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Democratic Republic of the Congo

Health Services for Women, Children and Adolescents in Conflict Affected Settings: Experience from North and South Kivu, Democratic Republic of Congo

Citation:

Altare, Chiara, Espoir Bwenge Malembaka, Maphie Tosha, Christopher Hook, Hamady Ba, Stéphane Muzindusi Bikoro, Thea Scognamiglio, Hannah Tappis, Jerome Pfaffmann, Ghislain Bisimwa Balaluka, Ties Boerma, and Paul Spiegel. 2020. "Health Services for Women, Children and Adolescents in Conflict Affected Settings: Experience from North and South Kivu, Democratic Republic of Congo." Conflict and Health 14.

Authors: Chiara Altare, Espoir Bwenge Malembaka, Maphie Tosha, Christopher Hook, Hamady Ba, Stéphane Muzindusi Bikoro, Thea Scognamiglio, Hannah Tappis, Jerome Pfaffmann, Ghislain Bisimwa Balaluka, Ties Boerma, Paul Spiegel

Abstract:

Background: Insecurity has characterized the Eastern regions of the Democratic Republic of Congo for decades. Providing health services to sustain women’s and children’s health during protracted conflict is challenging. This mixed-methods case study aimed to describe how reproductive, maternal, newborn, child, adolescent health and nutrition (RMNCAH+N) services have been offered in North and South Kivu since 2000 and how successful they were. 
 
Methods: We conducted a case study using a desk review of publicly available literature, secondary analysis of survey and health information system data, and primary qualitative interviews. The qualitative component provides insights on factors shaping RMNCAH+N design and implementation. We conducted 49 interviews with government officials, humanitarian agency staff and facility-based healthcare providers, and focus group discussions with community health workers in four health zones (Minova, Walungu, Ruanguba, Mweso). We applied framework analysis to investigate key themes across informants. The quantitative component used secondary data from nationwide surveys and the national health facility information system to estimate coverage of RMNCAH+N interventions at provincial and sub-provincial level. The association between insecurity on service provision was examined with random effects generalized least square models using health facility data from South Kivu. 
 
Results: Coverage of selected preventive RMNCAH+N interventions seems high in North and South Kivu, often higher than the national level. Health facility data show a small negative association of insecurity and preventive service coverage within provinces. However, health outcomes are poorer in conflict-affected territories than in stable ones. The main challenges to service provisions identified by study respondents are the availability and retention of skilled personnel, the lack of basic materials and equipment as well as the insufficient financial resources to ensure health workers’ regular payment, medicaments’ availability and facilities’ running costs. Insecurity exacerbates pre-existing challenges, but do not seem to represent the main barrier to service provision in North and South Kivu. 
 
Conclusions: Provision of preventive schedulable RMNCAH+N services has continued during intermittent conflict in North and South Kivu. The prolonged effort by non-governmental organizations and UN agencies to respond to humanitarian needs was likely key in maintaining intervention coverage despite conflict. Health actors and communities appear to have adapted to changing levels and nature of insecurity and developed strategies to ensure preventive services are provided and accessed. However, emergency non-schedulable RMNCAH+N interventions do not appear to be readily accessible. Achieving the Sustainable Development Goals will require increased access to life-saving interventions, especially for newborn and pregnant women.

Keywords: health services, health system, conflict, population displacement, North Kivu, South Kivu, Democratic Republic of Congo, maternal, newborn, child, reproductive health

Topics: Age, Youth, Conflict, Gender, Women, Girls, Boys, Health, Reproductive Health, International Organizations, NGOs, Sustainable Development Goals (SDGs) Regions: Africa, Central Africa Countries: Democratic Republic of the Congo

Year: 2020

Supporting Social and Gender Equity Through Micro-Grid Deployment in the DR Congo

Citation:

Avrin, Anne-Perrine, Hilary Yu, and Daniel M. Kammen. 2018. “Supporting Social and Gender Equity Through Micro-Grid Deployment in the DR Congo.” In 2018 IEEE PES/IAS PowerAfrica, 646–51. Cape Town: IEEE.

