The management of sexual assault victims at Odi District Hospital in the North West Province: How can the quality of hospital care be improved?
Background: This six-month study at Odi Hospital in the district of Mabopane in the North-West Province was undertaken to gain insight into the way in which alleged sexual assault victims experienced the treatment they received from doctors, nurses and others and how the quality of the care they received can be improved. Methods: Design: A descriptive cross-sectional survey was conducted using a questionnaire as well as interviews and focus group discussions. Setting: Odi District Hospital in the North-West Province, South Africa. Subjects: The subjects of the study were the patients who presented at Odi Hospital for alleged sexual assault between 1 March and 31 August 2001. A nurse or medical doctor completed a questionnaire for each patient. In addition, individual and focus group interviews were conducted with 20 rape victims, three rape crisis counsellors, nursing staff and doctors working in the casualty department. Results: A total of 213 patients presenting at Odi Hospital during the research period formed the sample group of this study. This group consisted of one male (a four-year-old child) and 212 female patients. The majority were black (211) as only two were coloured people. The ages of the victims ranged from two to 70 years. The highest percentage of victims was in the age group 16 to 20 years (25.4%), followed by the age group 11 to 15 years (16.4%) and 21 to 25 years (14.1%). A total of 68.2% of the assailants were known to their victims. The assailants' estimated age ranged from 15 to 50 years, and in almost 80% of the cases they operated on their own. Most rapes took place in the victims' homes (36.2%) and visible lesions were found only in 32.4% of cases. The following themes were identified and reported on: In terms of the "quality of service" offered by rape crisis counsellors, rape victims were "satisfied" with the service offered by rape crisis counsellors on the day of the assault and afterwards. The "waiting time" at the police station and at the hospital was apparently "too long". All parties involved agreed that the "waiting area" was not appropriate and that rape victims should be "separated" from other patients. As for the "consulting room", except for the younger group of victims, all other parties agreed that it "wasn't suitable" for the interview and examination of rape victims. There were mixed feelings about the attitude of nurses and doctors attending to rape victims. Some patients said that they were treated "nicely by both doctors and nurses". Others said they had the impression that "doctors and nurses did not believe they were really raped". Nurses and doctors complained about the "impatience of police officers and rape crisis counsellors". Conclusion: The quality of care of sexual assault victims presenting at Odi Hospital can be improved. The waiting time of sexual assaulted victims is too long and attempts should be made to provide dedicated rooms and staff to assist in the care of sexual assault victims. Further, attention needs to be focused on ongoing educational activities as part of a holistic approach to management. Such education may assist in informing potential victims of the general modus operandi of perpetrators and encouraging victims of sexual assault to come forward without fear of victimisation.