Women's voices: gender violence and sexual trauma among internally refugees in the Democratic Republic of the Congo
DOI:
https://doi.org/10.13129/2612-4033/0110-5381Abstract
Background: The study explores the impact of sexual violence and trauma on women living in a refugee camp in Democratic Republic of Congo. The influence of multiple adversities that Congolese women experience long-life (mainly extreme poverty, war, forced migration) and cultural factors (gender disparity, forced marriages, normalized intimate violence, etc.) which link to sexual violence in those territories are illustrated.
Methods: The study adopts a narrative research method, through interviews conducted with four raped women who screened positive at the Refugee Health Screener-15 for poor mental health (anxiety, depression, and PTSD).
Results: The devasting manifestations of sexual trauma on women’s health emerge, particularly the core symptoms of the Complex Post Traumatic Stress Disorder (CPTSD) and Disturbances in Self-Organization (affect dysregulation, damaged self-image, interiorized rape stigma, disturbed social relationships, loss of meaning in life, hopelessness).
Conclusions: The need to assume a culturally sensitive approach to understand both the hidden suffering of women, and the barriers limiting access to health services in low resource/adverse settings are discussed.
References
American Psychological Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev.). https://doi.org/10.1176/appi.books.9780890425787
Booysen, D.D., & Kagee, A. (2021). Preliminary effectiveness of brief prolonged exposure therapy for PTSD: Expanding access to effective therapies. Clinical Case Studies, 20(6), 482–497. https://doi.org/10.1177/15346501211017989
Bouzidi, H. (2017). The subject/Culture report in the trauma of rape in Algeria: the case of the Algerian girls. Mediterranean Journal of Clinical Psychology, 5(1). https://doi.org/10.6092/2282-1619/2017.5.1259
Bouzidi, H. (2018). The image of the family among the victims of rape in Algeria. Mediterranean Journal of Clinical Psychology, 6(1), 1-11. https://doi.org/10.6092/2282-1619/2018.6.1803
Bovey, M., Hosny, N., Dutray, F., & Heim, E. (2024). PTSD and complex PTSD manifestations in Sub-Saharan Africa: A systematic review of qualitative literature. SSM - Mental Health, 5, 100298. https://doi.org/10.1016/j.ssmmh.2024.100298.
Bryant-Davis, T., Ullman, S.E., Tsong, Y., Tillman, S., & Smith, K. (2010). Struggling to survive: sexual assault, poverty, and mental health outcomes of African American women. American Journal of Orthopsychiatry, 80(1), 61–70. https://doi.org/10.1111/j.1939-0025.2010.01007.x
Chiumento, A., Rutayisire, T., Sarabwe, E., Hasan, M. T., Kasujja, R., Nabirinde, R., Mugarura, J., Kagabo, D. M., Bangirana, P., Jansen, S., Ventevogel, P., Robinson, J., & White, R. G. (2020). Exploring the mental health and psychosocial problems of Congolese refugees living in refugee settings in Rwanda and Uganda: A rapid qualitative study. Conflict and Health, 14(77), 1–21. https://doi.org/10.1186/s13031-020-00323-8
Forest, M., & Blanchette, I. (2018). Memory for neutral, emotional and trauma-related information in sexual abuse survivors. European Journal of Psychotraumatology, 9(1). https://doi.org/10.1080/20008198.2018.1476439
Greer, T. M. (2011). Coping strategies as moderators of the relation between individual race-related stress and mental health symptoms for African American women. Psychology of Women Quarterly, 35(2), 215-226. https://doi.org/10.1177/0361684311399388
HCDH (Nations Unies, Haut-Commissariat aux droits de l’homme) (2010). République Démocratique Du Congo, 1993-2003. Rapport du Projet Mapping concernant les violations les plus graves des droits de l’homme et du droit international humanitaire commises entre mars 1993 et juin 2003 sur le territoire de la République démocratique du Congo. Available online: https://www.ohchr.org/fr/countries/africa/2010-drc-mapping-report (retrieved on 22.05.2024).
