In 2023, the Democratic Republic of Congo (DRC) faced yet another devastating year of sexual violence — 25,166 victims sought medical treatment following sexual violations, marking a grim continuation of the epidemic there.

Doctors Without Borders (MSF), in collaboration with the Ministry of Public Health, reported treating an unprecedented number of survivors, with the figure representing more than a two-fold increase from the previous year’s 9,724 cases. That was at least two victims treated every hour throughout the year.

In both May and September 2023, the number of victims receiving treatment at these sites surged, reaching as many as 70 cases per day. This, marking another devastating year for women in the DRC, as ongoing conflict and instability continued to contribute to widespread human rights abuses.

Read: Gender-based violence in DRC is increasing, UN says

Yet, according to the report released by MSF on Monday, this figure likely underrepresents the full extent of the crisis, as many victims of sexual violence do not seek help at health facilities.

In 2024, the number of victims of sexual violence treated in and around Goma has continued to rise, largely driven by the ongoing conflict, particularly in North Kivu province, where armed groups have weaponised sexual violence as a tool of terror.

The DRC has long struggled with systematic sexual violence, particularly in areas controlled by armed groups, where women and girls are frequently targeted as part of a broader culture of impunity.

In Goma and its surrounding displacement camps, where 71 per cent of the treated victims resided, MSF teams recorded an average of 100 cases per day by March 2024. This spike followed intensifying clashes, displacing hundreds of thousands and leaving women and children especially vulnerable to assault.

Most of the victims treated — 98 per cent — were women and girls, with 10 percent being minors. A significant 67 percent of the attacks were carried out by armed men, often targeting women during essential daily tasks like collecting firewood or fetching water.

Following the intensification of fighting in North Kivu province in 2023, hundreds of thousands of people fled the frontlines of the conflict to take refuge on the outskirts of the city of Goma.

Goma, a commercial and logistical hub located in eastern DRC, and the capital of North Kivu province, had the highest number of cases at 71 per cent, while the rest of North Kivu had 20 percent of the cases. The rest of the cases came from the rest of the regions.

Physical trauma

Health zones around the city of Goma, Karisimbi, Nyiragongo had the highest number of victims. And at least 91 percent or 22,905 victims of sexual violence, the total number of victims treated by MSF in 2023, were treated in North Kivu province. Of those treated, 75 per cent presented themselves at medical facilities within 72 hours of the attack.

Survivors not only suffer from physical trauma but also from severe psychological wounds. At least 9,755 of the victims required mental health support, while thousands of others faced the grim reality of unwanted pregnancies or sexually transmitted infections, including HIV. 8,115 women sought abortions, 94 percent of them in sites around Goma.

The testimonies from survivors paint a picture of unimaginable suffering: women raped in front of their children, a survivor, along with her baby raped after her husband was murdered; another forced to endure incest; and young girls under the age of 10 suffered such severe sexual violence that their genitalia were irreparably damaged.

Read: Rape and violence: Struggles of Goma’s displaced women

These harrowing stories reflect the horrific nature of sexual violence endured by countless women and children in conflict-affected regions like the DRC, and the systematic destruction of families through sexual violence.

The sheer scale of sexual violence, compounded by the lack of adequate protection and resources, has exposed the glaring gaps in humanitarian response. MSF’s community liaison officer in Goma described how women in displacement camps are vulnerable even in their shelters, with armed men cutting through tents at night to carry out assaults.

“Living conditions are very difficult here... Sometimes, men wake up in the middle of the night, cut their tarpaulin with a razor and pierce the canvas next to them to rape women who live alone,” Henriette Mbitse, MSF community liaison officer.

The number of victims treated by MSF teams and the testimonies shared by the victims, as well as the data shared by other humanitarian partners, illustrate the extent to which displaced people, especially women, are exposed to sexual violence after seeking refuge in Goma.

This situation is linked to the concentration of arms carriers in and around the sites for displaced people, as revealed by victims’ testimonies.

Humanitarian agencies

Access to justice and long-term medical care remains limited, and the DRC's fragile healthcare system struggles to cope with the overwhelming need for both immediate and ongoing care.

Despite numerous programmes aimed at addressing the crisis, efforts are often insufficient or short-lived.

MSF and other organisations continue to call for large-scale mobilisation to protect displaced populations and provide meaningful support to survivors.

The international community, alongside local authorities, must take urgent action to combat the culture of impunity that allows these atrocities to persist.

The scale of these violations, as documented by medical and humanitarian agencies, highlights the severity of the crisis. Health centres across the country, especially in the war-torn eastern regions, are overwhelmed with survivors seeking treatment for both the physical and psychological aftermath of their experiences.

Read: Silent no more: Leaders must be held accountable to end femicide

Yet, the reported cases are just the tip of the iceberg, as many incidents go unreported due to stigma, fear of reprisal, or lack of access to healthcare.

The DRC’s history of conflict, political instability,and weak governance has fostered an environment where sexual violence thrives.

There is a growing chorus of calls for stronger international intervention and domestic reform to address sexual violence in the DRC.

Advocates are pushing for more robust legal mechanisms to hold perpetrators accountable, greater support for survivors, and the dismantling of the culture of impunity that allows these atrocities to continue.

Efforts to address the root causes of violence, such as poverty, lack of education, and the ongoing conflict, are also essential. Without a comprehensive approach that tackles both immediate needs and long-term structural issues, the cycle of violence is likely to persist.

The number of cases registered in 2023, and continuing abuses underscores the urgent need for action to protect the country’s most vulnerable, as survivors continue to seek justice and healing.

Armed groups use rape as a weapon of war to terrorise communities, control territories and punish perceived enemies. Even outside of conflict zones, pervasive poverty, corruption, and lack of law enforcement contribute to a broader pattern of gender-based violence across the country.

Women in the DRC face multiple layers of vulnerability. In addition to the violence inflicted by armed groups, they are also victims of domestic abuse, human trafficking, and exploitation in displacement camps.

The absence of accountability for perpetrators and the slow pace of legal reforms exacerbate the problem, leaving many women with little recourse.

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According to the report, on paper, there appears to be numerous programmes to prevent sexual violence and respond to the needs of its victims, but in the sites for displaced people around Goma, MSF said its staff struggle every day to refer for support victims who are in urgent need of accommodation, social support, legal aid and food assistance.

“Programmes run by the government and its partners are invariably too small-scale and too short-lived to provide meaningful protection to women and to meet the urgent needs of victims of sexual violence for this to happen, mobilisation on a large scale is necessary,” urged the report.