Authors: Anne-Perrine Avrin, Hilary Yu, Daniel M. Kammen

Keywords: economics, sociology, statistics, electric potential, hydroelectric power generation, systematics, lightning

Topics: Conflict, Environment, Gendered Power Relations, Gender Equity, Governance, Infrastructure, Energy Regions: Africa, Central Africa Countries: Democratic Republic of the Congo

Year: 2018

“Provide Care for Everyone Please”: Engaging Community Leaders as Sexual and Reproductive Health Advocates in North and South Kivu, Democratic Republic of the Congo

Citation:

Steven, Victoria J., Julianne Deitch, Erin Files Dumas, Meghan C. Gallagher, Jimmy Nzau, Augustin Paluku, and Sara E. Casey. 2019. ““Provide Care for Everyone Please”: Engaging Community Leaders as Sexual and Reproductive Health Advocates in North and South Kivu, Democratic Republic of the Congo.” Reproductive Health 16. doi: 10.1186/s12978-019-0764-z.

Authors: Victoria J. Steven, Julianne Deitch, Erin Files Dumas, Meghan C. Gallagher, Jimmy Nzau, Augustin Paluku, Sara E. Casey

Abstract:

Background: Inadequate infrastructure, security threats from ongoing armed conflict, and conservative socio-cultural and gender norms that favour large families and patriarchal power structures contribute to poor sexual and reproductive health (SRH) outcomes in North and South Kivu provinces, Democratic Republic of the Congo (DRC). In order to expand contraceptive and post-abortion care (PAC) access in North and South Kivu, CARE, the International Rescue Committee and Save the Children provided technical support to the Ministry of Health and health facilities in these regions. Partners acknowledged that community leaders, given their power to influence local customs, could play a critical role as agents of change in addressing inequitable gender norms, stigma surrounding SRH service utilization, and topics traditionally considered taboo within Congolese society. As such, partners actively engaged with community leaders through a variety of activities such as community mapping exercises, values clarification and transformation (VCAT) activities, situational analyses, and education.

Methods: This manuscript presents findings from 12 key informant interviews (KIIs) with male political and non-political community leaders conducted in six rural health zones of North and South Kivu, DRC. Transcripts were analysed thematically to explore community leaders’ perceptions of their role in addressing the issue of unintended pregnancy in their communities.

Results: While community leaders in this study expressed overall positive impressions of contraception and strong support for ensuring access to PAC services following spontaneous and induced abortions, the vast majority held negative beliefs concerning women who had induced abortion. Contrasting with their professed opposition to induced abortion, leaders’ commitment to mediating interpersonal conflict arising between community members and women who had abortions was overwhelming.

Conclusion: Results from this study suggest that when thoughtfully engaged by health interventions, community leaders can be empowered to become advocates for SRH. While study participants were strong supporters of contraception and PAC, they expressed negative perceptions of induced abortion. Given the hypothesized link between the presence of induced abortion stigma and care-avoidance behavior, further engagement and values clarification exercises with leaders must be integrated into community mobilization and engagement activities in order to increase PAC utilization. 

Keywords: abortion, contraception, community leader, post-abortion care, DRC, Qualitative, community mobilization

Topics: Armed Conflict, Gender, Gender Roles, Gendered Power Relations, Patriarchy, Health, Reproductive Health, Infrastructure, International Organizations Regions: Africa, Central Africa Countries: Democratic Republic of the Congo

Year: 2019

African Democracy and Development: Challenges for Post-Conflict African Nations

Citation:

Veney, Cassandra Rachel, and Dick W. Simpson, ed. 2013. African Democracy and Development: Challenges for Post-Conflict African Nations. Lanham: Lexington Books.

Authors: Cassandra Veney, Dick Simpson

Annotation:

