Prevalence and under-reporting of sexual abuse in Ruwa: A human rights-based approach

kind in Ruwa. Its significance is embedded in how it reflects on the role played by culture, religion and societal views on matters of sexual abuse.


Introduction
Literature shows that Zimbabwe does not only have alarming levels of sexual abuse but is also experiencing a challenge associated with the under-reporting of these abuses (Mantula & Saloojee 2016;Obong'o et al. 2020;ZimStat, UNICEF & CCORE 2013). The Zimbabwe Demographic and Health Survey 2010-2011 highlighted that 27% of women aged 15-49 years reported that they experienced sexual violence when they were aged between 15 and 19 and that 9% of the women in this study were sexually abused before they reached the age of 14 (ZimStat 2012). Furthermore, approximately 22% reported that they had experienced sex against their will. Meanwhile, a survey conducted by the Zimbabwe National Statistics Agency (ZimStat), the United Nations Children's Fund (UNICEF) and the Collaborating Centre for Operational Research and Evaluation (CCORE) to assess the nature and extent of violence that affected children in Zimbabwe revealed that about 32.5% of the girls who participated in the survey and 8.9% of the boys who also took part in the survey reported that they had experienced sexual violence before they reached the age 18 (ZimStat et al. 2013). However, this survey also revealed that more than half of these young survivors of sexual abuse did not reveal to anyone the abuse they suffered. In their qualitative study conducted in Chitungwiza, and in which they assumed that disclosing child sexual abuse was a first step towards accessing health and legal services for sexual abuse survivors, Obong'o et al. (2020) suggested that social norms associated with sexuality should be addressed and awareness programmes should be created in order to The under-reporting of sexual abuse reduces the chances of winning the battle against sexual abuse of women and children in Zimbabwe. It leaves girl children powerless and vulnerable, despite the country's determination to put an end to injustice and gender discrimination in line with the Sustainable Development Goals (SDGs), in particular, SDG 5, which focuses on gender and equality, and SDG 16, which is concerned with justice and peace. The aim of this study was to explore the barriers to reporting sexual abuse in Ruwa. Informed by the human rights-based approach, the study adopted a quantitative research design. Survey data were solicited from 51 randomly selected female respondents. Results revealed that 69% of the respondents were abused, yet only 2% of the total respondents reported the abuse to authorities, while 67% did not report incidences of abuse. About 98% of respondents believed that most sexual abuse cases in Ruwa went unreported. Results also showed that barriers to reporting sexual abuses comprised cultural and economic factors, most of which were characterised by shame, embarrassment, and fear, as well as the desire to protect male breadwinners. The results are consistent with existing literature generalisations on sexual abuse, particularly in terms of the prevalence of sexual abuse and under-reporting. It is also argued that culture is the determinant factor for most of the barriers to reporting sexual abuse, as well as the effects of reporting. overcome the problem of child sexual abuse and to promote the rights of children. However, Mantula and Saloojee (2016) regret that while there are policies meant to protect (women and) children against sexual abuse, there is poor implementation of these policies because of limited human, financial and material resources. The problem of sexual abuse poses a problem for Zimbabwe in its endeavour to attain Sustainable Development Goal 5 (SDG 5), which focuses on promoting gender equity, and SDG 16 on justice (United Nations Sustainable Development 2016).
Under-reporting of sexual abuse is also a global problem, as research evidence reveals that the challenges associated with disclosure and reporting of sexual abuse is a global experience (Scurich 2020;Weiss 2010). In the United States of America (USA), sexual offences were described as the 'dark figure' of crime because most of these offences were not reported to law enforcement (Scurich 2020). Furthermore, evidence from USA suggests that possible reasons for the under-reporting of sexual abuse are numerous, and they range from the fear of embarrassment and stigma associated with the crime, to survivors' perception that the criminal justice system is not effective, to the fear of reprisal for reporting the abuse (Scurich 2020). Based on data from the National Crime Victimization Survey of the USA, Weiss (2010) argued that most women could not report sexual abuse because of shame. Their shame narratives drew upon cultural assumptions about how 'good girls' should behave and how 'bad girls' will be judged after rape or sexual assault. Weiss (2010) opined that women fear that they will be blamed, disgraced or defamed if they report their cases of sexual victimisation to the police.
A study conducted in the Netherlands found that 80% of sexual violence victims did not report to the police, chiefly because of shame and guilt (Ceelen et al. 2019). These results mirror the Netherlands' records, which show that only 7% of sexual abuse survivors report their cases (Netherlands Statistics 2011). In one study on Asian communities in Britain, Gilligan and Akhtar (2006) observed that some Asian women were afraid of reporting cases of sexual abuse because of cultural factors related to respect, modesty and embarrassment. Similarly, Leclerc and Wortley (2015) concluded that sexual abuse in India was considered a shame, embarrassment and loss of respect to the family; hence, reporting sexual abuse was considered a nightmare. The authors argued that disclosure became difficult when the perpetrator was a family member, or an individual close to the family, especially if the perpetrator lived with the victim (Leclerc & Wortley 2015).
