Two years of relentless fighting in the Democratic Republic of Congo’s eastern regions, ignited by the resurgence of the M23 armed group, have forced 1.3 million people to flee their homes. After decades of conflict and instability since the DRC gained independence in 1960, more than six million people are now displaced in the country, according to the United Nations High Commissioner for Refugees.
On top of this, there is a dramatic surge in the number of victims of sexual violence admitted to clinics in the DRC, particularly around Goma in the North Kivu province. In 2023, Médecins Sans Frontières (MSF) helped treat 25,166 victims of sexual violence in collaboration with Congolese authorities – that’s two cases every hour. These harrowing figures likely represent only the tip of the iceberg in a devastating situation that calls for urgent mobilisation from all concerned actors.
Painful choices
In 2023, hundreds of thousands of people arrived exhausted at the gates of Goma and sought refuge in often unsanitary areas with almost no infrastructure, inadequate shelters, scarce food aid and limited access to healthcare. Insecurity was a constant threat, as was exploitation. Some 67 per cent of the victims treated by MSF reported being abused by armed men, mostly during daily activities essential for survival, such as looking for food, water or firewood.
A survey conducted by MSF last spring in four camps for internally displaced people found that more than one in ten women aged 20 to 44 reported having been raped in the previous months. Our teams have also witnessed an increase in gang rapes. Unwanted pregnancies are inevitable, as highlighted by Wivine, an MSF midwife: “One victim told us she had been held for months by armed men…She was sexually assaulted by several attackers and was seven months pregnant when she finally managed to flee.” The situation continues to worsen in 2024, with the number of patients treated for sexual violence steadily rising.
Amid the deprivation and violence, displaced women face a succession of painful choices, where trying to meet the basic needs of their families means exposure to exploitation or aggression. An economy of poverty has taken root, with those who wield the slightest amount of power – whether political, financial or military – imposing the terms of survival on the most vulnerable. For instance, sex is often demanded in exchange for food or for work in the fields, while bribes are extracted at military checkpoints.
‘In Ituri province, cases are hidden’
In the northeastern Ituri province, which has been the scene of clashes for about 20 years, sexual violence is equally widespread. Fear of reprisals and the risk of stigmatisation prevent victims from seeking care. Workshops bringing together several stakeholders have been held in the region to help highlight these dangers and other issues surrounding sexual assault cases.
An MSF health worker in Ituri shared: “The perpetrator is often someone close to the victim, such as a family member or a neighbour. There is sometimes a feeling of shame, leading to a strong tendency to conceal the assault.” In such a grim setting, few people dare to seek help from health centres, where confidentiality is hard to guarantee. A veil of silence also covers children born from sexual assaults as well as cases of sexual violence against men, which often go unreported.
A call for action
MSF urges all parties involved, both governmental and non-governmental, to invest in better medical, legal, psychological and social care for victims of sexual violence. This must be accompanied by sustainable funding that enables the strengthening of medical training for healthcare workers and the supply of appropriate therapeutic resources to care facilities.
A tragic consequence of these acts of violence is the rise in unwanted pregnancies, which should lead to easier access to safe abortion services.
Ultimately, high-quality medical and psychological care is crucial for these women who, despite the adversity, continue to provide for their families, often shouldering the burden of domestic responsibilities alone and who still hold on to the hope of a better future.
Published in Geneva Solutions
