title: Sexual violence trends between 2004 and 2008 in South Kivu, Democratic Republic of Congo.
abstract: BACKGROUND
  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.
authors.affiliation: Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts 02215, USA. sbartels@bidmc.harvard.edu
authors.forename: Susan A
authors.initials: SA
authors.lastname: Bartels
authors.forename: Jennifer A
authors.initials: JA
authors.lastname: Scott
authors.forename: Jennifer
authors.initials: J
authors.lastname: Leaning
authors.forename: Jocelyn T
authors.initials: JT
authors.lastname: Kelly
authors.forename: Denis
authors.initials: D
authors.lastname: Mukwege
authors.forename: Nina R
authors.initials: NR
authors.lastname: Joyce
authors.forename: Michael J
authors.initials: MJ
authors.lastname: VanRooyen
mesh_terms: D000328:Adult; D015023:Democratic Republic of the Congo / Q000453:epidemiology; D005260:Female; D006801:Humans; D008889:Military Personnel / Q000706:statistics & numerical data; D011902:Rape / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012742:Sex Offenses / Q000706:statistics & numerical data*; D014857:Warfare