Bukavu, there was a significant increase in the number of sexual assaults in the region with some reports that as many as 16,000 women were raped in a single weekend.(49) This military advance is likely responsible for the dramatic increase in the number of sexual assaults reported to have occurred in June 2004. Similarly, there was an increase in the number of reported sexual assaults in April 2004 coinciding with a known clash between Congolese government troops and Rwandan Hutu rebels near Bukavu.(50) During this clash, rebels were reported to have attacked villagers as they retreated and we speculate that this may explain the increased number of reported rapes in April 2004. Patients at Panzi Hospital begin the day with a short prayer service (Susan Bartels, HHI) Trends over time suggest that the total number of women presenting to Panzi Hospital requesting post-rape care declined between 2004 and 2008 (Figure 6). This trend was also reported by Malteser, an NGO providing post-rape services in South Kivu.(46) The reduced number of reported sexual assaults between 2004 and 2008 may parallel a general decrease in the levels of military violence within the region during that time frame. However, given that there are significant delays between sexual assault and time to presentation, we expect that the numbers of reported cases for later years will continue to increase as women continue to access care up to several years following the actual rape. There is also more recent evidence that the number of sexual assaults has again increased in 2009 since the beginning of the joint Rwandan-Congolese military offensive against the FDLR.(51, 52) Collectively, this data provides strong evidence that the armed combatants in South Kivu have been responsible for the majority of sexual assaults documented to have occurred there. To try to specify responsibility more precisely, however, is very difficult. There are and have been many armed groups operating within the region during the time frame covered by this study. At the 34