Medical and psychological consequences of rape among survivors during armed conflicts in northeast Ethiopia

Abstract

Background Rape is the most common act of violence against women during wartime which is considered interpersonal, social and political violence because survivors usually suffer from stigma and discrimination in the community. Sexual violence is a serious threat to women’s health. The psychological and medical consequences of rape during the conflict period are not well documented. Therefore, this study investigated the psychological and medical consequences of rape among survivor in the northern Ethiopia conflict, which occurred since 2020–2022. Methods A retrospective cross-sectional survey supplemented with a qualitative data was conducted among survivors of rape recorded until June 2022. Health institutions that provide maternal and child health services in the study area were included. All rape victims who received medical care following the incident were included. Victims who were found in active war areas or rape care recorded before wartime were excluded. To understand the experience of raped women’s psychological consequences related to sexual assault we conducted 23 in-depth interviews. Thematic analysis was used to conduct qualitative interpretation. Results The mean age of the participants was 31.66 (SD ± 20.95) years. One-third of 92(33.9%) of the survivors were diagnosed positive for sexually transmitted infections. Chlamydia 54(58.4%) and HIV 32(34.8%) were the most frequently diagnosed infections. Among the rape survivors, one-tenth 29(10.7%) of them were positive for pregnancy, and induced abortion was done for 13 (44.8%) women who got pregnant due to sexual assault. The armed groups not only have sexual interests but inhumane individuals and consider rape as their way of expressing abjection to civilians. Survivors of raped women are confronted with social rejection and exclusion in the community that aggravates the traumatic process. Because of shame and fear, rape survivors often do not seek help but have to be offered support proactively. The victims claimed that they didn’t able to return to their previous life and considered their future in peril. Conclusion Conflict has a multidimensional devastating life effect, especially on women’s health. The victims experienced many physical and psychological consequences. Hence, resolving conflicts with peaceful discussion has numerous benefits for civilians.

Negative consequences of conflict-related sexual violence on survivors: a systematic review of qualitative evidence

“…In all the included studies, only qualitative data was extracted. When the study population also included minors, data was extracted only when it was clear that it was not referred to them [ 41 – 48 ]. Since none of the studies reporting the experiences of transgender victims provided details about their gender [ 42 , 49 ], information about this population will be presented separately from cisgender women and men, together with gender diverse survivors.…”

“… 13 adult women survivors of SV who were rejected by any family member; their husbands, community members, and community workers. X X X Tenaw, Ethiopia, (2022) [ 41 ]. Armed conflict, Ethiopia.…”

“…Eight themes can be recognized among the objectives of the retrieved studies: a) sexual violence-related pregnancy (SVRP), termination and living with children born after SVRP [ 43 , 50 , 51 , 57 , 63 ]; b) survivors’ help seeking and reporting behaviors, and barriers and facilitators in accessing services [ 42 , 48 , 52 , 62 ]; c) CRSV during conflict, flight, migration, displacement, encampment, and in prison [ 45 – 47 , 56 , 58 , 59 , 61 ]; d) consequences on physical and mental health and social dimensions [ 41 – 44 , 47 , 49 , 55 , 60 ]; e) men survivors and masculinity [ 42 , 47 , 54 , 62 ]; f) interventions, tools, and recommendations [ 43 , 45 , 48 , 55 , 62 ]; g) HIV + (Human Immunodeficiency Virus) survivors [ 53 ]; h) general descriptions of GBV [ 48 ].…”

A cross-sectional study on quality of life of survivors of sexual assault

“…[ 7 8 9 ] These physical symptoms may include injuries requiring medical attention, pain, and discomfort, according to earlier researchers. [ 10 11 ] In one study on sexual trauma, 4% had non-genital injuries requiring hospitalization and 1% had a genital injury requiring repair. [ 12 ] Survivors also reported higher levels of somatic complaints, poorer perceptions of physical health, and increased psychological distress compared to the general population.…”

A mini-review on safeguarding global health amidst a “Pandemic” of armed conflicts

“…According to international humanitarian laws and the Geneva Convention, the safety of healthcare workers is paramount during conflicts and should be prioritized. [ 40 ] One way to achieve that is to create safe zones where health workers can provide services to those in need. In addition, protecting health infrastructure from damage is equally important.…”