For hundreds of thousands of displaced people living in camps around Goma, Democratic Republic of Congo (DRC), survival is a daily struggle, especially for women. Every day, about 70 women who are survivors of sexual assault visit MSF health facilities in Lushagala, Bulengo, Elohim, Shabindu, Rusayo, and Kanyaruchinya camps. This unacceptable situation requires urgent action.
Poor conditions make women more vulnerable to sexual violence
The precarious living conditions in the camps—in which access to food, water, and other basic necessities is extremely limited—put women at greater risk of becoming exposed to sexual violence, often forcing them to venture to unsafe areas or participate in risky activities in order to access these needs. Families are sleeping in tents that do not close, and poverty can force some women to resort to transactional sex, making them more vulnerable to exploitation and abuse.
Many of the displaced people living in the camps around Goma have fled their homes due to the resurgence of armed conflict in North Kivu. In the camps, they face overcrowded, unsanitary conditions that add to health needs. Women are often the sole providers for their families, leaving many with no choice but to leave their camp in search of wood and food, exposing them to the risk of violence—particularly sexual violence. Most sexual assaults occur outside camps, to women doing just that.
Providing care for a growing number of survivors
"During the month of July alone, 1,500 female survivors of sexual violence sought care from MSF teams at Rusayo, Shabindu, and Elohim camps—more than twice as many than in May," said Rasmane Kabore, MSF head of mission.
"About 80 percent of these survivors were treated within 72 hours of being assaulted, which illustrates the scale of the emergency," Kabore continued. "The sooner they come forward, the sooner we can offer them emergency care to prevent unwanted pregnancies, sexually transmitted diseases—especially HIV—and other complications. Assaults are becoming increasingly violent, resulting in associated physical injuries. A growing number of women are raped more than once.”
In recent weeks, MSF teams have observed an increase in cases of sexual assault in the camps where MSF operates, by about 15 percent. Many survivors must then contend with the stigma of surviving sexual violence, which community mobilizers are doing essential work to fight against.
Women’s health requires a range of care services
As well as providing medical and psychological care for survivors of sexual violence, MSF teams offer women various methods of contraception, treatment for sexually transmitted diseases, and safe abortion care. In the Kanyaruchinya health center, MSF supports the obstetric and neonatal care department, where around ten women give birth every day.
"In addition to the medical consequences [of sexual violence], the women we see suffer from emotional problems, anxiety, depression, and insomnia,” said Jerlace Mulekya, mental health supervisor at the MSF clinic in Lushagala.
In some camps, access to water, latrines, and other basic services has improved in recent months, but women continue to live in poor hygiene conditions. "I often have infections, and it's very difficult to get soap," said a young woman who was three months pregnant in Rusayo camp.
In the maternity unit supported by MSF in Kanyaruchinya, a woman who had just given birth said that she’d had nothing to eat since the day before. "It's food that gives you strength. If I don't eat, the baby won't have anything to eat either, so I won’t produce enough milk to give him.”
To address the situation, it is urgent that humanitarian actors, donors, and Congolese authorities step up their efforts to sustainably improve the living conditions of women in the camps.
“This includes improving access to food, distributing fuels and cooking equipment, and setting up social and legal protection services so that women feel safe,” said Kabore. "We are a medical humanitarian organization. Other stakeholders, as well as the Congolese authorities, must do more to prevent violence against women, ensure their protection in the camps, and put an end to impunity for the perpetrators of these crimes.”
MSF response in DRC
MSF works in the sites of Lushagala, Bulengo, Elohim, Shabindu, Rusayo, Kanyaruchinya, and Nzulu, providing free medical care, distributing drinking water, building latrines and showers, and organizing the distribution of basic utensils according to the most urgent needs. In North Kivu, MSF continues to provide free essential medical care in Rutshuru, Kibirizi, Bambo, Binza, Mweso, Masisi, and Walikale.