Source: Health-e
In 1996, when South Africa returned to the World Health Organisation (WHO), the country made a resolution that declared violence a public health priority. But violent crime still remains endemic, with women and girls especially at risk.

Research shows that injury or death caused by violent crime in South Africa remains particularly high, although the scourge has gone down significantly in the last decade. Ten years ago about 60 – 70 people in South Africa would fall victim to injury or death as a result of violent crime. The rate has dropped, but is still exceptionally high compared to countries like the UK where one person out of every 100 000 would die violently every year.   

“We have got about 34/100 000. That’s indeed quite a high number compared to something under 10 for other developed countries. We are leaders in the incidence of murder, rape, robbery and violent theft”, says Dr Norman Mabasa, chairperson of the South African Medical Association (SAMA).

Mabasa adds that research also shows that South Africa has the highest rate of violence against women and girls.

“In 1997, the South African government reported rape and sexual abuse to be increasingly rapid and a matter of grave concern. In 1996 – 1998, girls aged 17 and under constituted approximately 40% of reported rape”, he says.

Violent crime in the country is at epidemic proportions and has far-reaching implications.  

“This is an epidemic that has huge consequences, not only on people’s personal lives, but also on the economy of the country and, also, the ability of South Africa to sell itself to its own people”, says Dr Gustav Wolvaardt, Chief Executive Officer of the Foundation for Professional Development (FPD), a SAMA project.

Violent crime against women, specifically rape, is a universal problem. In South Africa, it contributes to the high HIV infection levels among women.

“It exists in all countries, all religions and social classes. It also poses serious threats to public health and, in particular, sexual and reproductive health. It’s also a critical impediment to fighting HIV and AIDS. In South Africa, there are these twin epidemics of HIV and AIDS and gender-based violence. Both epidemics are severe and serious and disproportionately affect women and children. According to the latest national ante-natal survey, 30% of women between 20 and 24, 40% of those between 25 and 29 and 36% of those between 30 and 34, are HIV-positive”, Peter Teljer, Sweden’s ambassador to South Africa, explains.    

In their efforts to address sexual and gender-based violence, the Swedes have a telephone help-line.

For a relatively small country of under 10 million people, the contact centre receives about 40 000 calls per annum. Sexual violence is so rife that the World Health Organisation estimates that one-third of all women and girls worldwide will be raped and suffer sexual violence, at least, once in their lifetime.

The FPD’s Dr Gustav Wolvaardt says this is an epidemic that has been neglected. He says part of the reason the crime is so well-established is that professionals such as health care workers, including teachers, have never wanted to be involved in efforts to address sexual and gender-based violence.  He says there needs to be educational programmes to sensitise professionals such as health care workers and teachers about sexual and gender-based violence.

“Professionals, whether they are health care professionals or whether they are educational professionals, are perfectly positioned to identify victims of violence. For example, chronic victims of violence will show up within a hospital setting every six months – most of them. We’ve always left it to the psychologists or the social workers. We don’t expect them to get involved and do the work that’s expertise. But they need to know and spot patients that can be referred or spot kids because children are a very sensitive barometer of what happens in a household. These training programmes will ensure that these professionals can identify and then refer people for care”, Wolvaardt says.       

He says it is with a great sense of guilt that he recognises that even though South Africa flagged violence as a global public health threat more than a decade ago, his profession has for a long time overlooked sexual and gender-based violence.    

“I was part of the South African delegation that wrote that resolution in 1996 that we took to the World Health Organisation to say violence is something the health sector should get involved in. But, somehow, in South Africa we didn’t translate that focus that we created internationally into actions at a local level”.

“Part of it is because, firstly, it is a difficult problem and, secondly, it’s not a problem that people really want to grasp with.  So, it’s taken really a long time. And my experience was very similar to what my experience was in the beginning of the AIDS epidemic. When you went to people and said: ‘We want to do something about AIDS’, they used to say, ‘oooh, no, no, no. We don’t want to link our logo to that’. But it is changing. I think everything is aligning… coming right. It is the right time to do this. I feel a bit guilty. I think this is a big issue that we’ve not given sufficient attention in the country”, says Wolvaardt.

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