Authors : Rege, Sangeeta; Sana Contractor
Published Year: 2010
Poster Presentation in First Global Symposium on Health Systems Research, 16-19 November 2010 - Montreux Switzerland.
Abstract: Sexual Violence is an important Public Health issue for various reasons. Not only does such violence impact the health of those affected by it, but there is also a very crucial role that the health system has in providing treatment to survivors. Health professionals are in a unique position to provide treatment to survivors of violence as well as document and collect forensic evidence that can help a survivor prove her case in a court of law. Despite its importance, this role of Health Systems in such cases is a neglected one. In an effort to address the lack of systematic protocols for examination and evidence collection, we implemented a Sexual Assault Forensic Evidence kit (SAFE kit) in two public hospitals in the city of Mumbai, India. The pilot implementation of this kit highlighted several problems with the response of the health system to cases of sexual assault, in addition to improper forensic examination and evidence collection. Based on the findings of this pilot implementation, we designed a comprehensive health sector response to sexual assault which goes beyond the medico-legal role of health professionals and addresses several other issues which hinder provision of care to survivors. This paper will discuss the components of this model response and the manner of its implementation. These include laying down standard operating procedures in the hospital for management of cases of sexual assault, implementing protocols for seeking consent, documenting history, injuries and collecting evidence, maintaining a fool-proof chain of custody, building capacity of health care providers in understanding the issue of sexual violence and their role, and providing guidelines for medical treatment and provision of psychological support to cases of sexual assault including referrals to relevant departments and external agencies. We conclude that any effort by health systems to address sexual assault must take into account all of these components in order to fulfill its role.