Thulisile Mapongwana
The recent findings from an investigation into the Thuthuzela Care Centres (TCCs) in the Eastern Cape reveal significant gaps in service delivery across the 11 TCCs located in six districts, including Bizana, Lusikisiki, and Mthatha.
The National Strategic Plan on Gender-Based Violence and Femicide outlines a 10-year government strategy aimed at enhancing response, care, and support services for survivors of gender-based violence (GBV). This initiative emphasizes a victim-centred, survivor-focused, and trauma-informed approach to facilitate recovery and healing.
Central to this strategy are the TCCs, which provide integrated services at healthcare facilities. Managed by the National Prosecuting Authority and the Department of Health, these centres aim to offer comprehensive support for GBV survivors.
However, during the investigative hearing held in East London on Wednesday, the Commission for Gender Equality (CGE) highlighted key findings from its investigation in the 2022/23 financial year which hinder support to survivors of GBV.
Key Findings
Resource allocation and staffing disparities:
The investigation highlighted inconsistencies in resource distribution and staffing levels at TCCs. Only 27% of TCCs have dedicated forensic nurses, while only 63% of the centres offer 24-hour services. The legal officer presenting the findings, Noma-Afrika Wakashe, highlighted that this shortage delays assistance for survivors, prolonging trauma and increasing waiting times.
The lack of essential personnel:
Wakashe said many TCCs are without on-site SAPS officers, particularly in high-risk areas. Additionally, several centres lack Social Auxiliary Workers, further diminishing the quality of care available to gender-based violence survivors. Head of the Department of Health, Dr Rolene Wagner, conceded that they did not have enough medical personnel in the care centres. “The challenge that we have with utilising medical officers from casualty is that the medical officer has competing demands. It is not that the GBV victim is not important, but rather, he has to choose saving a life and limb over attending to the victim.”
Training gaps:
There is a critical need for training among healthcare workers. While forensic nurses receive comprehensive training, other staff members often lack gender sensitivity and GBV-related training, heightening the risk of secondary victimization for survivors. Wakashe strongly recommended ongoing training for all staff at TCCs. Dr Wagner acknowledged the gaps, saying previously, Forensic Science was not recognised by the South African Nursing Council, but now that it is, they would encourage nurses to take up the course by ways of bursaries, depending on the available budget. She also conceded that gender sensitivity needed to go beyond the TCC and into communities to be sensitised to the patient journey of a survivor.
Waiting times:
The average waiting time for survivors to receive clinical attention is reported to be two hours, but this can extend significantly in TCCs lacking dedicated medical personnel. Dr Wagner further acknowledged that inadequate infrastructure and budget constraints for additional staff as factors contributing to these delays.
Security concerns:
Wakashe highlighted the urgent need for a risk analysis of all centres. She said this analysis would assess the specific security needs of each TCC and help develop appropriate protocols to protect both staff and survivors to avoid secondary victimisation.
Confidentiality and file management:
Many TCCs lack standard protocols to ensure patient privacy and effective file management. CGE’s recommendation of implementing digital systems and updated privacy protocols was reported to be essential for improving efficiency and safeguarding sensitive information.
Budget constraints: A significant barrier to TCC effectiveness is the lack of dedicated funding. Many centres are said to operate under budget constraints, especially those housed in temporary structures. The Commission recommended centralised funding as necessary to address maintenance and infrastructure issues.
Accountability and oversight:
Wakashe urged government to improve accountability in the TCCs, highlighting that only one TCC has signed a Service Level Agreement (SLA) for the year. She said enhanced oversight is vital to ensure compliance with established protocols and improve overall service delivery.
Wakashe remarked by saying that the challenges faced by TCCs in the Eastern Cape hinder their ability to provide timely and effective support to GBV survivors. Addressing staffing shortages, comprehensive training, enhancing security measures while improving resource allocation are some of the critical steps toward better outcomes for victims.
“The CGE’s findings further underscore the urgent need for coordinated efforts to strengthen the capacity of TCCs to combat the ongoing scourge of gender-based violence in the region,” Wakashe concluded.
