Sexual and nonsexual violence and mental health among male refugees from the Democratic Republic of Congo residing in Kampala, Uganda: a population-based survey

ABSTRACT

We conducted a population-based survey in 2013 in Kampala, Uganda, to examine violence and mental health outcomes among self-settled male refugees from the Eastern Democratic Republic of Congo (DRC). Male DRC refugees aged 18+ years were sampled through respondent-driven sampling. Key interview domains included demographics, experiences of sexual and nonsexual violence, social support, PTSD, depression and suicide ideation. Data analysis was weighted to generate population-level estimates. We sampled 718 men (mean age: 33 years), most of whom had lived in North or South Kivu. Nonsexual violence, such as beatings (79.4%) and torture (63.8%), was frequent. A quarter (26.2%) had been raped; 49.9% of rape victims had been raped on multiple occasions, and 75.7% of rape victims had been gang raped. We estimated 52.8% had post-traumatic stress disorder (PTSD); 44.4% reported suicidal ideation. Numerous traumas were significantly (p < 0.05) associated with PTSD such as rape (adjusted odds ratio [aOR] = 1.82), war-related injuries (aOR = 2.90) or having been exposed to >15 traumas (compared to ≤10; aOR = 6.89). Traumata are frequent experiences in this self-settled male refugee population and are often accompanied by adverse mental health outcomes. Screening for trauma and adverse mental health outcomes and providing targeted services are paramount to improve these refugees’ lives.

KEYWORDS:

• DR Congo
• refugees
• conflict
• male
• sexual and nonsexual violence
• mental health

Acknowledgments

We thank the survey respondents for their participation.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Authors’ contributions

All authors substantially contributed to the study’s design, conduct, data analysis and interpretation, or wrote or edited parts of the manuscript, and approved the final version for publication.

Data availability statement

Reasonable requests for de-identified data will be considered.

Disclaimer

The findings and conclusions in this report are those of the authors and do not necessarily represent the views of the U.S. Department of Health and Human Services.

Notes

1. President’s Emergency Plan for AIDS Relief.

Additional information

Funding

This project has been supported by the President’s Emergency Plan for AIDS Relief (PEPFAR) through the Centers for Disease Control and Prevention under the terms of cooperative agreement [5U2GPS000971].

Notes on contributors

Wolfgang Hladik

Wolfgang Hladik is a Medical Doctor from Vienna, Austria, and a PhD in Epidemiology from the University of Amsterdam. He is currently Chief of the Epidemiology and Surveillance Branch, Division of Global HIV and TB, at the CDC.

Pamela Nasirumbi Muniina

Pamela Nasirumbi Muniina is a Statistician and Epidemiologist from Uganda with an MSC in Statistics from Kwazulu-Natal University and a PhD in Epidemiology from London School of Hygiene and Tropical Medicine. She is currently the Deputy Chief of the Data Science and Informatics branch at the CDC-Uganda.

Itziar Familiar

Itziar Familiar is a Medical Doctor from Mexico City with a PhD in Mental Health from Johns Hopkins Bloomberg School of Public Health. She is Assistant Professor at the Department of Psychiatry, Michigan State University.

Peter Kaiser

Peter Kaiser is a Medical Doctor from Germany, has a PhD from the University of Tubingen and is Professor of Religious Studies at the University of Bremen. A trained psychiatrist, he was Medical Doctor of the outpatient clinic for torture and war victims of the Swiss Red Cross in Bern.

Moses Ogwal

Moses Ogwal is a surveillance officer at the School of Public Health, Makerere University and leads the field implementation of the Crane Survey.

David Serwadda

David Serwadda is a Medical Doctor, has a Master’s in Public Health, and a Honorary Doctorate from Johns Hopkins University. He is Professor in the Department of Disease Control and Environmental Health at Makerere University’s School of Public Health.

Enos Sande

Enos Sande is a data management specialist from Uganda, currently working as a Health Information Systems Analyst at the CDC in Kampala.

Herbert Kiyingi

Herbert Kiyingi holds a medical degree and leads the HIV surveillance unit at the CDC in Kampala, Uganda.

Chantal Siya Bahinduka

Chantal Siya Bahinduka is from DR Congo, where she obtained a bachelor’s degree in Community and International Development and a Nursing Diploma. She currently works as nurse assistant with Action Marguerite, an NGO based in Winnipeg, Canada.

Chris Dolan

Chris Dolan is an academic, activist, consultant and practitioner, and currently professor in Global Sustainable Development at the University of Warwick, UK. He has a PhD in Development Studies from The London School of Economics has been the Director of Refugee Law Project.