‘We are with you’: The Sinawe Thuthuzela Care Centre providing hope for survivors of sexual violence

Lerato,* a 20-year-old first-year student at the local university, hunkers down on her chair a few metres from where I’m sitting, with her head fixed to the floor. She looks sad, tired and dejected, avoiding any eye contact, obviously ashamed of what we were going to talk about.  

During our roughly ten-minute talk, she gave short, hesitant answers. Dressed in a pink tank top and fading jeans with a small yellow handbag sitting on her lap, Lerato had come for her second assessment at a care centre for victims of rape.

On a quiet early Saturday evening – about a week before I met Lerato – while walking back home from the shops, a car abruptly stopped in the middle of the road and two men violently dragged her inside before speeding off. A few minutes later, the car stopped at a dark spot. Shocked and helpless – and before she could process what was happening, one man raped her as the other watched. 

Overnight, Lerato became one of the latest victims of sexual violence against women in South Africa. According to police statistics, there were 53,295 reported sexual offenses during the year between April 2019 and March 2020, an increase of 1.7% from the previous reporting period. This is the equivalent of a sexual offense every ten minutes. And these are only cases reported to the police. Experts believe the majority of the offenses are never reported.

We are with you

Some women, like Lerato, end up at care centres specifically set up to help victims of sexual violence. There are more than 50 such centres scattered throughout South Africa serving as “one-stop facilities” or frontline posts in the war against rape. Their key role is “to reduce secondary victimization, improve conviction rates and reduce the time” between when a crime is committed and when the perpetrator is finally convicted. The centres are attached or located close to hospitals, ensuring victims have access to urgent medical attention.

One such facility is the Sinawe Thuthuzela Care Centre located in the small town of Mthatha in Eastern Cape Province. Sinawe means “we are with you” in Xhosa, one of the country’s eleven official languages. It was at this centre that the head of the United Nations in South Africa (also called the UN Resident Coordinator), Nardos Bekele-Thomas, and her team – which included the head of the UN Women in Southern Africa, Anne Githuku-Shongwe – converged to sign an agreement with the government to revive the struggling local care centres, among other projects.

The plan is to pilot an approach to development that targets specific districts identified as most vulnerable to operational bottlenecks that slows down the delivery of social services to local communities. Three districts in the provinces of Eastern Cape, Limpopo and KwaZulu-Natal are expected to benefit from the programme termed “the district development model”.

Impact of Thuthuzela Centres

For many years, one-stop crisis centres made remarkable progress in living up to expectations. In 2012-2013, the Sinawe Centre won an award for being the best-run care centre in South Africa.

Dr. Nomonde Ndyalvan, an energetic, highly motivated and enthusiastic woman, heads the Sinawe Centre, which sits across the road from the provincial Mthatha General Hospital. She wears several hats as an activist on gender, disability and mental health issues. Dr. Ndyalavan is also “an active member” of the ruling party, the African National Congress (ANC).

A qualified medical doctor, Dr. Ndyalvan, 53, started as a volunteer in 2002, a year after the Sinawe Centre was launched. Notwithstanding the countless and formidable hurdles she faces as the manager, one easily senses the high energy and enthusiasm she exhibits once she starts talking about her job at the centre.

“The management needed doctors, counsellors, mental health specialists and nurses to come work here. It was emotionally challenging knowing how the women were being raped,” she recalls. Herself disabled, Dr. Ndyalvan says as a disability activist, “I realized that people with disabilities were targets for rape. And the statistics on this are high.” 

Night doctors

Shocked by the enormity of sexual violence in the district, Dr. Ndyalvan opted to work full time at the centre in March 2009. “There was no full-time doctor. The patients would wait for the whole day for university doctors to come, and they would only be seen at night.”

As the years went by, the Thuthuzela model gained fame. Incident reports from rape victims shot up. Prosecutors upped their game. The upshot was high conviction rates of offenders as more women felt safe enough to report cases to the police and care centres. Because the care centres offered dignified and friendly settings, they reduced secondary trauma among survivors. 

“Now we see about 60 to 80 patients a month on a low season,” says Dr. Ndyalvan, as she sat behind her office desk, a stone’s throw away from Mthatha General Hospital. “During holidays and festive seasons, rape cases go up to between 100 and 120 per month. We cover patients from as far as 200kms away. We go beyond OR Tambo municipality.” OR Tambo is one of the poorest municipalities in Eastern Cape Province, itself the most-poverty stricken of South Africa’s nine provinces. 

In 2012, UNICEF completed the construction of the building currently occupied by the Sinawe centre with funds from the Danish government and the US Agency for International Development (USAID). 

Asked who was funding the care centres, Dr. Ndyalvan conceded it wasn’t clear. “The bigger chunk of the budget to run the centre comes from the Department of Health. The department has also been maintaining the centre. But now we have been told that the department doesn’t have money anymore” as the budget for the centre is not clear where it is coming from. The centre now relies on funds from other stakeholders for its running costs. The programme is an “orphan” as the centre does not feature at all in the hospital’s organogram.

“We are just treating victims”

According to Dr. Ndyalvan, the current set up is that each department pays for its people, i.e., health workers receive their salaries from their respective departments. For example, doctors and nurses are paid by the health department, social workers by the social development department while prosecutors and magistrates, NGOs and police – who are all located at or closer to the centres – are on the payroll of relevant government departments. 

When I asked Dr. Ndyalvan what she would consider as the main challenge facing the Thuthuzela centres, she said without hesitation: “The lack of a coordinator and a clear reporting structure. There is no one [entity] stakeholder from the multidisciplinary team which is directly responsible for the centre.”  NPA has been trying to coordinate and lead but challenges still remain.

“The municipalities are not involved. Now that UN is here, we hope they will assist to align it and develop this centre through the district development model,” she said, adding, “Gender-based violence is such a bigger challenge in this part of the world. The districts must own these centres because the current model doesn’t address the issues of preventing rape. They are just treating victims.”

The challenge for the UN is do the best it can under the circumstances while at the same time managing the expectations that Dr. Ndyalvan and Lerato might have of the UN given its limited resources.  

 *Not her real name.