AFRO-NETS> Violence against women - South Africa

Violence against women - South Africa
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(New York, August 8, 1997)--Women victims of rape or assault in South
Africa face a criminal justice system that is too often unable or unwilling
to assist them in their efforts to seek redress. The police are frequently
callous or disinterested in their treatment of women and the court system
is little better. Of equal concern is the fact that while medical evidence
is crucial to the investigation and prosecution of rape or sexual assault,
few medical personnel are trained properly to collect and interpret such
evidence.

In Violence against Women and the Medico-Legal System in South Africa,
released to coincide with South African women's day, Human Rights Watch
calls on the South African government to intensify its efforts to protect
women from violence and to improve the state's response to such abuses,
with particular attention to the medico-legal system. "Despite recent
efforts at reform, South Africa continues to fail its women," charges
Dorothy Q. Thomas, Director of the Human Rights Watch Women's Rights
Project. "Too often, the treatment they receive when they try to report
rape or other abuse simply traumatizes them further, without offering them
any hope of punishing their attackers."

Of the 27,056 rapes reported in 1993, only 8,998 were prosecuted; of the
cases brought to court, 4,753 resulted in convictions, just 17.5 percent of
the total. Since 1993, the number of rapes reported has nearly doubled, to
50,481 in 1996; of these 21,863 were prosecuted, yet only 4,100 led to a
conviction or 8.1 percent of the cases reported. While the percentage of
cases prosecuted has increased, the rate of conviction has fallen. These
worsening figures demand urgent attention.

Women who wish to pursue a charge against their assailant are usually
examined by a doctor, in most cases a state-employed district surgeon, and
obtain a report of their injuries. Although no claim of rape is invalid
for lack of such medical evidence, it often offers the only non-testimonial
support of a woman's case and as such, can be crucial to its prosecution.
Currently, in South Africa a handful of specialised medico-legal clinics
offer a dedicated and technically excellent service. However, in most
cases, the doctors who carry out the medical examination of a woman (or
child) who has been raped have received no training in this part of their
practice. Additional problems include the following:

District surgeons often do not properly document medical evidence for use
in court, and incomplete medical records for rape cases are commonplace.
- Medical legal services are often inaccessible, particularly to the black
  townships and in the rural areas. Given the time-sensitive nature of
  much medical evidence of sexual assault, and the trauma that accompanies
  such abuse, such delays can be devastating.
- District surgeons are frequently unsympathetic or even biased in their
  treatment of women who report abuse.
- District surgeons are poorly remunerated compared to doctors in private
  practice and working conditions are likely to be poor.

Compounding these problems, police who are charged with referring and
transporting women to district surgeons often fail to do so. This not only
adds to already crippling potential delays, but given the inaccessibility
of many medico-legal clinics and the costs of transportation to them, may
effectively deny poor women in particular access to such services.
Moreover, if a rape case actually reaches court, police and prosecutors are
usually unable to evaluate or present medical evidence effectively to a
court, and neither magistrates nor judges are likely to be able to make up
for these deficiencies with their own training.

For the women involved, therefore, the price of reporting a sexual assault
may be hours of travel and waiting for attention, unsympathetic treatment
from police and medical personnel, and a negligible chance of seeing a
known perpetrator convicted. Moreover, having finally been examined for
such abuse, women must still go elsewhere for its treatment, as medical
legal work usually does not include any treatment for the physical or
psychological consequences of sexual assault.

The South African government has taken a number of steps to improve the
response of the criminal justice system to violence against women. On
August 9, the Department of Justice, which ran a campaign on violence
against women between November 1996 and March 21, 1997, is scheduled to
publish a major new set of guidelines for handling sexual assault cases,
addressed to all professionals in the criminal justice system, including
district surgeons. Health care is also undergoing radical reform, while
the role of the health professionals, district surgeons in particular, in
the human rights violations of the past has come under scrutiny from the
Truth and Reconciliation Commission.

Human Rights Watch welcomes these developments and commends the government
of South Africa for these and other key steps it is taking to improve the
state response to violence against women. However, if the history of
impunity for such abuse is to be more effectively curtailed, greater
attention must be given to current flaws in the medico-legal system. We
offer the following series of detailed recommendations for further
improvement of the criminal justice system in this crucial area:

General:
- Women who have been sexually assaulted and report to a police station
  should be taken by the police to be examined by a specialist medico-legal
  practitioner as soon as possible to ensure that forensic evidence is not
  lost.
- Following medico-legal examination, government policy should pay greater
  attention to the need for women to receive appropriate treatment for
  injuries, infections, or other related trauma.

District surgeons/medico-legal practitioners:
- In reforming district surgeon services, attention should be paid to the
  urgent need to ensure adequate expertise in medico-legal matters among
  those doctors providing medico-legal services. Training programs should
  be developed for those appointed to carry out medico-legal work, both as
  a requirement before appointment and as annual in-service training.
- Manuals should be developed for newly appointed district surgeons (or
  district medical officers, as they are now to be known) which outline the
  relevant laws for their work, review the necessary specialised medical
  information (for example, ways of determining the time of injury), and
  provide detailed descriptions of injuries specific to sexual assault in
  both adult and child victims.

Specialised curricula in clinical forensic medicine for medical students
should be developed by the universities offering medical training and made
compulsory for all medical students, with practical expertise in a medico-
legal clinic a requirement of such courses; a qualification in clinical
forensic medicine, similar to that for forensic pathologists, should also
be developed and made available to those doctors who wish to specialise in
this area of work.

Police:
Police investigating officers handling sexual assault and rape cases should
specialise in such investigations and be trained in the issues surrounding
violence against women and the use of medical and other forensic evidence.

The courts:
- As is already the trend, each regional magistrates court should identify
  specialized prosecutors to handle cases of sexual abuse and rape who
  should receive additional training in the issues surrounding gender
  violence.
- Legislation should be introduced to abolish the use of the "cautionary
  rule" in rape cases, which requires courts to exercise additional care in
  assessing the credibility of a rape survivor. The cautionary rule in
  rape cases places a particular premium on corroborative evidence if a
  woman is to win her case.

The collection and analysis of medico-legal evidence:
- The form used by medico-legal doctors to document the medico-legal
  examination should be redesigned along the lines set out in the body of
  the report.
- The Pretoria forensic biology laboratory, and forensic services in
  general, should be taken out of control of the police and placed under
  the Department of Health, with an independent status, similar for example
  to that of the attorneys general.

Collection and dissemination of information on violence against women:
- All health facilities should have information on display and available to
  be taken away on the medico-legal and other services available to women
  who have been subjected to sexual assault or domestic violence.
- A national directory of governmental and non-governmental services
  available to women should be developed, and information should be
  distributed to police stations and magistrates courts, as well as to
  district surgeons, hospitals and other health care facilities about
  locally available referral services for women who have been assaulted.

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Joost Hoppenbrouwer
Associate Professional Officer
World Health Organisation
Zambia National AIDS/STD/TB/Leprosy Programme (NASTLP)
P.O. Box 32346
Lusaka 10101
ZAMBIA

Telephone +260-1-264-042 (home)
Telephone +260-1-223-251 (work)
Fax +260-1-223-209 (work)
E-mail: joost@zamnet.zm

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