‘One-stop’ government centres face loss of important psychological help as international funding dries up.
Almost 50% of government’s service centres for rape survivors may be without counsellors after September after international funding for the centres has been slashed.
Government’s Thuthuzela Care Centres are “one-stop” facilities for rape survivors, providing services such as counselling, medical care and the collection of evidence used to prosecute alleged rapists. About 70% of centres rely on lay counsellors paid by non-governmental organisations (NGOs) to provide emotional counselling to survivors, according to researcher Lisa Vetten of the Wits Institute for Social and Economic Research.
Most of these NGOs depended on funding from the international health financing mechanism Global Fund to Fight Aids, Tuberculosis and Malaria to provide counselling services.
But about two-thirds of these NGOs have been left without funding after the Global Fund chose to only support centres in districts with high HIV prevalence rates, Vetten says. This follows a shift in strategy at the financing mechanism towards “high-impact investments” or programmes that can, for instance, avert the most new infections per dollar spent.
Centres in three provinces – the Free State, Northern Cape and Limpopo – have lost all Global Fund support.
“I consider some of their logic, and the assumptions on which it is based, to be a little shaky. It is also problematic to reduce violence against women to a problem of HIV,” Vetten argues.
The majority of NGOs providing counselling at the facilities lost Global Fund support in April. While the South African National Aids Council was able to negotiate partial funding to keep some counsellors at work until September, this money is running out.
Vetten says Lifeline has been forced to stop providing counselling at Thuthuzela Care Centres in Sasolburg in Free State and Taung in the North West. The organisation is also slated to halt similar services to centres at Stanger, Mahatma Ghandi and Port Shepstone hospitals in KwaZulu-Natal.
The NGO People Opposing Women Abuse is likely to stop providing emotional support to survivors in Tembisa in Gauteng and Tonga in Mpumalanga as well.
Despite the loss of counsellors, centres will stay open but Vetten says medical care is not enough for survivors.
“We put money for medical care but not enough money for mental healthcare for rape survivors,” she says. “The mental state of survivors seems to be an afterthought.”
A 2013 study published in the journal Addictive Behaviors found that sexual violence survivors are at a higher risk of developing post-traumatic stress disorder (PTSD), particularly among women with a prior history of assault. The US non-profit Mayo Clinic notes that PTSD is often triggered by a traumatic event and symptoms can include flashbacks, nightmares and severe anxiety. The condition can also put people at a higher risk of depression, eating disorders and suicide.
The responsibility for Thuthuzela Care Centres falls under multiple government departments including the National Prosecuting Authority, and the departments of social development and health.
Department of Social Development’s spokesperson Lumka Oliphant maintains the National Prosecuting Authority is responsible for funding the centres. “We provide support through availing our social workers to work in the centres; funding is not one of our duties,” Oliphant says.
The Department of Health and the South African National Aids Council had not responded to requests for comment at the time of publication.
The future for many other NGOs in Thuthuzela Care Centres, including Childline, remains unclear.
But Vetten says many organisations are trying to scale down to keep services going as they pursue alternate funding. “Rather than shutting down services completely, many organisations are opting to reduce hours, pay staff less or cut down on staff,” she explains.
Pontsho Pilane is the communications manager at Soul City Institute for Social Justice. Pilane was a health journalist at Bhekisisa from 2017 until 2019.