based violence and torture experiences of Sudanese refugees in Northern Uganda: health and justice responses

Purpose This British Academy/Leverhulme-funded research (Grant number: SG170394) investigated the experiences and impact of sexual and gender-based violence (SGBV) and torture on South Sudanese refugees’ health and rights and the responses of health and justice services in Northern Uganda. Design/methodology/approach It involved thematic analysis of the narratives of 20 men and 41 women refugees’ survivors of SGBV and torture; this included their experiences in South Sudan, their journeys to Uganda and experiences in refugee settlements. In total, 37 key stakeholders including health and justice providers, police, non-government and government organisations were also interviewed regarding their experiences of providing services to refugees. Findings All refugees had survived human rights abuses carried out in South Sudan, on route to Uganda and within Uganda. Incidents of violence, SGBV, torture and other human rights abuses declined significantly for men in Uganda, but women reported SGBV incidents. The research demonstrates linkages between the physical, psychological, social/cultural and justice/human rights impact on women and men refugees, which amplified the impact of their experiences. There was limited screening, physical and psychological health and support services; including livelihoods and education. Refugees remained concerned about violence and SGBV in the refugee settlements. While they all knew of the reporting system for such incidents, they questioned the effectiveness of the process. For this reason, women opted for family reconciliation rather than reporting domestic violence or SGBV to the authorities. Men found it hard to report incidences due to high levels of stigma and shame. Research limitations/implications Refugees largely fled South Sudan to escape human rights abuses including, persecution, SGBV and torture. Their experiences resulted in physical, psychological, social-cultural and justice effects that received limited responses by health and justice services. An integrated approach to meeting refugees’ needs is required. Practical implications The authors make recommendations for integrated gender sensitive service provision for refugees including more systematic screening, assessment and treatment of SGBV and torture physical and emotional injuries combined with implementation of livelihoods and social enterprises. Social implications The research demonstrates that stigma and shame, particularly for male refugee survivors of SGBV and torture, impacts on ability to report these incidents and seek treatment. Increasing gender sensitivity of services to these issues, alongside provision of medical treatment for injuries, alongside improved informal justice processes, may assist to counteract shame and increase disclosure. Originality/value There is currently a lack of empirical investigation of this subject area, therefore this research makes a contribution to the subject of understanding refugees’ experiences of SGBV and torture, as well as their perceptions of service provision and response. This subject is strategically important due to the pressing need to develop integrated, gendered and culturally sensitive services that listen to the voices and draw on the expertise of refugees themselves while using their skills to inform improvements in service responses and policy.

Sexual and gender-based violence and HIV in South Africa: An HIV facility-based study.

South Africa (SA) is known to have high levels of sexual and gender-based violence (SGBV) and HIV. Studies that explore the intersections of the two phenomena tend to be done at sites that provide services for survivors of SGBV, but few have explored experiences of SGBV of individuals attending HIV testing and treatment health facilities. Although HIV voluntary counselling and testing (VCT) services are generally well practised at ensuring pre- and-post-test counselling, there is little evidence that SGBV is included in routine screening. There is therefore a gap in knowledge of the prevalence of SGBV among patient populations in HIV testing and treatment settings. To assess levels of SGBV in a patient population of an HIV facility in SA. This cross-sectional study used a screening tool and a longer in-depth questionnaire on the prevalence of SGBV. A random sample of VCT clients were screened. Prevalence questionnaires were administered to a convenience sample of patients attending treatment literacy classes. A total of 1 936 VCT clients completed the screening tool, of whom 2% reported forced sex without a condom or rape. Of the 436 patients who completed the in-depth prevalence questionnaire, 71% were women; 12% of women had been forced to have sex the last time that they had sexual intercourse. The lifetime prevalence of sexual violence was 14% and the lifetime prevalence of physical violence was 16%. Levels of SGBV are high among populations attending HIV testing and treatment facilities. Healthcare providers need to be able to identify SGBV and provide appropriate services to survivors of SGBV who are seen at HIV testing and treatment facilities.

South Sudanese Refugee Survivors of Sexual and Gender-Based Violence and Torture: Health and Justice Service Responses in Northern Uganda.

