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One Size Fits All? Standardised Provision of Care for Survivors of Sexual Violence in Conflict and Post-Conflict Areas in the Democratic Republic of Congo

Author

Listed:
  • Jerlie Loko Roka
  • Rafael Van den Bergh
  • Sokhieng Au
  • Eva De Plecker
  • Rony Zachariah
  • Marcel Manzi
  • Vincent Lambert
  • Elias Abi-Aad
  • Kassi Nanan-N’Zeth
  • Serge Nzuya
  • Brigitte Omba
  • Charly Shako
  • Derick MuishaBaroki
  • Jean Paul Basimuoneye
  • Didier Amudiandroy Moke
  • Emmanuel Lampaert
  • Lucien Masangu
  • Anja De Weggheleire

Abstract

Background: Outcomes of sexual violence care programmes may vary according to the profile of survivors, type of violence suffered, and local context. Analysis of existing sexual violence care services could lead to their better adaptation to the local contexts. We therefore set out to compare the Médecins Sans Frontières sexual violence programmes in the Democratic Republic of Congo (DRC) in a zone of conflict (Masisi, North Kivu) and post-conflict (Niangara, Haut-Uélé). Methods: A retrospective descriptive cohort study, using routine programmatic data from the MSF sexual violence programmes in Masisi and Niangara, DRC, for 2012. Results: In Masisi, 491 survivors of sexual violence presented for care, compared to 180 in Niangara. Niangara saw predominantly sexual violence perpetrated by civilians who were known to the victim (48%) and directed against children and adolescents (median age 15 (IQR 13–17)), while sexual violence in Masisi was more directed towards adults (median age 26 (IQR 20–35)), and was characterised by marked brutality, with higher levels of gang rape, weapon use, and associated violence; perpetrated by the military (51%). Only 60% of the patients in Masisi and 32% of those in Niangara arrived for a consultation within the critical timeframe of 72 hours, when prophylaxis for HIV and sexually transmitted infections is most effective. Survivors were predominantly referred through community programmes. Treatment at first contact was typically efficient, with high (>95%) coverage rates of prophylaxes. However, follow-up was poor, with only 49% of all patients in Masisi and 61% in Niangara returning for follow-up, and consequently low rates of treatment and/or vaccination completion. Conclusion: This study has identified a number of weak and strong points in the sexual violence programmes of differing contexts, indicating gaps which need to be addressed, and strengths of both programmes that may contribute to future models of context-specific sexual violence programmes.

Suggested Citation

  • Jerlie Loko Roka & Rafael Van den Bergh & Sokhieng Au & Eva De Plecker & Rony Zachariah & Marcel Manzi & Vincent Lambert & Elias Abi-Aad & Kassi Nanan-N’Zeth & Serge Nzuya & Brigitte Omba & Charly Sha, 2014. "One Size Fits All? Standardised Provision of Care for Survivors of Sexual Violence in Conflict and Post-Conflict Areas in the Democratic Republic of Congo," PLOS ONE, Public Library of Science, vol. 9(10), pages 1-8, October.
    • Handle: RePEc:plo:pone00:0111096
    DOI: 10.1371/journal.pone.0111096
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    References listed on IDEAS

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    1. Jo Spangaro & Chinelo Adogu & Geetha Ranmuthugala & Gawaine Powell Davies & Léa Steinacker & Anthony Zwi, 2013. "What Evidence Exists for Initiatives to Reduce Risk and Incidence of Sexual Violence in Armed Conflict and Other Humanitarian Crises? A Systematic Review," PLOS ONE, Public Library of Science, vol. 8(5), pages 1-13, May.
    2. Peterman, A. & Palermo, T. & Bredenkamp, C., 2011. "Estimates and determinants of sexual violence against women in the Democratic Republic of Congo," American Journal of Public Health, American Public Health Association, vol. 101(6), pages 1060-1067.
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