Many victims, aged six to over seventy years, have been gang raped by up to twenty-five combatants or taken prisoner and used for months or years as sex slaves. The rapes have often been accompanied by sexual torture with, for example, bayonets or sharpened-sticks inserted into the woman’s vagina or even gunshots to the genitals.

Edith, aged 16, and her sisters Jeanette (22), and Francine (20), were raped by up to 20 soldiers of the dissident RCD-Goma force that took control of the city of Bukavu in early June 2004:

'That evening we could see them sitting with their vehicle in front of our house. As soon as it got dark, they came in. Jeanette was raped by seven soldiers in the storeroom, Francine by eight soldiers in the shop. They put me in the bathroom. I fought with five of the soldiers when they tried to make my brothers watch me being raped. But they beat me so hard. They tore off my clothes. It was the first time I’d had sexual relations. When I bled the soldier hit me in the face because he said I had 'dirtied' him. At some point my mother and brothers were brought in to watch. When one group had finished, another group came in. I just lay there, without moving. It lasted all night.'

The brutality of rape causes serious physical injuries that require long-term and complex medical treatment; injury to the reproductive system can require relatively expensive operations. There is also a massive increase in sexually transmitted diseases. The rate of HIV/AIDS infection may have reached over 20 per cent in the east and could threaten more than half of the population within the next ten years.

The health care infrastructure, already severely under-resourced, has broken down completely due to the war. There is often no water or electricity supply, and hospital windows, doors and beds are missing because of looting. Doctors and nurses are neither paid nor supported by the government. In the east of the country, only two hospitals, heavily assisted by the international community, have the gynaecologists and medical equipment needed to adequately treat survivors of sexual violence.

Amnesty International UK Campaigns Director Stephen Bowen said: 'Rape in eastern DRC is a human rights and a health crisis. Countless Women's rights's rightss rights's rights's rights's rights and girls are in desperate need of treatment but no organised or comprehensive response has been developed to assist them.

'The government and the international community must act now to ensure access to medical care for thousands of rape survivors and ensure that the rehabilitation of the health care system is a priority.'

All of the 20+ armed groups involved in the DRC conflict have committed rape and sexual violence, including government armed forces of DRC, Rwanda, Burundi and Uganda. Rape has been used as a deliberate strategy of warfare to destabilise opposition forces, as reprisal, and to terrorise whole communities. There is complete impunity for rape, meaning it can continue because combatants know they will not face justice.

As a result of the stigma attached to rape, survivors often suffer rejection by their communities and abandonment by their husbands. Women's rights's rightss rights's rights's rights's rights are left as the sole carers of themselves and their Children's rights and, generally, cut off from the means to make a living.

Amnesty International is calling for:

• an emergency assessment mission, composed of mixed DRC and international medical experts, to be formed immediately to evaluate the needs of the DRC’s national health care system. Its findings should form the basis of a joint national and international plan for the priority reconstruction of the DRC’s health system
• the DRC government to assume its responsibility to prevent, punish and eradicate sexual violence, and demonstrate that such behaviour is not tolerated
• a coordinated national and international effort to improve security in the eastern provinces as a priority.

Amnesty International’s global campaign to Women's rights's rights's rightss rights's rights's rights's rights is working to end this and other hidden human rights atrocities.

Women's rights's rightss rights's rights's rights's rights and girls interviewed by Amnesty International in the report include:

Odile, from Ituri in the East, was raped first in April 2003 by an RCD-ML soldier, again in June 2003 by two members of the UPC, and finally in September 2003 by another combatant from an unidentified force. She was pregnant from the last rape when interviewed and had been thrown out by her husband because of the second rape. Odile cannot work because of health problems following the rapes, and has two Children's rights to look after. She is entirely dependent on a cousin for her food and lodging, and is deeply worried about the future. Odette, a girl of six, was raped in December 2003 by a ‘mayi-mayi’ combatant as she played in front of her home. She was dragged into the grounds of the local school where the attack happened. After hours of searching, Odette’s parents found her lying on the ground behind the school at midnight, unconscious and bleeding profusely. In March 2004 she was still in hospital, having undergone surgery for a fistula (an opening caused by a loss of tissue from the wall of the vagina leaving it connected to the bladder and/or the rectum). She suffers nightmares, cries constantly and has difficulty in speaking.

Caroline, aged 15, was taken by a ‘mayi-mayi’ group in July 2003, who tortured and raped her over two months:

'I was on my way to the fields with my mother. The soldiers took us to Lubao. There, they tied us up, gave my mother 50 lashes of the whip and then put her in another house. They bound me hand and foot, too, and gave me 80 lashes. There were twelve soldiers and they raped us every evening. They gave us nothing to eat or drink and we had to drink whatever water we could find on the ground.

'One day, we ran away, but two 'mayi-mayi' caught us and took us back to Lubao. They tortured us for several weeks and raped us. In August, we managed to run away, but when we arrived [home], everything had been looted and the house had been burned down. Before, I was a student and had friends, but now we have no home, nothing, so I can’t study any more. When we walk along the street, people look down on us. The community despises us. I will never forget that I have been raped.'