Summary:
Various African nations have undergone conflict situations since they gained their independence. This book focuses on particular countries that have faced conflict (civil wars and genocide) and are now in the process of rebuilding their political, economic, social, and educational institutions. The countries that are addressed in the book include: Rwanda, Mozambique, Sierra Leone, Liberia, and the Democratic Republic of the Congo. In addition, there is a chapter that addresses the role of the African Diaspora in conflict and post-conflict countries that include Eritrea, Liberia, and Somalia. The book includes an examination of the various actors who are involved in post-conflict rebuilding and reconstruction that involves internal and external participants. For example, it is clear that the internal actors involve Africans themselves as ordinary citizens, members of local and national governments, and members of non-governmental organizations. This allows the reader to understand the agency and empowerment of Africans in post-conflict reconstruction. Various institutions are addressed within the context of the roles they play in establishing governance organizations such as the Truth and Reconciliation Commission in Sierra Leone, the African Union, chiefs in Liberia, and non-governmental organizations. Furthermore, the external actors who are involved in post-conflict reconstruction are examined such as international non-governmental organizations and the African Diaspora. They both have their own constituents and agendas and can and do play a positive and negative role in post-conflict reconstruction. It is obvious that countries that are addressed in the book are in dire need of financial assistant to rebuild much needed infrastructure that was destroyed during the conflict. All of the countries covered in the book need schools, medical facilities, roads, bridges, airports, ports, and the government does not have the money to provide these. This is where the international non-governmental organizations and the African Diaspora play an important role. The chapters that address these issues are cognizant of their importance and at the same time, the authors realize that sovereignty can be undermined if Africans are not in the forefront of policy and decision making that will determine their future. There are chapters that provide a gendered analysis of post-conflict when it is appropriate. For example, it is clear that women, men, boys, and girls experienced conflict in different ways because of their gender. They all participated in the conflict in various ways. Consequently, the efforts at peace building are given a gendered analysis in terms of what has happened to women and girls in the demobilization and rehabilitation period including an excellent analysis of land reform in Rwanda and how that affects women and members of a certain ethnic group that are often overlooked in the examination of the 1994 genocide. In sum, this book provides a very good contribution to the literature on conflict and post-conflict African countries because of its depth and the vast topics it embraces. It provides an analysis of the internal and external actors, the role of gender in post-conflict decision making, and it provides the voices of ordinary Africans who were affected by the conflict, and who are determined to live productive lives. (Summary from Google Books)
 
Table of Contents:
Introduction / Cassandra R. Veney --
No justice, no peace : the elusive search for justice and reconciliation in Sierra Leone / Sylvia Macauley --
The role of ex-combatants in Mozambique / Jessica Schafer --
Memory controversies in post-genocide Rwanda : implications for peacebuilding / Elisabeth King --
Land reform, social justice, and reconstruction : challenges for post-genocide Rwanda / Helen Hintjens --
Elections as a stress test of democratization in societies : a comparison of Liberia, Sierra Leone, and the Democratic Republic of the Congo / John Yoder --
Partners or adversaries? : NGOs and the state in postwar Sierra Leone / Fredline A.O. M'Cormack-Hale --
Chieftancy and reconstruction in Sierra Leone / Arthur Abraham --
The role of African diasporas in reconstruction / Paul Tiyambe Zeleza --
The role of the African Union in reconstruction in Africa / Thomas Kwasi Tieku --
Governance challenges in Sierra Leone / Osman Gbla --
Challenges of governance reform in Liberia / Amos Sawyer --
Achieving development and democracy / Dick Simpson

 

Topics: Armed Conflict, Civil Wars, Combatants, DDR, Gender, Women, Girls, Gender Analysis, Genocide, Governance, Infrastructure, Transportation, International Organizations, Justice, NGOs, Peacebuilding, Post-Conflict, Post-Conflict Reconstruction Regions: Africa, Central Africa, East Africa, Southern Africa, West Africa Countries: Democratic Republic of the Congo, Eritrea, Liberia, Mozambique, Rwanda, Sierra Leone, Somalia

Year: 2013

Impacts of Violent Rapes among Women in Eastern Democratic Republic of Congo

Citation:

Mirindi, Benoit Munganga. 2018. "Impacts of Violent Rapes among Women in Eastern Democratic Republic of Congo." PhD diss., Walden University.

