Hostname: page-component-78c5997874-xbtfd Total loading time: 0 Render date: 2024-11-19T08:48:01.489Z Has data issue: false hasContentIssue false
  • English
  • Français

Demographics and Care-Seeking Behaviors of Sexual Violence Survivors in South Kivu Province, Democratic Republic of Congo

Published online by Cambridge University Press:  08 April 2013

Susan A. Bartels ,
Jennifer A. Scott ,
Jennifer Leaning ,
Jocelyn T. Kelly ,
Nina R. Joyce ,
Denis Mukwege  and
Michael J. VanRooyen
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives: One of the most striking features of the ongoing conflict in the Democratic Republic of Congo (DRC) is the use of sexual violence. In spite of the brutality of these crimes, the experiences of women affected by sexual violence in Eastern DRC remain poorly characterized. This analysis aimed to (1) provide detailed demographics of sexual violence survivors presenting to Panzi Hospital; (2) examine how demographic factors might impact patterns of sexual violence; and (3) describe care-seeking behavior among sexual violence survivors.

Methods: The demographics and care-seeking behavior of sexual violence survivors in South Kivu Province were described from a retrospective registry-based study of sexual violence survivors presenting to Panzi Hospital (2004-2008).

Results: A total of 4311 records were reviewed. The mean age of survivors was 35 years. Most women (53%) were married, self-identified with the Bashi tribe (65%), and reported agriculture as their livelihood (74%). The mean time delay between sexual assault and seeking care was 10.4 months. Five reasons were identified to help explain the lengthy delays to seeking care: waiting for physical symptoms to develop or worsen before seeking medical attention, lack of means to access medical care, concerns that family would find out about the sexual assault, stigma surrounding sexual violence, and being abducted into sexual slavery for prolonged periods of time.

Conclusions: Many sexual assault survivors have very delayed presentations to medical attention. Promoting timely access of medical care may best be facilitated by reducing stigma and by educating women about the benefits of early medical care, even in the absence of injuries or symptoms.

(Disaster Med Public Health Preparedness. 2012;6:393-401)

Keywords

conflictDemocratic Republic of Congorapesexual violence
Type
Original Research
Information
Disaster Medicine and Public Health Preparedness , Volume 6 , Issue 4 , December 2012 , pp. 393 - 401
Copyright
Copyright © Society for Disaster Medicine and Public Health, Inc. 2012

