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South Africa: Increasing numbers attend the ‘one-stop’ Simelela Centre for Rape victims in Khayelitsha
South Africa has one of the highest incidences of rape in the world. It is estimated that one person is raped every 26 seconds . In Khayelitsha, a township of around 500,000 people close to Cape Town, the incidence of rape is one of the highest in the country. Khayelitsha never had a dedicated rape centre providing both emergency and follow up care. Instead, rape survivors had to seek emergency treatment and forensic examination in a neighbouring community 20 km away. The distance to the clinic and the cost to get there placed it out of reach for many of the most vulnerable survivors. In August 2005, Médecins Sans Frontières (MSF), along with key role players dealing with rape, launched Simelela as an acute "one-stop" rape survivors centre in the heart of the township. It provides comprehensive around-the-clock services to victims of rape, including emergency medical care and follow up, psychological and social support, forensic examination and judicial support, as well as specific care for children. The provision of services is coupled with strong community activism to condemn sexual abuse. More and more victims come forward for medical care In the last twelve months, 743 new victims of rape have received care, and a further 858 have attended the Centre for follow-up care. This is a significant increase in the number of Khayelitsha survivors seeking care showing the difference proximity can make. This is also a strong indication that the service is accepted and needed by the community. But it also highlights the extremely high incidence of rape in the township. Rape presents a number of medical risks, both in terms of physical and
mental injury, and the In the South African context, which has the highest prevalence rate of
HIV/AIDS in the world, Emergency contraception has successfully prevented unwanted pregnancies
in all survivors Counselling services are also given to help people cope with the psychological impact of rape. One survivor says “the counsellors listen. And they help you to understand that it is not your fault, that you didn’t ask to be raped…because of the counselling, I am learning to respect myself again.” Helping victims in reporting
Rape victims also have the opportunity to file complaints at the centre. In fact two small rooms are dedicated for the police so that they can come and put the complaints on record. Most survivors who sought medical treatment filed complaints (82%) although a few (mostly children) did not press charges. ‘Before Simelela Centre was created, rape victims had to go to the police station and file complaint, but they had to wait for a long time in the main waiting room and then tell why they were there in front of other people’, says Sister Ntwana, the nurse in charge of the centre. ‘In Simelela, people feel free to come and report because they know that they will find police in here’. But only a third of rapists have been arrested, with even fewer going to trial. The obstacles reported include poor investigations, failure to arrest suspects, failure to protect complainants from intimidation, and a harsh court environment, which creates a climate of impunity that encourages the perpetuation of sexual violence. As one rape survivor explains: ‘In cases like mine where it would be just my word against his, it is the rape victim who is on trial and not the rapist. And I know it would take years. I didn’t want to go through that’. Nearly half of the victims are under 14 years of age; of those, two thirds know their aggressor
Perhaps the most shocking figure is that 41% of rape victims are under the age of 14. Among those, 66% knew their aggressor. These appalling figures can only reinforce the idea that the attitude of the community towards rape needs to change which is why an essential component of the Simelela centre is community activism. ‘Prevention is an essential part of the response, and only through challenging communities to examine assumptions that perpetuate violence can we hope to reduce the number of cases that continue to arrive at the Simelela Centre every single day’ explains Sister Ntwana. The Treatment Action Campaign conducts intense community activities to promote public condemnation of sexual abuse. On her side, Sister Ntwana talks every Tuesday morning about rape on the Khayelitsha local radio station. She tries to dispel the many myths around sexual abuse and encourages people to seek care in Simelela if they have been raped. Simelela Centre has also a schools programme using drama to help learners understand that sexual abuse is wrong, and that Simelela offers services for them if they are abused. Although the first results gathered by the centre are encouraging in terms of people participating in the services offered by Simelela, a lot remains to be done to normalize the services, change attitudes in the community, and to make people perceive rape as what it is, a plague for society. The partners involved in the Simelela Centre are: Médecins sans Frontières, Rape Crisis, Department of Social Services and Poverty Alleviation, Nonceba, South African Police Services, Department of Correctional Services, National Prosecuting Authority, Department of Health, Treatment Action Campaign (TAC)
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