It was with a loan taken out in her own name and a giant leap of faith that Christina Rollin set up her clinic to treat child rape victims in South Africa’s Gauteng province.
After three years training as a forensic nurse at a trauma centre, Rollin had seen the lack of expertise among those treating children, and too many youngsters were being failed by the judicial system.
Recognising this woeful gap in specialised support she founded the Sexual Assault Clinic in Benoni in 2012 – a free service to treat children from birth to 12 years of age.
“Examining children requires a great deal of expertise and patience, and if someone is not adequately trained it can hinder the strength of the evidence and damage a case in court, meaning the perpetrator can escape justice,” says Rollin.
“Too often I saw this happen because children were being treated in the same way as adult victims when a different approach is required. That is what made me take a leap of faith in taking out a loan to set up the clinic. I’ve never regretted it for a moment.”
The service has become a lifeline for a community blighted by child sex abuse. Rollin, who also has a law degree, works closely with other partners across the region including the courts, where she is often called on to testify as an expert.
“As well as medical services I provide legal support in the protection of children and work with partners to provide mental health aftercare,” she says.
Since opening the clinic Rollin, as the only member of staff, has treated 530 child victims and testified in more than 300 court cases. But at a time when demand for the crucial service she provides has been increasing, she has had some devastating news.
The clinic has lost financial backing from a key donor, and after exhausting all other funding options Rollin says the service will be forced to close before Christmas.
The news couldn’t come at a worse time, with agencies across the country reporting an increase in the number of child rapes.
In October, South Africa’s police minister, Fikile Mbalula, announced that 9.1% of all reported rapes in the country were against children aged nine or younger. The grim disclosure came a fortnight after a security guard was arrested for assaulting 87 girls at a Soweto primary school.
Rollin says: “At the clinic we have seen an unprecedented increase recently in the reporting of sex crimes against children. We have also seen an increase in the brutality of the crimes such as pornographic-related sexual abuse and child-on-child rapes in our schools.”
The nurse says the national data fails to reflect the true scale of the sex abuse endured by South African’s children.
The company that provided the lion’s share of funding for Rollin’s centre is part of the Black Economic Empowerment programme set up to redress the inequalities of apartheid.
Rollin’s clinic is no longer eligible for support as it does not meet the required criteria that 90% of beneficiaries of the service should be black. “I can’t control who I see. Children are referred to me from social services, police, the courts – I take whoever is in need,” she says.
“Children are all hurt in the same way, irrespective of their skin colour. However, we do not blame the organisation – companies are fined millions of rand if they do not comply with the criteria.”
The cost of keeping the clinic open is estimated at £19,500 a year, says Rollin – including all overheads, medical supplies, her salary and payments to outside services.
It may not seem like much but the country is facing economic decline, with many organisations feeling the fallout. Meanwhile, Rollin continues to pay off the initial loan out of her own pocket.
“What we are seeing is a very volatile economic and political situation,” she says. “Other non-profit groups often lack transparency, and corporates become more and more afraid to donate to them.”
She worries what will happen to the children who will have to go elsewhere for help. “There is a desperate need for these services. Most state hospitals have rape crisis centres that use doctors who are often not experienced in forensic examinations.
“Elsewhere, they can call on the overburdened emergency units, and young victims may have to wait up to eight hours to see someone.”
Children who have been sexually assaulted can also visit one of the country’s 55 Thuthuzela Care Centres, which bring healthcare and justice services under one roof.
Doctors at these specialised centres report an increase in the number of children they are treating, according to Unicef.
Yet the specialist forensic training that nurses undertake to work in this area is not recognised by the South African Nursing Council, so there is no financial incentive to pursue the qualification.
Garret Barnwell, a Johannesburg-based clinical psychologist for Médecins Sans Frontières, says: “It’s traumatic work, and you don’t get paid any more. They are operationally recognised within the system to some extent but then some nurses are being pushed into administrative or managerial positions, so there is not allocation in the right places.”
Research published last year found that 35% of young people interviewed in schools had been sexually abused at some point in their lives.
The Optimus Study was the first nationally representative analysis of the extent of sexual violence against children in South Africa, according to Catherine Ward, head of psychology at Cape Town University.
Researchers questioned 4,086 school children between the ages of 15 and 17 and found that at least as many boys (36.8%) as girls (33.9%) reported some form of sexual abuse.
Extrapolating this figure, researchers estimated that at least 784,967 young people aged 15 to 17 in South Africa have been sexually abused.
The Thuthuzela Care Centres continue to support thousands of rape victims every year but they receive very little state funding, being largely financed by international backers.
With foreign donors understood to be withdrawing funding and government cuts on the horizon, there are no quick solutions to financing these essential services.
South Africa’s Department of Health was contacted by the Guardian but declined to comment.