Generally, Southern Africa is battling with the challenges of sexual abuse, coupled with low rates of reporting such offences. In 2010, the World Health Organization (WHO) revealed that over 24 million girls and 8.6 million boys below the age of 18, for instance, had experienced some form of sexual violence involving physical contact (WHO 2010). One in six of all the reported cases of sexual abuse in South Africa were reported to be girls below the age of 12 years, while a third of Eswatini women were observed to have experienced sexual abuse before the age of 18 (Mantula & Saloojee 2016). Lalor (2004) observed that in Southern African countries, sexual abuse (of children, in particular) was mostly perpetrated by family members, relatives and neighbours known to the child. Luyt (2008) conducted a survey in Camdeboo, South Africa, and found that 76.7% of the women who experienced sexual abuse did not report it to law enforcement. Only 31.2% reported the abuse. These results suggested that survivors tended to report abuse by strangers, while they were reluctant to report cases of abuse involving perpetrators who were close to them (Luyt 2008).
Studies on sexual abuse in sub-Saharan Africa indicate that cultural perceptions discourage sexual abuse survivors from reporting. For example, a survey conducted in Ghana showed that only one in three women and girls reported cases of sexual abuse to a third party (Appiah & Cusack 1999). In a Ghanaian study, Boakye (2009) attributed failure to report sexual abuse to cultural determinants, which were highly characterised by patriarchal customs. Men assumed that they had the right to take sexual advantage of women while threatening them not to disclose anything. Furthermore, Boakye (2009) argued that Ghanaian society entertained a false belief that men could not control their sexual desires and were justified in satisfying themselves while women had to tolerate the rape trauma. A 'collective shame problem', whereby protecting the family name was viewed as more important than disclosure, contributed to the problem of under-reporting in Ghana (Boakye 2009).
In Namibia, Kelly, Lovett and Regan (2005) found that sexual abuse survivors were stigmatised and isolated from the community, as if they were guilty. The study by Kelly et al. (2005) showed that some Namibians believed that men had uncontrollable sexual desires, and when aroused they were compelled to have sex. There was also a belief that emotionally mature women behaved themselves, dressed and walked in a way that did not provoke any sexual desires in men. Women who behaved in the contrary manner were judged as shameless and hence ought to face the consequences. Kelly et al. (2005) also suggested that a significant number of cases were dropped early on during the investigation before they were prosecuted, which affected the confidence of rape survivors, compelling others to shun reporting cases of sexual abuse.
In Zimbabwe, some scholars have focused on the causes of sexual abuse (Mapiko & Chinyoka 2017), while others have specifically addressed the rationale behind the underreporting of such offences (Mutanana & Gasva 2015;Obong'o et al. 2020). Obong'o et al. (2020) found that possible retaliation against survivors and their families was a major hindrance to disclosing sexual abuse. For Obong'o et al. (2020), survivors of sexual abuse also feared being stigmatised, blamed or doubted, physically assaulted and deprived of family life and education. The same scholars suggested that there was need for addressing social and cultural norms that were related to sex while strengthening legal protections for survivors of sexual abuse. Similarly, Mapiko and Chinyoka (2017) argued that cultural perceptions discouraged survivors of sexual abuse from reporting. Stigma was seen as leading to late reporting or not reporting sexual abuse at all. Victim blaming and financial status were considered strong barriers to reporting cases of sexual violence (Mapiko & Chinyoka 2017). Mutanana and Gasva (2015) revealed that fear of further victimisation was a strong barrier to reporting sexual abuse, especially because most of the perpetrators are often close family members.
Some cultural and religious beliefs and practices also tend to fuel and sanitise sexual abuse in the predominantly patriarchal Zimbabwean society (Hanzi 2006;Konyana 2018;Mawodza 2019;Muridzo & Malianga 2015). Consequently, these crimes are viewed as normal and therefore go unreported. The belief and practice of appeasing avenging spirits (kuripa ngozi) pities the girl child who at a tender age is handed over to the bereaved family as compensation. In the new family, the girl child becomes the wife of one of the male family members of the deceased (Hanzi 2006). Hanzi (2006) also attests to the customary practice of child pledging (kuzvarirwa), which commercialises the girl child as she is pledged in marriage in exchange for food provision during famine or in fulfilment of a pledge made at birth, for example, that a family will look after the child with the assistance of the future husband. Konyana (2018) observed that chiramu, a social norm among the Shona people, whereby elder sisters' or aunts' husbands seduced their wives' younger sisters or brothers' daughters, was another form of sexual abuse of women. In line with this view, Mawodza (2019) argued that the Constitution of Zimbabwe Amendment (No. 20) Act, 2013 offered a good opportunity to address this customary sexual dalliance in order to protect the rights of girls. Furthermore, sexual abuse also takes place in the guise of religious practices, particularly among some apostolic sects, which are popularly known for promoting early marriages following sexual abuses that occur in the context of church beliefs and practices (Mashonganyika 2019;Muridzo & Malianga 2015). During prophetic healings (kushandirwa) that are usually performed by self-acclaimed prophets in busy areas, women and girls with sexual health problems are often sexually abused in the name of sexual healing (Muridzo & Malianga 2015). For Mashonganyika (2019), prophetic dreams (kurotswa), whereby an apostolic church leader and prophet claims to have had a God-given dream to marry some girl, a member of the church, are also used to take advantage of unassuming girls within these churches. All these cultural and religious beliefs and practices tend to leave women vulnerable to sexual abuse, while society considers it normal.
While several studies have focused on sexual abuse and their causes, the subject of the under-reporting of these offenses is not well documented in the Zimbabwean context. There has not been any study that focused on the under-reporting of sexual abuse in Ruwa. Addressing this knowledge gap adds to the existing literature and shall also inform policies related to the protection of the rights of women and children in relation to sexuality.

