The myriad challenges of Zimbabwe’s response to rape

Imagine spending a weekend in a hospital casualty department just after enduring a brutal rape - traumatised and inconsolable, you are unable - for two whole days - to wash away the mess of blood, tissue and semen that provide a sour reminder of your ordeal.

On a recent visit to Harare's only adult rape clinic, staff at the centre recounted such an incident of a woman who had to spend two agonising days in the casualty department at Parirenyatwa Hospital, Harare’s main public hospital, waiting to get proper assistance from the rape clinic the following Monday. (NB: Staff did not want to be named for this article, nor did they want the identity of the clinic to be revealed)

“By the time she was brought here, the smell was very bad,” recalls one staff member, crinkling her nose in remembrance.

The reason why the woman did not bathe was because she was rightly advised not to, in order to keep the evidence of her rape for forensic tests and procedures. And the reason she could not be attended to immediately after her rape is because the clinic only operates on week days from 8am to 4pm.

Since it opened its doors early in 2009, the clinic has seen over 400 rape survivors, providing each with services that include medical examinations, HIV counselling and testing, emergency contraceptives (ECP), post-exposure prophylaxis (PEP) and treatment for sexually transmitted infections (STIs). The clinic also does collection of forensic evidence and fills out medical affidavits for survivors for use in criminal investigations.

It is the only such centre for adult rape survivors (16 years and above) in Harare and also gets referrals from hospitals and clinics in the small towns surrounding the city.

But due to funding shortfalls, the clinic cannot afford to expand its services and hire personnel to work 24 hours a day.

Currently, the clinic has a staff complement of just six – three nurse counsellors, a nurse aide on secondment from a local hospital, a financial administrator and a secretary. The clinic does not have a full-time doctor of its own, and the three doctors who come in to examine patients at the clinic do so on a voluntary basis.

“Sometimes there will be a case where you would really need the opinion of a doctor, but you find that all the ones that we work with will be busy,” explains one staff member.

This sadly also has had an impact on the clinic’s operating hours, meaning that rape survivors who come in overnight or over the weekend are referred to hospital casualty departments where service is far less efficient.

“The casualty staff are not trained to handle sexual assault cases and so are not able to give the survivors all the care they need,” observes the same staff member.

CULTURE SOCIETY AND RAPE

The majority of the cases (66%) that the clinic has recorded are of rape committed by a partner or relative, commonly known as acquaintance rape.

And the challenge with reporting these is that a woman can be disowned by her family either out of shame, or out of distrust and fear (from other female relatives who believe the woman can ‘seduce’ their husbands away from them). Due to these dynamics, many young women will not report a rape.

“I think the attitude around rape in Zimbabwe goes hand in hand with our attitude towards homosexuality - we are so set in our beliefs, we just won't budge,” observes Tafadzwa Dihwa (25). “It would be much easier to mobilise help for rape victims if the majority of Zimbabweans believed that the victim is not to blame.”

Anesu Katere (31) notes with concern how the overstepping of cultural boundaries is a major contributor to rape and sexual violence in Zimbabwe.

“At times, our culture extenuates rape. Just think of 'chiramu' and how a husband nowadays can fondle the breasts of his wife’s sister. That’s criminal!’

Traditionally, 'chiramu' refers to the goodwill expressed between a man and the relatives of his wife. The man may take to playfully calling his wife’s younger sister his second wife. But this goodwill can be abused and a man may sexually harass the woman in the belief that he is entitled to her body since she is the ‘other’ wife.

Katere mentions another tradition, 'kugara nhaka' – the handing over of a widowed woman to her deceased husband’s male relatives as a wife – as another enabling tradition for rape.

And he believes that cultural norms are being abused in order to justify rape.

The clinic staff also point out that some survivors seen at the clinic are raped during religious ceremonies such as healing sessions. The case of Diana (not her real name), a rape survivor who visited the clinic is one such example.

Diana is a 26-year-old woman, employed as a maid in Harare. She is a single mother of one child who is looked after by her mother at their rural home. Diana says she has been experiencing visual hallucinations for some time and because she had no one to confide in about her problem, she consulted an Apostolic Church prophet for help.

