Government and UNICEF to the rescue
MASERU--With the upsurge of the HIV/AIDS pandemic and the tragic legacy of Orphaned and Vulnerable Children (OVC) being left without parental guidance, care and protection; sexual abuse, exploitation and gender based violence are on the rise in Lesotho.
To start to seriously address this issue, the Ministry of Health and Social Welfare, supported by UNICEF and in collaboration with a wide range of stakeholders, developed specific guidelines for the management, support and protection of survivors of rape. This includes updated case reporting and data collection forms to strengthen referral and recording systems.
Recent reports from the Child and Gender Protection Unit (CGPU) - a Unit of the Police specifically dealing with cases of abuse and violence against children and women – revealed a rapid increase in the number of reported rape cases. In the first trimester of 2006, over 480 cases were reported and handled as compared to 500 cases for the whole of 2005. Given the alarming statistics, the training of health practitioners on the newly developed guidelines was imperative in order to more effectively enforce new and existing legislative frameworks for the protection of children.
According to Ms. Motselisi Mosotho, CGPU Coordinator, “the rise in reported cases of abuse could be attributed to the ongoing sensitization of communities on people's and children's rights and on the responsibility to report such cases. Rape used to be viewed as a family issue and dealt with silently. People now understand that perpetrators of abuse cannot go unpunished even if it is the same father raping his children” she noted.Since 2003, UNICEF has been supporting the strengthening and capacity development of the CGPU at national, district and community level.
The absence of clear guidelines on how to deal with cases of violence, rape and abuse, often results in inconsistent and insensitive treatment. Treatment of rape survivors often relies entirely on individual service providers and their own perceptions and morals, without further legal recourse and referrals. The rights of the child are frequently sacrificed in order to protect the name of the family or the adult perpetrator. This results in additional trauma for children and rape victims who have to live with the shame and stigma following the incident and often end up in a vicious cycle of abuse and violence.
Much too often cases of rape are dismissed or never reach courts, due to the absence of adequate medical evidence. “Capacitating health service providers to deliver adequate and sensitive care and medical attention to survivors of sexual abuse is essential especially in relation to the high risk of contracting HIV/AIDS following rape. Accurate medical information is also crucial in serving as evidence for rape cases to Social Welfare, Justice and Police departments to take appropriate legal action against the perpetrators” said Dr. Bertrand Desmoulins, UNICEF Representative in Lesotho.
The guidelines describe best practices in management of sexually assaulted people, recommending that all rape survivors be given access to post-exposure-prophylaxis (PEP), a regime of antiretroviral drugs that reduces the risk of contracting the HIV virus from an HIV positive attacker. They recommend for a sexually transmitted infection (STI) investigation, HIV and pregnancy tests and psychosocial support to be undertaken immediately upon proof that rape has occurred. The guidelines address vital linkages between different sectors such as Police, Social Welfare, Justice and Health calling for a holistic and integrated response to ensure the effective protection of abuse victims, mainly children, who require special sensitivity and care.
A member of the Lesotho Medical Council Dr Hassan Elhag, a gynecologist and obstetrician who has been working in Lesotho for over ten years, said that the training could not have come at a better time. “A rape survivor is examined only to look for signs of sperm and presence of STI. Then we prescribe medication for the STI and emergency contraceptives. We never gave PEP before. Counseling is also not sensitive enough and at times non-existent because in an emergency set up and with resources stretched to the limit, there is just no time for such procedures. Through this training and the new guidelines I am confident that survivors of sexual offences and abuse will be treated with more dignity and provided the necessary support” he said.
As part of the training, health professionals were provided an overview of the current child protection legislation in place in Lesotho. This includes the Sexual Offences Act, the Child Protection and Welfare Bill, [awaiting enactment] the National Policy for OVC and principles enshrined in international instruments ratified by Lesotho, such as the Convention on the Rights of the Child and the Convention on the Elimination of all forms of Discrimination Against Women and Children. “It is crucial for health professionals to be familiar with national legislation and policy frameworks in order to undertake their work more effectively” said Dr. Elhag.
Resource persons contributing to the training were drawn from key sectors responsible in enforcing policy and legislation, i.e. the Ministry of Justice and Human Rights, the Department of Social Welfare and Police.
“The active involvement of the health sector in issues affecting children is considered crucial for a multi-sectoral approach to new and emerging issues in child protection” said Dr. Desmoulins, UNICEF. “Children are struggling everyday to cope with the pressures of HIV/AIDS, orphan hood, poverty and violence. We have the tools to ensure a safe and protective environment for them, now we need to work together to protect their rights and ensure the continued existence of the nation as a whole.”
UNICEF is supporting the Government in training service providers [Police, CGPU, Social Workers, Teachers and Probation officers] on psychosocial care and support, such as Play Therapy, a means of counseling provided to child victims of abuse and orphaned and vulnerable children. It is also supporting training on legislative and policy frameworks for the protection of children. To date, parliamentarians, teachers, police officers, social workers, District Administrators and now health professionals have been trained.
All these new developments, including the implementation of child friendly courts and procedures – currently underway – are key interventions to ensure that children are treated with dignity and respect, that they are protected from abuse and violence, even when they are in conflict with the law, and that they are able to have a voice in decisions that affect their lives.