Theoretical underpinnings
The theoretical underpinnings of this study emanate from the human rights-based approach (HRBA). The HRBA is informed by the 1948 Universal Declaration of Human Rights (UDHR) of the United Nations, the first formal expression of human rights. It states that all human beings are born free and equal in dignity and rights. It also provides that this dignity is inherent and that human rights are equal and inalienable. The declaration states that these rights are also the foundation of freedom, justice and peace in the world. This international bill became customary international law, and all nations are bound to uphold its principles (UN General Assembly 1948). Societies and regions have since customised this bill of rights to suit their own contexts but without compromising the fundamental principles. Human rights are also enshrined in the current Constitution of Zimbabwe Amendment (No. 20) Act, 2013.
The HRBA focuses on those alienated members of the society, those deprived of equality, the marginalised, and those discriminated against, among others (Uvin 2007). The approach pays special attention to cultural and structural norms that usually lead to the violation of the universal human rights, with the view of transforming such norms for the betterment of society (United Nations 2003). The HRBA does justice to themes on sexual abuse, as the violated rights of the survivors are addressed in their proper context. The Committee on Economic, Social and Cultural Rights, 12/GC/22, para. 9 refers to human rights related to sexuality as sexual rights. Some of these sexual rights include the right to sexual and reproductive health, to freedom from violence, to education and information and to nondiscrimination and equality between men and women.

Research methodology
The quantitative approach was found appropriate because it assists in establishing the general assumptions implied in the literature review, namely that there are cultural and religious factors related to the under-reporting of sexual abuse of women in Zimbabwe. This approach is ideal for testing these assumptions by finding out what the situation is in a particular population. Unlike the qualitative approach, which is concerned about making an in-depth analysis using a few cases or interviewees who are considered experts in the field in the question being probed, the quantitative methodology considers the researcher to be the expert who objectively analyses the results. This report is a compilation of the facts as they were mined from the research field, while the conclusions are based on the evidence gathered from the field (Creswell 2009). These conclusions are expected to contribute towards the upheld generalisations regarding the under-reporting of sexual abuse among women. http://www.hts.org.za Open Access

Research setting
The study was conducted at Ruwa National Rehabilitation Hospital in Ruwa, located about 30 km south-east of Harare (Davison 2001). ZimStat (2016) estimated the population of Ruwa to be about 56 000. Ruwa Rehabilitation Hospital is the biggest health institution in the area, and it is visited by many local residents seeking medical assistance. The high volume of clients at the health facility offered the opportunity to mine data from female hospital clients. The study targeted women because they normally experience more sexual abuse when compared to their male counterparts.

