Introduction
Rape, including child rape, is increasing at shocking rates in South Africa. Sexual violence against children, including the raping of infants, has increased 400% over the past decade (Dempster, 2002). According to a report by BBC news, a female born in South Africa has a greater chance of being raped in her lifetime than learning how to read (Dempster, 2002). When South Africa became a democracy in 1994, there were already 18,801 cases of rape per year, but by 2001 there were 24,892 (Dempster, 2002). Numbers vary by different institutions, but are nevertheless extremely troubling. The Institute of Race Relations found that more than 52,000 rapes were reported in 2000, and 40% of the victims were under age 18 (du Venage, 2002). The University of South Africa reports that 1 million women and children are raped there each year (South Africa: Focus on the Virgin Myth, 2002).
High Profile Baby Rapes
A number of high profile baby rapes since 2001 (including the fact that they required extensive reconstructive surgery to rebuild urinary, genital, abdominal, or tracheal systems) increased the need to address the problem socially and legally. In 2001, a 9-month-old baby was raped by six men, aged between 24 and 66, after the infant had been left unattended by her teenage mother. A 4-year-old girl died after being raped by her father. A 14-month-old girl was raped by her two uncles. In February 2002, an 8-month-old infant was reportedly gang raped by four men. One has been charged (McGreal, 2001). The infant has required extensive reconstructive surgery. The 8-month-old infant's injuries were so extensive, increased attention on prosecution has occurred.
The Effect of Apartheid on the Current Violence
The apartheid system in South Africa separated Whites from Blacks and mixed race individuals. The Separate Amenities Act in 1948 created separate building entrances, schools, public restrooms, public benches, etc. for Blacks and mixed race individuals. Race was identified by physical attributes that tended to be arbitrary (if an official stuck a pencil in someone's hair and it stuck, the person was Black). The Population Registration Act of 1950 created the "pass laws" forcing non-Whites to carry a pass with them at all times. The Prevention of Illegal Squatting Act of 1951 enabled the government to force Blacks and mixed race individuals to live in designated areas. "Section Six" in Capetown remains a relative ghost town of empty apartments and homes. Individuals who lived there were forced to move outside of the city by the government, thus creating the townships, such as Soweto (near Johannesburg) and Cape Flats (near Capetown). Today, townships are miles and miles of tin shacks and/or boards haphazardly nailed together to form shelters.
Schools are Inadequate and Violent
The apartheid system and its removal have also had an indirect effect on the large number of rapes occurring in schools. For years, teachers fought against the apartheid system as their main objective, and schools were sites of political uprisings and violent places. Now that apartheid is dismantled, teachers and the education system have struggled to refocus resources on actual education and qualified teachers. The Bantu Education Act and its system, forced upon Blacks and individuals of mixed race during apartheid, provided only rudimentary skills for menial jobs, not professions. White domination was apparent through this education practice. The generation responsible for teaching children now is ill prepared. In addition, AIDS is killing teachers. AIDS is beginning to kill massive numbers of educated professionals. In a recent Cape Times article, discipline and AIDS were cited as the biggest threat to education in South Africa (Peer, 2002).
Gangs are growing in South Africa and intimidate teachers, disrupt lessons, and rape at will. According to a Human Rights Watch assessment, "Gangs... make schools places where drugs, thugs, and weapons can move as freely through the gates as people," and "Schools become territorial prizes... courses are not conducted according to any regular schedule" (Scared at School, 2001). The reorganization of schools after the apartheid system has created a chronic shortage of classrooms and teaching materials, high student-teacher ratios, and no access to proper sanitation with nearly half of the schools using pit latrines, which are inadequate in number. Thirteen percent of schools have no sanitation facilities and 56% have no electricity (Scared at School, 2001). Many girls are raped in bathrooms and latrines in schools, many by other classmates and 40% by teachers (Scared at School, 2001).
Police and Legal System
In the past, the police represented the oppressors. Police in Soweto and other townships killed hundreds of rioters and protesters before the apartheid system was removed. It has taken time for individuals, including women, to go to the police system for help after a rape or other violent act. In many instances, there are not enough police in the townships to cope with the growing numbers of murder, rape, and robbery. Police have had incidents where a woman or girl was being held and repeatedly raped by gangs in a township, but they didn't have enough manpower to go in to stop or overpower the number of men (Lydia Richards, Professor, University of Capetown School of Nursing, personal communication, June 7, 2002).
