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This thesis aims to investigate the phenomenon of war rape in Eastern Democratic Republic of Congo (DRC) in order to understand the dynamics, contextual realities and consequences of its perpetration. Practical and theoretical knowledge is generated which is relevant for health care interventions, humanitarian assistance and peace initiatives, that are cognizant of the actual needs of the affected populations. The study employed ethnographic methodology involving prolonged engagement with the field, participant observation, formal and informal interviews, keeping of field notes and the continuous practice of reflexivity. The four papers in this thesis represent formal interviews with participants from three distinct groups: local leaders (Paper I), ex-child soldier boys (Paper II) and women survivors of sexual violence (Paper III & IV). Qualitative Content Analysis was used for the interview study with local leaders (Paper I). Findings from this study reveal how mass rape and the methods of perpetration create a chaos effectively destroying communities. The leaders draw attention to the fact that an exclusive focus on raped women misses other structural factors that contribute to war and sexual violence, factors such as the global political economy, international apathy, the stance of the church, effects of militarization, inappropriate aid and interpretations of gender roles. Through the theoretical lenses of militarised masculinity and gender based violence, interviews with ex-child soldier boys, seen as both victims of war as well as proxy perpetrators of sexual violence, were analyzed using thematic analysis. Findings revealed the systematic and violent construction of children into soldiers, inculcating a rigid set of stereotypical hyper-masculine behaviors promoting dominance by violating the subordinate "other". These findings argue for a more complex, contextualized view of the perpetrator resulting from the ways society has (re)constructed gender, ethnicity and class. Papers III and IV reflect the interviews and narratives provided by women survivors. Guided by thematic analysis and a matrix of theories: Structural violence, Intersectionality and "new wars"; Paper III bears witness to the women's expressions of their profound losses and dispossession as they struggle to survive stigmatization in the impoverished margins of the warzone, along with children born of rape. The perpetrator is cited here as well as by the leaders as predominantly Interhamwe. Payne's Sites of Resilience model used in Paper IV situates stigmatized women survivors suffering in a global context as they navigate survival, demonstrating resilience in the margins through support from their faith in God, scarce health services, indigenous healing and strategic alliances. Findings suggest that collaborations of existing strengthened networks, ie: the church, healthcare and indigenous healers, could extend the reach of sustainable and holistic support services, positively effecting already identified sites of resilience. Findings draw attention to the challenges faced by public health in addressing mass trauma. Women's raped bodies represent tangible material damage, embedded in a matrix of globalization processes and structural violence involving gender, ethnicity and class. This requires serious reflection.

Background: In 2015 alone, 5,9 million children under the age of five died. In an attempt to reducechild mortality in Eritrea, the government implemented community- based child healthinterventions by community health workers (CHWs). Despite progress, challenges remain.In Eritrea, few studies have examined CHWs and community perceptions of child healthinterventions. The aim of this study was to explore the perceptions of CHWs regardingbenefits and challenges of community-based child health interventions in the Maekelregion in Eritrea. Methods: An explorative qualitative study was conducted employing focus group discussions. Data was analyzed using qualitative content analysis. Results: The CHWs reported positive aspects such as easier access to health services, generated relationships and support and opportunities to give back to the community. Perceived challenges were: constraints in delivering services, resources and supervision, inadequate knowledge and awareness and juggling multiple roles with no pay. The ministry of health (MoH) in Eritrea prioritizes reducing child mortality but, is still in the process of building and stabilizing the healthcare system. The biggest challenge is to incorporate community level Integrated Management of Childhood Illnesses and Case Management (C-IMCI/iCCM), involving communities, families and CHWs into the current system of limited resources. Conclusions: This study indicates the importance of focusing on identifying solutions to the challenges the CHWs faces and understanding factors associated with CHWs motivation. This with the hope of better effectiveness and sustainability of the C-IMCI/iCCM program.

This study is part of an ethnography focusing on war rape in eastern Democratic Republic of Congo where child soldiers are both victims and perpetrators of violence. Twelve ex-child soldier boys, aged thirteen to eighteen years, from a reintegration facility were interviewed about their soldiering experiences and their perspectives on sexual violence. Transcripts were analyzed using thematic analysis. Conceptual frameworks of militarized masculine identity and gender-based violence guided the process. Results revealed the systematic and violent construction of children into soldiers, inculcating a "militarized masculinity"; a rigid set of stereotypical hypermasculinized behaviors promoting dominance by violating, sexually and otherwise, the subordinate "other." This was achieved through terrorizing/coercing, use of indigenous preparations, substance abuse, and forbidden reflection. This article presents a more contextualized complex view of the violent perpetrator whose behaviors are a manifestation of the modes and mechanisms in which society has constructed/reconstructed gender, ethnicity, and class, and the power dynamics therein.