Where the Streets Have No Names:Factors Associated With the Provision of Counselling and Social Work Services for Child Rape Survivors in Kwazulu-Natal; South Africa

Objective:The aim of this study was to audit the provision of state-assisted counselling and social work services to child rape survivors presenting for medico-legal assessment at a state hospital in KwaZulu-Natal; South Africa. Method: A prospective design was used to collect data from the social and medical case files of 200 consecutive cases of child rape referred for medico-legal assessment to a state hospital located to the north of the City of Durban (South Africa). For each case; information was obtained regarding survivor and offender demographics; the nature and duration of abuse; and the extent and nature of counselling and social work services provided. Results: Only 49of survivors benefited from state-supported counselling and social work services; with the provision of such services being frequently delayed (by periods of up to six months); and with service provision being restricted to a single intake interview in all but one case. Social work service provision was significantly less likely in cases where the survivor resided in an informal dwelling (OR = 0.507) and where the child presented for medico-legal assessment outside of normal working hours (OR = 0.625). From observations made during the study; it would appear that patterns of professional collaboration in relation to service provision for child rape survivors falls somewhat short of the ideal of effective multi-sectoral engagement. Conclusions: Levels of service provision observed in the study are unacceptably low; with there being a clear need for the development and implementation of carefully considered multi-sectoral protocols which are designed to effectively meet the needs of all child rape survivors

Sexual Abuse of Boys in Kwazulu-Natal; South Africa: A Hospital-Based Study

Objective - The aim of the study was to determine the prevalence and factors associated with child sexual abuse in a total sample of boys referred for medico-legal assessment in a peri-urban area of KwaZulu-Natal; South Africa. Method - A retrospective analysis was undertaken of clinical and social work records for sexually abused boys presenting for medico-legal assessment at the Mahatma Gandhi Memorial Hospital (Phoenix; KwaZulu-Natal) during the period January 2001 to December 2003. Results - In the period reviewed; 131 boys reported an incident of sexual abuse with temporal trends indicating a significant increase in the incidence of reported abuse over the three year period. Most victims fell in the 4-11 year age category; anal penetration constituted the most common form of abuse (86of cases); and perpetrators were predominantly persons who were known to the child. Conclusion - Study findings indicate that the sexual abuse of boys constitutes a sizeable and emerging problem in peri-urban communities in South Africa. Evidence suggests that increased rates of victimisation are associated with a breakdown in family support networks in the context of rapid urbanisation

Sexual Abuse of Boys in Kwazulu-Natal; South Africa: A Hospital-Based Study

Objective - The aim of the study was to determine the prevalence and factors associated with child sexual abuse in a total sample of boys referred for medico-legal assessment in a peri-urban area of KwaZulu-Natal; South Africa. Method - A retrospective analysis was undertaken of clinical and social work records for sexually abused boys presenting for medico-legal assessment at the Mahatma Gandhi Memorial Hospital (Phoenix; KwaZulu-Natal) during the period January 2001 to December 2003. Results - In the period reviewed; 131 boys reported an incident of sexual abuse with temporal trends indicating a significant increase in the incidence of reported abuse over the three year period. Most victims fell in the 4-11 year age category; anal penetration constituted the most common form of abuse (86of cases); and perpetrators were predominantly persons who were known to the child. Conclusion - Study findings indicate that the sexual abuse of boys constitutes a sizeable and emerging problem in peri-urban communities in South Africa. Evidence suggests that increased rates of victimisation are associated with a breakdown in family support networks in the context of rapid urbanisation