Domestic Violence Act implementation: response by Department of Health

Meeting report

Mr M De Villiers (ANC, Western Cape) commented that there had been no response to the list of questions posed to the DoH in November 2011. These same questions had been re-submitted to the DoH in December 2011 and again in January 2012 in preparation for the meeting. Still, they had received no response.

The Chairperson suggested that while waiting for DoH, the Committee Researcher should brief the Committee on the concerns and recommendations posed to the DoH.

Ms Kashifa Abrahams, Committee Researcher: Portfolio Committee on Women, Children and People with Disabilities, briefed the Committee on the key issues and recommendations that emerged from October 2009 Public Hearings regarding the implementation of the Domestic Violence Act; the Committee oversight visits (2010/11); and the questions sent to the DoH about the implementation of the Domestic Violence Act.

Committee Recommendations derived from the Domestic Violence Act public hearings on the improvement of ‘health services’ were:
1. Psycho-social support services and programmes needed to be up-scaled; an audit on government personnel rendering psycho-social support should be undertaken to determine skills shortage and to identify a recruitment strategy; there was a need to distinguish which programmes were effective; and the Thuthuzela Care Centres and services should be extended to victims of domestic violence - not only to rape survivors.

2. There was a lack of effective information systems for systemized screening within and across the Departments of Health, Education and Police for locating pertinent information regarding the victim. This could be achieved through databases at schools and hospitals - for monitoring trends and incidences of violence as well as to refer victims to the necessary and appropriate psychosocial services based on their specific cases.

3. The DoH should develop a comprehensive health sector policy to deal with domestic violence, clearly outlining the roles, responsibilities and training of health care workers to implement the policy; a monitoring and evaluation strategy; as well as a budget to implement the policy effectively. The policy should be developed in consultation with civil society organizations and Parliament would oversee that the policy was developed and implemented. The Committee also recommended that DoH should develop a strategy to work with the Department of Police to ensure that victims were taken to a medico-legal facility to report the incident. In turn, health professionals should be trained to document the injury and testify in a court of law. In the context of the HIV and AIDS pandemic, the DoH should develop a plan on how the existing public communications campaigns would address domestic violence within the current messaging. A targeted strategy was required to deal with women in abusive relationships in terms of the DoH’s current prevention strategy (abstain, be faithful, use a condom).

Oversight Visits
The Committee had conducted oversight visits to health facilities in Limpopo, Kwa-Zulu Natal, Eastern Cape and Western Cape Province as a direct follow up to the public hearings to ascertain how services were rendered to victims of domestic violence and to identify challenges.

The Committee tabled reports clearly outlining the recommendations derived from the visits:

1. Limpopo Province – Tshilidzini Thuthuzela Trauma Centre in the Tshilidzini Hospital
The DoH and Department of Social Development should employ more forensic nurses, psychologists and social workers to assist victims of domestic violence in hospitals.

2. Kwa-Zulu Natal and Eastern Cape Province
The DoH should be made aware of the following concerns: High maternal deaths and infant mortality; high number of teenage pregnancies pointed to a need for improving sexual reproductive health care and family planning programmes; a significant number of women were not allowed follow-up after consultation on termination of pregnancy; lack of professional nurses; and need for specialist professionals to deal with psycho-social rehabilitation.

3. Western Cape Province
The Departments of Basic Education (DBE), Health and Social Development should work together to address the challenges faced by the schools and community; DBE should ensure that the Sexual Harassment and Teenage Pregnancy Policies were implemented and that parents/communities were involved in the activities of the school; and awareness campaigns on teenage pregnancies and substance abuse should be regularly held by DBE.

Questions to the Department of Health
A list of questions was sent to the DoH in November 2011 (see Appendix A in document). To date, the DoH had not sent forth a response to the questions. Drawing on issues that emerged during oversight visits, a further set of questions had been compiled for consideration by the DoH:

(a) Had the DoH developed a comprehensive health sector policy to deal with domestic violence? If not, why not? Alternatively, if such a policy existed, how had it been implemented and evaluated?
(b) How were health care professionals in the under-graduate and post-graduate levels being trained and equipped to deal with domestic violence?
(c) How many forensic social workers and nurses were within the employ of the DoH at present? Where were those professionals based – tertiary, secondary or primary health level?
(d) What was the nature of the psycho-social support currently being offered to victims of domestic violence by the DoH? How effective were those services and how was continuity of care for a victim of domestic violence ensured?
(e) What was the nature of the relationship between the DoH and Thuthuzela Care Centres?
(f) How were services adapted to ensure that victims of domestic violence received adequate and appropriate care insofar as gender, age (child-friendly) and disability was concerned?
(g) How many state forensic laboratories were there and what was the current turnover time for forensic laboratories to deal with cases?

After the presentation, Adv Phelelani Khumalo, DOH Acting Cluster Manager: Legal Services, and Ms Rebecca Motlatla, Acting Director: Gender Focal Person; Department of Health arrived to deliver a presentation to the Committee and the Chairperson officially opened the meeting, though copies of the report were still outstanding.

Mr D Worth (DA, Free State) said that it was unacceptable to start the year this way with the DoH being unprepared and late for the meeting.

Mr T Mashamaite (ANC, Limpopo) agreed and said that the Director-General was undermining Parliament, in general, by sending two junior representatives to take responsibility for the number of important issues requiring responses by the DoH. He therefore proposed that the meeting should not proceed.

The Members agreed.

The Chairperson said that a quality report was required from the DoH.

The Committee Secretary then made him aware that an apology had just been received from the Director-General, advocating that the representatives in attendance should lead the meeting.

The Chairperson said that he expected that the Minister or Director-General should lead the meeting. DoH was given offices in which to work, to answer the questions and respond to people of the nation. Parliament was part of the monitoring system that called Departments to account on issues. He referred to the speech by the Minister in the Presidency, Collins Chabane, on the significance of monitoring and evaluation to ensure service delivery. As Chairperson of the Committee, he shared the sentiments expressed by Members and endorsed - ‘emphatically so’ - that the Committee could not accept a report by those not delegated to take responsibility for what was said in the meeting. He declared the meeting closed until issues were rectified.

The meeting was adjourned.