coordinated information campaigns across communities in conjunction with a range of opinion-leaders. C ONCLUSIO NS In South Kivu, women are extremely vulnerable to sexual violence, regardless of their age, ethnicity or marital status. They cannot feel safe while they cultivate their fields, collect firewood or sleep with their families in their own homes. The brutality of the sexual violence has become one of the defining characteristics of the war in South Kivu. The gang rape, sexual slavery, genital mutilation, forced rape between victims and rape in the presence of family members speak to the horrific nature of these crimes. Tragically, rape survivors are also often subjected to witnessing the torture and murder of their own family members. These are strategic acts of violence intended to intimidate, terrorize and control an entire population. Rape in South Kivu is perpetrated predominantly by armed combatants and this militarized sexual violence has a characteristic pattern. It is primarily gang rape and sexual slavery, usually associated with pillaging, and often involving the beating or killing of family members. These attacks often occur on individual homes at night but also occur in the forest and in the fields. There has been an overall decrease in the total number of reported rapes at Panzi Hospital between 2004 and 2008. While this decrease is promising, a more detailed analysis of these trends demonstrates a disturbing shift in perpetrators and patterns of attack. Between 2004 and 2008, there was an astounding increase in the number of civilian rapes in conjunction with a significant reduction in the number of rapes committed by armed combatants. This shift suggests a civilian adoption of sexual violence and the normalization of rape within a society that has been exposed to brutal militarized rape over the last decade. To curb the sexual violence epidemic in South Kivu, we can no longer accept rape as “collateral damage” of armed conflict. Because sexual assaults are often carried out on individual homes and in very remote areas, humanitarian organizations need to collaborate with local communities to identify new and innovative protection programs based on the patterns of attack that we know to be most prevalent in the region. 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. Civilian adoption of rape is now becoming recognized as an emerging problem in South Kivu and is one that requires urgent attention. To address civilian rape, the environment of impunity must end and sexual violence legislation must be enforced to the fullest extent. Furthermore, the mindset of an entire society will have to be reset to recognize rape as a morally unacceptable and criminal act. Meanwhile, immediate assistance is required for all sexual violence survivors including medical services, psychological counseling and social support. Men must be actively involved in all stages of survivor care such that families can recover as a unit and learn how to move forward together. The needs of all children affected by rape must be recognized, including child 56