system rapes victims over and over again

By Kerry Cullinan (Source: Sunday Tribune)

April 29, 2007: Rape survivors are not getting the health care they need. To make matters worse, teenage girls who are raped are often scolded or branded liars by health workers attending to them, while men, gays and lesbians and sex workers who have been raped are also discriminated against.

Other problems include the denial of health care to those who have not reported the rape to police, a lack of privacy for examinations and staff ignorance of basic treatment procedures.

This is according to the National Working Group on Sexual Offences, a group of 25 organisations including Childline, the Teddy Bear Clinic, People Opposing Women Abuse and the Tshwaranang Legal Advocacy Centre.

The group has sent a detailed submission to the South African Human Rights Commission on the experiences of rape victims. The commission is convening public hearings in May on the "availability, accessibility, acceptability and quality" of health services.

Almost a third of health practitioners said they did not consider rape to be a serious medical condition, according to a survey carried out at 31 national facilities that treat rape survivors.

Health workers at 26 Gauteng medico-legal services were often "unsympathetic, judgmental and impatient". One teen victim reported that she was screamed at by the nurse. "While she was busy doing the blood test she kept asking me questions like what happened... and she was like shouting.

"So I had to tell her what happened. That's when she told me that, 'As a 17-year-old girl what you were thinking? You deserve things like that.'"

Another teenage girl was lectured on the shortness of her skirt, with the nurse stating that fewer rapes had occurred in her day because longer skirts had been worn.

"Both health care providers and members of the criminal justice system are prone to believe that girls are likely to lie about being raped in order to cover up illicit sexual activity," according to the group.

Gays and lesbians also faced discrimination when reporting rape, with a small proportion actually being denied health care altogether because of their sexual orientation.

The Teddy Bear Clinic and Resources Aimed at the Prevention of Child Abuse and Neglect (Rapcan) note that homophobia and ignorance about male-on-male rape affect men and boys' access to healthcare.

Health workers sometimes viewed male rape victims as "failed men" or gay, while they sometimes did not believe that gay men had been raped.

A broad assumption that sex workers have given up their right to withhold consent to other sexual advances so cannot be raped affected this group's access to services.

Many rape services are in the casualty section of hospitals. "But these are precisely the departments most unsuited to dealing with rape patients, being noisy, busy, chaotic, bloody, frightening and conflictual - hardly the ideal environment for someone in a state of shock," according to the group.

"Further, unless rape survivors have suffered serious physical injury they will be bypassed in order to treat those patients whose conditions are seen as more life-threatening."

Victims often have to wait long periods to be treated, particularly as rapes are most likely at night and over weekends when the fewest services are available.

Many women depend on the police to transport them to health care facilities, and often wait for some time at police stations before being taken to these facilities.

Long waits negatively affect victims' rights to emergency medical treatment in the form of anti-retroviral drugs taken as post-exposure prophylaxis to prevent HIV infection. These should be taken as soon as possible after the rape and no more than 72 hours later.

Victims who do not report the rape to the police are also frequently denied health care, although this is contrary to policy. Staff members often refuse to give prophylaxis to those who had not reported their rape as a means of distinguishing the "real" rape survivors from the "liars" who merely wanted medication.

Of the 31 health facilities surveyed, less than half (47,4 percent) had a private room available for the examination of rape survivors and these rooms were often kept locked after hours.

Although most victims desperately want to wash after their attack, none of the health care facilities in Gauteng, Limpopo, North West or Free State had access to showers or baths and few had access to basins. In contrast, all Western Cape facilities had basins while more than half (56,8 percent) had showers or baths. There were often shortages of forensic kits necessary for collecting evidence.

Although only medical personnel should be present while the rape victim is being examined, police officers and other unauthorised people were sometimes present in the examination room.

Less than a third (30,3 percent) of the health care practitioners surveyed had received training on caring for rape survivors. Their emotional needs are generally not addressed, with most not being referred for counselling. Where counselling existed, it was generally focused on preparation for an HIV test and prophylaxis drugs, "with less thought and time being spent on the emotional needs".

The group has asked the Human Rights Commission to invite the department of health to testify about what practical steps it is taking to implement its policies on sexual assault treatment, as well as targets and budget for the next three years. - Health-e News Service