Women in the Rustenburg municipality face startling levels of sexual violence, while very few report to healthcare services after rape. A new report by Doctors Without Borders (MSF) reveals and outlines numerous barriers to accessing post-rape care, including low knowledge levels among women about the benefits of receiving timely medical attention.
The report, entitled Untreated Violence: The Need for Patient-Centred Care for Survivors of Sexual Violence in the Platinum Mining Belt, discusses the findings of an in-depth survey of over 800 women aged 18-49. The survey found that one in four women has been raped in her lifetime, with approximately half of women reporting experiences of sexual violence or physical intimate partner violence.
MSF called on the South African government to urgently roll out a comprehensive and widely accessible medical and psychosocial response that removes barriers to accessing a basic package of healthcare services for victims of sexual violence, both in the platinum mining belt around Rustenburg and countrywide.
In the Rustenburg municipality, it is estimated that around 11 000 women and girls are raped each year. Yet 95% of rape survivors had never told a health professional about it, and only half of those surveyed knew HIV could be prevented after being raped.
The local economy around Rustenburg is fuelled by the extraction of platinum-group metals. Unemployment is particularly high for migrant women, creating conditions that promote dependency on men who are more readily employed by mines in the area. The communities living alongside one of South Africa’s biggest industries are particularly vulnerable to violence, financial dependence on others and disease.
Unaware of vital treatment opportunities
According to MSF epidemiologist Sarah-Jane Steele, the findings show rape is not only highly prevalent in the Rustenburg municipality, but that opportunities to reduce the more serious health impact of rape are being missed.
“Treatment and psychosocial counselling for rape survivors reporting within 72 hours can prevent HIV infection and unwanted pregnancy, and help mitigate long-term psychological suffering,” said Steele, “but the majority of women we interviewed don’t know such treatment exists, services close to where they live are sorely lacking and lack of financial independence may make access difficult even when services are present.”
Kgomotso Care Centre offering comprehensive support
Since July 2015, MSF has worked in Rustenburg supporting the North West Province department of health in running the Kgomotso Care Centre (KCC) in Boitekong. The centre provides patient-centered care for survivors of sexual violence and other forms of domestic violence. The model of care offered at KCC emphasises the importance of addressing the survivor’s medical and psychosocial needs first. Patient-centred services include: medical first aid to treat injuries; comprehensive medical assessment, including forensic examination; post-exposure prophylaxis to prevent HIV infection and treatment for other sexually transmitted infections; vaccinations to prevent hepatitis B and tetanus; emergency contraception to prevent unwanted pregnancies; as well as counselling and linkage to appropriate social support measures.
MSF will soon extend its support to Bapong and Letlhabile community health centres in Madibeng Local Municipality to increase the capacity of these facilities to provide comprehensive patient-centered care for survivors of sexual and intimate partner violence. MSF has embarked on piloting a clinical mentorship programme for professional nurses in the care and management of survivors of sexual and domestic violence in Bojanala Health District.