This British Academy/Leverhulme-funded research investigated the health and justice service responses to the needs of South Sudanese refugees living in refugee settlements in Northern Uganda who had been subjected to sexual and gender-based violence (SGBV) and torture. It involved the collection and thematic analysis of the narratives of 20 men and 41 women who were refugee survivors of SGBV and torture, including their experiences in South Sudan, their journeys to Uganda and experiences in refugee settlements, in particular their access to health and justice services. Thirty-seven key stakeholders including international, government, non-government organisations and civil society organisations were also interviewed regarding their experiences of providing health and justice services to refugees. All refugees had survived human rights abuses mainly carried out in South Sudan but some had also occurred on route to Uganda and within Uganda. Despite the significant impact of their experiences, the analysis indicated that there was limited service response in refugee settlements in Northern Uganda once the immediate humanitarian crisis ended. The thematic analysis indicated five main themes coming from the interviews. These included: the nature of refugee experiences of SGBV and torture, including domestic violence and child abduction and forced marriage; issues associated with service provision such as lack of adequate screening and under resourcing of health and justice services; a lack of gender sensitivity and specialist services, particularly for men; the sustained involvement of civil society organisations and local non-governmental organisations in providing counselling and offering emotional support and hope to survivors; and enhancing health and justice responses and services to improve refugee recovery, dignity and resilience. The authors recommend that integrated gendered and culturally sensitive service provision should be adopted, which brings together formal and informal health, justice services and survivor support programmes.

How women’s silence secures the peace: analysing sexual and gender-based violence in a low-intensity conflict

ABSTRACTMost studies of the gendered impact of conflict focus on sexual and gender-based violence (SGBV) atrocities committed in high-intensity conflict environments. In contrast, this article focuses on the patterns of SGBV in Mindanao, Philippines – an environment of protracted low-intensity conflict within a fragile state. We examine the current Mindanao peace process to highlight the disempowerment of survivors of SGBV, due in large part to the reporting constraints that affect those most likely to be targeted for sexual violence by rival groups, some of whom are closely associated with the peace process. By making visible the significant social, political-economic, and institutional barriers affecting the recognition and reporting of SGBV, we discuss how and why conflict-related SGBV continues in fragile and low-intensity conflict environments.

'Changing the World': The Africa Regional Sexual and Gender-Based Violence Network

Editorial The last thirty years have been characterized by tremendous growth in the number of existing health networks world-wide; yet, little is known about why such networks emerge, what their effects are, and their roles in the governance of health [1]. The ‘Africa Regional Sexual and Gender-Based Violence (SGBV) Network’ emerged in the East and Southern African region in 2006. Led and coordinated by the Population Council, this network materialized as a consequence of the landscape of SGBV work in the region. At the time, while discourse and initiatives related to SGBV prevention were not unheard of, far less attention was being given to programmatic response to the service needs of SGBV survivors. With initial funding from the Swedish-Norwegian Regional HIV and AIDS Team for Africa, Embassy of Sweden, Lusaka, Zambia, the Population Council identified a number of implementing partner organizations in East and Southern Africa to facilitate collective action around the issue of responding to the needs of SGBV survivors in the region. Since then, network partner organizations have continued to work on fostering a multisectoral response (centered on those who have already experienced SGBV) in their countries and beyond exploring what such a response means in low-resource settings, what it can mean, and what it should mean, given the constraints and realities. Each partner contributes toward the network by strengthening the capacities of the medical, legal, and/or justice sectors to care for survivors of SGBV, and by building an evidence base for SGBV programming. Partners develop, implement, and evaluate core elements of a multi-sectoral response model that incorporates the overlapping and complementary responsibilities of the health, police and justice, and social service sectors. The ethos of the Africa Regional SGBV Network centers on the conviction that survivors require access to all services, but that it may not be feasible, appropriate, or cost-effective to deliver all services in one location. Through their interventions over the years, network partners have not taken the conventional understanding of a multi-sectoral approach for granted, but have instead allowed other viewpoints and actions to emerge in regard to such an approach. Where necessary, partners have conceived programmatic response to survivors’ service needs differently, testing out innovative and, sometimes, daring approaches. On December 4, 2013, for the first time ever, the Africa Regional SGBV Network convened a meeting in Washington, DC, USA. The meeting commemorated the 16 Days of Activism Against Gender Violence and raised awareness of interventions for survivors of SGBV in low-resource contexts. The forum reflected a culmination of efforts from seven years of grounded research and practice-building in the field of SGBV, and brought together network partner organizations from Kenya, South Africa, Swaziland, and Zambia, in addition to policy, practitioner, and researcher audiences from the Washington, DC area. This volume of extended abstracts summarizes network partner presentations delivered during the meeting. The presentations centered on each partner’s interventions and main results, coupled with the effectiveness of partners’ endeavors in responding to the needs of survivors. The notion of ‘effectiveness’ as employed here draws on Shiffman’s [1] definition of the concept in regard to networks and their policy consequences. As he explains:

Sexual and gender-based violence.

