a1 Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts USA
a2 Harvard Humanitarian Initiative, Cambridge, Massachusetts USA
a3 Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, Massachusetts USA
a4 Harvard School of Public Health, Boston, Massachusetts USA
a5 Hôpital de Panzi, Bukavu, South Kivu, Democratic Republic of Congo
a6 Department of Emergency Medicine, Brigham and Women's Hospital, Boston, Massachusetts USA
Introduction: For more than a decade, conflict in the Eastern Democratic Republic of Congo (DRC) has been claiming lives. Within that conflict, sexual violence has been used by militia groups to intimidate and punish communities, and to control territory. This study aimed to: (1) investigate overall frequency in number of Eastern DRC sexual assaults from 2004 to 2008 inclusive; (2) determine if peaks in sexual violence coincide with known military campaigns in Eastern DRC; and (3) study the types of violence and types of perpetrators as a function of time.
Methods: This study was a retrospective, descriptive, registry-based evaluation of sexual violence survivors presenting to Panzi Hospital between 2004 and 2008.
Results: A total of 4,311 records were reviewed. Throughout the five-year study period, the highest number of reported sexual assaults occurred in 2004, with a steady decrease in the total number of incidents reported at Panzi Hospital from 2004 through 2008. The highest peak of reported sexual assaults coincided with a known militant attack on the city of Bukavu. A smaller sexual violence peak in April 2004 coincided with a known military clash near Bukavu. Over the five-year period, the number of sexual assaults reportedly perpetrated by armed combatants decreased by 77% (p = 0.086) and the number of assaults reportedly perpetrated by non-specified perpetrators decreased by 92% (p < 0.0001). At the same time, according to the hospital registry, the number of sexual assaults reportedly perpetrated by civilians increased 17-fold (p < 0.0001). This study was limited by its retrospective nature, by the inherent selection bias of studying only survivors presenting to Panzi Hospital, and by the use of a convenience sample within Panzi Hospital.
Conclusions: After years of military rape in South Kivu Province, civilian adoption of sexual violence may be a growing phenomenon. If this is the case, the social mechanisms that prevent sexual violence will have to be rebuilt and sexual violence laws will have to be fully enforced to bring all perpetrators to justice. Proper rehabilitation and reintegration of ex-combatants may also be an important step towards reducing civilian rape in Eastern DRC.
(Received November 02 2011)
(Accepted November 27 2011)
(Revised December 05 2011)
(Online publication March 20 2012)
Bartels SA, Scott JA, Leaning J, Kelly JT, Mukwege D, Joyce NR, VanRooyen MJ: Sexual violence trends between 2004 and 2008 in South Kivu, Democratic Republic of Congo. Prehosp Disaster Med 2012;26(6):408–413.