Heim, E., Karatzias, T., & Maercker, A. (2022). Cultural concepts of distress and complex PTSD: Future directions for research and treatment. Clinical Psychology Review, 93, 102143. https://doi.org/10.1016/j.cpr.2022.102143
Hollifield, M., Verbillis-Kolp, S., Farmer, B., Toolson, E. C., Woldehaimanot, T., Yamazaki, J., Holland, A., St. Clair, J., & SooHoo, J. (2013). The Refugee Health Screener-15 (RHS-15): Development and validation of an instrument for anxiety, depression, and PTSD in refugees. General Hospital Psychiatry, 35(2), 202–209. https://doi.org/10.1016/j.genhosppsych.2012.12.002
Hsu, C.-M. K., Kleim, B., Nicholson, E. L., Zuj, D. V., Cushing, P. J., Gray, K. E., Clark, L., & Felmingham, K. L. (2018). Sex differences in intrusive memories following trauma. PLOS One, 13(12), e0208575. https://doi.org/10.1371/journal.pone.0208575
Idemudia, E.S., William, J.K., Boehnke, K., & Wyatt, G. (2013). Gender differences in trauma and posttraumatic stress symptoms among displaced Zimbabweans in South Africa. Journal of Traumatic Stress Disorders & Treatment, 2(3), 1340. 10.4172/2324-8947.1000110
IOM (International Organization for Migration) (2024, Dec 16). DTM RDC — Rapport d'enregistrement: 13 sites & centres collectifs à Goma, Nord-Kivu (7-18 Novembre 2024). IOM, Democratic Republic of the Congo. Available online: https://dtm.iom.int/reports/rdc-rapport-denregistrement-13-sites-centres-collectifs-goma-nord-kivu-7-18-novembre-2024 (retrieved on 12.01.2025).
Jewkes R., Mhlongo, S., Chirwa, E., Seedat, S., Myers, B., Peer, N., Garcia-Moreno, C., Dunkle, K., & Abrahams, N. (2022). Pathways to and factors associated with rape stigma experienced by rape survivors in South Africa: Analysis of baseline data from a rape cohort. Clinical Psychology & Psychotherapy, 29(1), 328–338. https://doi.org/10.1002/cpp.2637
Kandemiri, P. (2019). Forgiveness as a positive contributing factor on the mental wellbeing of Congolese refugees and asylum seekers post-war experience. Journal of Human Behavior in the Social Environment, 29(8), 1044–1058. https://doi.org/10.1080/10911359.2019.1658685
Kuo, C., LoVette, A., Slingers, N., & Mathews, C. (2021). Predictors of Resilience Among Adolescent Girls and Young Women Who Have Experienced Intimate Partner Violence and Sexual Violence in South Africa. Journal of Interpersonal Violence, 37(15-16), NP13425-NP13445 (Original work published 2022). https://doi.org/10.1177/08862605211005158
Kuupiel, D., Lateef, M. A., Adzordor, P., Mchunu, G. G., & Pillay, J. D. (2024). Injuries and/or trauma due to sexual gender-based violence among survivors in sub-Saharan Africa: A systematic scoping review of research evidence. Archives of Public Health, 82, 78. https://doi.org/10.1186/s13690-024-01307-3
Lambert, J. E., Karugahe, W., & Baguma, P. K. (2024). Unpacking gender-specific risk and protective factors for mental health status among Congolese refugees in Uganda. European Journal of Psychotraumatology, 15(1), 2334190. https://doi.org/10.1080/20008066.2024.2334190
Mhlongo, S., Seedat, S., Jewkes, R., Myers, B., Chirwa, E., Nöthling, J., Lombard, C., Peer, N., Kengne, A. P., Garcia-Moreno, C., Dunkle, K., & Abrahams, N. (2023). Depression and post-traumatic stress symptoms two years post-rape and the role of early counselling: Rape Impact Cohort Evaluation (RICE) study. European Journal of Psychotraumatology, 14(2), 2237364. https://doi.org/10.1080/20008066.2023.2237364
Mhlongo, M. D., Tomita, A., Thela, L., Maharaj, V., Burns, J. K. (2018). Sexual trauma and post-traumatic stress among African female refugees and migrants in South Africa. South African Journal of Psychiatry, 24, a1208. https://doi.org/10.4102/sajpsychiatry.v24i0.1208
Mukwege, D. (2021). The power of women: A doctor's journey of hope and healing. New York: Flatiron Books.
Muluneh, M. D., Stulz, V., Francis, L., & Agho, K. (2020). Gender based violence against women in Sub-Saharan Africa: A systematic review and meta-analysis of cross-sectional studies. International Journal of Environmental Research and Public Health, 17(3), 903. https://doi.org/10.3390/ijerph17030903
Neuman, M. (2023, 16 Jun). Les déplacés de Goma, une catastrophe pourtant si visible. Available online: URL https://msf-crash.org/fr/blog/camps-refugies-deplaces/les-deplaces-de-goma-une-catastrophe-pourtant-si-visible (retrieved on 12.09.2025).
