Can South Africa afford to have post-rape assistance severely compromised?
The United States-based Global Fund to Fight Aids, Tuberculosis and Malaria has decided to severely limit its funding to the eight areas in South Africa with the highest prevalence of HIV.
These cuts will also apply to the critical services that nongovernmental organisations offer rape victims in the areas outside these designated ones, including Limpopo, the Northern Cape and the Free State.
In Gauteng, only Tshwane is eligible for funding, and in the Western Cape and KwaZulu-Natal, only the big metros of Cape Town and eThekwini. These include Thuthuzela Care Centres – government’s “one-stop” services, which offer support and counselling for rape victims – in the affected areas.
The implications of these funding cuts raise important questions that require urgent attention. The first is why services to rape victims are dependent on international donor funding and thus are vulnerable to donor policy trends and changes.
Efforts to address gender-based violence, including the allocation of state money spent on campaigns such as 16 Days of Activism against Gender-Based Violence, are strongly policy-driven. For this reason, it seems unconscionable that services to those worst affected by rape should be vulnerable to funding cuts.
Thuthuzela Care Centres’s counselling service is provided by NGO employees at a far lower rate of pay than their state counterparts.
While it seems sensible to concentrate efforts to tackle HIV in the areas with the highest infection rates, these areas do not overlap with those where reported rape statistics are highest.
Because rape frequently carries the risk of infection with HIV, funding cuts may compromise the vital support survivors need to complete their course of post-exposure prophylaxis.
According to research published in 2008 by the South African Stress and Health Survey, rape was the form of violence most likely to result in post-traumatic stress disorder.
Further, depression, anxiety, suicidal tendencies, substance abuse, repeated victimisation, disability, HIV infection and chronic physical health problems can also develop in the aftermath of rape.
Government needs to ‘step up’
Many rape victims do not have the emotional resources and resilience to deal with violence. Many are not surrounded by supportive family members and friends. And many do not enjoy the benefit of assistance by trained, empathetic and knowledgeable officials. Rape affects not only the emotional and physical wellbeing of survivors, but also their ability to work and, if they are parents, to provide the love and attention their children require. A rape victim’s family members and friends may be absent – if not actually involved in the abuse themselves – while officials can be untrained or indifferent to the victims’ needs.
For all of these reasons, counselling services to rape victims are essential. But, where rape is concerned, no service is actually better than bad service. A substantial body of research shows that services do more harm than good when provided by people who have not been adequately trained to respond to rape; they may hold victim-blaming beliefs or have not received debriefing and supervision.
A degree of specialisation is required to provide quality services, which also take a range of different forms, such as psychological first aid (an evidence-based approach to assisting victims in the aftermath of trauma). Counselling and testing for HIV is another important aspect, as is assistance regarding post-exposure prophylaxis to prevent HIV infection.
Other support services include:
- Individual, group or family counselling in the medium and long term; and
- Legal help, which consists of preparation for testifying in court, accompaniment to court, writing reports for court and providing expert testimony.
This requires dedicated investment by the state to ensure the services are available sustainably – at least at all Thuthuzela Care Centres.
But for now, these services are about to disappear for many rape victims who need support. The women who have been providing the services also face an uncertain future.
Rape is an entrenched social problem in South Africa; post-rape care will remain necessary for the foreseeable future.
The interministerial committee on gender-based violence must step up to their task and find ways to ensure rape survivors and the people who care for them are not subject to the shifting priorities of donor decision-making. – © ISS Today