In a clay room with a thatched roof, Georgina, 16, sits with her chin buried in her palm, thinking about what happened to her nearly two years ago.
During Ghana’s COVID-19 lockdown, Georgina said she was sexually assaulted. Georgina, who lives in Kisi, a small fishing village in the central region of Ghana, asked to use her first name only to protect her identity.
Georgina said she reported the case to the police but could not afford the medical exam fee required to file a police report.
She realized while at the hospital that getting justice was a distant mirage.
“I remember the doctor telling my mother [that] the medical report will cost 550 cedis [about $85]. But we didn’t have the money and so we didn’t pursue the case again.”
“At the hospital, I was in so much pain,” she recalled. “I remember the doctor telling my mother [that] the medical report will cost 550 cedis [about $85]. But we didn’t have the money and so we didn’t pursue the case again.”
The majority of residents in Kisi live on less than $2 a day. The men fish while the women either smoke or sell the fish in the market.
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The painful memory is still fresh in her mind.
“In 2020, when the lockdown was imposed, schools were shut, so I was home. Times were really tough and even food to eat was hard to come by,” she said.
One day, she said she met a man and told him she was very hungry. He offered to buy her food.
“After that, he invited me into his room, pounced on me and had sex with me,” she said.
Georgina’s experience is one of many in the central region of southern Ghana where poverty, neglect and pandemic lockdowns have led to precarious situations for young people that have sometimes led to sexual violence.
Ghanaian authorities say at least 40 cases of sexual assault are reported every day.
The medical forensic exam, often called a rape kit, helps assess a victim’s health needs. This documentation is also necessary to launch criminal investigations by providing evidence of injuries and other indicators of force or coercion. Kits can also help establish the identity of the offender through DNA samples.
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Ghana’s Medical Association told The World that doctors can charge up to about $125 to fill out police medical forms and about $300 for giving a medical opinion for legal purposes.
Few can afford the prohibitive fees. Yet, without a medical exam, justice remains elusive.
According to Ghana Police Service’s domestic violence and victim support unit, rape and sexual assault cases often occur in deprived areas where parents cannot bear the costs to initiate a legal process on behalf of their children.
Georgina’s mother, Grace Awortwe, said the current arrangement is discriminatory and a travesty of justice.
“It breaks my heart that the man who did that to my daughter is walking around scot-free, because I couldn’t pay for a medical form to prove he defiled my child.”
“It breaks my heart that the man who did that to my daughter is walking around scot-free because I couldn’t pay for a medical form to prove he defiled my child,” she said. “Why is it that only the rich get justice in this country?”
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The trauma of reporting rape or assault, coupled with having to pay huge amounts of money to complete medical processes to initiate prosecution means that victims and their families give up easily, said Vera Elikem Awuye, with the nongovernmental human rights organization International Needs Ghana.
“If these, our people, in the communities can hardly afford certain basic things, where are they going to get 500 cedis [about $85] to pay for medical exams to get justice and get help for their children?”
“If these, our people, in the communities can hardly afford certain basic things, where are they going to get 500 cedis [about $85] to pay for medical exams to get justice and get help for their children?”
Sometimes, her organization pays for medical reports in an effort to encourage victims to pursue justice, hoping to break the vicious cycle of sexual violence against girls and women.
“The perpetrators are left in the community, and they defile more girls and abuse more girls. And it has become a trend, and nobody does anything about it,” she said.
According to the UN children’s agency, UNICEF, at least 120 million girls under the age of 20 — about 1 in 10 – have been forced to engage in sex or perform other sexual acts (and the actual figure is likely much higher).
COVID-19 restrictions shuttered schools — a primary resource for vulnerable children and youth to access a free lunch. This has left girls like Georgina even more vulnerable to exploitation and sexual abuse.
A 2021 UN report warned that the longer that children and youth are out of school, the greater their risk of sexual assault in their communities. Experts worry that as the pandemic continues, sexual abuse cases are likely to increase.
Francis-Xavier Sosu, a human rights lawyer and member of Ghana’s Parliament, agrees that cost-prohibitive medical exams end up silencing victims.
“Clearly, that is a practice that denies victims of sex assault of their right to be heard in court — to their right to be fairly treated by the state — and to also protect them under the law.”
“Clearly, that is a practice that denies victims of sex assault of their right to be heard in court — to their right to be fairly treated by the state — and to also protect them under the law,” he said.
Yet, sexual violence is also underreported due to other factors.
Police often lack the capacity for thorough investigations, which can take years to reach a court.
And community leaders often agree to quick, out-of-court settlements to avoid draining the meager savings of poor families. Transportation fees alone are just too much for many of these families.
Sosu said he’s putting together draft legislation that entitles victims to free medical exams and health care.
“We need [a] law that will be very clear that every child or female or person violated under the law will be entitled to free medicare,” he said.
The law would help reinforce several other major international conventions and protocols that Ghana has ratified related to sexual crimes, such as the Convention on the Elimination of all Forms of Discrimination against Women, along with related juvenile justice and human trafficking acts.
Back in the village of Kisi, Georgina said that she prays that the country will back legislation that will abolish all fees involved in pursuing sexual abuse cases.
She believes that bringing these cases to court will help deter further incidents of sexual violence against girls and women.
“If there is a law like that in place, all these bad guys will not harm us again. Because they will then know that the poor can also go to court and the law will deal with them,” she said.