WashU takes a holistic approach to assessing holistic care
Written by Kim Thuy Seelinger, JD, director of the Center for Human Rights, Gender & Migration at the Institute for Public Health
Since 1999, Panzi Hospital in South Kivu province, eastern Democratic Republic of the Congo (DRC), has cared for survivors of sexual violence – including women and small children who have been violated. Established by 2018 Nobel Peace Prize co-recipient, Dr. Denis Mukwege, the hospital is special: it doesn’t only provide medical care but also provides psychosocial counseling, socio-economic reintegration support, and legal aid.
Dr. Mukwege understands that holistic care is beneficial for many survivors of sexual violence, who, once their physical injuries are healed, may also need support recovering from trauma, re-integrating into society or seeking justice. Now, he is asking researchers at Washington University to help understand exactly how, when and why the holistic model works. Can it improve an individual survivor’s well-being better than if she simply received medical care? Can attending to a survivor’s psychological, socio-economic, and legal needs actually improve the well-being of her community?
I met Dr. Mukwege back in 2007 when he was visiting San Francisco – I remember being amazed by this OB/GYN who could speak so powerfully about law, about international security, and about the economics of war. In 2014, when researching accountability for conflict-related sexual violence, I was able to visit Panzi Hospital. It was a powerful visit. Interviewing the hospital staff, counselors, and lawyers about their work with survivors, I was struck by their determination to provide wrap-around care in such an insecure context. Holistic care is ambitious in any environment. Trying to repair harm inflicted by armed actors in eastern DRC? That struck me as outright courageous.
After we reconnected in Oslo during the Nobel Peace Prize celebrations in December 2018, Dr. Mukwege asked me to help assess the impact of Panzi Hospital on patient well-being. Weeks after arriving at WashU together in August 2019, Center Manager Julia Uyttewaal and I traveled to Panzi Hospital with a Ugandan medical records systems expert. We interviewed Dr. Mukwege and his team to understand Panzi’s current model of care, assessed its various databases, and established relationships with local Congolese researchers.
Now, in collaboration with the IPH Center for Implementation and Dissemination, Julia and I are moving forward to design an evaluation plan. The evaluation results will shed light on the impact of holistic care for survivors of sexual violence in eastern DRC at the individual level and, possibly, at the community level.
We are already lining up faculty advisors with expertise in gender-based violence and evaluation methods (like Lindsay Stark, Peter Hovmand, Jessica Levy, and Patrick Fowler from the Brown School), international criminal law and legal aid in Africa (like Leila Sadat and Karen Tokarz, from the Law School) and quality improvement, mental health, fistula repair and medical documentation of human rights abuses (like Elvin Geng, Rumi Price, Lewis Wall, and Rupa Patel, from the School of Medicine.) Together, these colleagues will bring a wide range of insights to the project from across Washington University’s two campuses. It seems the best way to evaluate a holistic model of care is with a holistic model of expertise.