Facing medical care problems of victims of sexual violence in Goma/Eastern Democratic Republic of the Congo

BACKGROUND: Since 1998, the Eastern Democratic Republic of the Congo has been torn by a military conflict. A particular atrocity of the war is widespread sexual violence. METHODS: In this combined retrospective analysis and prospective survey, we sought to identify hospital facilities and resources available to treat victims of sexual violence in Goma, the capital city of the North Kivu province. RESULTS: Of twenty-three acute care hospitals registered in the area of Goma, four (17%) regularly cared for victims of sexual violence. One hospital had all resources always available to appropriately care for victims of sexual violence. From Jan 2009 until Oct 2010, 7,048 females sought medical care because of physical or psychological sequelae from sexual violence in the four hospitals of Goma. Only half of the hospitals had physicians specialized in gynaecology or gynaecological surgery available. Similarly, anaesthetists and psychiatrists/psychologists were available in two (50%) and one (25%) hospital, respectively. Post-discharge care facilities, material resources, such as surgical and anaesthesiological equipment and drugs, were inconsistently available in the hospitals caring for sexually abused females. At one selected hospital, acyclovir and/or antibiotics were administered to 1,202 sexually abused females (89.5%), whereas post-exposure HIV prophylaxis and surgery because of vesico-vaginal fistula was provided to only 75 (5.6%) and 121 (9%) patients, respectively. CONCLUSIONS: This study provides data that only few hospitals in Goma care for victims of sexual violence. In addition, these hospitals suffer from a relevant shortage of human and material resources to provide adequate care for sexually abused females. Aside from establishment of adequate protection strategies, steps must be taken to increase the availability of trained health care professionals and resources to provide adequate care for victims of sexual violence in Goma and the North Kivu province.