The prophet took her through some healing sessions, and at the end told Diana to undress and allow him to bathe her. She consented. After that, however, he told her she still needed to have another session.

This time she had to lie on a red cloth with her eyes closed. The prophet then took off her underwear and raped her, assuring her that she was healed but that the problem would resurface if she told anyone about the rape.

Diana`s hallucinations did not get better and she consulted another faith healer to whom she disclosed the rape. This faith healer, a woman, then advised her to report the rape to the police who then referred her to ARC.

Since the rape, Diana has been complaining of backache, abdominal pains and foetal movements in her abdomen. The pregnancy test done at ARC was negative however, as were HIV tests.

Views, though, are mixed around who is to blame for sexual assault, especially of women.

Primrose Mukumba (33) a vendor at a Harare flea market believes there is no such thing as rape within marriage.

“A woman is meant to fulfill all of her husband’s desires, even when she doesn’t feel like it,” she says.

Harmony Savanhu (23) believes that women are sometimes to blame for their own rape.

“If we’ve decided to have sex and the girl changes her mind at the last minute, then she will be wrong,” says Savanhu to the grunts of approval of the small group of men that has gathered to hear what is being discussed. “There are feelings and hormones involved and when it’s up (the penis), it will be ready!”

Harmony and his friend, Norbert Zhuwao (29) think the same of women who visit bars in mini skirts.

“She’s showing the men a sign about what she’s come for,” explains Norbert energetically. “Men are visual and are easily excited. And in a bar where there is alcohol and drugs, a woman must know that.”

THE FEMINISED HIV EPIDEMIC

Because rape usually takes place without the use of condoms, it leaves the victim at risk of acquiring a host of sexually transmitted infections, including HIV. Ironically, one of the reasons that men rape infants or young girls is in the belief that sex with a virgin can actually cure HIV.

But with HIV continuing to be an epidemic of immense proportion in Zimbabwe (approximately 13.9% prevalance in the 15-49 age bracket), prevention of new infections has been underscored by government and civil society as the main target of the national response.

Statistics from the rape clinic show that one in ten clients seen test positive for HIV. They also show that 70% of survivors who visit the clinic are females in the 17-25 year age group, one of the most vulnerable age groups for HIV infection.

In what is already a feminised epidemic, rape puts more women at risk of contracting HIV; women who are already identified as being socially and economically disadvantaged in comparison with their male counterparts.

This is why provision of PEP (currently donated by a local hospital) at the clinic is key. If a survivor presents within 72 hours of the rape and tests HIV negative, they will be offered a starter pack of ARVs (Combivir and a protease inhibitor called Aluvia) for 3 days. They will then get the rest of the drugs for the 28-day course at the clinic for opportunistic infections. Monitoring of any side effects is done during periodic visits to ARC.

The clinic is working closely with Musasa Project, an NGO which is involved in community outreach and provision of psychosocial and legal support to survivors of gender-based violence (GBV).

When Musasa Project receives a rape survivor, they refer the person to the clinic for medical assistance. And when the clinic receives a client who might need further counselling, they refer the individual to Musasa Project.

But they too experience challenges in getting women to realise that they have been raped, especially within the context of marriage.

“Unfortunately, most married women do not perceive it as rape,” says Musasa Project Executive Director, Netty Musanhu. “They will just talk about the consequences of the incident, for example contracting HIV. It’s only when you explore further how they got the virus that they then say that their husbands forced themselves onto them. That’s when you realise that they have been raped.”

At the end of 2009, Zimbabwe became only the second country after Namibia to ratify the SADC (Southern Africa Development Community) Gender and Development Protocol which among other things commits member states to ensure that laws on gender based violence provide for the comprehensive testing, treatment and care of survivors of sexual offences to include emergency contraception, as well as ready access to post exposure prophylaxis at all health facilities.

But with just one clinic, facing its own challenges, serving a whole city, more work obviously still needs to be done.