The forensic nursing seminar hosted by the Tshwaranang Legal Advocacy Centre on behalf of the Shukumisa Campaign brought together a passionate and committed group of professionals who provide healthcare services to rape survivors.
As Dr Sagie Naidoo of KwaZulu-Natal explained, forensic nursing is the application of clinical nursing practice to trauma survivors. Although forensic nursing was first introduced to South Africa in 1998, it is still not recognised by the South African Nursing Council (SANC). As a consequence a number of different training programmes of varying length and with different content have sprung up. This means there is no standardised training for nurses. Because their skill is not recognised they do not qualify for occupation-specific dispensation (OSD) payments and are often not placed in positions where their skills can be used. The fact that their training is not standardised also means that some courts don’t recognise them as experts able to testify knowledgeably about rape. Finally, a perception exists that nurses offer inferior services in comparison to doctors
Both the SANC and Department of Health need to change this situation to ensure that rape survivors can enjoy the benefits of forensic nursing. Unlike forensic nurses, doctors haven’t received specialised training around conducting forensic examinations or caring for rape patients. They can be unsure of the correct procedures to follow and often don’t have time to testify in court. In fact, one reason why the conviction rate for sexual offences is so low is due to poor evidence collection and inadequate forensic examinations. Doctors in state hospitals also have huge case-loads, especially if they work in casualty, and don’t have time to spend with rape patients. The situation is even worse in rural areas where there is a shortage of doctors.
It is also a challenge that no one directorate in the Department of Health is responsible for health care services to rape survivors. Because these services are split between Maternal, Child and Women’s Health, HIV/AIDS and Sexually-transmitted Infections and victim empowerment, there is no central vision driving the service. It also does not have its own budget. The nurses who attended the seminar resolved to work together to pressurise the Department of Health to recognise their speciality and improve budget allocations to hospitals so that they can work more effectively with rape and sexual assault survivors. They also noted that the time had come to set up an association of forensic nurses in South Africa.