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The Democratic Republic of the Congo, and the east of the country in particular, has been described as the "rape capital of the world" and the prevalence and intensity of all forms of sexual violence has been described as the worst in the world. Human Rights Watch defines sexual violence as “an act of a sexual nature by force, or by threat of force or coercion,” and rape as “a form of sexual violence during which the body of a person is invaded, resulting in penetration, however slight, of any part of the body of the victim, with a sexual organ, or of the anal or genital opening of the victim with any object or other part of the body.” Despite evidence on how pervasive sexual violence is in the DRC, the topic still remains a under-researched and under-resourced.

Historical background
Sexual violence has been prevalent in the Democratic Republic of the Congo historically. The Democratic Republic of the Congo has been ravaged by war, violence, and instability for decades, and this has lead to a culture of violence that often takes its form in a sexual nature.

The Republic of the Congo gained independence in 1960. The new president Mobutu renamed the country to Zaire and ruled the nation under an autocratic and corrupt regime. Under Mobutu's regime, sexual abuse was used as a method of torture.

After the 1994 Rwandan Genocide, many génocidaires fled across Rwanda's western border into the DRC in hopes of escaping censure. Hutu extremist militias were reformed across the border, particularly in Kivu, the DRC's easternmost city, bringing more crime and violence to the DRC. The Rwandan crisis and fighting in Burundi were catalysts for the First Congo War. This war occurred when the Alliance of Democratic Forces for the Liberation of Congo (AFDL), led by Laurent Kabila, launched a rebellion against the Mobutu regime in 1995 in the eastern part of the country.

Wilhelmine Ntakebuka, who coordinates a sexual violence program in Bukavu, believes: "The epidemic of rapes seems to have started in the mid-1990s. That coincides with the waves of Hutu militiamen who escaped into Congo’s forests after exterminating 800,000 Tutsis and moderate Hutus during Rwanda’s genocide 13 years ago. Mr. Holmes said that while government troops might have raped thousands of women, the most vicious attacks had been carried out by Hutu militias."

The Second Congo War officially ended in 2006 with the election of the first democratically elected president, Joseph Kabila, but there has been no end to violence. A major confrontation in 2007 between government forces and troops of Tutsi general Laurent Nkunda culminated in another major confrontation in the eastern province of Nord-Kivu. Recently, instability and violence have greatly increased since the mutiny of members of the Government of DRC and the creation of the rebel movement, M23, supported by the Government of Rwanda and individuals of the Government of Uganda. The UN accused M23 rebels of raping and killing civilians in eastern DRC in December 2012. Rumors of a military attack, including the rapes of 72 civilians, in the Minova area has been discussed but not verified in December of 2012.

Much of the continuing violence is a result of long-lasting animosity between the Tutsis, the Hutus, and other groups. Other factors of the continued violence are control of land, control of minerals, and economic tensions. Rape in the Democratic Republic of Congo has frequently been described as a "weapon of war," and the United Nations officially declared rape a weapon of war in 2008. War Rape makes a particularly effective weapon in genocide because not only does it destroy its physical victims, but entire communities as well. This long history of violence as lead to a culture of desensitization to violence, a lack of respect of international norms of human rights, and inadequate education which has lead to the high prevalence of sexual violence as a weapon of war.

Today, the Democratic Republic of the Congo, particularly the eastern region of the country, is known as the rape capital of the world. While "the law specifically prohibits and provides penalties of 10 to 20 years' imprisonment for child and forced prostitution, pimping, and trafficking for sexual exploitation....There were no reported investigations or prosecutions of traffickers during the year [2007]." There is no law against spousal sexual assault.

Rape of women
It is said that rape is simply a fact of life in the DRC. As Noel Rwabirinba, a sixteen-year-old who had been a militiaman for two years said, “If we see girls, it’s our right…we can violate them” This casual statement reflects a generally callous attitude towards the female sex as well as the normalization of rape in the DRC. Because of conflicts, between 60 and 90 percent of women are single heads of households. This puts many burdens upon them, such as having to travel long distances to find resources, leaving them vulnerable to violence.

