Despite the high volume of rape patients, Panzi Hospital has only one specialty-trained gynecologist, Dr. Denis Mukwege. Dr. Mukwege has been at the hospital since 1999 and estimates that he treats about 3600 rape victims annually. Many of the women have developed fistulas, either genitourinary or rectovaginal, and much of Dr. Mukwege’s work has focused on genital and pelvic reconstruction. Many of these surgeries are complex and many women require multiple surgeries over a period of time in order to repair their injuries. Panzi Hospital has a trained psychologist and several social workers addressing the psychological consequences of sexual violence. The social workers do the initial intake/history and continue to follow the patients both during the hospital course and after discharge. The women also undergo vocational training while at the hospital to learn basic skills that might allow them to support themselves once they leave the hospital. A large percentage of the patients are either widows, or have been abandoned by their spouses and families because of the shame and stigma associated with rape. M ETHODS This is a retrospective cohort study conducted at Panzi Hospital. Using a non-systematic convenience sample, interviews were conducted on sexual violence survivors as they presented to hospital between 2004 and 2008. Individual women were chosen for interview based on staff availability and severity of trauma. The interviews were conducted in private by trained female officers using a two-paged, semi-structured questionnaire. The questions were asked in Kiswahili or Mashi and were recorded in French. The questionnaire asked basic demographic information and then allowed the patient to describe her sexual violence experience in an open, self-reporting narrative. All data sheets were subsequently filed in a locked administrative office at Panzi Hospital and were kept independent of the patient’s hospital record. To date, the data collected in these interviews have not been analyzed. Between November 2007 and April 2009, a total of 4,311 records were reviewed from sexual violence survivors presenting to Panzi Hospital. This represents all women who were interviewed under the Victims of Sexual Violence Program from 2004 to 2008. In the same fiveyear period, another 4,709 women accessed post-sexual violence care at Panzi Hospital. However, because of staffing limitations these women did not undergo the in-depth interview and detailed information on their sexual assaults was not captured. Although those 4,709 sexual assaults are not included in this analysis, for reasons explained in “Limitations”, the omission of these cases is not believed to have affected the validity or significance of the data reported here. For each questionnaire, a single sexual violence experience was recorded and this was the most recent sexual assault prompting the woman to seek medical attention. An individual woman may have had a prior rape experience but the details of that prior rape were rarely described in the questionnaire and even if described, were not included in this analysis. Thus, there are 4,311 sexual violence experiences in this dataset. 8

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