Population and sampling method (systematic random sampling)
The population of this study consisted of 108 adult female hospital clients from Ruwa, who had come to seek medical services from Ruwa Rehabilitation Hospital on Monday, 09 November 2020. These were identified and recorded as they entered the facility.
A systematic sampling was used to select respondents among the 108 women. According to Taherdoost (2016:21), this is whereby 'every nth case after a random start is selected'. Because the facility's outpatient department closed during weekends, Mondays became very busy as large volumes of people usually turned up to seek medical services. Nurses of the outpatient department would routinely take this opportunity to briefly educate their clients on matters of health. The researchers took this opportunity to select and distribute their research questionnaire. The systematic sampling technique used entailed counting from one to two, such that at every interval, the second person was selected as a respondent. Every second person was selected as respondent. The sample size, according to this criterion, was 51.

Data collection method and instrument
Interviews were conducted using structured questions designed by the researchers. These were closed questions that prompted respondents to rate their responses by ticking boxes of their desired responses. The possible answers ranged from strongly agree, agree, I don't know, disagree, strongly disagree. The design of the questions was informed by both the objectives and theoretical underpinnings of this research. Hence, the questions sought to investigate the perceptions of the respondents in relation to the prevalence of sexual abuse in their community and the possible causes of under-reporting. These questions were designed to determine whether there is any infringement of human rights related to sexuality. The assumption in this research was that failure to report the abuse cases meant that the sexual rights of the survivors remained unprotected. It is for this reason that the questionnaire included questions that attempted to investigate the views of the respondents in relation to sexual abuse and crime, disclosure, cultural norms and practices and other possible grounds associated with under-reporting.
These questions were conveyed to the respondents through a questionnaire which was designed in such a way that respondents remained anonymous. A total of 51 questionnaires was distributed among the selected women. The completed questionnaires were submitted at the gate as the women left the facility.

Reliability and validity
In order to ensure reliability, a pilot study was carried out with a few women who had visited the medical facility a week earlier. This was an opportunity to test the quality of the questionnaire and improve it. Data cleaning was effected through the assistance of a statistician.

Results
The results show that most respondents experienced sexual abuse. However, they also believed that most of these abuse cases in Ruwa went unreported. It was also revealed that barriers to reporting sexual abuses included cultural and economic factors, most of which were characterised by shame, embarrassment, fear of retaliation from the male perpetrators and protecting male breadwinners.

Sexual abuse experiences and reporting
The study sought to draw knowledge on the lived experiences of respondents of sexual violence or abuse. Firstly, respondents were asked if they had ever been sexually abused and subsequently if they reported the case.
As shown in Figure 1a, most (69%) of the respondents stated that they had been sexually abused, while only 31% had not been previously abused.
In addition, it was interesting to find that unreported cases were significant. As shown in Figure 1b, approximately 67% of the respondents stated that they had not reported sexual abuse. Only 2% of the abused had reported the cases.

Views on the prevalence and reporting of sexual abuse cases
The study established the views of respondents on the prevalence of sexual abuse. As shown in Table 1, all the respondents agreed that there were many cases of sexual abuse in Ruwa. Results also showed that the practice of reporting cases of sexual abuse was rare. Respondents were asked about their opinion towards the statement, 'Most cases of sexual abuse in Ruwa are not reported'. In response to this statement, most respondents strongly agreed with the statement. Approximately 9% simply agreed with the statement.
Respondents indicated that law enforcement on reported cases of abuse was poor. This could be one of the reasons, among others, as to why many cases went unreported. Most respondents agreed with this statement while only a few disagreed.
The study enquired about respondents' views regarding sexual abuse as a criminal offence. About 36% of the respondents strongly agreed that sexual abuse is a criminal offence. Furthermore, approximately 29% agreed with the view. However, about 18% of the respondents disagreed that sexual abuse is a criminal offence, while some 18% of the participants did not know whether sexual abuse is a criminal offence.

Reasons for not reporting sexual violence or abuse
Respondents were presented with several statements that explained some of the reasons why sexual abuse cases may not be reported. Most respondents generally supported the views, as illustrated in Table 2.
The study revealed that the number of people who were in agreement with the views were disproportionately higher than those that disagreed. For example, about 82% of the respondents strongly agreed that sexual abuse cases may not be reported in order to protect the male perpetrator if he is the breadwinner. Furthermore, respondents strongly agreed that cultural (73%) and religious (69%) beliefs were barriers to reporting sexual abuse cases. Approximately 78% of the respondents strongly agreed that it is embarrassing to report sexual abuse, while close to 69% indicated that fear was a reason for not reporting. In contrast, only 22% disagreed that cultural beliefs discouraged them from reporting. Very few (2%) respondents disagreed with the idea of not reporting a sexual abuse to law enforcement as a way of protecting the male perpetrator who is the breadwinner.

