Forensic nurse Nontuthuzelo Ntwana. (Photo: Supplied) 
When Nontuthuzelo Ntwana talks about her work, her voice carries no embellishment. Just a quiet clarity. For nearly two decades, as a forensic nurse, she has worked at the point where violence becomes evidence, where survivors of rape and assault take their first steps towards seeking justice.
She is one of only two full-time forensic nurses in the Western Cape. Her job is to restore dignity to survivors and to make sure that what happened to them is seen, recorded and cannot be erased. She completes the J88 medical-legal forms, collects DNA through crime kits, documents injuries, prescribes emergency contraception and HIV prevention, and connects survivors with counselling. “What I do is the same as what the doctors do,” she tells me, “but nurses are never recognised, never empowered to lead this work.”
Her path to forensic nursing began in 2005. Back then, she watched community after community turn on its own children. Girls would disclose rape by neighbours, uncles, even their own fathers, only to be called liars. “That’s when my passion started,” she says. “The mothers were not supporting their children. They couldn’t understand. They said the children were making things up.” Out of that disbelief, she carved a vocation: to be the one who would believe, and to gather the evidence that others could not ignore.
Years later, she trained under a UCT pilot programme that sought to professionalise forensic nursing. She has been doing it full time ever since. But forensic nursing is a lonely profession. There is little appetite from the Department of Health to fund and expand it. Doctors at Thuthuzela Care Centres (TCCs), the state’s flagship model for post-rape care, are often overworked, called in on part-time shifts, or pulled between emergency wards and the TCC.
“After hours and weekends, patients wait for hours,” Ntwana says. “They wait for the police to fetch them, they wait for doctors to arrive. Sometimes the cases are not handled the right way. And it doesn’t sit well with me.”
What haunts her most are not only the survivors but the failures of the system itself. At Mitchells Plain TCC, she tells me there are locked cupboards where crime kits (swabs, evidence kits) sit uncollected for months. Some have been waiting there since 2024. “We follow up again and again, but the police don’t come. The evidence is just sitting here.” She knows the same is true at other centres. Without the police collecting, logging and submitting the kits, cases vanish before they reach a courtroom.
And sometimes, even when the evidence is collected, the system conspires to make it disappear. She tells me about an 18-year-old girl who was raped by her aunt’s ex-boyfriend, a police officer. “She came here every morning, terrified. Her aunts were calling her, telling her to drop the case. I listened as they shouted at her over the phone. When the police went to the house later, the girl was gone. Hidden. The case disappeared.”
Ronel Stevens, Mosaic’s acting director, said they can confirm that rape kits continue to remain uncollected at the Mitchells Plain TCC. “This ongoing issue is deeply concerning, as delayed collection jeopardises the integrity of the chain of evidence in rape cases. Evidence that is not processed timeously undermines survivors’ chances of receiving justice and further erodes confidence in the criminal justice system.”
/file/dailymaverick/wp-content/uploads/2025/05/ED_552806-1.jpg "A protester on Mary Fitzgerald Square in Johannesburg during a gender-based violence and femicide protest on 8 April 2025. (Photo: Gallo Images / Alet Pretorius)")
Ntwana’s passion is clear when she remembers this. “I have never put a phone down on anyone in my life,” she says. “But that day, I did. I couldn’t bear it.” Her stories confirm what survivors know too well: the chain of evidence is only as strong as the weakest link. And the weakest link, far too often, is the state.
Yet despite the despair, Ntwana insists on the small, radical acts that matter most: telling survivors that what happened to them was not their fault. “People come in blaming themselves,” she says. “‘Maybe I was out at night, maybe I drank too much, maybe I should not have gone there.’ I tell them, you did nothing wrong. The guilt is not yours to carry.”
She also makes sure that treatment is given immediately: HIV prevention within 72 hours, STI treatment, pregnancy prevention. And she does it gently. “People expect nurses to be rude. I try by all means to restore dignity, to approach each person with respect. That makes a difference.”
But now, Ntwana herself is about to be lost. Her post is not funded by the government. It is covered through Mosaic, the NGO where she works, via Global Fund resources channelled through the Networking HIV and Aids Community of Southern Africa. That funding has dried up. Her contract ends this month. This is one of the ripple effects of recent funding cuts from the US, which have already strained frontline gender-based violence services across the country.
It is almost unthinkable. At the very moment South Africa is recording staggering rates of gender-based violence, when TCCs are already buckling, one of its few forensic nurses is being let go. The irony is painful: the cupboards of evidence are overflowing, while the expertise to handle them walks out the door. Survivors are told to come forward, but the system ensures that their cases stall.
Read more: Thuthuzela centres working well to support rape victims – but experts say we need more of them
What works in the TCC model, Ntwana insists, is thanks to civil society. “The first responders, the counsellors, the follow-up that is the NGOs like Mosaic. The Department of Health provides the medication, and that part works well. But the real commitment comes from organisations like Mosaic.”
It is precisely this patchwork that exposes the fragility of South Africa’s response to violence. When international donors step back, services collapse. When nurses train themselves into expertise, the state refuses to recognise or reward it. When survivors find the courage to report, their evidence waits in cupboards for collection that never comes.
Ntwana’s career highlight is simple: “That I can empower women, tell them they are not to blame, restore their dignity.” Her lowest moments: “When cases are not handled, when I know the evidence is here but nobody cares.”
The question, then, is whether South Africa cares enough to keep her. If we lose her skill, we lose more than a nurse. We lose the care that turns evidence into justice, the dignity she restores, the fragile hope she gives to women and children who have survived the worst. DM
Mosaic’s perspective
Acting director Ronel Stevens says Mosaic, like many nonprofit organisations, continues to experience the harsh impact of ongoing funding volatility in the GBVF sector. “Unfortunately, we do not currently have a contingency plan to replace our forensic nurse, Sister Ntwana, whose role was vital in strengthening access to justice for survivors.
“It is important to note that this loss is not isolated. Reduced funding has also led to the discontinuation of our emergency vehicle service, which previously enabled survivors to be transported safely, day and night, to access medical and psychosocial care. These cuts weaken an already overstretched GBVF response system and ultimately compromise the safety and wellbeing of survivors who rely on urgent and specialised care.”
Joy Watson is book editor-at-large at Daily Maverick.