In October 2004 the human rights group Amnesty International said that 40,000 cases of rape had been reported over the previous six years, the majority occurring in South Kivu. This is an incomplete count, as the humanitarian and international organizations compiling the figures do not have access to much of the conflict area; only women who have reported for treatment are included. It is estimated that there are as many as 400,000 surviving rape victims living in the Democratic Republic of the Congo today.

According to research conducted by The Journal of the American Medical Association, 39.7% of women in the Eastern Region (North Kivu, South Kivu, and Province Orientale) of the DRC reported to have been exposed to sexual violence during their lifetime, most commonly taking its form in rape. Another study found that two in five women living in the eastern region have been the victims of sexual violence.

Rape, as related to the conflicts, is the most prevalent form of sexual violence in the country, particularly in the eastern region. However, civilians are also the perpetrators of rape. Furthermore, many assume that men always perpetrate conflict-related sexual violence against women, rape against women perpetrated by women also occurs. In the study conducted by the American Medical Association, of those who reported conflict-related sexual violence in Eastern Region of the DRC, 41.1% reported women as their perpetrators.

Rape of men
The rape of men is also common. More studies are coming out to show that both women and men are the victims and perpetrators of sexual violence in the DRC.

Research conducted by The Journal of the American Medical Association cites that 23.6% of men in the Eastern Region of the country have been exposed to sexual violence. And, a similar study conducted in 2010 found that 22% of men (as compared to 30% of women) in eastern Congo reported conflict-related sexual violence. A cross-sectional, population-based study found that one in four men living in the eastern region of the country have been the victims of sexual violence.

The prevalence of rape of men in the country is likely underreported due to extreme stigma attached to sexual abuse of males. Men who admit to being raped risk ostracism by their community and criminal prosecution, because they may be seen as homosexual, which is a crime in 38 African countries. Male victims are less likely to appear in court, and those who do are cast away in their villages and called "bush wives." According to Denise Siwatula, a programme officer at the Women’s Synergy for the Victims of Sexual Violence based in Kivus, many men are victims of sexual violence and they need different assistance than women who come to their center.

Sexual abuse of children
UNFPA reported that over 65% of victims during the past 15 years were children. The majority of this percentage was adolescent girls and roughly 10% of child victims are said to be under 10 years old. Many child soldiers, after being recruited from refugee camps, often are sexual abused.

Sexual violence perpetrated by minors also occurs, particularly among those involved with combatant forces. A previous child soldier of the Mai-Mai fighters’ movement, who fought to resist the Interahamwe from Rwanda who took refuge in the DRC after they fled from the Rwandan Patriotic Front, said that reasons that child soldiers and other combatants rape women include: witch doctors’ advice, drug use, long periods in bush, to gain sexual experience, punishment, revenge, and a weapon of war. Over 12 percent of children in the eastern part of the DRC do not reach their first birthday, tens of thousands of children have been recruited as child soldiers, and rape of girls and gender-based violence of minors is widespread.

Sexual violence related to trafficking of persons
The Democratic Republic of the Congo is a source and destination for trafficking for forced labor and forced prostitution, much of which is internal and perpetrated by armed groups in the eastern region of the DRC. The DRC is said to be the main regional source country, where women and children are trafficked to sex industries in western Europe, particularly Belgium, in very large numbers. Prostitution and forced prositution also occurs often in refugee camps in the country.

According to Tier Rating, the Government of the Democratic Republic of the Congo does not comply with minimum standards for efforts to eliminate this problem by prosecuting perpetrators and providing services to victims.

Domestic violence
The reintegration of combatants, circulation of arms, and post-traumatic stress in times during and after conflict has fostered an environment where domestic violence is extremely prevalent in the DRC. According to some studies, such as a reproductive study conducted by RHRC, 100 per cent of women in some areas reported to have experienced domestic violence. In a study conducted, intimate partner violence was reported by 31% of women and 17% of men.

Marital rape is not considered an offense in the DRC.

Other forms
The United Nations includes rape, public rapes, sexual slavery, forced prostitution, forced pregnancy, gang rape, forced incest, sexual mutilation, disemboweling, genital mutilation, cannibalism, deliberate spread of HIV/AIDS, and forced sterilization as other forms of sexual violence that occur in the DRC that are used as techniques in war against the civilian population.

