The role of NGOs in the delivery of services to sexual assault survivors at specialist centres called Thuthuzela Care Centres (TCCs) was a critical theme at the NACOSA End it Now! Together in response to GBV and HIV, a national conference to promote linking, learning and action on the state response to gender based violence (GBV), the interaction between HIV and GBV and the impact of GBV on young people from 24-26 October in Johannesburg.
Colleen Rogers from Lifeline Vaal presented findings from an assessment of the role of NGOs in the delivery of services to sexual assault survivors at TCCs. The assessment was conducted by the Shukumisa Coalition – a civil society grouping shaking up social attitudes to sexual violence and the treatment of survivors by the criminal justice system.
Interviews were conducted with a sample of 35% of organisations working in TCCs across the country and while participants thought the TCC model was a good one, they identified significant challenges that they needed to overcome. Long waiting times, poor stakeholder relationships, poor access to TCCs and the late reporting of cases were some of the challenges reported. Reporting of sexual assault more than 72 hours after the assault means that the victim is not able to receive post-exposure prophylaxis (PEP), which can prevent them from contracting HIV as a result of the assault.
Another critical challenge is the funding and sustainability of organisations’ work in the centres. Funding for TCCs needs to cover 24 hour, seven-days a week services but funding for the psychosocial services these organisations provide is often fraught with inadequacy and uncertainty. Inequity in the salaries for social workers was reported as being detrimental to patient care.
Despite the challenges, the organisations that participated in the study had a lot to be proud of. They highlighted some of their successes and reflected on how they had remained committed to providing a quality service to the patients and ensuring that victims are indeed transformed into survivors. In fact, the challenges meant that these organisations have had to think out of the box in TCCs and find innovative ways of providing patient-centred services in the facilities.
The NGOs have provided continued, uninterrupted psychosocial services to survivors in TCCs in spite of funding shortages and uncertainties. Many of the organisations reported that they had developed a substantial community footprint with strong relationships, trust and a reputation as advocates for women’s rights.
Most of the NGOs felt that the containment counselling helped manage trauma and that it formed the basis for a smooth experience within the TCC. The ability to advocate for the patient and provide psychosocial support, particularly around court preparation, helped achieve quicker trial times and higher conviction rates. In addition, the organisations have used this experience to collaboratively develop guidelines and standards for rape survivors in the acute stage of trauma – the first of its kind to attempt to benchmark services for sexual assault victims.
In response to this assessment, the Shukumisa Coalition is calling for a differentiated point of care for victims of sexual violence to ensure post violence care is available to all – satellite TCCs in rural areas, for example. South Africa’s level of gender based violence means there is a need for more TCCs which means lobbying government is critical. Making good progress through existing TCCs is not enough, there is a need to have a legal framework in place which is crucial for the sustainability of these services.
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