Author: Benoit Munganga Mirindi

Abstract:

For the last 22 years, systematic rapes and punitive violence against women in the Democratic Republic of Congo (DRC) were utilized as weapons of war and a control strategy. This quantitative study built upon the ecological model of impact of sexual assault on women’s mental health to investigate the relationship between the health impacts and chronic pain and depression among women survivors of sexual rape in eastern DRC. The sample included 156 female rape survivors, between 18–80 years old, and raped between 2010 and 2014 while residing in the conflict area. The research questions focused on the association between fistulas, other sexual rape-related injuries, post-traumatic stress disorder (PTSD), feelings of worthlessness, social rejection, support from family/friends, and chronic pain and depression among women victims of sexual rape in eastern DRC. Results from multinomial logistic regression and ordinal regression tests showed strong links between independent and dependent variables: Fistula was strongly linked with chronic illness over 6 months (p = 0.003), and with upset all the time (p = 0.033); PTSD was associated with chronic illness due to violent rapes ( p = 0.004) and sadness (p = 0.000); feelings of worthlessness was related to prolonged illness over 6 months (p = 0.024) and feeling blue (p = 0.006); social rejection was linked to avoidance (p = 0.003); and support from family/friends was associated with prolonged illness over 6 months (p = 0.025) and lack of excitement (p = 0.011). The results of this study could assist health care providers in formulating response strategies for identifying public health priorities in conflict area, addressing health needs, and defining approaches for reducing war-related sexual violence, chronic pain, and depression among rape survivors.

Topics: Armed Conflict, Conflict, Gender, Women, Health, Mental Health, PTSD, Sexual Violence, Rape, SV against women, Violence Regions: Africa, Central Africa Countries: Democratic Republic of the Congo

Year: 2018

Sexual Violence Against Men in Global Politics

Citation:

Zalewski, Marysia, Paula Drumond, Elisabeth Prugl, and Maria Stern, eds. 2018. Sexual Violence Against Men in Global Politics. Abingdon: Routledge.

Authors: Marysia Zalewski, Paula Drumond, Elisabeth Prugl, Maria Stern

Annotation:

Summary: 

“Sexual violence against men is an under-theorised and under-noticed topic, though it is becoming increasingly apparent that this form of violence is widespread. Yet despite emerging evidence documenting its incidence, especially in conflict and post-conflict zones, efforts to understand its causes and develop strategies to reduce it are hampered by a dearth of theoretical engagement. One of the reasons that might explain its empirical invisibility and theoretical vacuity is its complicated relationship with sexual violence against women. The latter is evident empirically, theoretically, and politically, but the relationship between these violences conjures a range of complex and controversial questions about the ways they might be different, and why and how these differences matter.

It is the case that sexual violence (when noticed at all) has historically been understood to happen largely, if not only, to women, allegedly because of their gender and their ensuing place in gender orders. This begs important questions regarding the impact of increasing knowledge about sexual violence against men, including the impact on resources, on understandings about, and experiences of masculinity, and whether the idea and practice of gender hierarchy is outdated. This book engages this diverse set of questions and offers fresh analysis on the incidences of sexual violence against men using both new and existing data. Additionally, the authors pay close attention to some of the controversial debates in the context of sexual violence against men, revisiting and asking new questions about the vexed issue of masculinities and related theories of gender hierarchy.

The book will be of great interest to students and scholars of sex, gender, masculinities, corporeality, violence, and global politics, as well as to practitioners and activists.” (Zalewski, Drumond, Prugl, and Stern 2018)

Table of Contents: 

INTRODUCTION - Sexual Violence Against Men in Global Politics

Marysia Zalewski, Paula Drumond, Elisabeth Prügl, and Maria Stern

"Tribulations" – Poem by Nziza D.Harouna

SECTION 1: PROVOCATIONS

1. Provocations in Debates about Sexual Violence against Men

Marysia Zalewski

2. Battle-Induced Urotrauma, Sexual Violence, and American Servicemen Chris Hendershot

3. Masculinity, Men and Sexual Violence in the U.S. Military

Elizabeth Mesok

4. Languages of Castration – Male Genital Mutilation in Conflict and Its Embedded Messages

Henri Myrttinen

5. Medical Approaches to Sexual Violence in War, in Guidelines and in Practice

Caroline Cottet

6. The Political Economy of Sexual Violence Against Men and Boys in Armed Conflict

Sara Meger

Reflections

Reflections on Sexual Violence Against Men and Boys in Global Politics
Paul Higate and Nivi Manchanda