Townships Breed Violence and Social Breakdown
A social worker at Red Cross Children's Hospital in Capetown, a hospital that treats the largest number of child rapes, described the geographical outlay and problems in townships that may contribute to child rape (Carla Brown, Chief Social Worker for Child Rape Victims, Red Cross Children's Hospital, Capetown, personal communication, June 11, 2002). Many areas lack running water and electricity, and outhouses are used by a large number of individuals. Living spaces may be a 10 x 8 room where a large number of individuals live (10 or more) - parents, children, grandparents, uncles, or friends all live in one cramped space. People must undress, bathe, and sleep in extremely small areas without partitions. There are no private areas for parents to have sexual relations and members of the family may sleep next to children on the floor - grandfathers or uncles sleeping next to small children. Children going to outhouses late in the evening may be sent alone and exposed to possible rape or violence. Townships have areas of tall grasses, garbage, and discarded junk. Girls walking to school have been raped in these areas because of lack of visibility from the outside world. Gang initiation is beginning to consist of child rape, including the rape of young boys. Individuals who are not lucky enough to have a job are left with other family members, sometimes other children or other male relatives who rape these children. There is an increasing number of children orphaned due to the death of their parents from AIDS. These children are left with other young caregivers, exposing them to rape and violence.
Reasons for Rape
Various cultural beliefs in South Africa regarding rape hinder the problem of decreasing and reporting rape. It is difficult to impossible for a woman to say no to sex. Many girls and women believe that if they know the boy or it is a boyfriend who rapes them, they cannot say no to sex, even forcible sex. Many men believe they are entitled to sex or even believe that women enjoy being raped. In a study done in the Gauteng area, 8 in 10 men believed women were responsible for causing sexual violence and 3 in 10 "asked for it" (Scared at School, 2001). Approximately 50% of male youth believed no to sex meant yes, and nearly one third said forcing sex on someone they knew was not sexual violence (Scared at School, 2001). A majority of men thought "jack rolling" ("recreational" gang rape) was bad, but boys between the ages of 15 and 19 thought it was "good" or "just a game" (Scared at School, 2001).
The raping of infants and/or children may also be due to the belief that sex with a child or baby will cure AIDS. Virginity testing is growing and many times occurs in school. Girls must lie on their backs with their pants and underwear off and legs in the air, preferably on a sloped floor (IRIN HIV/AIDS Weekly, 2001). A survey in East London, South Africa, by the University of South Africa found that 18% of 498 workers believed that sex with a virgin could cure AIDS (South Africa: Virgins, victims..., 2002). In Gauteng, 32% of those interviewed believed this myth. Some discount this belief for the reason behind rape, but Barbara Kenyon, director of the Greater Nelspruit Rape Intervention Project in the Northern Province of South Africa, has found in follow-up visits that many children become HIV positive and that children who are raped are getting younger and younger. Some analysts have stated that desperate people are desperate for a cure. Money for AIDS drugs is essentially unavailable despite the victory by the South African government last year against pharmaceutical companies to buy AIDS-treatment drugs at a cheaper price. Unemployment among Blacks and mixed race is anywhere from 30%-60%, but typically around 60%. Many individuals work without formal work contracts and benefits. The median income for Blacks and mixed race can be as low as $300/year, and the cost for AIDS drugs average $40 to $50 per month, clearly out of reach for a large majority of the population. Payment for health care in hospitals or care centers is means-based. Others blame the high rate of violence, including sexual violence, on a culture of violence that existed in South Africa for decades because of apartheid.
