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

Conflict and Health

M J VanRooyen⁵  R Lipton⁴  D Mukwege³  T S Betancourt²  J T Kelly¹ 

[1] Harvard Humanitarian Initiative, 14 Story Street, 2nd Floor, Cambridge, MA 02138, USA;Harvard School of Public Health, François-Xavier Bagnoud Center for Health and Human Rights, 651 Huntington Avenue, Boston, MA 02115, USA;Hôpital de Panzi, Bukavu, 8e CEPAC V/C, South Kivu, Democratic Republic of the Congo;Department of Emergency Medicine, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA 02215, USA;Department of Emergency Medicine, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, USA

关键词: sexual violence;    rape;    Panzi Hospital;    Democratic Republic of the Congo;    conflict;   

Others  :  810520
DOI  :  10.1186/1752-1505-5-25

 received in 2011-05-19, accepted in 2011-11-02,  发布年份 2011

【 摘 要 】

Background

The 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.

Methods

Using 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.

Findings

Of 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.

Interpretation

Rape 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.

【 授权许可】

   
2011 Kelly et al; licensee BioMed Central Ltd.

【 参考文献 】

• [1]WHO: [http://www.who.int/whr/2000/en/] webciteThe world health report 2000. Health systems: improving performance. Geneva: WHO; 2000.
• [2]Oxfam GB, Save the Children, Christian Aid: No End in Sight: The Human Tragedy of the Conflict in the Democratic Republic of Congo. London: Oxfam GB, Save the Children, Christian Aid; 2001.
• [3]WHO: Country Profile: DRC. Geneva: WHO; 2002.
• [4]International Rescue Committee: [http://www.theirc.org/resources/2007/2006-7_congomortalitysurvey.pdf] webciteMortality in the Democratic Republic of Congo, an on going crisis. New York: International Rescue Committee; 2008.
• [5]International Crisis Group: [http:/ / www.crisisgroup.org/ ~/ media/ Files/ africa/ central-africa/ dr-congo/ Congos%20Elections%20Making%20or%20 Breaking%20the%20Peace.pdf] webciteAfrica Report N°108. Congo's Elections: Making or Breaking the Peace. Brussels: International Crisis Group; 2006.
• [6]Report of the Secretary-General Pursuant to Security Council resolution 1820. S/2009/362 [http:/ / daccess-dds-ny.un.org/ doc/ UNDOC/ GEN/ N09/ 405/ 56/ PDF/ N0940556.pdf?OpenElement ] webcite
• [7]Human Rights Watch: [http://www.hrw.org/legacy/reports/2002/drc/Congo0602.pdf] webciteThe War Within the War: Sexual Violence Against Women and Girls in Eastern Congo. New York: Human Rights Watch; 2002.
• [8]Grignon F: Rape as a Weapon of War in Congo. Spiegel International; 2009.
• [9]Report of the International Parliamentary-expert mission addressing impunity for sexual crimes the Democratic Republic of the Congo [http:/ / www.humanrights.se/ upload/ files/ 2/ Rapporter%20och%20seminariedok/ 080916%20DRCReport.pdf] webcite 2008.
• [10]International Crisis Group: [http:/ / www.crisisgroup.org/ ~/ media/ Files/ africa/ central-africa/ dr-congo/ Congo%20Five%20Priorities%20for%20a %20Peacebuilding%20Strategy.pdf] webciteAfrica Report N°150. Congo: Five Priorities for a Peacebuilding Strategy. Brussels: International Crisis Group; 2009.
• [11]United Nations Population Fund: [http://www.unfpa.org/public/News/pid/2181] webciteSecretary-General Calls Attention to Scourge of Sexual Violence in DRC. New York: United National Population Fund; 2009.
• [12]Human Rights Watch: [http://www.hrw.org/sites/default/files/related_material/drc_0.pdf] webciteCountry Summary: Democratic Republic of Congo. New York: Human Rights Watch; 2011.
• [13]Peterman A, Palermo T, Bredenkamp C: Estimates and Determinants of Sexual Violence Against Women in the Democratic Republic of Congo. American Journal of Public Health 2011, 101(6):1060-1067.
• [14]Johnson K, Scott J, Rughita B, Kisielewski M, Asher J, Ong R, Lawry L: Association of Sexual Violence and Human Rights Violations With Physical and Mental Health in Territories of the Eastern Democratic Republic of Congo. JAMA 2010, 304(5):553-562.
• [15]Swiss S, Jennings P, Aryee G, Brown G, Jappah-Samukai R, Kamara M, Schaack R, Turay-Kanneh R: Violence Against Women During the Liberian Civil Conflict. JAMA 1998, 279(8):625-629.
• [16]Igreja V, Kleijn W, Richters A: "When the war was over, little change..." Women's Posttraumatic Suffering after the War in Mozambique. J Nerv Ment Dis 2006, 194:502-509.
• [17]Steiner B, Benner M, Sondorp E, Schmitz P, Mesmer U, Rosenberger S: Sexual violence in the protracted conflict of DRC: Programming for rape survivors in South Kivu. [http://www.conflictandhealth.com/content/3/1/3] webciteConflict and Health 2009., 3(3)
• [18]Strauss A, Corbin J: Basics of Qualitative Research. Newbury Park: Sage; 1990.
• [19]Bernard HR: Social research methods: qualitative and quantitative approaches. California: Sage; 2000.
• [20]Résau des Femmes pour un Développement Associatif (RFDA), Réseau des Femmes pour la Défense des Droits et la Paix (RFDP) and International Alert: [http://www.grandslacs.net/doc/4053.pdf] webciteWomen's Bodies as a Battleground: Sexual Violence Against Women and Girls During the War in the Democratic Republic of Congo. Bukavu/London: Résau des Femmes pour un Développement Associatif/International Alert; 2005. Accessed 12 October 2009
• [21]Medecins Sans Frontiers: [http:/ / www.doctorswithoutborders.org/ publications/ reports/ 2004/ sexualviolence_2004.pdf ] webciteI have no Joy, No Peace of Mind: Medical, Psychosocial and Socio-Economic Consequences of Sexual Violence in Eastern DRC. Geneva: Medecins Sans Frontiers; 2004. Accessed 12 October 2009
• [22]Physicians for Human Rights, with the Support of the United Nations Assistance Mission in Sierra Leone: [http:/ / physiciansforhumanrights.org/ library/ reports/ war-related-sexual-violence-sierra- leone-2002.html] webciteWar-Related Sexual Violence in Sierra Leone: A Population-Based Assessment. Cambridge, Mass.: Physicians for Human Rights; 2002. Accessed 12 October 2009
• [23]Trenholm JE, Olsson P, Ahlberg BM: Battles on women's bodies: War, rape and traumatization in eastern Democratic Republic of Congo. Global Public Health 2011., 6(2)