Homo Interruptus
Paul Kirby

Can Our Intellectual Curiosity on Gender Cause Harm?
Madeline Rees

Gender, Sex and Sexual Violence Against Men
Laura J. Shepherd

Not for the Faint of Heart: Reflections on Rape, Gender, and Conflict
Lara Stemple

SECTION 2: FRAMING

7.  Uncovering Men’s Narratives of Conflict-Related Sexual Violence

Michele Leiby

8. Sex, Violence and Heteronormativity: Re-visiting Performances of Sexual Violence against Men in Former Yugoslavia

Paula Drumond

9. “Only a Fool…" Why Men Don’t Disclose Conflict-Related Sexual Violence in an Age of Global Media

Chris Dolan

10. Masculine Subjectivities in United Nations Discourse on Gender Violence (1970-2015): Perpetrators, Allies, and Victims

Gizeh Becerra

11. Sexual Violence or Torture? The Framing of Sexual Violence against Men in Armed Conflict in Amnesty International and Human Rights Watch Reports

Thomas Charman

12. Conflict-Related Sexual Violence against Men and the International Criminal Jurisprudence

Patricia Viseur Sellers and Leo Nwoye

Reflections

Familiar Stories, the Policing of Knowledge and Other Challenges Ahead
Maria Eriksson Baaz

Reflections on the Slippery Politics of Framing
Harriet Gray

Male Victims: A Blind Spot in Law
Charu Hogg

Sexual Violence against Men and Boys in the Congo
Ilot Muthaka

SGBV Against Men and Boys as a Site of Theoretical and Political Contestation
Jill Steans

"People you May Know" – Poem by Kevin Kantor

Topics: Conflict, Gender, Men, Boys, Masculinity/ies, Gendered Power Relations, Gender Hierarchies, Justice, International Tribunals & Special Courts, Post-Conflict, Sexual Violence, Rape, SV against men, Torture, Violence Regions: Africa, Central Africa, Europe, Balkans, Central Europe, Eastern Europe Countries: Bosnia & Herzegovina, Croatia, Democratic Republic of the Congo, Macedonia, Montenegro, Serbia, Slovenia

Year: 2018

Delivering Integrated Care after Sexual Violence in the Democratic Republic of the Congo

Citation:

Bress, Joshua, Givano Kashemwa, Christine Amisi, Jean Armas, Cindy McWhorter, Theodore Ruel, Arthur J. Ammann, Denis Mukwege, and Lisa M. Butler. 2019. "Delivering Integrated Care after Sexual Violence in the Democratic Republic of the Congo." BMJ Global Health 4. 

Authors: Joshua Bress, Givano Kashemwa, Christine Amisi, Jean Armas, Cindy McWhorter, Theodore Ruel, Arthur J. Ammann, Denis Mukwege, Lisa M. Butler

Abstract:

In the eastern Democratic Republic of the Congo, ongoing armed conflict increases the incidence of gender-based violence (GBV) and presents a distinct and major barrier to care delivery for all survivors of GBV. A specific challenge is providing emergency contraception, HIV prophylaxis and treatment for sexually transmitted infections to all survivors within 72 hours of violence. To address the multiple barriers to providing this time sensitive medical care, Global Strategies and Panzi Hospital implemented the Prevention Pack Program. The Prevention Pack is a prepackaged post-rape medical kit containing antiretroviral post-exposure prophylaxis, antibiotics for treatment of sexually transmitted infections and emergency contraception. The Prevention Pack Program combines community sensitisation about post-rape medical care with the provision of Prevention Packs and the implementation of a cloud-based and Global Positioning System (GPS)–enabled inventory management system. The Panzi Hospital gender-based violence team implemented the Prevention Pack Program at Panzi Hospital and 12 rural clinics in the South Kivu Province. The data manager took GPS coordinates of each site, provided an initial stock of Prevention Packs and then called all sites daily to determine demand for post-rape care and Prevention Pack consumption. Inventory data were entered into the GPS-enabled cloud-based inventory management system. Project personnel used the consumption rate, trends and geolocation of sites to guide Prevention Pack restocking strategy. Between 2013 and 2017, a total of 8206 individuals presented for care following rape at the study sites. Of the 1414 individuals who presented in the rural areas, 1211 (85.6%) did so within the first 72 hours of reported rape. Care was delivered continuously and without a single stockout of medication across all sites. The Prevention Pack Program provided timely and consistent access to emergency contraception, HIV prophylaxis and treatment for sexually transmitted infections for rape survivors in the eastern Democratic Republic of the Congo.

