Belinda Beresford The fight between Aids activists and the government intensified this week when an NGO that helps rape survivors in Mpumalanga issued court papers against the provincial health MEC after being banned from state hospitals.
The MEC for Health, Sibongile Manana, also accused the NGO, the Greater Nelspruit Rape Intervention Project (Grip), of illegally supplying medicines and endangering the lives of poor black people. With the agreement of the relevant hospital authorities, Grip had been offering counselling and assistance to rape survivors. In addition they had been supplying post-exposure prophylactic packs of anti-retroviral drugs in an attempt to reduce the chances of the women catching HIV from their attackers. Grip had also been helping to raise money to enable rape survivors to fill prescriptions given to them by hospital doctors for a full, month-long supply of anti-retrovirals. In the six months that it has been operating, Grip has funded a month’s anti- retroviral treatment for 78 women and girls – more than half of whom were under 16. Each course cost between R1 800 and R2 000 and was sponsored by members of the community, including business people. However, earlier this month Grip was evicted from the two hospitals where it was operating. According to one doctor who works at the Rob Ferreira hospital, this effectively means that there is no assistance for rape survivors outside office hours.
Grip’s lawyer, Liesl Gerntholtz, of the Aids Law Project, said this week that she intended to file papers at the Pretoria High Court on Friday to allow Grip to return to the hospitals. Additionally, she and her clients were also considering whether to challenge the provincial government’s decision that Grip could no longer provide the starter packs, or facilitate women getting further supplies of AZT. The decision to evict Grip was made by the MEC, apparently on the grounds that Grip was present in the hospital illegally and that the provision of anti-retroviral drugs contravened government policy. In a speech dated October 13 Manana said: “Any individual or groups who want to play a role and be part of the Partnership against HIV and Aids has to do that openly, not by blackmailing government and masquerade [sic] as a good Samaritan [sic] whilst at the very same time undermine [sic] the present government.
“The so called Greater Nelspruit Rape Intervention Project sneaked into Rob Ferreiba [sic] Hospital and operated without the permission from the provincial Department of Health. “As if that was not enough they supplied scheduled five medicines which … ONLY [sic] doctors, dentists, verinerians [sic] and pharmacists can supply. The health and lives of our poor black people were placed under serious threat by these organisation [sic] which claimed to have their interest at heart.” Post-exposure prophylaxis kits are provided to rape survivors in many state hospitals, as well as being widely available in the private sector. The parliamentary medical aid will provide anti-retroviral drugs to its members – including MPs – in such circumstances. If she is a member of the scheme, Manana would also be entitled to anti-retrovirals if she was raped. In addition the Western Cape government has just announced that it will pay for a month’s supply of AZT for all rape survivors in the province.
But, as one doctor said, the help in getting anti-retrovirals to rape survivors was the smallest part of Grip’s activities. Facilitating the legal, medical and social work aspects of dealing with rape survivors was more important. “Anti-retrovirals are important but the most immediate thing is to get Grip back. “They smoothed out the problems. Without the clinic it’s been awful. For example, a patient came in, but the policeman didn’t have the relevant forms and equipment. On top of being raped, she spent six hours in casualty with no privacy, with blood dripping everywhere. There is no time for a doctor to sit with a patient and deal with the psychological trauma. You just can’t.” In agreement with the hospital superintendent, Grip had been allocated a room at each of the two hospitals, which it refurbished. When rape survivors went to the hospitals, they would wait for examination in the privacy of the rooms and receive counselling. After a medical examination, they were given kits including soap, clean underwear, deodorant, and tissues, and were given access to a bath. Grip chief executive Barbara Kenyon said they also provided toys for the children – but frequently adult women also asked for a toy as something comforting to hold. Anti-retroviral drugs have not been approved by the Medicines Control Council for use after rape to reduce the victim’s chances of catching HIV. A key reason companies have not applied for drugs to be registered for this use is that it would be almost impossible to ethically conduct trials to prove they work. In addition, the chances of the rape survivor contracting the virus depend on a wide range of factors that cannot easily be quantified, such as how much physical damage was done to the victim, how high the rapist’s viral load was, and whether he had open sores from sexually transmitted diseases. Tearing of vaginal or anal tissues during rape greatly increases the chance of infection by providing direct access for the virus.
Provincial authorities declined to comment.