Forensic nurses are going to be trained throughout the country to improve the treatment of rape victims, and ensure that sound medical evidence is collected to improve the chances of convicting violent criminals.
This decision was taken recently by the Department of Health following a successful pilot training of forensic nurses in the Northern Cape.
Dr Tromp Els, head of forensic medical services in the Northern Cape and the person who introduced the idea of the forensic nursing to this country, is to lead the training in all provinces.
“Only 8% of rapists who are charged ever see the world from behind bars,” says Els. “Cases well presented in court will improve the conviction rate. We want to prevent cases from being thrown out of court on technicalities.”
But, he stresses, “we don’t want to train genital technologists, but people who are able to treat human beings in toto. The nurses will be trained to deal with physical as well as psychological trauma.”
Els says he first heard about forensic nursing four years ago, and thought it would offer a solution to South Africa’s acute shortage of forensic medical staff. There are only about 20 practising forensic pathologists in the country.
Els is the only forensic medical practitioner in his entire province, despite the fact that the Northern Cape has a population of over 840 000 and the highest rape and violent assault rate in the country.
It is also the biggest province, and people have to travel great distances to seek specialised medical help. It would make a huge difference if forensic nurses were stationed in each of the province’s six regions.
After getting more information from the US, one of the few countries that recognises forensic nursing, Els approached Premier Manne Dipico’s crime prevention committee, which them mandated him to get forensic nursing off the ground in the Northern Cape.
This he did in 1998 when, with the help of US forensic experts, 13 nurses and two police officers completed a six-week forensic medicine course in Kimberley. A second course was held in May last year, in which nine nurses were trained.
The courses trained participants to examine and assist sexual assault victims, conduct death investigations, collect specimens for evidence collection and present this evidence in court.
Els says most doctors are inadequately trained to deal with victims of violence, and the evidence they collect may be inadequate and lead to the acquittal of attackers. In addition, many are reluctant to treat rape victims as they do not want to have to give evidence in court.
Health Minister Manto Tshabalala-Msimang said at a recent forum for government officials dealing with sexual offences that she had been told medical students were given 45 minutes’ training in the handling of sexual offences.
“Imagine a doctor with a 45-minute exposure to the issue of sexual offences examining a victim or survivor of a brutal, intimate and potentially soul-destroying crime like rape’¦ For me, the thought is unbearable,” Tshabalala-Msimang told the forum.
Els, who has been a forensic examiner for 20 years, confesses that the job of a forensic medical examiner can be harrowing. For this reason, nurses will be carefully selected for the course.
“One Saturday afternoon, I was called to examine a 15-year-old girl who had been gang-raped by 11 guys,” says Els. “They had urinated in her mouth and spat on her. She was a total mess. It was worse than doing an autopsy on a motor vehicle victim.”
For the sake of victims like this 15-year-old, Els says that he is looking forward to the challenge of establishing forensic nursing throughout the country.
However, funds are likely to be a problem. Northern Cape nurses who have been trained have not yet had an opportunity to put their skills to the test.
Health MEC Dipuo Peters says the health department has not yet created a forensic nurse category, so these nurses are simply regarded as professional nurses and work largely in casualty wards.
The province also has no money to pay overtime to forensic nurses. Yet most rapes happen at night and they need to be on call.
“When we train other nurses in future, we will make sure that they come from a particular area or clinic where forensics is needed, and that they will be able to use their training when they go back,” says Peters. ‘ Health-e News Service