injury control

• Impact of violence on Health Workers
  Escalating levels of crime and violence have increased the workload of public and private sector trauma services, taken up resources necessary for the treatment of other conditions and also adversely affected staff security and public access. The high levels of crime and violence nationally also complicate a wide range of public services, mostly rendered by local authorities.

  A joint study with the Institute of Criminology at the University of Cape Town is currently capturing the diverse effects of such violence on service delivery in the health sector at institutional, interpersonal and individual levels. Preliminary research observations have been published in Trauma Review, Vol 8, No 2, December 2000.

• Evaluation of medico-legal services in Gauteng, South Africa 
  The evaluation was commissioned to ascertain the current status of medico-legal services in Gauteng against the Health Department's stated objectives and  various other stakeholders' views of how the service could and should function. This project was initiated in 2000 following recommendations that emerged from the ISHS's Rape Surveillance Project, which was conducted in collaboration with the Gauteng Health Department's Directorate of Medico-Legal Services from 1994-1998.

  The scope of the evaluation  project includes an assessment of the structure (resources/input), process (activities) and outcome (effectiveness/output) of after-care services for  adult rape survivors at 26 medico-legal centers in Gauteng. The evaluation framework included a focus on issues related to the availability, accessibility, quantity, quality/effectiveness and acceptability of the services. The analysis of qualitative data obtained suggests that the current system of service provision  at medico-legal clinics in Gauteng remains flawed in many respects.

  Although the medico-legal  system is increasingly engaged in developing and improving service provision at district and regional levels, these reform efforts have not been consistently  applied across the province. Consequently, minimum standards of care are not  being met, with problems of access, charges of insensitive treatment of rape  survivors, incompetent documentation of medico-legal evidence, lack of resources, inadequate training, disparities across clinics and weak inter-sectorial collaboration being the leading concerns affecting the quality of care provided to rape  survivors.

  • Implications for the Development of Best Practices in the After-Care of Rape Survivors