The right to have access to health care services for survivors of gender-based violence

Bannister, Tarryn (2012-12)

Thesis (LLM)--Stellenbosch University, 2012.

Includes bibliography

Thesis

ENGLISH ABSTRACT: In South Africa gender-based violence (hereafter “GBV”) has reached extreme levels. This violent manifestation of gender inequality is compounded by the fact that women are disproportionately affected by poverty, the HIV/AIDS epidemic and inadequate health care services. This is in spite of South Africa’s progressive constitutional and legislative framework which appears highly conducive to combating gender inequality and GBV. For example, the Constitution protects the right to equality (section 9), human dignity (section 10), life (section 11), freedom and security of the person (section 12) and the right to have access to health care services, including reproductive health (section 27(1)(a)). Extensive legislation has also been enacted for the protection of women. For example, the preamble to the Domestic Violence Act 116 of 1998 (hereafter “DVA”) recognises domestic violence as a serious social evil. While the DVA is notably silent as to the role of the health care sector, the DVA is progressive in that it contains a broad definition of domestic violence, and recognises a wide range of relationships. The Criminal Law (Sexual Offences and Related Matters) Amendment Act 32 of 2007 also seeks to afford complainants of sexual offences “the maximum and least traumatising protection that the law can provide”. In addition to this, South Africa has international law obligations to address GBV and gender inequality. For example, under the Convention on the Elimination of All Forms of Discrimination against Women (1979), States are obliged to address private acts of violence and to remove discrimination against women in all fields, including health. However, despite this progressive framework of rights, some interpretations of these integral rights have been unduly formalistic, in addition to being disengaged from the lived reality of many women. There is also a substantial gap between policy and practice, with the implementation of existing legislation a continuing problem. It is therefore imperative that we analyse the right to have access to health care services through a gender lens so as to transcend a purely legalistic perspective and to interrogate gendered social processes and power relations. This thesis analyses how existing law and policy can be transformed so as to be more responsive to these lived realities and needs of survivors of GBV.

AFRIKAANSE OPSOMMING: Geslagsgebaseerde geweld (hierna ‘GGG’) in Suid-Afrika het uiterste vlakke bereik. Hierdie gewelddadige manifestasie van geslagsongelykheid word vererger deur die feit dat vroue buite verhouding erg deur armoede, die MIV/vigs-epidemie en ontoereikende gesondheidsorgdienste geraak word. Dit is ondanks Suid-Afrika se vooruitstrewende grondwetlike en wetsraamwerk wat op die oog af hoogs bevorderlik vir die bestryding van geslagsongelykheid en GGG voorkom. Die Grondwet verskans, byvoorbeeld, die reg op gelykheid (artikel 9), menswaardigheid (artikel 10), lewe (artikel 11), vryheid en sekerheid van die persoon (artikel 12) en toegang tot gesondheidsorgdienste, met inbegrip van reproduktiewe gesondheidsorg (artikel 27(1)(a)). Omvattende wetgewing oor vrouebeskerming is ook reeds uitgevaardig. Die aanhef tot die Wet op Gesinsgeweld 116 van 1998 (hierna die ‘WGG’) identifiseer, byvoorbeeld, huishoudelike geweld as ’n ernstige maatskaplike euwel. Hoewel die WGG swyg oor die rol van die gesondheidsorgsektor, is dit nietemin vooruitstrewend aangesien dit ’n uitgebreide omskrywing van huishoudelike geweld bevat en ’n wye verskeidenheid verhoudings erken. Die Wysigingswet op die Strafreg (Seksuele Misdrywe en Verwante Aangeleenthede) 32 van 2007 is ook daarop afgestem om klaagsters van seksuele oortredings “die omvattendste en mins traumatiese beskerming te gee wat die wet kan bied”. Daarbenewens verkeer Suid-Afrika onder internasionale regsverpligtinge om GGG en geslagsongelykheid aan te spreek. Ingevolge die Konvensie vir die Uitwissing van Alle Vorme van Diskriminasie teen Vroue (1979), byvoorbeeld, is state verplig om privaat geweldsdade teen te staan en diskriminasie teen vroue op alle gebiede te verwyder, insluitend gesondheid. Nietemin, benewens hierdie vooruitstrewende menseregteraamwerk is sommige interpretasies van hierdie onafskeidbare regte nie net oormatig formalisties nie, maar ook verwyderd van die daaglikse realiteit van baie vroue. Daar is ook ʼn wesenlike gaping tussen beleidsmaatreëls en die praktyk, terwyl die uitvoering van bestaande wetgewing ʼn voortgesette probleem verteenwoordig. Dit is dus gebiedend om die reg op toegang tot gesondheidsorgdienste deur ʼn geslagslens te analiseer om sodoende ʼn bloot regsgedrewe perspektief te bo te gaan en om maatskaplike prosesse en magsverhoudinge in oënskou te neem. Hierdie tesis analiseer hoe bestaande wetsraamwerke en beleidsmaatreëls getransformeer kan word om beter te reageer op die realiteite en behoeftes van oorlewendes van GGG.

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