Women and children fleeing deadly violence in eastern Democratic Republic of Congo (DRC) have reported surviving gruesome sexual attacks and genital mutilation by armed men using tree branches, guns, and knives, Save the Children said.

Psychologists working with Save the Children’s local partners in displacement camps in North Kivu have documented mass events of sexual violence against children as young as nine. Teams are treating survivors nearly every day who are facing unwanted pregnancies, health complications, stigma, and suicidal thoughts.

The majority of sexual violence cases in North Kivu are happening when survivors are fleeing the escalating fighting between the DRC army, the M23, and many other armed groups, which has forced more than 250,000 people, including about 130,000 children, from their homes.

Elvis, a clinical psychologist with Save the Children’s partner organisation, Heal Africa, spoke of the horrific sexual attacks she’s treated:

“What pains me the most is the seriousness of the atrocities being committed. Some survivors tell us several men raped them at the same time, and objects were used on them, such as knives, tree branches, and guns. Others have been raped on numerous occasions, during different armed displacements, return movements or in search of something to eat in their village.

“These girls are left with unwanted and very high-risk pregnancies. Some survivors, no longer wanting to bear it, have the urge to commit suicide. I work with the survivor, so they know that what happened to them is not their fault. I establish jointly with the person or their relatives, a safety plan to mitigate the risk of suicide.

“There are also cases of some partners wanting to end their marriage because they believe their partner wanted it. Imagine the stigma, distress, guilt and rejection faced by these women and girls who are survivors of sexual violence. In these cases, if the partner is approachable, I do therapy sessions to find their family harmony.”

Last month, two Save the Children-supported health facilities in North Kivu were looted. Both facilities help provide desperately needed medical attention to survivors of sexual and gender-based violence.

The current wave of violence follows a tumultuous year of heightened outbreaks of conflict in North Kivu in 2023, when intensified fighting in the east of the country displaced more than 1 million people, including at least 500,000 children.

Save the Children documented more than 800 cases of sexual and gender-based violence across the three conflict-affected provinces Ituri, North Kivu and South Kivu. These statistics are likely to be a significant underestimate of the true number of cases, as sexual violence often goes underreported due to stigma and fear.

Florence*, 15, was subjected to acts of sexual violence by two men while fleeing her home:

“One of them took me by force, strangled me, and [they] raped me one after another. He had strangled me so much that I no longer had the strength to scream. Then they left. I was afraid and ashamed to tell this story to the couple who had welcomed me into their home - they were friends of my parents, and even when I arrived at my mother's [I couldn’t say anything]."

Florence explained that she only felt comfortable speaking up about her experience after attending an awareness-raising activity about abuse and violence against women and girls that Save the Children helped organise in the displacement camp.

“When I told agents from Save the Children that I was raped a few weeks ago, they quickly took me to the hospital; and there, the nurse told me that I was pregnant,” said Florence. “My greatest wish is to see, one day, my aggressors before the judges and be sentenced.”

Save the Children and its local partners are supporting sexual assault survivors like Florence in the DRC through mental health and psychosocial support, hospital and specialist referrals, organising support groups where survivors can share their experiences, and hosting awareness-raising activities about children’s rights and abuse.

Save the Children also provides survivors with information about support and medical attention to help prevent HIV/AIDS, sexually transmitted infections, unwanted pregnancies, and to cope with distress.

In many conflicts, sexual violence continues to be used as a weapon of war to terrorise women and children. Save the Children calls for an immediate end to the impunity of sexual violence against children by strengthening laws and enforcing them, while holding perpetrators to account. The child rights organisation also calls for increased investment to strengthen and better coordinate the collection of data on sexual violence and ensure survivors have access to adequate health and care services to support them on their long road to recovery.

Save the Children has worked in the DRC since 1994 to meet humanitarian needs linked to the arrival of refugees and the displacement of populations due to armed conflict in eastern provinces. Save the Children has scaled up its humanitarian response to support existing care systems, training local leaders and communities to prevent and respond to exploitation and abuse and ensuring access to healthcare through mobile clinics.