Title: Rape Survivors’ Experience in Tigray: A Qualitative Study
Version: 1 Date: 20 Feb 2023
Reviewer's report:
OVERALL COMMENT:
This article addresses a very important subject, the experience of rape survivors in a conflict
zone. Despite this, the document requires extensive language revision. As it stands, the
manuscript is difficult to understand due to language, grammatic and spelling mistakes.
The authors are commended on conducting in-depth interviews despite difficult conditions.
SUGGESTED MAJOR REVISIONS:
This manuscript requires major language revision. It is not comprehensible as it stands.
The abstract introduction states that the study aimed to “explore the severity level of rape”. This
implies that rape can have different degrees, mild or severe. All cases of rape must be considered
severe, thus ‘severity of rape’ is not an acceptable term.
Then, the introduction concludes that the aim of the study is “to explore the extent of rape in the
Tigray…”, however determining the prevalence of rape cannot be achieved through a qualitative
study with 10 survivors.
Further, in the discussion section the aim of the study is stated as exploring “the level of war
damage on humanitarian and Tigran’s health system…”, but this is better achieved through a
physical survey of the damage and not a qualitative study with 10 persons.
The results of the study clearly demonstrate that the aim of the study was to explore survivors’
experience of rape. It is highly recommended that this is stated as the aim and that the manuscript
refers to the same aim throughout the document.
Methods
It is surprising that the interviewers are males given the sensitive topic they are discussing with
the interviewed girls and women. It is recommended that a reflection is included on how this may
have affected the interaction with the interviewees – how could it have hindered or facilitated
the discussion?
It is unclear if any referral was made for counseling or other support that is available given the
challenging context of conflict.
It is unclear if consent of guardians was obtained for interviewed minors.
Results
The generated themes are all important, but some may overlap. For example, ‘inflicting
long-lasting trauma’ and ‘rape left survivors with health problems’ are both related to the
consequences of the rape.
Some of the generated themes are unclear. For example, it is unclear whether the theme ‘safety’
relates to feelings of safety before rape or after it.
It is difficult to understand the codes and categories due to poor language. For example, what is
‘overkillings’ and what is meant by ‘searching young females’?
It is advisable to review the themes so they are more distinct. For example, one theme could
be ‘children’ and under that theme would be whether they witnessed the rape, were exposed to
violence themselves, were abandoned due to the rape, etc. Another theme could be the effects of
the rape which would include issues such as stigma, physical effects (HIV risk, bleeding/injury,
pain), disfigurement and emotional/psychological effects. Another theme could be violence
itself including gang rape, repeated rape, one-time rape, witnessed or not, etc.
How is ‘violence’ defined and explained as depicted in table 1? Is it restricted to physical
violence? If not, was this explained to the interviewees? Does it include physical discipline by
a parent?
The information under the subheading ‘armed conflicts ravaging a health system’ belongs more
to the introduction section as it recounts factual information rather then reported experiences
from a qualitative interview.
Conclusion
Conclusions can only be made about the experience of the interviewees. It is highly
recommended that they be rephrased as such. For example, “In the experience of the interviewed
women and girls….”
SUGGESTED MINOR REVISIONS:
Abstract
“industrial-scale rape”: the term is not a usual one and should either be explained and justified
with data or changed.
Concluding that “rape in war-stricken Tigray was rampant” requires a reference since it cannot
be concluded from this study alone.
Introduction
The introduction requires the addition of references for various statements, namely:
• References to Resolution 1325 and 1820 at the end of the first paragraph
• Reference to the statement that “rape in the above places are ethnically and religiously
motivated” (end of 2nd paragraph)
• Reference to the statement “level of severity and pervasiveness of the violence reported to be
high” in the 5th paragraph.
Methods
Since some interviewees were unable to read, it is important to clarify if the informed consent
was read to them.
Results
What is meant by ‘parity’ in table 1?
For those reporting more than one ‘abuser’ (recommend this be changed to ‘rapist’ if that is the
case), was this during the same incident or were there several rape incidents?