Support Thuthuzela Care Centres #EnditNow
By Kathleen Dey
I’m listening to a rape survivor tell a conference room filled with people the story of how she was raped at the age of 14, shot, shoved into a pit latrine and left for dead. How she didn’t die. How she lived. How she crawled to safety. How she named her assailant and sent him to jail for life. How she lives with a bullet in her neck. How she prevailed against thoughts of suicide by finding the Rape Crisis counselling service. How she wrote a book about her experiences called Dear Bullet or a letter to my shooter. Many in the audience are in tears. Others are shocked even though they are experts in this field. As she ends she says, “We need to stop rape. We need to save rape survivors by helping them to talk.” Her name is Sixolile Mbalo.
In the 20 years since Sixolile was raped South Africa has escalated its response to gender based violence, combining criminal justice, medical and mental health related services in an innovative model called the Thuthuzela Care Centres. At these centres, based in hospitals around the country, counsellors called first responders meet each survivor as they arrive to greet them, calm them down and contain them until they are composed enough to be able to absorb information. They then inform them about the complex processes involved in reporting rape and walk them through the process step by step: A nurse will counsel the survivor about potential health risks including potential HIV infection and prepare them for the forensic examination, which is conducted by a doctor specially trained to collect forensic evidence for the crimes of rape and sexual assault.
After this examination the first responder gives the survivor a care pack containing toiletries so that she can shower, change into clean underwear and brush her teeth. A police detective will either take a statement immediately or escort the survivor to their home and make an arrangement to take the statement the following day. Before they leave the nurse will make sure that if the HIV test was negative that the survivor has Post Exposure Prophylaxis (PEP) medication to prevent HIV, pregnancy and STIs. The first responder will make sure the survivor has contact details for ongoing counselling services for future reference as well as an information booklet on recovering from rape. As this case makes its way through the criminal justice system it will be supervised by a specially trained prosecutor and investigated by a specially trained detective. As they adhere to the PEP regimen survivors are followed up to ensure they complete the full course and do not seroconvert and become HIV positive.

Thuthuzela Care Centre Coordinator, Nomnqweno Gqada with the care back bags rape survivors receive at TCC’s.
At the Rape Crisis Cape Town Trust we see over of 3 000 rape survivors a year at these centres. We see the extraordinary impact this care has on survivors, making sure they don’t struggle and suffer as Sixolile did but get the help they need right from the very beginning in the hours immediately after the rape. We see the incredible collaboration between medical teams, police officials and NGOs. These NGOs are gathered today to discuss the future of the Thuthuzela Care Centres.
A future that seems suddenly uncertain. The South African Government has not given any clear signs that it will continue this project once foreign donor funding comes to an end. With 50 centres across the country the budget for maintaining these services is high. Where will the funding for this budget come from? Foreign donor policies are moving towards prevention and away from care, seeming to ignore the preventive role that care plays in the cycle of violence. The impact on economic development of gender based violence is significant, with women, who are still bearing the main brunt of these crimes forming a major portion of the workforce or supporting that workforce. The Thuthuzela Care Centres represent the state’s most comprehensive response to gender based violence especially when coupled with specialised sexual offences courts. Yet many donors are unwilling to subsidise services they consider the responsibility of the South African government.
The fact is that these services remain dependent on a strong collaboration between donors, both local and international, the government and civil society. The goals of each of these three sets of actors complement one another perfectly while their roles in achieving free, accessible services post rape to survivors are different. If this three way partnership were to fail, with no commitment from donors or from the state to continue to support survivors in the years to come, what will be the fate of these survivors?
One thing is certain. South African civil society is strong. The conference hall is full, the audience attentive. Many have been in the sector for long years and have accumulated a wealth of experience and expertise. Panel after panel present successful results and in depth research. The evidence is rich and absorbing. With such success to hand this partnership should never fail. Sixolile’s message should be heard. #EnditNow
Kathleen Dey is director of the Rape Crisis Cape Town Trust.
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