Widespread sexual violence, human rights abuses in DRC linked with physical, mental health outcomes

A recent survey of men and women in specific territories of Eastern Democratic Republic of the Congo found sexual violence and human rights violations were prevalent and were associated with physical and mental health outcomes, according to an article in the August 4 issue of JAMA, a theme issue on violence and human rights.

The Democratic Republic of the Congo (DRC, formerly Zaire) has experienced continued violence and civil conflict for more than a decade and is routinely listed as the site of one of the world's worst humanitarian crises. Studies from the Eastern Region of the DRC have provided anecdotal reports of sexual violence. But in many settings survivors of sexual violence resist speaking out for fear of social stigmatization.

Kirsten Johnson, M.D., M.P.H., of McGill University, Montreal, Canada, and colleagues conducted a cross-sectional, population-based cluster survey of 998 adults aged 18 years or older to assess the prevalence of and correlations with sexual violence and human rights violations on residents of specific territories of Eastern DRC. The survey was conducted over a four-week period in March 2010, using structured interviews and questionnaires focusing on basic needs, health care access, physical and mental health and other issues.

"The findings of this study indicate widespread sexual violence and human rights abuses in North and South Kivu and Ituri since the start of the conflict," the authors report.

"Rates of reported sexual violence were 39.7 percent among women and 23.6 percent among men," they write. "Women perpetrated reported conflict-related sexual violence in 41.1 percent of female cases and 10.0 percent of male cases."

The survey also found 67 percent of households reported conflict-related human rights abuses; 40.5 percent of the represented adult population met symptom criteria for major depressive disorder; and 50.1 percent met criteria for post-traumatic stress disorder.

"Sexual violence can have serious physical, social, and psychological consequences on the well-being of survivors, families, and communities," the authors write.

"The prevalence of sexual violence is significantly higher than previously reported in other conflict and post-conflict settings with associated poor mental outcomes as seen in other studies," they report. "Based on current population estimates in our sample area, 1.31 million women and 0.76 million men are survivors of sexual violence and need health services specific to sexual violence-related care."