By Charlene Smith

Police reported this week that they were achieving success in combating most crimes, but not rape. Jackie Selebi, the national police commissioner, said there were 115,3 cases per 100 000 people in 1994, compared with 113,7 in 2003/04.

Selebi said rape statistics might be exaggerated because many rape cases were reported on a Friday and Saturday night, only to be withdrawn on a Monday.

It’s the withdrawal of cases that bears closer examination, because it says nothing about women “lying” about rape as the ignorant might believe, but it says everything about a society that fails women and children and is allowing HIV/Aids to proliferate without check.

South Africa has the highest rates of rape in the world, according to Interpol, and the highest incidence of HIV. The National Prosecuting Authority tells us that 50 percent of all cases before South African courts are for rape, except in Durban and Mdantsane, where it is 60 percent.

Although the Law Reform Commission estimates there are 1,7 million rapes a year, on average only 54 000 rape survivors lay charges each year. Why? It is because rape survivors are treated so badly by so many.

Every time a rape survivor does not lay a charge, she allows a rapist or rapists – because 75 percent of rape in South Africa is gang rape – to believe he or they can do it again. And he or they will. Again and again, until a rape survivor does battle with the police, doctors, psychologists and the courts to get the justice she deserves, and to protect the next woman

or child.

A Medical Research Council study into conditions for rape survivors in Gauteng in 2002 found that the treatment of survivors by police and medical and court personnel was deplorable. Two researchers were so traumatised by what they witnessed that they had to go for counselling.

The Medical Research Council reported that “26 percent of doctors and nurses who treated rape cases didn’t think them a serious medical problem”. Yet rape carries the risk of sexually transmitted diseases (STDs), including HIV, a range of other infections, pregnancy and long-term psychological scarring.

Last year the cabinet removed Section 21 from the new Sexual Offences Bill, which would have given post-exposure prophylaxis (PEP, which is medication to prevent HIV) as well as medication to prevent STIs and pregnancy to rape survivors. They left in Section 22, which guarantees medical care for the rapist and undertakes to rehabilitate any alcohol or narcotics addictions he might have.

In other words, the government will help to remove self-inflicted addictions from the criminal, but won’t have legislation compelling hospitals to provide women and children with the medication that prevents them from getting criminal-inflicted HIV.

Professor Ames Dhai of the University of Natal points out that there are twice as many rape survivors at risk of seroconversion to HIV than there are babies born in South Africa to HIV-positive mothers, yet there are few calls for PEP for rape survivors. She asks: “Is it because of residual stigma against those raped?”

Just over a month ago a 21-year-old student was forced at knifepoint into an alley off Long Street, Cape Town, and was raped. When she went to Groote Schuur Hospital she, like many rape survivors, found it difficult to use the word “rape”.

She told the admissions clerk she had been attacked. Because government hospitals do not see the necessity to train staff to be sensitive towards this problem, he told her to see her private doctor. She had to wait until the next morning – and yet the administration of PEP is urgent: to prevent HIV it has to take place less than 72 hours after the first act of penetration or attempted penetration.

Her doctor, being as incompetent as most GPs in dealing with rape survivors – in part because most universities give scant training to medical students on how to deal with rape – made her wait while he tried to figure out what medicines she should take. He finally gave her a prescription for two months of PEP instead of just 28 days.

It took her six hours and eight chemists to find a chemist that stocked anti-retrovirals – she finally sat in the eighth pharmacy, which didn’t have the drugs, and refused to move until she was told where she could find them. Only then did a chemist pick up a phone and help her to get access to them.

In the country with the world’s highest rate of HIV and rape, why do so few pharmacies stock anti-retrovirals, or at the very least three-day PEP starter packs for rape survivors? This failure has nothing to do with the new medical regulations: few were stocking ARVs before.

The young woman’s father phoned the police from Johannesburg, and was told that the cameras on Long Street had not picked up anything untoward on that night, so there was no point in laying a charge. Failures like these lead to statistics like these:

• UNAids reported last year that in South Africa two-and-a-half times more women are infected than men because many women experience forced sex;
• Unicef reports that six times more girls than boys in Africa are infected with HIV;
• A Human Sciences Research Council study found a significant cohort of HIV-infected children whose mothers were not HIV-positive. How did they become infected?
• In South Africa, police tell us, 41 percent of those raped are under the age of 12. In Meadowlands, Soweto, police say 90 percent of rape in that community is against children younger than 12.

Superintendent Nico Snyman, head of that police station, says that despite a good arrest rate, only a small percentage of cases get prosecuted because families will accept “compensation” from the rapist or rapists, and the child is then prevented from testifying.

In the case of a young man raped in Wentworth, Durban, three years ago, when he was 14, the thugs who raped him offered his impoverished grandmother R3 000 to get him to drop the case. She wanted the money, but he refused despite continuing threats.

Investigating officers were changed three times, the prosecutors four times. The victim went for counselling at a well-known child counselling centre, but because he is an orphan and his grandmother unemployed, he couldn’t afford bus fare to continue and no one bothered to go to him.

Last week the case against the accused was dismissed for lack of evidence. The prosecutor did not add extortion to the charge sheet, nor did she bother to get anyone to testify how he the victim took rat poison after the rape and spent a week in Addington Hospital’s psychiatric ward because he was so traumatised.

The investigating officer was on leave and did not testify, and no victim impact statement was used. Gangsters got away with the rape of a boy because no one cared, and this was a case the National Prosecuting Authority’s Sexual Offences Unit received frequent complaints about.

A nine-year study by Cape Town’s Red Cross Children’s Hospital, published in the SA Medical Journal in December 2002, found that the average age of children raped was three. Research has shown that 40 percent of those raped in South Africa are at risk of becoming HIV-positive if they do not receive PEP.

Experts believe that if post-exposure prophylaxis was given immediately to rape survivors, South Africa could cut new HIV transmission dramatically. Yet little is done to advance this HIV preventive mechanism.

What are the costs of providing PEP? The cost to the government of each HIV test is less than 60c, according to the department of health. PEP costs it about R60 for 28 days.

In other words, to treat 54 000 reported rapes each year would cost the government less than R600 000.

A rape specialist, Dr Adrienne Wulfsohn, says the hospital costs of treating one rape survivor who contracts HIV is around R600 000 during her shortened life.

Better treatment of rape survivors would result in more reporting and would give them the confidence to go through with their cases. What is more, most rapists are involved in other crimes – you jail a rapist and you invariably put away a dangerous criminal responsible for other offences.

South Africans need to become more serious about combating this crime.

• Charlene Smith, a journalist, was raped and stabbed in her home in 1999 and has since become an internationally recognised expert on sexual violence and post-exposure prophylaxis.