Treating survivors of rape and sexual assault

From communityhealth.in
Revision as of 19:11, 20 January 2013 by GeethaS (Talk | contribs)

Jump to: navigation, search

Sexual assault, which can be of many forms, including rape can have long-lasting emotional, physical, and social effects on survivors. It is a violation of a person's human rights. Health care workers are often a first point of contact for survivors of sexual assault and rape, and it is the responsibility of the health care worker to provide both emotional support and first aid, as well as collect evidence for the prosecution of perpetrators.

Contents

Initial Examination

Setting

The setting for the initial examination of a rape survivor should be a quiet, private place with sufficient lighting and a comfortable bed. The examination itself should be carried out in a non-threatening manner. Any medical doctor can conduct the examination. A female doctor is preferable, but if one is not available, a male doctor should conduct the examination with presence of a female chaperone. If the rape survivor is a minor, a parent, guardian or other trusted person should be in the room during the examination. The examination should be conducted without delay, because evidence is lost with time. The law currently states that a sexual assault survivor does not require an FIR from police to receive a rape examination, and any medical institution which the survivor approaches (whether public or private) is required to perform treatment as well as documentation [1]

Consent

Informed consent for the rape examination, evidence collection, police briefing, and treatment is mandatory. The consent must be signed by the survivor if above 12 years of age, and by the parent or guardian if younger. The survivor has the right to refuse any part of the examination or evidence collection, however if they do so should be informed of the importance of data collection for future prosecution. If the survivor continues to refuse evidence collection, they should still be given full medical treatment according to standards of care.

Police requisition

Once the case is booked at a particular police station or court, the investigating officer (minimum rank sub-Inspector of police) will forward a requisition for medical examination of the survivor of sexual assault. However, as stated above, if the rape survivor enters a hospital before going to a police station, she must be examined and evidence collected regardless of whether she has a requisition or not.

Medical Documentation

General Information

  • Name, age, and sex of the survivor (ie. female, male, transgender)
  • Address and contact info for the survivor
  • Information about the police case (eg. medico-legal case number)
  • Date, time and place of exam
  • Names and relations of persons accompanying the survivor
  • 2 marks of bodily identification on survivor (eg. moles, tattoos, etc.)

Past Medical History

  • History of STD's
  • History of surgery in ano-genital region
  • Obstetric and sexual history are usually irrelevant, and cause stigma to the patient when documented on the sexual assault examination form

Sexual Assault History

  • Narration is often traumatizing, and the survivor may not immediately want to tell all the details
  • The doctor must be sensitive to the patient, and explain that the history is essential for proper treatment as well as prosecution of assailants
  • The doctor must aim to establish rapport by not making judgemental or disbelieving comments
  • Rapport is essential for a thorough and accurate history
  • The police must not be present during the history taking or examination
  • Record should be as complete as possible and direct quotes can be used
  • Time and place of the assault should be recorded
    • Nature of force, places of contact


Evidence Collection

Examination

See also, Rape trauma syndrome

Treating rape flowchart.png

Source: CEHAT Manual for Medical Examination of Sexual Assault pg 8


Resources for survivors of rape, sexual assault and domestic violence

Delhi


Mumbai

Bangalore

External links

Notes

  1. http://www.indiankanoon.org/doc/1214266/

This article is a stub. Find out how you can help communityhealth.in expand it at the Community Portal.

Personal tools
Namespaces

Variants
Actions
Navigation
Toolbox
Share