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The Mosaic Training, Service and Healing Centre for Women is one of a kind in South Africa. Based in the coastal city of Cape Town, it is dedicated to preventing and reducing violence against women, particularly the poor and the young living in disadvantaged communities. This community-based, non-governmental organization offers a range of social support services to women suffering from sexual and gender-based violence, including health care, legal services and court support, and counseling. In a country with high levels of violence against women and in which survivors have limited access to the public health and criminal justice systems, Mosaic’s services intersect to help victims survive and recover.
Over the past five years, Ipas has collaborated with Mosaic to improve women’s access to reproductive health care in Cape Town, including abortion services.
Access to appropriate and sensitive health care is particularly important to rape survivors. A woman who has been raped may need abortion care and HIV prophylaxis, in addition to support during a forensic examination and dealing with the police, explains Marieta de Vos, Mosaic’s executive director. Mosaic’s court support program helps some 20,000 women every year, while the Simelela Centre in Khayelitsha assists survivors of sexual violence, handling about 60 new cases a month.
Mosaic has two health clinics that offer pregnancy tests, contraceptives and sexual and reproductive health and rights counseling, HIV voluntary counseling and testing, treatment of sexually transmitted infections, pap smears and abortion care.
Women’s need for abortion care is frequently related to domestic violence. Some women do not want their husbands or partners to find out about the pregnancy, lest they be forced to carry it to term against their will. Studies have also found that abusive men specifically target their female partners when they are pregnant, which is why some women want to avoid pregnancy, says de Vos. Some married women explain that their husbands “forced them to have sex”, a euphemism for rape.
In other cases, women feel they are too old to have another child or, in the case of students, that they wish to take advantage of life’s opportunities before becoming parents. Being HIV positive is another factor, while refugee women from other African countries, especially the Democratic Republic of Congo and Malawi, request abortion mostly for economic reasons. Only 20 percent of the women accessing abortion services at Mosaic are employed, reveals Sandra Mabila, Mosaic’s clinic manager.
South Africa suffers from high levels of social stigma about abortion, which is why most women who receive abortion care at Mosaic decide to keep their decision private. Mosaic decided to provide abortion care because of the barriers that women faced in the public health sector, partly due to resistance from health-care workers, ostensibly as “conscientious objectors.”Abortion is broadly legal under South African law, as is the right of a provider to refuse to provide abortion services. While the law only applies to the actual procedure, some health-care workers undermine women’s access by other means, including withholding information or refusing to give referrals.
Ipas South Africa supports Mosaic’s work in several ways, providing funding for counseling services, workshops on abortion care and sexual and reproductive health and rights, medical instrument donations and educational materials development.
For more information, contact media@ipas.org