The medical community can play an important role in a coordinated response to sexual assault. In addition to participating in SANE/SART programs, health care providers can take a number of steps to more effectively respond to the needs of victims. Staff should be provided with on-going and consistent training on sexual assault and violence against women. Health care providers can establish consistent policies on patient confidentiality and reporting of incidents, on screening patients for violence, and documenting injuries caused by violence. The role of health care professionals is particularly important in rural communities, where other avenues of relief may be limited. From World Health Organization, First World Report on Violence and Health 170 (2002).
Screening, broadly described, involves asking patients a series of questions designed to help identify violence concerns so that they can be put in touch with appropriate support services. Screening for sexual violence issues in a health care context is similar to screening for domestic violence, and is described in more detail in that section of this website. At the same time, however, there are a couple of screening considerations specific to sexual violence. Principally, health care providers should be aware of the fact that victims, particularly victims of acquaintance or intimate partner sexual violence, may not identify their experiences as sexual assault or rape. As a result, it is important to ask questions that are more descriptive. For example, it may not be enough to ask: "Have you ever been raped." Rather, health care providers might ask: "Has anyone ever pressured you to do things sexually you felt uncomfortable with?" From Raquel Kennedy Bergen, Marital Rape (March 1999).
The Department of Reproductive Health and Research (RHR) of the World Health Organization (WHO) has released protocols for health professionals working in emergency situations with refugees and internally displaced persons who have been raped in a report entitled “Clinical Management of survivors of rape.” The guide takes into account available resources, materials, drugs and national policies, allowing health professionals to develop a “situation specific” health care protocol for each emergency. The report offers an eight-step procedure that includes how to make preparations to offer medical care to rape survivors, prepare the survivor for an examination, take history, collect forensic evidence, perform the examination, and offer treatment, counseling and follow-up care to the victim. A separate section of the report outlines protocols for care of children who are victims of rape. The report focuses on a survivor’s “right to self-determination,” requiring that medical professionals not pressure rape survivors into submitting to an examination against their will. Although the guide was created to adapt to each emergency, the WHO instructs health professionals to comply with minimum requirements in every situation. A rape survivor should be able to access care in one health facility that is open 24 hours a day, 7 days a week. Each community member should be informed of why rape victims would benefit from medical care, what services are available, where the services are provided, and that they will be treated with dignity by each medical professional.
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