AIDS Role
Africa is home to 70% of the adults and 80% of the children living with HIV in the world (Avert, 2002). South Africa has the largest population of individuals in Africa infected with HIV. More than 4.8 million people there have AIDS; 250,000 died from AIDS in 1999; and by the year 2015, the population loss of AIDS-related deaths in South Africa will be 4.4 million (Centers for Disease Control [CDC], 2002). By the year 2010, HIV prevalence could reach 25%, and by 2008, 1.6 million children will be orphaned by AIDS, increasing the number of children who are at risk for no caregivers, rape, sex work, or life on the street (CDC, 2002). At least 5.7 million children in South Africa could lose one or both parents from HIV/AIDS by 2015 unless there are major interventions (IRIN Daily News Alert, 2002). In African countries where at least 15% of adults are infected, AIDS will claim approximately one third of today's 15-year-olds (HIV & AIDS in Africa, 2002). Teachers are increasingly dying in Africa from AIDS. Economically, AIDS will continue to impact upon the very root of why violence and sexual violence could increase due to unemployment and the break down of the social fabric. AIDS will reduce economic impact by 0.3-0.4% annually in South Africa, and by the year 2010, AIDS will reduce South Africa's gross domestic product by 17% and eliminate $20 billion of the country's economy (Avert, 2002).
There continues to be debate in South Africa among members of Parliament, including President Thabo Mbeki and other leaders as to whether HIV causes AIDS and whether drugs will help. President Mbeki has restricted the use of AIDS drugs in hospitals on the grounds of safety. Cost also restricts treatment drugs such as AZT, but Nevirapine (reduces mother-child transmission) has been tested in 18 pilots (Seindells, 2002). An estimated 50% to 70% of all tuberculosis patients are infected with HIV. For children (Blacks and mixed race who are not economically sound) who are infected with HIV, no medicines are available due to cost. In Red Cross Children's Hospital, pneumocystis carnae pneumonia (PCP) is treated with Bactrim®. Few if any drugs are available for treating Karposis' Sarcoma (leaving parents with tremendously disfigured infants until they die) and cytomegolarovirus (CMV), CMV retinitis, or CMV pneumonia.
Prosecution of Rape Cases and New Health Programs
Many families, women, or girls are reluctant to report rape or prosecute the rapist. If a woman's husband is raping children in the household, she may be reluctant to go to the police if he is the only source of income. Prosecution of rape crimes has been slow as well. The government and legal system came under tremendous scrutiny with the gang rape of a 9-month-old girl in the Northern Cape in October 2001. Six men were arrested for the crime but released after lack of evidence could connect them to the crime. The child suffered extensive internal injuries and required a colostomy. Protesters called for the execution or castration of child rapists after the incident. (South Africa outlawed the death penalty in 1995.) Community lynching of rapists has started to occur in townships. In addition, discussions to change the legal definition of rape has occurred. The current legal definition would not apply to the raping of boys (or men) or rape of a girl or boy with an object. Occasionally girls are raped by the insertion of objects into their vagina. The rape of a boy (or man) is handled under a different legal definition as an indecent act.
Program for Women and Girls
In 1999, the government established approximately two dozen courts specifically to handle sexual offenses. The Bureau's current project, the Thuthuzela Care Centre, in cooperation with the Vera Institute in New York City helps the justice system treat rape survivors (girls 14 and older) with respect and handle criminal cases more effectively. The project's goal is to improve police investigations, collection of evidence, and prosecution. The project is a result of a small study in Cape Flats that showed women and girl's treatment after rape led to poor investigations and unsuccessful prosecutions. Before the center, women or girls waited an average of 3-4 hours in police stations repeating their stories. Medical exams were delayed hours or days, and evidence was routinely lost. Girls and women were rarely tested for HIV, and many women walked home alone from the hospital. Girls or women did not know of court hearing schedules, and many stopped case prosecution.
The Centre is located in Jooste Hospital in Manenberg near Cape Flats and Mitchell's Plain (Capetown townships). A second care center opened in July 2001 in Mdantsane in the Eastern Cape. The Centre sees women and girls as young as 14. The matron of the center reports the Centre sees approximately 30 rapes per month in children age 14-17 (in addition to women). Many of these rapes occur in schools (Carla Brown, Chief Social Worker for Child Rape Victims, Red Cross Children's Hospital, Capetown, personal communication, June 11, 2002). They are perpetrated by boys (some as young as 10), and approximately 40% of the rapes are perpetrated by teachers. Recently, Parliament Education Committee Chair Shepard Mayatula has advocated for publicly "naming and shaming" teachers who rape students (Terreblanche, 2002).
