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Implementation of protocols to deal with sexual assault – experiences from field

Sangeeta Rege Sana Contractor Centre for Enquiry into Health and Allied Themes (CEHAT). Implementation of protocols to deal with sexual assault – experiences from field .

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Implementation of protocols to deal with sexual assault – experiences from field

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  1. Sangeeta Rege Sana Contractor Centre for Enquiry into Health and Allied Themes (CEHAT) Implementation of protocols to deal with sexual assault – experiences from field

  2. Development of a model for examination and collection in cases of sexual assault/Rape, called Sexual Assault and Forensic evidence kit (SAFE KIT) in 1998. • This kit is based on the Ontario Police Force kit used in Canada. Extensive feedback was sought from several forensic experts, gynecologists, public health experts and women’s rights groups. SAFE KIT

  3. Manual for Safe kit usage • Protocol • Equipments required for collecting evidence. Safe Kit Contents

  4. Medical history , sexual assault history , nature of evidence collected and treatment provided • Body maps to record injuries(for both male and female bodies) • Tables for Tanner Staging for boys and girls are provided for age estimation Contents of the Protocol

  5. Negotiation with the Hospital Authorities to implement SAFE KIT in 2 Public Hospitals in April 2008. These were: • Rajawadi - a 500-bed, well equipped hospital;& • Oshiwara Maternity home - an extension centre of the Cooper hospital. • Agreement over conducting periodical training on understanding sexual violence, provision of crisis intervention by CEHAT team and documentation of the experience of using the kit. implementation of the safe kit

  6. Trainings conducted for: • Defining sexual violence. • Addressing Myths and Facts related to sexual violence. • Use of Case studies to facilitate the use of the SAFE KIT Training Health Care Providers

  7. Mandatory Admission • Mandatory Police case. • Patients shuttled from major tertiary hospital to maternity home for examination. • Discharge date prolonged till evidence is sent to Forensic laboratory. • X-rays/ USG/ and procedures conducted rampantly • Option of partial evidence collection not given to women Procedural issues arising post safe kit implementation

  8. Lack of confidentiality, privacy • Lack of belief in the woman's story • Precedence of forensic role over clinical role. • Multiple players in the chain of custody. Attitudinal issues amongst HCPS’S

  9. Review and change obsolete procedures related to management and care of victims of Rape • Clarify ambiguity between forensic and clinical role of Doctors • Evolve a multidisciplinary team to respond to various needs of the victims issues for discussion

  10. Obtaining consent of survivor before collecting evidence and explaining the importance of such evidence • Collection and documentation of evidence • A clear and fool proof chain of custody that preserves evidence collected • Providing medical care • Providing psychological support • Referral and follow up for further care Defining Comprehensive health care for Rape

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