A/HRC/10/59 page 13 37. Both the Special Rapporteur on violence against women and the Special Representative of the Secretary-General on children and armed conflict have found that while many perpetrators of sexual violence are armed actors (FARDC, PNC, and armed groups), a significant and increasing number are also civilians not only in zones affected by the conflict but also in other parts of the country.16 This is explained by the climate of impunity, absence of rule of law and the normalization of violence as an additional aspect of women’s oppression. 38. It is also alarming that a significant percentage of the victims are girl-children (and in some cases also boys). From June 2007 to the end of June 2008 in Ituri, out of 6,766 cases reported and assisted by partners of the United Nations Children’s Fund (UNICEF), 2,893 were children (43 per cent): 2,516 girls and 377 boys. In cases of child rape, 42 per cent of the perpetrators were members of the security forces or armed groups and 58 per cent were civilians. In the same period in North Kivu, UNICEF partners assisted 4,770 cases of sexual violence, of which approximately 38 per cent were against girl-children. For cases of rape of children, 70 per cent of the perpetrators were members of the security forces or armed groups and 30 per cent of the perpetrators were civilians. In South Kivu, out of 6,242 cases of sexual violence reported and assisted by UNICEF partners.17 39. The consequences of violence against women and girls are devastating. Since most rapes are collective, carried out with an extraordinary brutality and often accompanied by additional atrocities, women and girls often die as a result of the violence. Survivors often suffer vaginal fistula (a hole torn between vagina and rectum or vagina and bladder), lose their reproductive capacity or are infected with HIV and other sexually transmitted diseases.18 In view of the massive level of reported sexual violence, and of the clear link between mass rapes and the transmission of HIV/AIDS, it is particularly important that health services be affordable and accessible to those living with the disease. Furthermore, health personnel should assist in the collection of evidence to ensure that those responsible are brought to justice and held accountable for their actions. The fact that survivors of rape have to pay a fee they often cannot afford for the forensic medical evidence certificate needed to open criminal investigations and the inconsistent use of a standardized certificate obstructs access to justice and thus contributes to impunity. 40. Survivors of sexual violence often end up destitute and struggle for their mere survival,19 because they will often be rejected by their own husbands, families and communities and loose their social support networks. Under Congolese law, criminal courts can order perpetrators of crimes, including the State, to pay compensation to victims. The Congolese State has been sentenced to pay compensation to a number of women raped by State agents. However, none of 16 A/HRC/9/3, paras. 10 and 11. 17 Report of the Secretary-General on children and armed conflict in the Democratic Republic of the Congo to the Security Council (S/2008/693), paras. 42-44. 18 A/HRC/7/6/Add.4, para. 57. 19 Ibid., para. 61.