One in four women living in a key platinum mining area in South Africa has been raped in her lifetime, a survey by medical charity MSF has said.
About half of women in Rustenburg had been subject to sexual violence or intimate partner violence, it said.
The charity said the findings of its survey were "shocking but not uncommon" in South Africa.
South Africa has one of the highest incidences of rape in the world and a low prosecution rate.
Based on its survey of more than 800 women aged 18-49 in Rustenburg municipality, north-west of Johannesburg, MSF said only 5% of the approximately 11,000 women and girls raped each year reported the incident to a health worker.
The research also suggested that a very low number of these women were aware of how to prevent HIV transmission and even pregnancy.
MSF said survivors of sexual violence faced numerous other barriers to seeking care.
"Stigma within communities is high and options are few for accessing well-resourced, dedicated sexual violence health services," it said.
Despite lying at the centre of South Africa’s platinum belt, Rustenburg is home to many poor communities.
The area attracts both men hoping to work in the mines and women from across South Africa and abroad who hope to benefit from the local mining economy.
MSF said unemployment was particularly high for migrant women "creating conditions that promote dependency on men who are more readily employed by mines in the area".
The charity said there was a need to increase the number of staff trained in sexual healthcare in the area.
The BBC’s Pumza Fihlani in Johannesburg says the authorities hope ongoing awareness campaigns will encourage rape victims to seek medical attention and even legal recourse.
The survey was published on the fourth anniversary of the shooting by police of striking workers at the Marikana mine in the Rustenburg municipality.
Thirty-four people died in what was the worst violence in South Africa since the end of apartheid 20 years earlier. The incident led to intense scrutiny over the roles of the police, mining companies, unions and the government.