After a rape occurs, the police bring the woman or girl to the Centre. A doctor collects evidence using DNA analysis kits. Only visual detection of evidence is used, as a colposcopy machine is unavailable due to cost (and would require additional training). If a woman or girl appears at the center within 72 hours after the rape, she is offered AZT and tested for HIV and sexually-transmitted diseases. A doctor may be called away during the exam and return a number of times. The woman or girl can change into clean clothes and eat something after the examination. A special prosecutor handles all rape cases at the Thuthuzela Care Centre. This prosecutor is experienced in rape cases as well as child rape. Despite this, girls, women, and families of infants or children who have been raped are many times reluctant to go through with criminal prosecution due to threats of violence, murder, and prior incidents of family homes being burned in retaliation for reporting rapes to the police and judicial system (Pauline Berzi, Matron Nurse, Thuthuzela Care Centre, Mitchell's Plain, South Africa, personal communication, June 7, 2002).
Infants and Children
For children below age 14 and those requiring reconstructive surgery, many go to the Red Cross Children's Hospital, a tertiary hospital in Capetown and for the Western Cape area. In 1995, the social worker responsible for child rape victims saw an average of 100 child rapes per month. It has slowly decreased to approximately 25 per month, but this number is deceiving (Carla Brown, Chief Social Worker for Child Rape Victims, Red Cross Children's Hospital, Capetown, personal communication, June 11, 2002). Most child rapes are now seen in primary care centers in the community where reporting is still haphazard. The incidence may still be 100 or more a month. The number of child rapes and rapes in South Africa was so embarrassing that the government placed a moratorium on government crime statistics in 2001 stating that they needed "reassessment" (Scared at School, 2001).
If a child is seen within 72 hours after the rape at Red Cross Hospital, the child is started on AZT. Parent(s) are counseled on safety and psychological effects. The child is placed initially in the intensive care unit (ICU) because heightened security for the child and family can be provided in the ICU if retaliation by the perpetrator takes place. Many parents are reluctant to continue the prosecution due to long delays and fears of "reliving" the attack. Dolls are used in Red Cross Hospital and court to demonstrate abuse, although many children have never seen a doll and have been initially afraid of dolls (Carla Brown, Chief Social Worker for Child Rape Victims, Red Cross Children's Hospital, Capetown, personal communication, June 11, 2002). Social workers work with caregivers to increase the safety of these children so further abuse does not take place.
Prosecution of Child and Infant Rapes
If a parent continues with the prosecution, the government has developed the Sexual Offenses and Community Affairs Unit. In Capetown, both women from the Thuthuzela Centre and child rape cases are held in a special section for security. Child-friendly rooms in the Capetown courts were developed with the assistance of Resources Aimed at the Prevention of Child Abuse and Neglect (RAPCAN), a South African child abuse non-profit group that has done community education and media campaigns on child abuse. Children are taken to a special room where an "intermediary" assists the child and a closed circuit video monitor is placed for viewing in the courtroom (Special Rape Prosecutor, Capetown, personal communication, June 7, 2002). There is also security for the child in this room. The child can be seen in the courtroom but cannot see the alleged perpetrator. This differs from the American system where a child may be forced to "face" the accused (Althea Handy, Division Chief Sex Offense Division of State's Attorney's Office for Baltimore City, personal communication, June 5, 2002.). The intermediary sits next to the child and assists him or her in translation of languages and informs the court if the child needs a break for the toilet, food, or rest. Because there are so many cases waiting to be heard, the government recently put out a call to hire more prosecutors for child rape cases.
Sexual-assault nurse examiners (SANE) are nonexistent in South Africa but could provide a means to increase health care and collection of evidence for a wider section of the population, particularly in rural areas. Generally, nurses see children for immunizations or illnesses in rural areas or primary care settings. The South African government is trying to increase prosecution of rape cases but already has a backlog of 1-2 years. With an increasing number of children left without parents due to AIDS, cultural myths regarding rape, and economic downturns, the violence of child rape will continue to take its toll.
Pediatr Nurs. 2002;28(5) © 2002 Jannetti Publications, Inc.
Cite this: Child Rape in South Africa - Medscape - Sep 01, 2002.
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