Other forms of sexual savagery reported include: forcing of crude objects such as tree branches and bottles into the vagina, public rape in front of the family and community, forced rape between victims, the introduction of objects into the victims' cavities, pouring melted rubber into women's vaginas, shooting women in the vagina and inducing abortions using sharp objects.

Medical ramifications
The medical repercussions of the sexual assault in the DRC vary from severed and broken limbs, burned flesh, rectovaginal and vesicovaginal fistulas, STIs, pregnancy, and urinary incontinence to death. Adequate medical care for these injuries is very hard to come by, and many survivors remain ill or disfigured for the rest of their lives. These are all more severe the younger the victim is. Young girls who are not fully developed are more likely to suffer from obstructed birth, which can lead to fistulas or even death. On a young girl, a pelvis “[hasn’t] yet grown large enough to accommodate the baby’s head, a common occurrence with young teenagers…[these girls end] up in obstructed birth, with the baby stuck inside [their] birth passage[s]…[often, they can’t] walk or stand, a consequence of nerve damage that is a frequent by-product of fistulae.” At the Doctors on Call for Service/Heal Africa Hospital in Eastern DRC, 4,715 of the women reported having suffered sexual violence; 4,009 received medical treatment; 702 had a fistula, 63.4% being traumatic and 36.6% being obstretric.

Sexual assault has also contributed to the HIV rate. Before the conflict in 1997, only 5% of the population was HIV positive; by 2002, there was a 20% HIV positive rate in the eastern region. A study conducted found that sociocultural barriers and strict obedience to Vatican doctrine prevented adolescents from receiving condoms or comprehensive sex education, which contributes to the spread of HIV.

Psychological and social ramifications
There are also many psychological and social consequences to being the victim of sexual violence. Victims often suffer from Post-Traumatic Stress Disorder (PTSD), depression, and suicide. This can be particularly severe in cases in which men have been forced at gunpoint to sexually assault their daughters, sisters, or mothers. Psychological trauma after experiencing sexual violence can have a negative effect on sexual behavior and relationships, feelings about sex, ability to negotiate safer sex, and increased likelihood of drug abuse.

The most common social consequence for victims of sexual violence is isolation from their families and communities. Raped women are seen as impure, frequently leading to their being abandoned by their husbands or having trouble marrying. The most extreme versions of this stigmatization can lead to "honor killings" in which the victim of sexual violence is murdered by her family or community due to the belief that she has brought them shame and dishonor.

Young women and girls who are cast outside of their homes, or leave due to shame will most likely become even more vulnerable to further abuse.

Perpetrators
According to Human Rights Watch, while many of the perpetrators of sexual violence are Militia groups, some of whom have been known to kidnap women and girls and use them as sex slaves, the Congolese army, Forces Armées de la République Démocratique du Congo (FARDC), is the "single largest group of perpetrators." In 2007, the United Nations Organization Stabilization Mission in the Democratic Republic of the Congo (MONUSCO) reported that 54% of all recorded sexual violence cases in the first 6 months of that year were committed by FARDC soldiers. Some commanders have been purported to overlook sexual violence perpetrated by those under their command.

There are also incidents of rape involving the police, others in authority, civilians, and other opportunistic criminals. In June 2010, UK aid group Oxfam reported a dramatic increase in the number of rapes occurring in the Democratic Republic of the Congo. Contrary to MONUSCO's 2007 report, the study found that 38% of rapes were committed by civilians in 2008. Rapes by civilians are increasing, demonstrating that sexual violence is becoming even more widespread throughout the country. This is a particularly dramatic rise compared to the number of civilian-perpetrated rapes in 2004, which was less than 1%. Researchers from Harvard discovered that rapes committed by civilians had increased seventeenfold. Consistent with these studies is a statement from Dr. Margaret Agama, the DRC's United Nations Population Fund (UNFPA) representative: Initially, rape was used as a tool of war by all the belligerent forces involved in the country’s recent conflicts, but now sexual violence is unfortunately not only perpetrated by armed factions but also by ordinary people occupying positions of authority, neighbours, friends and family members.