Sexual and gender-based violence (SGBV) continues to be a pervasive problem for women, men and children around the world. Many survivors are understandably concerned about the potential health sequelae of being sexually assaulted, primarily about unwanted pregnancies and transmission of sexually transmitted infections (STIs), including the human immunodeficiency virus (HIV). There has been much emphasis on prompt referral to medical care, as it has been shown that post-exposure prophylaxis (PEP) for STIs and HIV as well as emergency contraception are significantly more likely to be effective if taken within the first 72 hours following the assault.1 Historically, provision of post-assault care has been challenging in developing countries such as Kenya.2 Survivors may not be aware of the benefits of early medical care, post-assault medical protocols may not be in widespread use, confidentially may be poorly maintained and the required medicines may not be available at local clinics. Furthermore, there are often significant delays to seeking medical care, far beyond the recommended 72 hours, thus rendering prophylactic medical interventions almost useless.3,4 The article by Buard et al. in this issue of Public Health Action on the characteristics, management and outcomes of survivors of gender-based violence in Nairobi, describes the successful implementation of a comprehensive medical program for survivors of SGBV.5 The demographics of the sexual violence survivors presenting to their program were similar to those described by other providers in Kenya.6 In the program by Buard et al., many of the barriers to high quality post-assault medical care were overcome. Because it was an urban setting, lengthy travel times to access medical care were not a problem and, in fact, almost three quarters of the survivors sought medical attention within the recommended 72 hours. Being open 24 h per day, 7 days per week was likely important in allowing survivors to access medical services promptly. Furthermore, the fact that the clinic was well established, having run for 5 consecutive years, likely contributed to it being well known within the community. Within the SGBV program offered by Buard et al., there was good uptake of HIV PEP, prophylactic antibiotics and emergency contraception, similar to reports by others.6 Although the attrition rates for subsequent hepatitis B and tetanus vaccination were high, they are within the realm of what might be expected given the setting and context. The authors make reasonable recommendations for addressing this high attrition, including digital tracking or reminders using mobile phones. Buard et al. are to be commended for the high quality medical services they are providing to survivors of SGBV in Nairobi, and their program should serve as a model for other programs in similar urban settings. In circumstances where a survivor has been violated (often by someone known to him/her) and in the context of a judicial system that often fails the survivor either by re-traumatization and/or by failure to bring the perpetrator to justice, it is important that the health care system do right by these individuals by offering the best possible protection for their current and future health.

Experiences of female survivors of sexual violence in eastern Democratic Republic of the Congo: a mixed-methods study.

BackgroundThe conflict in eastern Democratic Republic of the Congo (DRC) is the deadliest since World War II. Over a decade of fighting amongst an array of armed groups has resulted in extensive human rights abuses, particularly the widespread use of sexual violence against women.MethodsUsing a mixed-methods approach, we surveyed a non-random sample of 255 women attending a referral hospital and two local non-governmental organizations to characterize their experiences of sexual and gender-based violence (SGBV). We then conducted focus groups of 48 women survivors of SGBV to elaborate on survey findings. Quantitative and qualitative data underwent thematic and statistical analysis respectively.FindingsOf the women surveyed, 193 (75.7%) experienced rape. Twenty-nine percent of raped women were rejected by their families and 6% by their communities. Thirteen percent of women had a child from rape. Widowhood, husband abandonment, gang rape, and having a child from rape were significant risk factors for social rejection. Mixed methods findings show rape survivors were seen as "contaminated" with HIV, contributing to their isolation and over 95% could not access prophylactic care in time. Receiving support from their husbands after rape was protective against survivors' feelings of shame and social isolation.InterpretationRape results not only in physical and psychological trauma, but can destroy family and community structures. Women face significant obstacles in seeking services after rape. Interventions offering long-term solutions for hyper-vulnerable women are vital, but lacking; reintegration programs on SGBV for women, men, and communities are also needed.

