INVESTIGATION OF SEXUAL VIOLENCE IN EASTERN DRC extraordinary brutality of sexual violence in DRC, which includes gang rape, instrumentation, kidnapping, forced “marriages” and genital mutilation.(38, 39, 41, 43, 45) MSF reported that over half of all victims were raped while working in the fields and concluded that, “Sexual violence has been so clearly linked to the military strategy of warring parties [in DRC] and has occurred in such a systematic way that it is wrong to think of it as a side effect of war.”(42) Human Rights Watch described the extraordinary brutality of rapes in DRC – girls as young as five and women as old as 80 were reportedly shot in the vagina or mutilated with knives and razor blades.(45) Anneke Van Woudenberg, the Human Rights Watch specialist for Congo, believes that rape has been so widespread that “it [rape] has become a defining characteristic” of the DRC war.(47) Two Congolese organizations, Réseau des Femmes Pour un Développment Associatif (RFDA) and Réseau des Femmes Pour la Défense des Droits et la Paix (RFDP) performed focus groups with nearly 500 rape survivors in 2003(2). Eighty-five percent of women participating in the focus groups reported vaginal discharge, 79% reported lower abdominal pain and 10% reported that they became pregnant as a result of the rape.(2) Fistulas were also common with 41% of assaulted women reporting urinary or fecal discharge from the vagina.(2) Despite the magnitude of the sexual violence epidemic in Eastern DRC and despite the number of organizations devoting resources to sexual violence programs, rigorous data on sexual violence in DRC is lacking. Because rape is so stigmatized in the Congolese culture and because it is a challenging environment in which to work, little systematic research has been done on rape as a weapon of war in this context. Thus, many important questions remain unanswered. With the support of Oxfam America and in collaboration with medical staff at Panzi Hospital, researchers from the Harvard Humanitarian Initiative (HHI) performed a retrospective cohort study of sexual violence survivors presenting to Panzi Hospital with a specific aim of answering the following outstanding questions: 1) When, where and how are women being attacked and what makes them vulnerable to sexual violence; and 2) How has the rape epidemic in South Kivu evolved over the last five years? PANZI HOSPITAL Panzi Hospital is a 334-bed hospital in Bukavu, South Kivu Province that provides general services including OB/GYN, pediatrics, internal medicine, surgery, dentistry and nutrition. The hospital is equipped with radiology services (including ultrasonography), general laboratory services, and an endoscopy unit. Although offering a variety of services, the majority of patients at Panzi Hospital are rape survivors being cared for under the hospital’s Victims of Sexual Violence Program. The Victims of Sexual Violence Program provides rape survivors with free medical treatment and free psychological and spiritual care in addition to socio-economic assistance. Two hundred of the 334 beds are allocated to the Victims of Sexual Violence Program and it is not uncommon to have 450 sexual assault survivors admitted to the hospital at any given time. The center can accept 10 to 12 new rape patients daily but additional survivors must be turned away and asked to return the following day. 7