and then allowed the patient to describe her sexual violence experience in an open, self-reporting narrative. A total of 4,311 records, representing all post-rape interviews conducted at Panzi Hospital between 2004 and 2008, were reviewed and the relevant information extracted for quantitative and qualitative analysis. RESULTS In South Kivu, women are subjected to sexual violence regardless of age, marital status or ethnicity. The majority of rape survivors are illiterate and rely on subsistence farming to support their families. Most rape survivors wait extended periods of time before accessing medical care and many arrive at Panzi hospital alone, without the support of family or friends. Women in South Kivu are not safe anywhere; they are attacked not only while they farm their fields or collect firewood in the forest but also in the supposed safety of their own homes, often while sleeping at night with their families. Just over half of all perpetrators (52%) were identified as being armed combatants. Although another 42% were identified only as “assailants”, analysis of the patterns of violence, strongly suggests that this group is also comprised largely of armed combatants. Thus, the sexual violence in South Kivu is largely militarized. Military rape in South Kivu is marked with a predominance of gang rape, which was described by almost 60% of sexual violence survivors presenting to Panzi Hospital. Sexual slavery was also common with some women being held captive for several years. Sexual slavery more frequently involved young, single women. The sexual assaults are also remarkable for extraordinary brutality including genital mutilation, instrumentation with foreign objects, forced rape between victims and rape in the presence of family members. There are also horrific reports of young children being slaughtered in front of their parents and of family members being tortured and killed. The military pattern of rape was also notable for a preponderance of pillaging with many survivors reporting the loss of cash, food, livestock, clothing and other valuables. Likewise, there were many descriptions of armed combatants demanding ransom in exchange for the victim’s release from sexual slavery. An analysis of sexual violence trends over time revealed that the total number of reported assaults at Panzi Hospital had steadily decreased between 2004 and 2008. The analysis also demonstrated a civilian adoption of rape. From 2004 to 2008, the number of civilian rapes increased by an astounding 1733% or 17-fold, while the number of rapes by armed combatants decreased by 77%. These findings imply a normalization of rape among the civilian population, suggesting the erosion of all constructive social mechanisms that ought to protect civilians from sexual violence. As highlighted in the qualitative analysis, sexual violence survivors experienced a host of physical symptoms following rape, including pelvic, lumbar and abdominal pain as well as reproductive abnormalities such as infertility and premature labor and delivery. Women often expressed 2