The cost of accessing justice in cases of rape and defilement remains a burden on victims leading to the abandonment of pursuing such cases, despite the provision for establishment of a Support Fund as well as several state agencies mandated to ensure that victims get access to all critical services, of which medical care is key.
Payment of ‘medical endorsement or examination fees demanded at medical facilities, is one of the key barriers identified by stakeholders in Ghana and families of victims who have been defiled, raped, or suffered any form of sexual and gender-based violence.
The medical endorsement is an extracted medical examination report signed by a certified medical practitioner on the Police medical forms, confirming defilement or rape and the extent of damage suffered by a victim from the act, and it is a key component in the prosecution evidence.
This medical fee ranging between Gh¢300 and Gh¢1000 depending on the nature of case, has become a ‘thorn in the flesh’ of families who against all odds of societal pressure, community, and traditional values, take the step to report such cases in pursuit of justice for their children who have suffered damages and trauma from such criminal acts.
Reports from the Domestic Violence and Victim support Unit (DOVVSU) of the Ghana Police Service indicates that families whose children have suffered these criminal acts find it difficult to pay the money and logistical constraints in going through the legal process so after reporting the case, do not one back again to continue with the processes for justice.
Madam Mary Ako, a 45-year-old woman whose 17-year-old daughter with disability was defiled, told GNA that, but for the benevolence of the State Attorney who offered to pay for the medical examination fee at the hospital, she would not have been able to go beyond the Police report, “I decided not to go to the hospital for any medical examination because, I didn’t have the money to pay for it’.
The Police Investigator who issued the medical forms, informed the state attorney in a conversation that she offered to help and gave me Gh¢700 cedis to cater for the transportation and the medical expenses, but for her, I would have left it for God to judge the offender.”
A DOVVSU Coordinator told the GNA on condition of anonymity that, many victims with defilement cases do not return with the medical forms due to the charges demanded at the medical facilities and cited instances where officers of the DOVSSU have had to contribute to raise the money for the victims to obtain the medical endorsement. “This medical endorsement fee is a burden to all of us, both the Police and the victims’ parents”.
She said apart from finding it difficult to get the fees demanded at the medical facilities, “getting transportation to commute from their respective communities to the district hospital and the courts is another hurdle, and we have seen many who have abandoned the case midway due to financial difficulties” she sadly said.
There have been instances where Police officers handling defilement cases have to raise monies from their own resources to support families of victims to enable them to go through the grueling burden of financing all bills from transportation, medical care, and several others to ensure that prosecution had all the evidence and witnesses needed for determination of such cases.
“The reality is that, when the victims themselves abandon the matter, there is little we can do because, both the victims and parents serve as prosecution witnesses and this situation tends to make sexual and Gender-based violence easy to offenders because of lack of deterrents”.
A UNICEF report on funding services for children and women victims of sexual and Gender-based violence 2021, estimates that, a victim of Gender-based violence paid an average cost of Gh¢ 900 on services such as medical examination and treatment, procurement of the Police medical form and transport to court for themselves and at times for other service providers.
As a result of these expenses and other factors related to gender and culture, close to 55% of cases involving children continue to be reported through traditional systems such as chiefs, and heads of families, with only 38 % referred through the formal justice system.
Already, culture, customs, and some traditional values such as regarding defilement and rape as abominations and must not be heard in certain societies, religious influence and many others makes it difficult for such matters to be reported, financial demands therefore become the height of impediment on reporting such cases.
The reality is in contradiction of the Domestic Violence Act, 2007, which makes provision for establishment of a “Support Fund” and Act 732 Section 8 stipulates that, “Police assistance to victims of Sexual and Gender Based Violence (SGBV) consist of issuing a medical form to the victim and where necessary sending the victim to a medical facility, a victim is entitled to free medical treatment from state once issued with medical form from the Police”.
The GNA in its findings gathered that the combined team of mandated State institutions to deal with SGBV, cases like the DOVSSU, Commission on Human Rights and Administrative Justice (CHRAJ) and other decentralised departments under the Ministry of Gender, Children and Social Protection are all handicapped, for lack of funds and well-coordinated systems.
Madam Esther Tawiah, Executive Director of the Gender Centre for Empowering Development (GenCED), in an interview with the GNA, indicated that Implementation of the Domestic Violence Bill to the fullest remains a critical tool in ensuring that victims of Gender-based Violence (GBV) and all forms of sexual violence against women and children were given the necessary state support.
She called on government to as a matter of urgency and in compliance of, our own domestic laws and international human rights conventions of which Ghana is a signatory to implement the Support Fund.
“Where the mother of a defiled or raped girl have to abandon such a criminal case due to lack of financial capacity to follow-up from the Police Station through to medical facilities for endorsement of the Police report forms and many other issues which come up in matters like this is too huge a burden to be left on parents of victims who are usually rural dwellers or low-income earners”.
She noted that even though the domestic Violence Support Fund had been set up years ago, the fund has not been allocated with any money to support victims over the years and it was high time it was implemented fully as a sign to support women and children.
UNICEF recommended that Hospitals and health facilities should set side dedicated funds as per the Hospital fee Act to victims of SGBV medical expenses particularly the endorsement of the medical examination forms.
Again, statistics show that in 2019, DOVVSU of the Ghana Police Service registered a total of 1,285 of defilement and 376 cases of rape also show that 667 Domestic violence cases including 44 defilement cases were reported at the four lockdown affected areas in Ghana, in 2020.
Globally, Amnesty International (AI) has reported that over 3, 600 defilement and rape cases were recorded during the COVID-19 lockdown in Nigeria whiles in the Central Africa Republic (CAR), 60 cases of conflict-related sexual violence including defilement and rape, forced child marriage and sexual slavery cases were recorded between June-October 2020.
Mr Emmanuel Dartey, Eastern Regional Director, Department of Children of the Ministry of Children, Gender, and Social Protection in an interview with the GNA described the medical examination fees as a huge barrier thwarting efforts of all stakeholders to protect the rights of women and girls from SGVB, especially in the rural communities.
He said home settling of sexual abuse cases especially defilement underestimates the gravity of such criminal offences, but unfortunately, with the financial constraint in accessing state sanctioned services, many victims find the traditional setting as a critical alternative, At least, “they will not incur any such cost since there is no demand for medical examination to prove it or otherwise.”
The responsibility, therefore, lies squarely on the Ministry of Gender Children and Social Protection, to trigger the implementation of the Support Fund in line with Act 736 of the Domestic Violence law to ensure that victims do not suffer undue disadvantage in addition to the trauma suffered already.
A well funded coordinated system is key to accessing the bottlenecks in cases of SGBV and experts believe that, with the implementation of the Support Fund, victims especially children who are defiled and their families would be emboldened to report such cases for the offenders to be dealt with severely to deter others who may have inclinations for similar Acts.
By Bertha Badu-Agyei