INVESTIGATION OF SEXUAL VIOLENCE IN EASTERN DRC concern about infections, particularly HIV, after being raped. Psychological symptoms following sexual violence were also common. Women described sadness, anger, fear, anxiety, shame and misery. Many women also suffered significant losses such as the death of family members, spousal abandonment and loss of personal valuables as a result of the attack. CONCLUSIONS In South Kivu, sexual violence is pervasive, affecting women of all ages, ethnicities and marital statuses. Women are attacked everywhere, even in the privacy of their own homes. The sexual assaults are ruthless, with horrific reports of gang rape, sexual slavery, genital trauma, forced rape between victims and rape in the presence of family members. Sexual violence survivors often witness the torture and murder of their children and spouses. Although the sexual atrocities in South Kivu are perpetrated primarily by armed combatants, we should not view the sexual violence as “collateral damage” of armed conflict. Peacekeeping mandates need to be amended to more explicitly protect civilians from sexual violence and peacekeeping forces will need to have sufficient resources to effectively meet those mandates. Because the attacks are often carried out on individual homes in rural regions, aid organizations will need to collaborate with local communities to identify new and innovative protection programs based on the patterns of attack most prevalent in South Kivu. To end the environment of impunity, national sexual violence laws will need to be fully enforced and the capacity to investigate and prosecute crimes against women will need to be greatly expanded. After years of military rape in South Kivu, civilian adoption of sexual violence is becoming recognized as its own problem. To address this new wave of civilian perpetrated sexual violence, the environment of impunity in DRC must end. Congolese sexual violence laws must be fully enforced and perpetrators must be held responsible. In parallel with upholding accountability, the mindset of an entire society will have to be reset to recognize rape as a morally unacceptable and criminal act. Meanwhile, sexual violence survivors require urgent support including medical services, psychological counseling and social assistance. The approach to survivor care must involve men at all stages, allowing families to recover together as a unit. In addition to assisting child survivors of sexual violence and children born out of rape, assistance must also be provided to all children who have been indirectly affected by sexual violence. With appropriate interventions, there exists an enormous opportunity to ameliorate the trauma and distress caused to the next generation in South Kivu. 3