A local trauma centre counsellor took a child abuse case to Hilbrow Clinic in December and was presented with a letter stating that child rape victims who appear at the clinic after 10pm will only be examined in the morning.
“I was absolutely astonished when the staff showed me the letter. When I complained they refused to let me keep the letter,” said the counsellor who wishes to remain anonymous.
The letter was date stamped 26 March 2013 from the Department of Health, the Office of the Clinical Manager, Johannesburg Health District:
It reads, “After lectures and training by Dr.Neil Mckerrow (November 2011) – a leading Paediatrician in South Africa and working for KZN Health Department. It was noted that the time we examine children especially query rape, the child is tired and it is long past their bedtime, the chances of finding anything is nil due to the child’s irritability.
He has suggested that when children come after 22h00, it is better to let them sleep in the clinic and to examine them in the morning. PLEASE LET THEM SLEEP IN THE CLINIC AND EXAMINE THEM IN THE MORNING. Do not turn them away but explain to the parent/policeman that they will be examined but later.
If parents refuse to stay, they must sign to the effect.”
Department of Health spokesperson Steve Mabona commented, “The said letter was utilised to protect sexually violated children, the trauma counsellor handling the case could have managed the matter better, by raising all concerns to the clinician in charge at that moment.”
He further added, “It is important to indicate that all forensic clinicians are well trained on screening children and categorise them accordingly.”
The Teddy Bear Clinic has provided holistic child protection services since 1986. The head office in Parktown clinic manager Dr Shaheda Omar commented on the time period needed to examine children of abuse or rape. “It is critical that a sexually abused child be examined as soon as possible after the alleged incident or otherwise within 24 hours.”
Dr Omar further explained that it is important to note that sometimes penetration may not show physical evidence, depending on the stage of menarche [start of menstruation] of the child where the hymen may be estrogenised, meaning that it is thickened and penetration is possible without rupturing the hymen.
According to Dr Omar with regards to the big question of leaving a child to sleep after 10pm at night and then examining them in the morning, she replied. “In the event of acute abuse it would be preferable to examine the child as soon as possible. Otherwise the child would not be allowed to take a bath or remove the clothing. We always focus on the best interests of the child according to the Child Care Act.”
Rape Crisis is the oldest South African institution supporting victims of rape. They categorically state to the victims, “Do not wash yourself; there might be hair, blood or semen on your body or clothes that can be used as evidence of the rape.”
Dr Omar explained, “Children are resilient and healing may occur soon after the penetration, leaving no evidence. Sometimes if an examination is conducted a few days later there may be no conclusive physical findings despite the history or allegations of rape.”
Mabona replied, “An emergency examination is required when: there is genital or anal pain, evidence of genital, anal bleeding or injury, finally, when the window of opportunity for the collection of forensic evidence is running out.” He emphasised that the children are not turned away as the clinic has sleepover facilities.
The Department of Health Uniform National Health guidelines for dealing with survivors of rape and other sexual offences state that a victim of a sexual offence should have access to:
“Services available on a 24-hour basis with minimal delays in victim/survivor being seen for the following reasons: Rape victims should be forwarded to the front of a health queue – though confidentiality should be maintained. For forensic reasons, medical evidence needs to be captured as quickly as possible.The victim should be allowed to wash after the examination.The medical/psychological problems should be dealt with quickly.”
Dr Omar was asked if there was an expiration time for evidence to be collected. She said, “If there is evidence of oral genital contact, this evidence or swabs should be taken within 11 hours.”
Mabona concluded, “We will work closely with trauma counsellors to assist the efficient management of sexually violated children, and to avoid misunderstanding.”
Details: Department of Health, www.health.gov.za or Teddy Bear Clinic, 011 484 4554.