Effects of reporting sexual abuse
The study presented respondents with an array of outcomes or effects that may emanate from reporting a sexual abuse case. Table 3 illustrates respondents' views towards each of the statements presented to them.   One of the striking results is that most (98%) respondents strongly agreed that reporting a case of sexual abuse to law enforcement led to painful interrogation by the police. None of the respondents disagreed with this position. All the respondents were in agreement with the view that reporting a sexual abuse case puts the victim in a position of vulnerability. About 69% strongly agreed and 31% agreed with this view. Results showed that blame by relatives if the perpetrator was a close relative was one of the consequences of reporting a case of sexual abuse. Most of the respondents (84%) strongly agreed with this view, while very few (7%) disagreed. In contrast, respondents were in support of the view that reporting of sexual abuse cases facilitated reduction of these cases. About 64% strongly agreed and 20% agreed, while only 9% disagreed with this view. Almost 7% of the respondents did not know if reporting could facilitate the reduction of sexual abuse incidences.

Discussion
These findings will be discussed in light of the HRBA. A close analysis of the results shows that respect, protection and fulfilment of human rights related to sexual abuse are compromised through fear, embarrassment, poverty, cultural beliefs and poor law enforcement, and also because of inadequate knowledge on the part of the survivors regarding sexual abuse as a criminal offence. These findings not only validate views already held by some scholars discussed in this study but also have implications for policy formulation and implementation, as discussed further below.
The results confirmed observations from relevant literature that sexual abuse is a challenge in most societies and that under-reporting of this offence is fraught with complications in terms of how sexual abuse can be addressed. However, the prevalence level in this study is higher (69%) than the one reported by ZimStat, UNICEF and CCORE (32.5%) and by the Zimbabwe Demographic and Health Survey 2010-2011 (27%). However, while the other surveys mainly intended to establish child sexual abuse, the current study included abuse that could have been experienced even after attaining the age of 18. Despite this, the overall perception by the respondents (100%) was that there was high sexual abuse prevalence in the area. This position is in concurrence with reviewed literature which shows concern about the high prevalence of sexual abuse both nationally and internationally (Obong'o et al. 2020;Scurich 2020).
Low sexual abuse disclosure rates also mean that the rights of the sexual abuse survivors continue to be violated without anyone noticing and without anyone being held accountable.  (2019) believes that Zimbabwean society has a good legal framework for protecting the sexual rights of women and girl children. In particular, Chapter 4, Section 80, para 3, which provides for the rights of women, guards against the violation of some rights of women because of cultural practices and beliefs.
This study has also shown that some survivors of sexual abuse do not report their cases to law enforcement agents in order to avoid painful interrogation from the police, placing them in a position of vulnerability. This issue is also raised in the literature reviewed above (Ceelen et al. 2019;Mapiko & Chinyoka 2017;Mutanana & Gasva 2015). This finding has implications on the kind of law enforcement services offered to complainants in search of justice and protection of their human rights related to sexuality. The few respondents who indicated that reporting changed nothing can be a wake-up call for the police to improve their service provision. This finding validates the argument by Mantula and Saloojee (2016) that poor implementation of policies that are meant to protect women and girl children from sexual abuse compromises the protection of their human rights.
In line with the results, the study recommends that local institutions, inclusive of local government, health facilities, schools, churches and the business community, collaborate and run programmes to raise awareness on sexual abuse and encourage reporting cases. The programmes may also consider how cultural barriers can be eliminated. Local police also need to be capacitated on how best to deal with cases of sexual abuse without humiliating the survivors. Future research can focus on acquiring an in-depth understanding of the barriers and consequences of reporting sexual abuse in Ruwa.

Conclusion
Results from this survey on women's perceptions on the prevalence and under-reporting of sexual abuse in Ruwa revealed that this community has a high prevalence of sexual abuse, while the disclosure rate is strikingly low. The results concur with literature that common reasons why sexual abuse survivors do not report include embarrassment, cultural and religious beliefs, fear and protection of a male perpetrator if he is the breadwinner. The outcomes of reporting sexual abuse are also generally in agreement with literature, and these also double as reasons for not reporting sexual abuse cases to law enforcement agents. The effects range from shame, blame by relatives if perpetrator is a close relative and painful interrogation from the police. It should be noted, however, that the study established that reporting sexual abuse cases to the police would reduce the incidences of sexual abuse in Ruwa.
Reporting is also a sure way of ensuring that the rights and dignity of the sexual abuse survivors are protected. Hence, it is suggested that awareness programmes be conducted in the community of Ruwa in order to promote and protect the sexual rights of women and girl children.