Document 17049

Date : July, 01 , 2010 Publication : SA Medical Journal Page Number: 362-363
Reported rapes at a hospital rape centre: Demographic and
clinical profiles
Kees I . i m H U T S I i i u l i M a r t i n , D onavan A n d r e w s , Soraya Seedat
To the l-ditor: figures ior tin- period 2008/2009 indicate a 10%
support tor the ongoing call for the provision o l effective and
rise in Ilu* number of reported sexual offences compared w i t h
integrated post-rape ser\ ices tor rape survivors.
figures lor 2007/2008.' The increase may be partly attributable
to the recent version of the acl regulating sexual offences:
the t I .iw (Sexual Offences and Related Matters)
Amendment Act, Acl 32 of 2007 (Acl). In this Act, the definition
of rape has been broadened to include the non-consensual
vaginal, oral or anal penetration ol any person, regardless ol
gender, w i l h a m object." South Africa has one of the highest
incidences of rape in the w o r l d and the most v iolent types.
o l rape in ihe w o r l d , w i l h gang rape and severe p i n sical
injury to rape viclims commonly occurring.
Moreover, the
consequences ol rape potent iaIK include m a i n medical and
We conducted a retrospective rev iew o l patient records for all
male and teniale rape survivors, including children and adults,
w h o presented to the Karl Bremer I lospital Rape v e n t r e from I
August 2007 to " I | u l \ 2008. Standard procedures at this centre
include a medical and forensic examination and treatment o l
physical injuries and STIS. A 28-day course o l prophylactic
anliretroviral medication is also provided to rape survivor*.
presenting w i t h i n 72 hours ot the reported rape.
psychological difficulties, such as unwanted pregnancy, risk
Data from patient records included age ol rape survivors.
Ol Sexually transmitted inleclions (SI Is), genital and physical
day ot the week that the rape was reported, alcohol and d r u g
injurs, and psychological disturbance e.g. post-traumatic stress
use of the rap*' surviv or. number o l perpetrators involved,
disorder, major depression, increased risk ol suicidal ideation,
whether the perpetrator was k n o w n / u n k n o w n to the rape
and alcohol and d r u g abuse problems.*' Rape s u n ivors have
survivor, injuries sustained d u r i n g the rape, I I I V status o l
spei ilu health needs, ideally met by p r o v i d i n g integrated
the rape survivor, a m i the type ol rape committed (anal
MK\ holistic pOSl-rape services, including the provision o l
a n d / o r vaginal). D ata were analysed on SI*SS version 17.
pregnancy testing and prevention, termination of pregnancy,
Descriptive statistics (means and standard de\ iations (SI H))
testing and treatment of S I N ,ui\.i injuries, and ps\ chosocial
were computed lor the variables ol interest, lo determine
counselling. Rapt' survivors strongly value the ax ailabilit)
whether any significant differences were evident between
o l I IIV prophylaxis, an understanding health care provider,
males and females in terms of the variables of interest, the chi-
access to and r i v e n ing counselling, ,ii^\ thorough physical
sijuare test or Fisher's exact test wen- used where appropriate.
examination, emphasising the need tor a holistic appioai h
I thical permission to conduct the study was obtained from the
to post-rape c a r e . " The Act amis to provide certain s e n ices
Stellenbosch University ethics committee.
to survivors of sexual assault to minimise or present further
traumatis.ition, yet the only medical sen ice conditional!)
provided to rape survivors is the provision o l post-exposure
prophylaxis (PI I V
A total of I 1.12 confirmed rape cases were identified,
comprising I 013 female (mean age 20.7 years, 5 D 11.2) and
We aimed to replicate and build on a previous record review
I I ' ' male < mean age 11.3 years, SD8.7) rape cases,
o l female rape survivors 1 by p r o v i d i n g An overview o l the
(Table h. The mean age for the total sample was 19.7 years
demographic, clinical, and rape characteristics ol female and
(SI) 11.4), w i t h the youngest survivor being a newborn and
male children ami adult rape survivors presenting to a rape
the eldest 7N years o l d ; 34.1% were < IS years old. Most patient
centre in the Western Cape. We aimed to provide evidence and
visits occurred o n a Sunday and Monday. I here was clinical
evidence o l alcohol use i n 20.7".. of rape sur\ ivors, and ol d r u g
use in \ 0 " . , . In 333".. o l gang rapes, survivors had consumed
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alcohol, and d r u g use was reported in 7S\> o l the gang rapes.
I're\ ions rapes were reported hv (•."".. of alcohol users and h\
6.3% oi d r u g users. In 10".. of »as(-s. there were ?2 perpetrators,
ranging f r o m I lo S. In d/.H".. o l cases, the perpetrator was
k n o w n lo the s u n ivor. and in survivors < I 5 years o l d , 84.S"»
had been raped previously by someone known to them. A
significant difference between males and females was found in
terms of genital a n d / o r anal injuries; '2.4".. o l female sur\ ivors
sustained genital injuries, whereas 4.V".. of male survivors
had genital or anal injuries. A significant difference between
genders i n terms ot moderate physical injuries, was observ ed.
In 18.5% of all cases, physical injuries were documented.
Moderate p i n sical injuries included abrasions and scratches
(17.3",.); more severe physical injuries included stab w o u n d s
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