Topics: Armed Conflict, Gender-Based Violence, Health, HIV/AIDS, Livelihoods, Sexual Violence, Rape, Violence Regions: Africa, Central Africa Countries: Democratic Republic of the Congo

Year: 2019

Hybrid Clubs: A Feminist Approach to Peacebuilding in the Democratic Republic of Congo

Citation:

Martin de Almagro, Maria. 2018. “Hybrid Clubs: A Feminist Approach to Peacebuilding in the Democratic Republic of Congo.” Journal of Intervention and Statebuilding 12 (3): 319-34.

Author: Maria Martin de Almagro

Abstract:

Critical approaches to peacebuilding have achieved a local turn wherein alienated indigenous experiences are the cornerstone of emancipatory practices – yet this emancipation of the ‘different’ risks perpetuating the discrimination and normalization of the challenged liberal peace. Using the case study of a feminist campaign to elect more women in the Democratic Republic of Congo (DRC), this article’s feminist approach to critical peacebuilding utilizes storytelling to develop a conceptual grid that reveals the complexities of the politics of difference, and proposes the concept of the ‘hybrid club’ as a cluster of local and international actors coalescing to develop peacebuilding initiatives.

Keywords: hybridity, gender, Democratic Republic of the Congo, space, embodiment, experience, peacebuilding

Topics: Feminisms, Gender, Women, Governance, Elections, Peacebuilding Regions: Africa, Central Africa Countries: Democratic Republic of the Congo

Year: 2018

Perceptions of Justice and Hierarchies of Rape: Rethinking Approaches to Sexual Violence in Eastern Congo from the Ground Up

Citation:

Aroussi, Sahla. 2018. "Perceptions of Justice and Hierarchies of Rape: Rethinking Approaches to Sexual Violence in Eastern Congo from the Ground Up." The International Journal of Transitional Justice 12 (2): 277-95.

Author: Sahla Aroussi

Abstract:

Based on extensive fieldwork in South Kivu in eastern Democratic Republic of the Congo (DRC), this article considers the question of justice for survivors of sexual violence from the ground up. It argues that survivors of rape by armed groups or civilians in the DRC primarily conceive of justice as economic assistance and have limited interest in the prosecution of perpetrators. Such emphasis on economic assistance cannot be separated from the reality of poverty in which survivors live and local perceptions and practices of justice that are rooted in the concept of reparation. At the same time, survivors’ reluctance to pursue formal justice must be understood in the light of the inaccessibility of the Congolese criminal justice system and its failure to play a positive role in society. The article concludes by offering some recommendations for actors and scholars in this area.

Topics: Economies, Poverty, Justice, Reparations, Military Forces & Armed Groups, Sexual Violence, Rape Regions: Africa, Central Africa Countries: Democratic Republic of the Congo

Year: 2018

Women Peace and Security: Adrift in Policy and Practice

Citation:

Davis, Laura. 2019. "Women Peace and Security: Adrift in Policy and Practice." Feminist Legal Studies 27 (1): 95-107.

Author: Laura Davis

Abstract:

This comment refects on how the Women, Peace and Security (WPS) agenda has been translated into policy and put into practice by the European Union and the Democratic Republic of Congo. Although the WPS agenda has enabled many gains by women peacebuilders, this comment identifes important challenges from these two very diferent contexts. First, situating WPS policy areas within a broader feminist political economy analysis demonstrates how little infuence the WPS agenda has across government. Second, the WPS agenda is being (mis)used to promote heteronormative, patriarchal understanding of ‘gender’, stripped of any power dynamics and excluding any gender identities that do not conform. The result, then, is that WPS policies and practice are adrift in the patriarchal policy mainstream.

Topics: Feminisms, Feminist Political Economy, Gender, Gendered Power Relations, Patriarchy, Peacebuilding, Peace and Security, UN Security Council Resolutions on WPS Regions: Africa, Central Africa, Europe Countries: Democratic Republic of the Congo

Year: 2019

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