In a retrospective report published on October 1, Doctors Without Borders/Médecins Sans Frontières (MSF) announced—together with the Ministry of Health— that MSF teams treated an unprecedented number of victims and survivors of sexual violence in the Democratic Republic of Congo in 2023, and that this upward trend continued in the first five months of 2024.
The vast majority of victims were treated in displacement camps in Goma, where tens of thousands of people have fled in recent years due to escalated fighting between various warring groups. The medical humanitarian organization is calling on all national and international stakeholders to take urgent action to prevent sexual violence and improve care for survivors.
The report outlines that in 2023, MSF teams in DRC helped treat 25,166 victims and survivors of sexual violence across the country, averaging more than two patients every hour. This figure is by far the highest number ever recorded by MSF in DRC, based on data from 17 projects set up by MSF in support of the Ministry of Health in five Congolese provinces—North Kivu, South Kivu, Ituri, Maniema, and Central Kasai.
In the three preceding years, MSF teams treated an average of 10,000 victims per year in the country. The year 2023 marked a massive increase in admissions.
This trend accelerated in the first months of 2024: In North Kivu province alone, 17,363 victims and survivors were treated with MSF assistance between January and May. Not even halfway through the year, this already represented 69 per cent of the total number of victims treated in 2023 in the five provinces studied.
After being analysed and verified over several months, the 2023 care data presented in the report show that 91 per cent of victims treated with MSF assistance in DRC were admitted in North Kivu, where clashes between the M23 group and the Congolese army with their respective allies have been raging since late 2021.
The escalation has forced two million people to flee their homes in the northeast region encompassing North Kivu, South Kivu, and Ituri provinces.
The vast majority of victims were treated in the displacement camps around Goma, which continued to grow throughout 2023.
“According to the testimonies of our patients, two-thirds were attacked at gunpoint,” said Christopher Mambula, head of MSF’s programs in DRC. “These attacks took place in the sites themselves, but also in the surrounding area when women and girls—who accounted for 98 per cent of the victims treated by MSF in DRC in 2023—went out to collect wood or water, or to work in the fields.”
While the massive presence of armed men in and around displacement camps explains this explosion of sexual violence, the inadequacy of the humanitarian response and the inhumane living conditions fuel the phenomenon. The lack of food, water, and income-generating activities exacerbates the vulnerability of women and girls (one in 10 victims treated by MSF in 2023 were minors), who are forced to go to neighbouring hills and fields where there are many armed men.
The lack of sanitation and safe shelter for women and girls leaves them vulnerable to attack. Others are sexually exploited to support their families.
“On paper, there seems to be many programs to prevent and respond to the needs of victims of sexual violence—but on the ground in displacement sites, our teams struggle every day to refer victims who need help,” Mambula said. “The few programs that do exist are always too short-lived and grossly under-resourced. Much more is needed to protect women and meet the urgent needs of victims.”
Sexual violence is a major medical and humanitarian emergency in DRC.
According to the latest Gender-Based Violence Area of Responsibility DRC information, which compiles data from various humanitarian organizations offering gender-based violence care services in 12 provinces, 55,500 survivors of sexual violence received medical care in the second quarter of 2024.
Based on the needs expressed by the victims and building on previous work to solve this long-standing problem in the country, the MSF report lists some 20 urgent actions to be taken by parties to the conflict, Congolese authorities—national, provincial and local—as well as international donors and the humanitarian sector.
MSF urged all parties involved in the conflict to ensure respect for international humanitarian law.
In particular, MSF called for the absolute prohibition of acts of sexual violence, as well as respect for the civilian nature of displacement sites, stressing that the protection of civilians caught up in the fighting must be a priority. Those involved in humanitarian programs must also protect civilians from abuse.
The organisation said living conditions in camps for the internally displaced must be improved, namely, access to basic needs—food, water, and income-generating activities—and access to safe and well-lit sanitation facilities and shelter. It added that these investments must also be accompanied by increased efforts to raise awareness of sexual violence.
“While humanitarian funding must be sufficiently flexible to respond to emerging and urgent needs, implementing partners must also demonstrate accountability in delivering interventions,” stressed MSF.
It called for investment in better medical, social, legal and psychological care for victims of sexual violence, noting that this requires long-term funding to improve medical training, post-rape kits for care facilities, legal support, as well as the provision of shelter for survivors.
“Funding is also needed for awareness-raising activities to prevent stigmatisation or marginalisation of victims, which sometimes prevents them from seeking help. Given the high number of victims requesting abortions, MSF is also calling for the adaptation of the national legal framework to guarantee access to comprehensive medical abortion care,” stated the organisation.
