“Every day I tried to get a voucher for humanitarian aid, but I couldn’t. He saw me and said he could get me one if I came with him one evening. So I followed him,” says Gisèle* a survivor of sexual violence in Democratic Republic of Congo (DRC).
For hundreds of thousands of people who are displaced in DRC, survival is a daily struggle. In addition to the psychological impact of unrelenting conflict and fleeing their homes, many, especially women and girls, are exposed to sexual violence in and around displacement camps.
In 2023 alone, Doctors Without Borders/ Médecins Sans Frontières (MSF) teams helped treat more than 25,000 survivors of sexual violence across the country. That’s more than two every hour. Of the total, one in 10 survivors were minors.
The figures, presented in MSF’s retrospective report, We are calling for help, are by far the highest ever recorded by MSF in the country. The alarming numbers increased further in the first months of 2024.
Many people displaced by ongoing conflic in provinces in eastern DRC are exposed to sexual violence.
CATASTROPHIC SCALE OF SEXUAL VIOLENCE IN NORTH KIVU
Of the total number of survivors of sexual violence treated by MSF in 2023, more than 91 per cent are from North Kivu alone.
Since 2021, an unprecedented number of people in the province have been forced to flee due to clashes between the M23 group, the Congolese army and their respective allies. Many of them settled in and around Goma, in overcrowded camps with limited access to water, safe shelter and sanitation facilities.
As the weeks passed, MSF teams witnessed an increase in the number of survivors of sexual violence received in our facilities. Almost all of the patients we treated were women. Last year, the number of survivors of sexual violence treated by MSF in and around Goma increased starkly, with an average of 100 patients received per day during March 2024.
The testimonies of survivors illustrate women are not safe anywhere, whether they are collecting wood or water, working in the fields or sleeping in their shelters. Two thirds of them were attacked at gunpoint.
While the massive presence of armed men in and around displacement sites explains this catastrophic rise in sexual violence, the inadequacy of the humanitarian response and the inhumane living conditions in these sites further worsen the situation. Due to limited access to food, water and proper livelihood, many women have no choice but to go to neighbouring fields, where there are many armed men, to collect firewood to sell. The lack of sanitation and safe shelter also leaves them vulnerable to attack.
“Other women tell us that they prefer to go home [to their village of origin],
because at least they had their fields and they didn’t lack food, even though there
is still a war going on there.”
“Sometimes they are being told: ‘I’ll give you food if you sleep with me,’” says Daddy, an MSF midwife. “Other women tell us that they prefer to go home [to their village of origin], because at least they had their fields and they didn’t lack food, even though there is still a war going on there.”
The numbers do not fully convey the intensity of the crisis. Many women do not go to health facilities because they are unaware treatment is available or because they are afraid of being rejected by their families or communities because of the stigma.
“After I was attacked, my husband’s acquaintances advised him to abandon me. Now I live alone with my four children,” says Maria*, a young pregnant woman treated by MSF.
“On paper, there seem to be many programs to prevent and respond to the needs of survivors of sexual violence,” says Christopher Mambula, head of MSF’s programs in DRC. “But in displacement sites, our teams struggle every day to refer survivors who need help. The few programs that do exist are always too shortlived and grossly under resourced.”
URGENT CALLS FOR ACTION
Sexual violence is a major medical and humanitarian emergency in DRC. Based on the needs expressed by survivors and building on previous work to solve this long-standing crisis, MSF calls for three main areas of urgent action:
- All parties to the conflict should ensure respect for international humanitarian law.
- Living conditions in sites for people who are internally displaced must be improved.
- There must be specific investment in better medical, social, legal and psychological care for survivors of sexual violence.
It is critical for humanitarian actors and authorities to step up their efforts to improve living conditions and care for people in displacement camps and across the country.
*Names changed to protect identity.
A COMMUNITY OF SUPPORT AGAINST SEXUAL VIOLENCE
Year after year, Doctors Without Borders/Médecins Sans Frontières (MSF) witnesses firsthand the scale and impact of sexual violence in DRC, including in Salambabila. Many people face several barriers to care including lack of information, long travel distances and fear of stigma.
To break these barriers, MSF works with community members in Salambabila and organizes activities to raise awareness and share information on what to do in case of an assault.
“When I saw that the women of Salamabila and Kambambare were suffering a lot, I agreed to work with MSF and help women like me,” says Mama Hortense. “Initially, we met every Sunday to talk, raise awareness and socialize… We are mostly women, but even the men come to us when they have a problem.”
Some women stay back at the end of the session so they can speak with the MSF staff in confidence.
SOLIDARITY PART OF CARE
The women in this network are the first to take care of survivors. They help provide essential first aid and refer serious cases to MSF’s team at Salamabila regional hospital. At the hospital, a system is in place to facilitate access to medical care. Survivors use a password to request care discreetly.
“After that horrible night I was scared all the time,” says Mona*, a survivor. “It became very difficult for me to feed my children. But since Alice [MSF social worker] helped me, I sell coal and I am able to feed my family again.”
