Ukunakekela “Working hand in hand to improve services to rape survivors”

In May 2003, Lifeline/Rape Crisis received funding to specifically train and employ full-time HIV/AIDS Rape Crisis Counselors, and install them at the Crisis Centre in the Northdale Hospital in Pietermaritzburg.  Monies and assistance were raised from the Provincial Department of Health (DoH),     OxFam Great Britain, Anglo American, ICCO, Northdale Hospital, and Pietermariztburg Department of Medicine Research Unit.  LifeLine/Rape Crisis also secured funds, through ABSA GAYE, to provide "care packs" for rape survivors that include toiletries and a change of clothing.  Additionally, Lifeline/Rape Crisis works closely within the South Africa Police Service (SAPS), specifically the Family Violence, Child Abuse, and Sexual Assault Unit (FCS), to bring victims to the centre for treatment and counselling. 
 

The LifeLine/Rape Crisis centre secured funding for 12 HIV/AIDS counselors in the city clinic.  General consensus amongst the staff was that a counselor focused primarily on HIV issues was not entirely sufficient, and what was needed was a trained Rape and HIV/AIDS counselor.  The additional training allowed the counselors to approach the healing process with a much greater perspective regarding the mental and physical needs of the survivor.  12 Counselors at the clinic see an average of 30 to 35 individuals a month. 
 

If the survivor is presented to the LifeLine/Rape Crisis centre at the Northdale Hospital within 72 hours of the incident, and tests negative for HIV/AIDS, she is given 28 days worth of ARVs to lessen her chances of sero-converting.  If the survivor is found to be HIV-positive, they are given vitamins and a package of fortified porridge as well as a pamphlet on positive living.  In addition, individuals are referred to local support groups and offered psycho-social counseling to better deal with the trauma of testing positive.  Despite their HIV status, all survivors receive on-going counseling to move beyond such a traumatic event.  
 

Innovation
 

The Northdale Crisis Centre, through LifeLine/Rape Crisis, provides a 24-hour comprehensive medico-legal service to rape survivors, which includes: medical examination and treatment where necessary; immediate follow-up psychological counselling; provision of ongoing support for PEP antiretroviral therapy; and practical care in the form of a pack providing toiletries and change of clothing, as well as bathing facilities. 
 

Effectiveness
 

Research conducted by the Pietermariztburg Department of Medicine Research Unit during the initial 7 months of the project showed an encouraging 53.54% compliance with PEP, the first 10 months showed compliance at 58%, and the first year was 59%.  Also, counsellors receive training in post-rape crisis counselling and sensitivity training.   
 

Poverty Impact
 

LifeLine/Rape Crisis, with the help of the National Government, provides PEPs, free of charge to impoverished individuals, while the crisis centre offers counseling and support groups.
 

Sustainability
 

Annual costs for the project is R200 000. Funding from corporate and international donors ensure the continuation of the project.

Replication
 

This model, that provides the full spectrum of service for rape survivors, can be replicated by any health facility in the country. All the time of winning the award, tentative plans were underway to extend the project to other facilities in the province.  A service level agreement has already been signed with the Provincial Department of Health.

Partnerships

• Northdale Hospital
• Pietermaritzburg Department of Medicine. Research Unit
• Provincial Department of Health
• Anglo American
• ICCO
• ABSA GAYE
• OxFam Great Britian