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

1.International Rescue Committee, Burnet Institute. Mortality in the Democratic Republic of Congo: An Ongoing Crisis. Melbourne, Australia: Burnet Institute; 2007. http://www.rescue.org/sites/default/files/migrated/resources/2007/2006-7_congomortalitysurvey.pdf.Google Scholar
2.Maigua, P. Fresh Displacements Caused by Fighting in Eastern DRC. Geneva, Switzerland: United Nations Radio; 2009.Google Scholar
3.Amnesty International. Democratic Republic of Congo. Mass Rape: Time for Remedies. New York, NY: Amnesty International; 2004. http://www.amnesty.org/en/library/info/AFR62/018/2004.Google Scholar
4.Human Rights Watch. Seeking Justice: The Prosecution of Sexual Violence in Congo War. New York, NY: Human Rights Watch; March 2005. http://www.hrw.org/sites/default/files/reports/drc0305.pdf.Google Scholar
5.Human Rights Watch. Democratic Republic of the Congo: Confronting Impunity. New York, NY: Human Rights Watch; February 2, 2004. http://www.hrw.org/reports/2004/02/02/democratic-republic-congo-confronting-impunity.Google Scholar
6.Medecins Sans Frontieres. “I Have No Joy, No Peace of Mind” - Medical, Psychological and Socio-economic Consequences of Sexual Violence in Eastern DRC. Amsterdam, the Netherlands: Medecins Sans Frontieres; 2004. http://www.doctorswithoutborders.org/publications/reports/2004/sexualviolence_2004.pdf.Google Scholar
7.Wakabi, W. Sexual violence increasing in the Democratic Republic of Congo. Lancet.January 5, 2008;371.Google Scholar
8.Human Rights Watch. The War Within the War: Sexual Violence Against Women and Girls in Eastern Congo. New York, NY: Human Rights Watch; 2002. http://www.hrw.org/reports/2002/drc/Congo0602.pdf.Google Scholar
9.Steiner, BBenner, MTSondorp, ESchmitz, KPMesmer, URosenberger, S. Sexual violence in the protracted conflict of DRC programming for rape survivors in South Kivu. Confl Health. 2009;3:3.Google Scholar
10.Amnesty International. Democratic Republic of Congo; North Kivu: No End to War on Women and Children. New York, NY: Amnesty International; September 2008.Google Scholar
11.Kelly, JVanRooyen, MLeaning, JCragin, WHarvard Humanitarian Initiative. Characterizing Sexual Violence in the Democratic Republic of Congo: Profiles of Violence, Community Responses and Implication for the Protection of Women. Cambridge, MA: Harvard Humanitarian Initiative; August 2009.Google Scholar
12.Bartels, SVanRooyen, MLeaning, JScott, JKelly, J. Now, the World Is Without Me: An Investigation of Sexual Violence in Eastern Democratic Republic of Congo. Cambridge, MA: Harvard Humanitarian Initiative; April 2010.Google Scholar
13.Bartels, SScott, JLeaning, JMukwege, DLipton, RVanRooyen, M. Surviving sexual violence in Eastern Democratic Republic of Congo. J Int Women Studies. 2010;11(4):37–49.Google Scholar
14.Human Rights Watch. Soldiers Who Rape, Commanders Who Condone. New York, NY: Human Rights Watch; July 16, 2009.Google Scholar
15.Bartels, SAScott, JAMukwege, DLipton, RIVanrooyen, MJLeaning, J. Patterns of sexual violence in Eastern Democratic Republic of Congo: reports from survivors presenting to Panzi Hospital in 2006. Confl Health. 2010;4:9.CrossRefGoogle ScholarPubMed
16.Johnson, KScott, JRughita, B, et alAssociation of sexual violence and human rights violations with physical and mental health in territories of the Eastern Democratic Republic of the Congo. JAMA. 2010;304(5):553–562.Google Scholar
17.Gingerich, TLeaning, J. The Use of Rape as a Weapon of War in the Conflict in Darfur, Sudan. Washington, DC: US Agency for International Development/OTI; 2004:6–56.Google Scholar
18.Vinck, PPham, PNBaldo, SShigekane, R. Living With Fear: A Population Based Survey on Attitudes About Peace, Justice and Social Reconstruction in Eastern Democratic Republic of Congo. Berkeley, CA: Human Rights Center, University of California; August 2008. http://www.law.berkeley.edu/HRCweb/pdfs/LivingWithFear-DRC.pdf.Google Scholar
19.Oxfam America. Waking the Devil: The Impact of Forced Disarmanment On Civilians in the Kivus. Boston, MA: Oxfam America; July 2009. http://www.oxfamamerica.org/files/waking-the-devil.pdf.Google Scholar
20.International Crisis Group. Congo: Five Priorities for a Peacebuilding Strategy. New York, NY: International Crisis Group; May 11, 2009. Africa Report No. 150. http://www.crisisgroup.org/en/regions/africa/central-africa/dr-congo/150-congo-five-priorities-for-a-peacebuilding-strategy.aspx.Google Scholar
21.Panzi Hospital of Bukavu. Panzi Hospital website. www.panzihospital.org.Google Scholar
22.Workowski, KABerman, S, Centers for Disease Control and Prevention (CDC). Sexually transmitted diseases treatment guidelines, 2010. MMWR Recomm Rep. 2010;59(RR-12):1–110.Google Scholar
23.Bates, CK. Evaluation and management of adult sexual assault victims. In: Marx, J (ed). UpToDate. Waltham, MA: UpToDate; February 2011.Google Scholar
24.Smith, DGrohskopf, LBkack, RJD, AVeronese, FStruble, K, et alAntiretroviral postexposure prophylaxis after sexual, injection-drug use, or other nonoccupational exposure in the United States: recommendations from the U.S. Department of Health and Human Services. MMWR Recomm Rep. 2005;54(RR-2):13–20.Google ScholarPubMed
25.Linden, JA. Clinical practice. Care of the adult patient after sexual assault. N Engl J Med. 2011;365(9):834–841.CrossRefGoogle ScholarPubMed
26.Duroch, FMcRae, MGrais, RF. Description and consequences of sexual violence in Ituri province, Democratic Republic of Congo. BMC Int Health Hum Rights. 2011;11(5):5.Google Scholar
27.World Factbook CIA. The Democratic Republic of Congo. 2008 [cited December 5, 2008]. https://www.cia.gov/library/publications/the-world-factbook/print/cg.html.Google Scholar
28. Reseau des Femmes pour un Developpement Associatif, Reseau des Femmes pour la Defense des Droit et la Paix, International Alert. Women's bodies as a battleground: sexual violence against women and girls during the war in the Democratic Republic of Congo. 2005 [cited January 3, 2007]. http://www.international-alert.org/publications/getdata.php?doctype=Pdf&id=32.Google Scholar
29.Food and Agriculture Organization of the United Nations. Women, agriculture and rural development: a synthesis report of Africa. 2003 [cited September 1, 2009]. http://www.fao.org/docrep/X0250E/x0250e03.htm#TopOfPage.Google Scholar
30.Peterman, APalermo, TBredenkamp, C. Estimates and determinants of sexual violence against women in the Democratic Republic of Congo. Am J Public Health. 2011;101(6):1060–1067.Google Scholar
31.Nelson, BDCollins, LVanRooyen, MJJoyce, NMukwege, DBartels, S. Impact of sexual violence on children in the Eastern Democratic Republic of Congo. Med Confl Surviv. 2011;27(4):211–225.Google Scholar
32.Casey, SEGallagher, MCMakanda, BRMeyers, JLVinas, MCAustin, J. Care-seeking behavior by survivors of sexual assault in the Democratic Republic of the Congo. Am J Public Health. 2011;101(6):1054–1055.Google Scholar
33.Amowitz, LLReis, CLyons, KH, et alPrevalence of war-related sexual violence and other human rights abuses among internally displaced persons in Sierra Leone. JAMA. 2002;287(4):513–521.CrossRefGoogle ScholarPubMed
34.Chaudhry, SSangani, BOjwang, SBKhan, KS. Retrospective study of alleged sexual assault at the Aga Khan Hospital, Nairobi. East Afr Med J. 1995;72(3):200–202.Google Scholar