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

ABSTRACT

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