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Abstract

Since 1996 a deadly conflict has been ongoing in the Democratic Republic of Congo (DRC). Within this conflict, sexual violence has been inflicted upon women as a strategic weapon of war. Given the challenges of working in this setting, this sexual violence epidemic has not been well studied. The current work is a retrospective chart review of women presenting to Panzi Hospital in 2006 requesting post-sexual violence care. The goals were to describe the demographics of sexual violence survivors and to define the physical and psychosocial consequences of sexual violence in Eastern DRC. A total of 1021 patient medical records were reviewed. The mean age was 36 years with an age range of 3.5 years to 80 years. Approximately 90% of sexual violence survivors were either illiterate or had attended only primary school. There were significant delays between the incidents of sexual violence and presentation to Panzi hospital (mean = 16 months, median = 11 months). Physical consequences reported following sexual violence included pelvic pain (22% of women), lumbar pain (11%), abdominal pain (7%) and pregnancy (6%). Thirty six percent of women reported being concerned about their health and sexually transmitted infections (STIs) plus HIV/AIDS were the most commonly singled out health concerns. Six percent of women reported that their husbands had abandoned them after the rape and abandonment was more common after gang rape or if the sexual violence resulted in pregnancy. Treatment programs for survivors of sexual violence must specifically address the economic hardships faced by victims must meet their time-sensitive medical needs and must provide them with psychological care.

Note on the Author

Susan Bartels MD, MPH Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA. Dr. Bartels is an emergency room physician with fellowship training in International Health (Brigham & Women’s Hospital) and a Masters of Public Health degree (Harvard School of Public Health). She is currently an Attending Physician at Beth Israel Deaconess Medical Center and an Instructor at Harvard Medical School. Her international and public health work are currently focused on sexual violence as a weapon of war and women’s health. She has worked in the Ethiopia, Democratic Republic of Congo, Tanzania, Kenya and Chad.

Jennifer Scott MD, MBA, Harvard Humanitarian Initiative, Cambridge, MA. Dr. Scott received a joint MD/MBA degree from the University of Colorado. She completed her residency training in Obstetrics and Gynecology at Beth Israel Deaconess Medical Center in Boston, Massachusetts. She is currently involved in a two-year Global Women’s Health Fellowship at Brigham and Women’s Hospital and is pursuing a Master of Public Health degree at Harvard School of Public Health. Her professional interests include reproductive health access, program development, and outcomes research in resource-limited settings.

Jennifer Leaning MD, SMH Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, MA. Dr. Leaning is Director of the François-Xavier Bagnoud Center for Health and Human Rights and a Professor of the Practice of Global Health at the Harvard School of Public Health. She has field experience in public health assessments and human rights in a range of crisis situations (including Afghanistan, Albania, Angola, Kosovo, the Middle East, Somalia, the Chad-Darfur border, and the African Great Lakes area) and has written widely on these issues.

Denis Mukwege PhD, Hôpital de Panzi, Bukavu, South Kivu, Democratic Republic of Congo. Dr. Mukwege is the Medical Director of Panzi Hospital in Bukavu, South Kivu Province, Democratic Republic of Congo. He is also a practicing Obstetrician / Gynecologist. Throughout his work during the conflict in Eastern DRC, Dr. Mukwege has become known as an expert in the care of sexual violence survivors, particularly in the surgical management of fistulas and pelvic trauma. Dr. Mukwege has received both the “African of the Year” award and the prestigious UN “Humanitarian Award in the Field of Human Rights.”

Robert Lipton MD – Harvard School of Public Health, Boston, MA Dr. Lipton has extensive training and experience in epidemiology, particularly spatial, social and psychiatric epidemiology. He is the Director of research in Emergency Medicine at Beth Israel Deaconess Medical Center in Boston where he oversees and assists with a wide variety of research topics. Further, he has conducted research in international settings, including the Philippines and Norway.

Michael VanRooyen MD, MPH - Department of Emergency Medicine, Brigham and Women’s Hospital, Boston, MA. Dr. VanRooyen is the Director for the Division of International Health and Humanitarian Program at Brigham and Women’s Hospital as well as an Associate Professor at the Harvard Medical School. He is also Director of the Harvard Humanitarian Initiative. Dr. Vanrooyen has worked extensively in humanitarian assistance in Somalia, Bosnia, Rwanda, Iraq, North Korea, Darfur-Chad and the Democratic Republic of Congo, both as a physician and a policy advisor with numerous relief organizations, including CARE, Save the Children, and Physicians for Human Rights.

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