INVESTIGATION OF SEXUAL VIOLENCE IN EASTERN DRC E XECUTIVE S UMM ARY BACKGROUND In the aftermath of the 1994 Rwandan genocide, conflict erupted in the Democratic Republic of Congo (DRC). This conflict has been become known as “Africa’s World War” and has been responsible for an estimated 5.4 million deaths,(1, 2) making it the deadliest conflict since World War II. Despite an official end to the war with the signing of peace agreements in 2003, the fighting continues in Eastern DRC due to ethnic violence and due to competition for control of DRC’s rich natural resources. The conflict in Eastern DRC has been marked by a number of human rights abuses, including the use of extreme sexual violence. Although the true extent of the sexual violence is not known, it is estimated that tens of thousands of women have been systematically raped by combatant forces.(3) The extraordinary brutality of sexual violence in Eastern DRC has also been documented, with reports of young girls and elderly women being tortured and violently raped.(4) Rape is an extremely effective wartime weapon. It is strategically used to shame, demoralize and humiliate the enemy. By systematically raping women and girls, armed groups assert power and domination over not only the women, but their men as well. The results are devastating. Rape survivors in Eastern DRC face multiple medical problems including HIV/AIDS and sexually transmitted infections. Pregnancy, infertility and genital mutilation are common consequences of rape in this context. The psychosocial consequences of being raped are also devastating. Fear, shame, insomnia and nightmares are frequently noted among sexual violence survivors.(2) In Eastern DRC, rape is highly stigmatized and social sequelae include spousal abandonment, inability to marry and being ostracized by the community. Spousal and community abandonment lead to isolation and homelessness. PURPOSE Research on sexual violence in DRC is extremely challenging. Sexual violence is deeply stigmatized in Congolese culture and many of those affected live in remote or insecure regions. Thus, rigorous data are lacking and many important questions remain unanswered. With the support of Oxfam America and in collaboration with medical staff at Panzi Hospital, researchers from the Harvard Humanitarian Initiative (HHI) performed a retrospective cohort study of sexual violence survivors presenting to Panzi Hospital with a specific aim of answering the following outstanding questions: 1) When, where and how are women being attacked and what makes them vulnerable to sexual violence; and 2) How has the rape epidemic in South Kivu evolved over the last five years? METHODS This was a retrospective cohort study conducted at Panzi Hospital in Bukavu, South Kivu Province. Using a non-systematic convenience sample, interviews were conducted on sexual violence survivors as they presented to Panzi Hospital requesting services from the Victims of Sexual Violence Program. The hospital’s questionnaire asked basic demographic information 1