Category: Inclusive, Enabling Communities | Women and children affected by abuse/violence | 28 February, 2013 - 00:08← BACK
PATCH – Prevention And Treatment of Child abuse in the Helderberg – is an organisation dedicated to providing free professional therapy to child victims of sexual abuse. PATCH provides specialist sexual abuse assessment (medical examinations) and therapeutic services to children who have been sexually abused in the Helderberg. PATCH also operates an after-hours emergency crisis Centre seven days a week and has satellite offices in six different locations.
PATCH employs 13 staff members and provides a range of services such as assessing allegations of child sexual abuse, providing therapy to child victims, offering prevention/awareness programmes to encourage disclosure of child sexual abuse, running a 24 hour crisis centre, providing victims Post-Exposure Prophylaxis to prevent the transmission of HIV and STD, offering court preparation and support for the child victim, and advocating the child victim’s rights to testify in camera with the help of an intermediary.
This learning brief describes the involvement of PATCH in a national research study on improving accessibility and use of the criminal justice for child victims of abuse and their families. Often such research projects neglect to consult the experienced views of small community-based organisations and the findings lead to limited and ineffective policies and practices. In this instance, the on-going research involvement of PATCH in this study shows how “small voices” can have an impact and can lead to useful research findings that result in helping victims better navigate the treatment and legal systems.
PATCH collaborates with the Gender Health and Justice Unit of the University of Cape Town, Simelela, RAPCAN, and the Rape Crisis Cape Town Trust on a research project that aims to better understand sexual abuse victim’s perspectives of the legal system. This study falls under the purview of the Western Cape Working Group on Sexual Offences, which has been monitoring the implementation of the Sexual Offences and Amendment Act (2007) since 2008.
The study aims to find practical ways in which to meet the needs of sexual violence victims as they navigate the criminal justice and treatment systems. The research findings so far have highlighted victim experiences with treatment and legal systems after their abuse. A central finding is that victims lack sufficient information regarding the multiple processes to follow in order to receive legal, health and mental health care. They simply do not know how to navigate the different systems and which steps to take next in order to receive appropriate assistance at the tight time.
The results of the research focus on the following:
Six factors cause the most confusion for victims and their families seeking post-abuse assistance. Community-based crises centres, like PATCH, have been able to suggest best-practice solutions in order to address these confusing factors and so to better assist victims in the future.
1. Knowing where to go first
After a child has been sexually abused, neither the child nor their parents know what steps to follow in terms of accessing appropriate health care and legal justice. Police stations are usually the first port of call. Victims also do not know that they have the right to be assisted in any of the 11 official South African languages, and that they can give their statement in a private, confidential manner to a person of the same gender as the victim.
Suggested solution: Community-based abuse Centres, in partnership with the SAPS, can be the first safe haven for victims. Trained Centre volunteers/case workers can then accompany victims to the nearest police station and ensure that they make their report following all the appropriate steps, without compromising their victim rights.
2. Accessing health care services in time
Many child abuse victims do not access health care service within 24 hours of their abuse because they do not know about centres dedicated to this service or because they are geographically distant from a public clinic or hospital. This jeopardises the collection of forensic evidence and puts the child at risk of not receiving life-saving health care, such as Post-Exposure Prophylaxis to prevent the transmission of HIV and STDs. Most public hospitals are also only able to provide a seven-day treatment of Post-Exposure Prophylaxis.
Suggested solution: Community-based abuse centres, in partnership with public clinics and hospitals can run satellite offices throughout high-risk communities, thus expanding access points for victims. These satellites and abuse centres (such as PATCH) can provide rapid medical legal examination in a safe, reassuring and child-friendly environment.
PATCH for instance, has trained volunteers who provide HIV counselling, HIV testing and also provide the necessary medication needed to prevent HIV infection, Sexually Transmitted Diseases as well as possible pregnancy. In addition to the 7-day treatment provided by public hospitals to abuse victims, community-based abuse centres can makes the necessary arrangements for the family of the child victim to obtain the remaining Post-Exposure Prophylaxis medication.
3. Correct information on Post-Exposure Prophylaxis
Unfortunately, crowded hospitals and over-burdened clinical staff do not pay enough attention to provide child victims of sexual abuse with the necessary counselling and information about how to take Post-Exposure Prophylaxis and other medication. The study found that traumatised children and families did not adhere adequately to the treatment regimens because they received poor and rushed advice.
Suggested solution: Community-based abuse centres, in partnership with public clinics and hospitals can provide the vital pre and post-test counselling for each child victim and their families. Volunteers can also spend time explaining how to correctly take the prescribed medication and can offer follow up advice in the days after a hospital examination.
4. Remembering critical information
Parents and children often experience a range of emotions once they have reported their child’s abuse and they often forget critical information that was given to them by the police and the hospital staff, such as: doctor and hospital names, case number, name of investigating officer, etc.
Suggested solution: Community-based abuse centre volunteers or intake workers can help victims remember/access this information and keep it on record in a victim file to ease future queries.
5. Negotiating the court process
Most sexual abuse victims are unfamiliar with courtrooms and they find the legal system a daunting and unknown obstacle. Victims find it confusing and stressful to know when they are expected in court and if they will have to face the accused.
There are also numerous misconceptions and myths surrounding the manner in which child victims are expected to testify in courtrooms. The lay view is that children will face the accused and be exposed to a harsh cross-examination. This is infrequently the way the court operates, and in general, effort is made to minimize secondary trauma related to testimony.
Suggested solution: Having the option to contact the prosecutor, investigating officer or a crises centre volunteer (such as a PATCH employee) could ease some of this tension and uncertainty. Other community-based abuse centres can model best practice from PATCH, which advocates for the child and witness rights in court and makes recommendations regarding a child testifying in court on a case-by-case basis. PATCH also assists child victims and their family members to know all the information regarding the court process in order to ease their distress and uncertainty about pursuing a criminal case against the perpetrator.
6. Interpreting outcomes of court procedures
The research found that because most sexual offenders are known to their victims, the dynamics of interpersonal relationships between the victim, their family members and the offender often causes substantial conflict – particularly in clos-knit communities. In a close knit community the offender and/or victim might be labelled and people gossip about the alleged abuse. People supporting the accused might attempt to discredit or intimidate the victim or their family members in order to have the case withdrawn, or they may fail to adequately inform the victim of bail hearings, dates for postponements of the case, or the reasons for postponements. This can lead to secondary traumatisation and frustration for the victim and associated family.
Suggested solution: In close-knit communities dedicated crisis centres that focus on victims can play an important role in protecting victims from secondary trauma. These centres can ensure that child victims of sexual abuse get the correct information when necessary and can help hold legal systems accountable.
Putting research findings into practice
As a result of the research findings, the Western Cape Working Group on Sexual Offences has design and is distributing a “My Safe Card” to all child victims of abuse.
The Safe Card is pocket sized and can easily be carried discretely in a purse. It provides step-by-step information on what should be done after being raped. It contains vital information on laying a criminal charge, on important victim rights, and what to expect from the legal system. It also details how to access a health facility, what to expect, and provides information on the Post-Exposure Prophylaxis treatment. The card also offers a section where the victim can write the name of the investigating officer and the case number, valuable information for follow up.
At this point, the My Safe Card is limited in its focus on teenagers and older victims and because it is only currently available in English. The next step is to adapt the card to children and parents, and to translate it into Xhosa and Afrikaans.
Dorhill Street, Somerset West, Western Cape
(021) 852 6110
PATCH provides a model case of how community centres can be involved in the formulation of evidence-based strategies and solutions for better assisting victims of sexual abuse.