Context Studies from the Eastern Region of the Democratic Republic of the Congo (DRC) have provided anecdotal reports of sexual violence. This study offers a populationbased assessment of the prevalence of sexual violence and human rights abuses in specific territories within Eastern DRC. Objective To assess the prevalence of and correlations with sexual violence and human rights violations on residents of specific territories of Eastern DRC including information on basic needs, health care access, and physical and mental health. Design, Setting, and Participants A cross-sectional, population-based, cluster survey of 998 adults aged 18 years or older using structured interviews and questionnaires, conducted over a 4-week period in March 2010. Main Outcome Measures Sexual violence prevalence and characteristics, symptoms of major depressive disorder (MDD) and posttraumatic stress disorder (PTSD), human rights abuses, and physical and mental health needs among Congolese adults in specific territories of Eastern DRC. Results Of the 1005 households surveyed 998 households participated, yielding a response rate of 98.9%. Rates of reported sexual violence were 39.7% (95% confidence interval [CI], 32.2%-47.2%; n=224/586) among women and 23.6% (95% CI, 17.3%-29.9%; n=107/399) among men. Women reported to have perpetrated conflict-related sexual violence in 41.1% (95% CI, 25.6%-56.6%; n=54/148) of female cases and 10.0% (95% CI, 1.5%-18.4%; n=8/66) of male cases. Sixty-seven percent (95% CI, 59.0%-74.5%; n=615/998) of households reported incidents of conflict-related human rights abuses. Fortyone percent (95% CI, 35.3%-45.8%; n=374/991) of the represented adult population met symptom criteria for MDD and 50.1% (95% CI, 43.8%-56.3%; n=470/989) for PTSD. Conclusion Self-reported sexual violence and other human rights violations were prevalent in specific territories of Eastern DRC and were associated with physical and mental health outcomes.

HE CONFLICT IN LIBERIA BEGAN in late 1989 when then−rebel leader Charles Taylor launched an incursion from neighboring Cote d'Ivoire. This conflict has been characterized by ethnic killings and massive abuses against the civilian population between 1989 and 1997 and again in 2003 and 2004. 1 Relative peace was established in 2004 and today, a fragile peace is maintained by the 15 000-strong United Nations Mission in Liberia troops 2 and a large international aid agency presence. The health, mental health, and psychosocial consequences of populations exposed to or forced into combat are well delineated. 3-7 Combatants are both participants in and victims of atrocities. They are forced to perpetrate brutal acts of violence including rape, torture, and murder while they are subjected to the same. 8 Often, female combatants are made to perform as sex and domestic slaves, while males' fate is combat. 9 Although in Liberia there are indications that females were forced into combat as well, and that males may have been used routinely for sexual purposes. 10-13 The use of males for sexual slavery is not well documented in the postconflict literature. The Disarmament, Demobilization, and Reintegration educational program of Liberia was meant to deliver health care, education, skills training, family Author Affiliations are listed at the end of this article.

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The number of people employed in international humanitarian care is growing at a yearly rate of 6%. The demand for better coordination, accountability, and training has led to a need for standardized humanitarian training programs for providers. Training should be based on comprehensive core competencies that providers must demonstrate in addition to their skill-specific competencies. This report explores the competencies specific to humanitarian training that are practice- and application-oriented, teachable, and measurable. Competency-based, standardized programs will be used to select humanitarian workers deployed in future crises and to guide the professionalization of this discipline.

clinicaltrials.gov Identifier: NCT01947283.