Sexual and gender based violence against men in the Democratic Republic of Congo: effects on survivors, their families and the community

Media and service provider reports of sexual and gender based violence (SGBV) perpetrated against men in armed conflicts have increased. However, response to these reports has been limited, as existing evidence and programs have primarily focused on prevention and response to women and girl survivors of SGBV. This study aims to contribute to the evidence of SGBV experienced by males by advancing our understanding of the definition and characteristics of male SGBV and the overlap of health, social and economic consequences on the male survivor, his family and community in conflict and post-conflict settings. The qualitative study using purposive sampling was conducted from June–August 2010 in the South Kivu province of Eastern DRC, an area that has experienced over a decade of armed conflict. Semi structured individual interviews and focus group discussions were conducted with adult male survivors of SGBV, the survivors' wife and/or friend, health care and service providers, community members and leaders. This study found that SGBV against men, as for women, is multi-dimensional and has significant negative physical, mental, social and economic consequences for the male survivor and his family. SGBV perpetrated against men and boys is likely common within a conflict-affected region but often goes unreported by survivors and others due to cultural and social factors associated with sexual assaults, including survivor shame, fear of retaliation by perpetrators and stigma by community members. All key stakeholders in our study advocated for improvements and programs in several areas: (1) health care services, including capacity to identify survivors and increased access to clinical care and psychosocial support for male survivors; (2) economic development initiatives, including microfinance programs, for men and their families to assist them to regain their productive role in the family; (3) community awareness and education of SGBV against men to reduce stigma and discrimination and increase acceptance of survivors by family and larger community.

Impact of sexual violence on children in the Eastern Democratic Republic of Congo

The conflict in the Eastern Democratic Republic of Congo (DRC) has been particularly devastating for children and has been typified by high levels of sexual and gender-based violence (SGBV). In this study, we seek to characterize the patterns and impact of sexual violence on children in the Eastern DRC. Semi-structured questionnaires were administered among a convenience sample of women <18 years of age presenting for post-sexual-violence care at Panzi Hospital in South Kivu, DRC. Analysis included quantitative and qualitative methods to describe the characteristics of the violence, perpetrators, and survivors and to illuminate common themes within the narratives. A total of 389 survivors of SGBV under the age of 18 were interviewed between 2004 and 2008. These paediatric survivors were more likely than adult survivors to have experienced gang rape, been attacked by a civilian perpetrator, and been assaulted during the day. Survivor and perpetrator characteristics were further stratified by type of attack. Reports of violence perpetrated by civilians increased 39-fold while reports of violence perpetrated by armed combatants decreased by 70% between 2004 and 2008. Qualitative analysis of the narratives revealed common themes, such as physical signs and symptoms among SGBV survivors (23.9%), pregnancy resulting from rape (19.3%), perpetrators being brought to justice (18.3%), and neighbourhood men as perpetrators (17.7%). Children in the Eastern DRC continue to face significant threats of sexual violence. By understanding the patterns of this violence, local and international approaches could be more effectively implemented to protect these vulnerable children.

A Congolese–US participatory action research partnership to rebuild the lives of rape survivors and their families in eastern Democratic Republic of Congo

The Democratic Republic of Congo (DRC) remains an all-too-potent reminder of how war, human rights violations and their related health and economic impacts can devastate a society. The last decade has seen the use of rape as a weapon of war in the DRC, where rebels and soldiers subject women and girls to brutalising attacks, rape, torture and mutilation. Survivors of sexual and gender-based violence (SGBV) are often further traumatised by infections, disease, poverty, stigma and social isolation. Substantial evidence exists showing an association between social determinants (e.g., poverty, stress and trauma, stigma, lack of access to health care) and health; however, limited research has been conducted to elucidate these relationships or to develop and test interventions to change social determinants of health, especially in conflict and post-conflict settings such as the DRC. The purpose of this article is to present a Congolese–US community-academic research partnership to obtain evidence to develop and implement a sustainable intervention to begin to address the social determinants of health, including poverty and traumatic stress for survivors of SGBV and their families in the South Kivu province of eastern DRC.