Published on Nasikiliza

“We felt like human beings again:” Treating and supporting survivors of sexual violence

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Supporting Women Survivors of Violence in Africa's Great Lakes Region

We felt like human beings again” asserts a survivor of sexual violence at the Panzi Hospital in Eastern DRC.  Survivors arrive here with serious physical injuries and deep psychological scars.  Some are accompanied by children who are painful reminders of the rape and trauma they suffered. They face numerous hurdles to putting their lives back together—stigma, isolation, and hopelessness.  While many organizations provide support, only a few are able to offer the full range of services required—medical care, mental health support, legal aid and economic activities.

Violence against women and girls has reached epidemic proportions in Africa’s Great Lakes Region.  In DRC, nearly three-quarters of women report having suffered from spousal or partner abuse at one time in their lives. In Rwanda, nearly half of women have experienced physical and sexual violence. In Burundi, entrenched poverty, gender inequality and socio-cultural beliefs perpetuate high levels of domestic violence. Survivors of sexual violence need emergency and long-term care and services.

Health systems have a critical role to play, both in treating and supporting survivors, and in identifying those at risk early enough, preventing further violence. Effective support for survivors of sexual violence is a good barometer of health system performance as several critical elements need to work in tandem. For example, when treating survivors of sexual and gender based violence, time is of the essence, both to prevent pregnancy and HIV transmission.

Medical workers need to provide high quality, confidential care; emergency kits and drugs need to be readily available at clinics; and services need to be free of charge without under the table payments. Counselling and other mental health services need to be more of a priority since they are vital to start the healing process.  There is currently a shortage of mental health professionals in the region; for example, the Kivu provinces of DRC with a population of over 20 million have only two psychiatrists and eight psychologists. 

Improving health outcomes for women and survivors of sexual based violence in Africa's Great Lakes


Strengthening the capacity of health systems in developing countries to deal with survivors of sexual violence will have mutually reinforcing benefits for other vulnerable women who continue to die unnecessarily from complications of pregnancy and labor. Investing in facilities and human resources will enable these countries to deal more effectively with a broader range of medical emergencies. 

Adoption of integrated service delivery approaches for both survivors and other vulnerable women is particularly critical in health systems which are fragile and severely under-resourced. Likewise, improving access to high impact interventions, including family planning, antenatal care, and institutional deliveries, will allow women to take control over their reproductive health, and will improve chances of survival for mothers and newborns. 

Reflecting back on my visit to Eastern DRC during the early preparation of our project, I remember so vividly a woman huddled in a corner weaving a colorful basket, gently threading her life back together and thinking of a brighter future. 

The recently approved Great Lakes Emergency Sexual and Gender Based Violence and Women’s Health Project will help her and many other survivors as they begin to rebuild their lives.




Miriam Schneidman

Lead Health Specialist, World Bank Africa Region

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