Results of a national survey in South Africa of more than 11,000 women aged under 50 years—detailed in a research letter in this week’s issue of THE LANCET—suggest that child rape is becoming more common, with a third of rape of girls perpetrated by school teachers.
Sexual abuse of girls is a problem worldwide, and a growing concern in sub-Saharan Africa. Such abuse constitutes a profound violation of human rights, and has been associated with long-term mental and physical health consequences; however, little research has been done on sexual abuse in early childhood. In 1998, Rachel Jewkes and colleagues from the Medical Research Council, Pretoria, South Africa, did a cross-sectional study—the South Africa Demographic and Health Survey—of a nationally representative sample of 11,735 women aged 15–49 years.
153 (1.6%) of the women interviewed reported rape before the age of 15 years, two of whom had been raped by a gang of three and ten men, respectively. Of the reported child rape, 85% took place in children aged 10–14 years, and 15% between 5 and 9 years. School teachers were the largest group of rapists, and were responsible for a third (33%) of rapes. Relatives were also a major group (21%), as were strangers or recent acquaintances (21%), and boyfriends (10%). White women reported rape more frequently than African women; women from the Western Cape reported rape more frequently than women from other provinces in South Africa.
Rachel Jewkes comments: “Our findings confirm that rape of girls, especially in school, is a substantial public-health problem in South Africa. Research is needed to understand its broader social context, nature, and magnitude, and to develop interventions for primary prevention and prevention of its long-term health consequences. Effective action to address rape and sexual harassment of girls in schools is needed. South Africa has only recently made sexual relations, consensual or otherwise, between staff and students a serious offence that results in dismissal of staff. Many countries do not have such legislation. Enforcement still presents a substantial challenge.”
In an accompanying Commentary (p 274), Graeme Pitcher and Douglas Bowley from Johannesburg Hospital and the University of the Witwatersrand Medical School, Johannesburg, South Africa, discuss the disturbing context in which child rape may occur in sub-saharan Africa, including the myth that sex with young virgins can rid men of HIV/AIDS and other sexually transmitted infections; they are also deeply critical of the South African Government’s refusal to accept the causal link between HIV and AIDS, which has resulted in the lack of post-attack availability of antiretroviral drug therapy for rape victims. They conclude: “Community education programmes must be vigorously expanded and appropriately targeted to the populations at risk. Traditional healers must play an important role in delivering appropriate messages. A system of obligatory reporting of all infant and child rapes is needed with standardised protocols for the collection of forensic evidence…In South Africa the current circumstances surrounding HIV testing of alleged rapists is confused and has been described as a legal minefield, so urgent clarification is needed in this area. Legislative changes should be made to ensure harsh deterrent sentencing for rapists. Infant rape is a brutal act, which appears to be increasing in frequency in South Africa. Medical practitioners cannot stand idly by and merely treat these horrendous injuries; concerted action is needed to halt this abhorrent crime.”
Contact: Dr Rachel Jewkes, Gender & Health Group, Medical Research Council, Private Bag X385, Pretoria 0001, South Africa; T) +27 12 339 8525; F) +27 12 339 8582; E) rjewkes@mrc.ac.za
Dr Graeme Pitcher, Department of Paediatric Surgery, Johannesburg Hospital and the University of the Witwatersrand Medical School, Johannesburg 2193, South Africa; T) +27 11 488 4160; F) +27 789 2270; Cell) +27 (0)83 677 3514; E) pitchmax@icon.co.za
Journal
The Lancet