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Mankuta D.,Hebrew University of Jerusalem | Mankuta D.,Bat Ami Sexual Assault Treatment Center | Aziz-Suleyman A.,Malteser International | Yochai L.,Latet Organization | Allon M.,Israel Psychology Association
Israel Medical Association Journal | Year: 2012

Background: During the horrific war in the Democratic Republic of Congo during the years1996-2007 the number of casualties is estimated to be 5.4 million. In addition, 1.8 million women, children and men were raped, many as a social weapon of war. Many of these women still suffer from post-traumatic stress disorder (PTSD) and mutilated genitals. Objectives: To assess a short-term interventional team for the evaluation and treatment of sexual trauma victims. methods: The intervention program comprised four components: training the local staff, medical evaluation and treatment of patients, psychological evaluation and treatment of trauma victims, and evacuation and transport of patients with mutilated genitals. A diagnostic tool for post- traumatic stress disorder (PTSD) - the Impact Event Scale (IES) - was used. The psychological treatment was based on EMDR (eye movement desensitization and reprocessing) principles. Using questionnaires, the information was obtained from patients, medical staff and medical records. results: Three primary care clinics were chosen for intervention. Of the 441 women who attended the clinics over a period of 20 days, 52 women were diagnosed with severe PTSD. Psychological intervention was offered to only 23 women because of transport limitations. The most common medical problems were pelvic inflammatory disease and secondary infertility. Nine patients suffered genital mutilation and were transferred for surgical correction. The 32 local nurses and 2 physicians who participated in the theoretical and practical training course showed improved knowledge as evaluated by a written test. conclusions: With the short-term interventional team model for sexual assault victims the combined cost of medical and psychological services is low. The emphasis is on training local staff to enhance awareness and providing them with tools to diagnose and treat sexual assault and mutilation. Source

Gerstl S.,Malteser International | Sauter J.,Malteser International | Kasanda J.,Malteser International | Kinzelbach A.,Malteser International
PLoS ONE | Year: 2013

Introduction:The Democratic Republic of the Congo is today one of the poorest countries in the world; the health status of the population ranks among the worst in Sub-Saharan Africa. Public health services charge user fees and drug prices. Since 2008, north-eastern Congo is facing a guerrilla war. Malteser International is assisting with free health care for internally displaced persons as well as the general population. Before the incursion the health system was based on user fees. The aim of this study was to determine the socio-economic conditions of the population and to assess their ability to contribute to health care.Methodology:Heads of 552 randomly selected households in 23 clusters in two health zones were interviewed using a standardised questionnaire.Findings:The demographic description and socio-economic conditions of the study population were homogenous. Major source of income was agriculture (57%); 47% of the households earned less than US$ 5.5/week. Ninety-two percent of the interviewed households estimated that they would be able to contribute to consultation fees (maximum amount of US$ 0.27) and 79% to the drug prices (maximum amount of US$ 1.10). Six percent opted for free consultations and 19% for free drugs.Conclusions:Living conditions were very basic; the estimated income of the study population was low. Almost half of the population perceived their current living situation as fairly good/good. More than 90% of the study population estimated to be able to contribute to consultation fees and 80% to drug prices. As a result Malteser International suggested introducing flat-rates for health care services. Once the project ends, the population will have to pay again for their health service. One solution would be the introduction of a health care financing system with the goal to reach universal coverage to health care. © 2013 Sibylle Gerstl. Source

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