Victim testimonies
In a 2008 V-Day and UNICEF global campaign, “Stop Raping Our Greatest Resource: Power to Women and Girls in DRC,” 12 women and 2 girls recounted their sexual abuse before an audience of government and UN officials as well as other international delegates and civil society members. One of the women, Lumo Furaha, testified: "Over 50 armed men took me and another woman to the bush where they raped us over and over again. After, they pulled us like goats to the main road where they left us abandoned.'"

Another woman, 50 year old Zamuda, described her attack: "The men did it with objects, it wasn’t from any physical desire. The only answer I have is that they wanted to destroy me; destroy my body and kill my spirit."

Jullienne Chakupewa, a rape counselor in Goma, a city on the DRC's eastern border with Rwanda had a similar sentiment when being interviewed by reporter Nicholas Kristof: All militias here rape women, to show their strength and to show your weakness.”

Another speaker at the 2008 V-Day and UNICEF event described her assault to the audience: "They kicked me roughly to the ground, and they ripped off all my clothes, and between the two of them, they held my feet. One took my left foot, one took my right, and the same with my arms, and between the two of them they proceeded to rape me. Then all five of them raped me."

The mother of a six year old named Augustine in Kindu describes her experience: "One afternoon when I was preparing the evening meal, Augustine – who loved to play with other children – left the house. Just fifteen minutes later a neighbour brought us shocking news that our little girl had been kidnapped by armed men…Finally, her father could not bear it and decided to go outside. It was our girl, lying on the ground, abandoned and exposed, naked as a frog… My daughter Augustine, only six years old, had been raped by grown men."

Claudine Mwabachizi, another survivor at the event described her experience of being kidnapped by bandits, tied to a tree in the forest and gang-raped. Later, she was forced to watch as her rapist disemboweled a pregnant woman in front of her.

Regional differences
The highest rates of rape against women occurred in the North Kivu province. The war-torn and mineral-rich areas in the eastern part of the country are those with the highest rates of sexual violence.

Recently, M23 controlled the territory in North Kivu, the city of Goma, and other areas of the Ruthuru region. Anthony Gambino, mission director for the Congo of the United States Agency for International Development, has also said that “shockingly high rape statistics are found in western Congo as well as northern and eastern Congo,” but that conflict-related rape is less prevalent in that area.

Preventative efforts
Increasing awareness regarding the problem of sexual violence in the DRC has led to both national and international efforts to prevent the continuation of the atrocities taking place.

Government policy
Sexual violence is a form of gender-based violence and gender discrimination (article 14); a cruel, degrading, and inhuman treatment (article 16); a crime against humanity (article 15); and a violation of an individual’s right to peace (article 52). Congolese law draws a distinction between rape and systematic rape, sexual violence being a crime against the state and systematic sexual violence as an international crime.

In 2006, the Palais du Peuple, the Congolese government, enacted sexual violence amendments to the 1940 Penal Code and the 1959 Penal Procedure Code. Part of these changes was criminalizing “insertion of an object into a woman’s vagina, sexual mutilation, and sexual slavery” as well as defining “any sexual relation with a minor as statutory rape.” The Congolese government's department, The Ministry of Gender, Family Affairs and Children, is dedicated to dealing with sexual violence within the nation.

International community and nongovernmental organizations
International human rights organizations began to document sexual violence in 2002.

In September 2009, following her visit to the DRC, U.S Secretary of State Hillary Clinton oversaw the adoption of the U.N Security Council Resolution 1888, which details specific efforts that must be taken to protect women from sexual violence in war-stricken regions, and measures taken to bring perpetrators to justice. Clinton has also urged the Congolese government to personally investigate members of FARDC who have committed crimes of sexual violence, and FARDC generals have declared that they will set up new military tribunals to prosecute soldiers accused of sexual violence. Additionally, she has supported a $17 million plan to combat the sexual violence in the DRC.

In addition, Eve Ensler's nongovernmental organization, V-Day, has not only been crucial in the growing awareness regarding sexual violence in the DRC, but has also entered into a project with UNICEF and the Panzi Foundation to build The City of Joy, a special facility in Bukavu for survivors of sexual violence in the DRC. The center, which can host up to 180 women a year, has resources such as sexual education courses, self-defense classes, and group therapy, as well as academic classes and courses in the arts. The City of Joy facility opened in February 2011.