Patterns of sexual violence in Eastern Democratic Republic of Congo: reports from survivors presenting to Panzi Hospital in 2006

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.

‘A Girl Who Gets Pregnant or Spends the Night with a Man is No Longer a Girl’: Forced Marriage in the Eastern Democratic Republic of Congo

“…Since abortion is a criminal offence in the Democratic Republic of Congo, and since adoption is rarely taken as an alternative in Congolese society, most pregnant survivors of sexual violence find themselves responsible for raising a child because of being recognized as a ''rape victim'' and ''mother'' hinder their chances of marrying (Bartels et al 2010). Girls are victims of unwanted pregnancy, because access to pregnancy contraception is unavailable or limited in many places (De Bruyn 2000).…”

Greentree White Paper: Sexual Violence, Genitoanal Injury, and HIV: Priorities for Research, Policy, and Practice

“…85,86 Poverty and desperation may force them to exchange sex for survival, to cross borders, or even for protection. The same conditions that increase the risk of sexual and gender-based violence can also facilitate the spread of HIV, including the use of rape as an instrument of war, genocide, and/or displacement and the breakdown of protective family and community structures.…”

War and the systematic devastation of women: the call for increased attention to traumatic gynaecological fistulae

“…A study conducted by Bartels et al (2010) found that there are certain patterns to SV in the DRC. Most attacks of SV occur in individual homes, at night, despite the presence of male spouses and/or other male relatives.…”

“…Abortion is illegal in the DRC and there are few family planning clinics. This either results in unsafe abortions or unwanted children, and girls as young as thirteen are left having to care and fend for infants in a society where men typically provide economic support (Bartels et al 2010).…”