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Impact of Violent Rapes Among Women in Eastern Democratic Republic of Congo Benoit Munganga Mirindi Walden University

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Impact of Violent Rapes Among Women in Eastern Democratic Republic of Congo Benoit Munganga Mirindi Walden University Walden University ScholarWorks Walden Dissertations and Doctoral Studies Walden Dissertations and Doctoral Studies Collection 2018 Impact of Violent Rapes Among Women in Eastern Democratic Republic of Congo Benoit Munganga Mirindi Walden University Follow this and additional works at: https://scholarworks.waldenu.edu/dissertations Part of the Epidemiology Commons This Dissertation is brought to you for free and open access by the Walden Dissertations and Doctoral Studies Collection at ScholarWorks. It has been accepted for inclusion in Walden Dissertations and Doctoral Studies by an authorized administrator of ScholarWorks. For more information, please contact [email protected]. Walden University College of Health Sciences This is to certify that the doctoral dissertation by Benoit Munganga Mirindi has been found to be complete and satisfactory in all respects, and that any and all revisions required by the review committee have been made. Review Committee Dr. Sriya Krishnamoorthy, Committee Chairperson, Public Health Faculty Dr. Xianbin Li, Committee Member, Public Health Faculty Dr. Diana Naser, University Reviewer, Public Health Faculty Chief Academic Officer Eric Riedel, Ph.D. Walden University 2018 Abstract Impact of Violent Rapes Among Women in Eastern Democratic Republic of Congo by Benoit Munganga Mirindi MPH, Tulane University, 2005 MPA, University of Maine at Orono, 2000 BA, University of Maine at Orono, 1998 Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Doctor of Philosophy Epidemiology Walden University November 2018 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. Impacts of Violent Rapes Among Women in Eastern Democratic Republic of Congo by Benoit Munganga Mirindi MPH, Tulane University, 2005 MPA, University of Maine, 2000 BA, University of Maine, 1998 Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Doctor of Philosophy Epidemiology Walden University November 2018 Dedication Praise, honor, and glory to the Lord God, my Maker, He Who made this plan for me and allowed it to be a dream in me and kept me alive to achieve it. He has blessed me with many blessings, breathed in me the spirit of life, lifted me up from the dust, protected me against flying arrows, strengthened me in my brokenness, and loved me in my worthlessness. At His will, He filled me with the gifts of knowledge, wisdom, and understanding. For He has done so many great things and has made them all possible for me, Holy is His Name. To Him all the praises and glory forever. This work is dedicated to my lovely and dearest spouse, Sylvie S. Mirindi, whose patience and continued support have made this journey bearable, and to my lovely children, Gracia Ali’Eka, Aldrich Nabugobe, Alina Binty, and Joseph-Gabriel Busane, who have been my greatest inspiration for this accomplishment. Without your continued support, my effort could have been fruitless. This work is in honor of my dearest parents, Maurice Mirindi and Leocadie Mujijima, who taught me the way of life, emptied themselves so that I could live, and helped me to understand that it is never enough to do good if you have a chance to do better or best. To my brothers and sister who have been the greatest source of encouragement, and particularly to my brother-in-law, Steven (Etienne) Bundi Mushegerha, who, since my younger age lifted and believed in my abilities. To the honor of all the 13 million people who have died as a result of violence in DR Congo, and to the victims of violent sexual rape, you will never be forgotten. Acknowledgments It is with heartfelt gratitude that I acknowledge all my committee members who, with demonstrated dedication, wisdom, and patience, guided me through this journey to make it through this day. More particularly, special thanks to my Committee Chair, Dr. Sriya Krishnamoorthy, for exceptional advising and mentoring and for efficient and passionate leadership in this dissertation process. I sincerely thank you because you understood my struggles and knew how to positively use them to challenge and motivate me, while you directed my attention to focus on a successful end results. I am greatly thankful to Dr. Daniel Li Xianbin, my second committee member, for being there for me, for your guidance, support, and especially for your tough questions which gave me a new work approach. I would like to sincerely thank Dr. Diana Naser, my University Research Reviewer, for her commitment and dedication for my success. Your timely responses, constructive criticisms, and attention to details revealed a sense of completeness toward a successful achievement. To Dr. Tammy Root, I owe special thanks for your individualized advice that you offered me from my early days in this program. You assisted me with every request that I presented to you, and you worked diligently to find a proper response to all my concerns. Your advice, support, and encouragement helped me make it to this day. I would like to extend my gratitude to Dr. Peter Anderson, who assisted me as my second committee member from the beginning of dissertation journey, but who couldn’t continue due to special health circumstances. Dr. Anderson, thank you, because your expertise, timely and consistent feedback, your tough, unwavering challenges and focus on high-quality product inspired me in defining the nature and form of this study. My gratitude also extends to the WU IRB Commission for their ethical assessment of my study and for making vital recommendations which assisted me in understanding the WU PhD research requirements. Many thanks also go to all the WU faculty and administrative members, as well as the academic advisory team whose teaching and advice positively affected my learning toward reaching this goal. Special thanks also to Dr. Denis Mukwege, Director and Founder of Panzi Hospital and Panzi Foundation, for supporting my effort and for encouraging me. Despite your busy schedule, you countlessly made your-self available for me and used your expertise in health issues affecting the women victims of sexual violence in eastern DR Congo to advise me on how to understand them. Special thanks also to your staff members, Dr. Neema Rukungu and Dr. Christina Amisi of the International Center for Advanced Research and Training (ICART) for their consultancy during the data collection process. My special thanks also go to you, Dr. Nadine Muhune Mugaba of St. Vincent Hospital, for making yourself available and for answering my questions during my consultancy visits in preparation for data collections. Special thanks also to Mr. Amani Matabaro Tom, Director and Founder of Actions Pour le Bien être de la Femme and de L’Enfant au Congo (ABFEC), who introduced me to the local communities where I personally met the study participants for data collection. I would like to thank Dr. Chukwuma Eze at Good Samaritan Hospital and Health Center, Dayton, OH; Dr. Jim Toner of the University of Maine, Orono; Dr. James Warhola, University of Maine, Orono; and Dr. Lyombe Eko, University of Iowa, Iowa City, IA. You all have believed in me since our first encounter and have since encouraged me to follow the dreams of my heart. You have made an everlasting impact in my academic and professional life. I would like also to thank Dr. Fidele Mutima and Dr. Regina Hutchins for being great and consistent mentors. My special thanks go also to my family members, and all men and women whose work of kindness and word of encouragement have touched me and moved me toward achieving this goal. May the Lord our Savior bless you all with many blessings. Table of Contents List of Tables ...................................................................................................................
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