Ndungu, J., Ramsoomar, L., Willan, S., Washington, L., Ngcobo-Sithole, M., Gibbs, A. (2020). Depression, posttraumatic stress disorder (PTSD) and their comorbidity: Implications of adversity amongst young women living in informal settlements in Durban, South Africa. Journal of Affective Disorders Reports, 1, 100022. https://doi.org/10.1016/j.jadr.2020.100022
Ng, L. C., Stevenson, A., Kalapurakkel, S. S., Hanlon, C., Seedat, S., Harerimana, B., Chiliza, B., & Koenen, K. C. (2020). Correction: National and regional prevalence of posttraumatic stress disorder in sub-Saharan Africa: A systematic review and meta-analysis. PLOS Medicine, 17(7), e1003312. https://doi.org/10.1371/journal.pmed.1003312
Nöthling, J., Abrahams, N., Jewkes, R., Mhlongo, S., Lombard, C., Hemmings, S. M. J., & Seedat, S. (2022). Risk and protective factors affecting the symptom trajectory of posttraumatic stress disorder post-rape. Journal of Affective Disorders, 309, 151–164, https://doi.org/10.1016/j.jad.2022.04.032
Onana, C. (2023). Holocauste au Congo: L'omerta de la communauté internationale. Paris: L’Artilleur.
Osman, W., Ncube, F., Shaaban, K., & Dafallah, A. (2024). Prevalence, predictors, and economic burden of mental health disorders among asylum seekers, refugees and migrants from African countries: A scoping review. PLOS One, 19(6), e0305495. https://doi.org/10.1371/journal.pone.0305495
Otita Likongo, M., Mavinga Tana, A., & Atimnedi Biwaga, L. (2022). Conséquences traumatiques de l’exposition à la violence coniugale chez les enfants et adolescents congolais à Kisangani en Republique Democratique du Congo. IJRDO - Journal of Social Science and Humanities Research, 8(10), 18–31.
Patel, A. R., & Hall, B. J. (2021). Beyond the DSM-5 diagnoses: A cross-cultural approach to assessing trauma reactions. Focus, 19, 197–203. https://doi.org/10.1176/appi.focus.20200049
So, C. J., Miller, K. E., & Gehrman, P. R. (2023). Sleep disturbances associated with posttraumatic stress disorder. Psychiatric Annals, 53(11), 491–495. https://doi.org/10.3928/00485713-20231012-01
Tadesse, G., Andualem, F., Rtbey, G., Nakie, G., Takelle, G. M., Molla, A., Tadesse Abate, A., Kibralew, G., Kelebie, M., Fentahun, S., & Tinsae, T. (2024). Gender-based violence and its determinants among refugees and internally displaced women in Africa: systematic review and meta-analysis. BMC Public Health, 24, 2851. https://doi.org/10.1186/s12889-024-20329-8
Taheri, M., Harding, N., Stettaford, T., Fitzpatrick, S., & McCormack, L. (2024). Female-specific refugee trauma impacting psychological wellbeing post-settlement: A scoping review of research. Journal of Loss and Trauma, 29(8), 1017–1046. https://doi.org/10.1080/15325024.2024.2325077
Verelst, A., De Schryver, M., Broekaert, E. & Derluyn, I. (2014). Mental health of victims of sexual violence in eastern Congo: associations with daily stressors, stigma, and labeling. BMC Women's Health, 14, 106. https://doi.org/10.1186/1472-6874-14-106
Veling, W., Hall, B. J., & Joosse, P. (2013). The association between posttraumatic stress symptoms and functional impairment during ongoing conflict in the Democratic Republic of Congo. Journal of Anxiety Disorders, 27(2), 225–230. https://doi.org/10.1016/j.janxdis.2013.01.007
Yotama, T., & Yotama, M. (2021). Rapport Yotama sur les massacres de Beni et Irumu: Terrorism, djihadisme ou génocide Nande?, Butembu, Nord Kivu. Available online: https://dc.sourceafrica.net/documents/121107-RAPPORT-YOTAMA-sur-les-massacres-de-Beni-et-Irumu.html (retrieved on 22.05.2024).
Wikipedia, The Free Encyclopaedia (2025). 2025 Goma offensive. https://en.wikipedia.org/wiki/2025_Goma_offensive (consulted on October 10, 2025)
Wonderlich, S. A., Crosby, R. D., Mitchell, J. E., Thompson, K. M., Redlin, J., Demuth, G., Smyth, J., & Haseltine B. (2001). Eating disturbance and sexual trauma in childhood and adulthood. International Journal of Eating Disorders, 30(4), 401–12. https://doi.org/10.1002/eat.1101
World Health Organization. (2019). International statistical classification of diseases and related health problems (11th ed.). WHO. https://icd.who.int/browse/2025-01/mms/en#585833559
Wyatt, G. E., Davhana-Maselesele, M., Zhang, M., Wong, L. H., Nicholson, F., Sarkissian, A. D., Makhado, L., & Myers, H. F. (2017). A longitudinal study of the aftermath of rape among rural South African women. Psychological Trauma: Theory, Research, Practice, and Policy, 9(3), 309–316. https://doi.org/10.1037/tra0000246
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