CLINICAL MANAGEMENT OF RAPE(CMR)- PSYCHOSOCIAL AND LEGAL ASPECTS

2ND MEETING OF THE MENA REGIONAL IAWG WORKING GROUP

19-21ST MARCH 2012, CAIRO, EGYPT

North Darfur- Sudan

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CMR Objectives

To increase skills for responding in a sensitive and holistic way

to survivors of violence.

To establish system for the proper management of the Sexual

and Gender based Violence in health facilities (establish

referral pathway)

To establish link between the health centers and women

societies for psychosocial support to the cases of the sexual and

Gender Based Violence.

To increase knowledge of the legal rights of survivors of rape.UNFPA - because everyone counts.

CMR training 2010

CMR training 2011

Darfur CMR Training

2010 – 2011

367 Health Providers

Psychosocial Aspect

The SGBV is traumatic sensitive experience and most of women

for various reasons difficult to express it, so, the health providers

needs special skills to facilitate the communication about the

experiences

The time spent by the health providers is not enough for the

survivors to build the trust.

The psychosocial interview is more open and flexible

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Lesson learned of Psychosocial Aspect

The following competences HP need to be trained identified in

Assessment

Assessment Post Traumatic Stress Symptoms (PTS)

Communication skills (Counselling attitude, listening,

questioning techniques, confidentiality)

Explanation of psychosocial symptoms

Explanation of assessment and referral procedure

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Legal aspect

Form 8 is a criminal medical form,Form 8, to be completed by the examining doctor

(Medical Assistant) in relation to possible court proceedings.

Form 8, is an attempt to ensure that standard elements of evidence are collected during the investigation.

From 8 consists of three parts:-Part one, should be fill by the police.Part two, Should be filled by the prosecutorPart three, should be filled by the doctor. Any

authorized doctor (Medical Assistant) is allowed to examine, treat victim and fill in form 8.

Best Practice

CMR manual endorsed and launched by Federal Ministry of

Health on 2007.

CMR services available 24hours/7 days in some hospitals,16 in

ND

CMR training contents; Medical, PSS, Legal part and targeted

HW(MD,HV.MW)

Trained midwives helped on referral of cases to the nearest

health facilities

Established a comprehensive management system for survivor

Strengthened multi-sectors coordination between the GBV actors.

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Best Practice

New legislation exempted the survivor to do Police report

prior to the treatment

Medical doctor report is accepted in the court

Health provider will orient the survivors of their legal

rights

Survivor might open court case at any time

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Challenges and constrains

• Community and families having lack of awareness of

resulted on delay of seeking medical advice.

• Most of survivor families focus on having the police report

more than the medication and some of them need to keep

the issue confidential, because of stigma.

• Under reporting of cases.

• Partners are afraid of reporting rape cases particularly

after expulsion of NGOs

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Continue

Presence of the police in the main entrance in hospitals will

affect the survivors accessibility to the services and break the

confidentiality.

Some of the health managers do not consider the CMR as a top

priority issue in their clinics.

highly politicization of rape issue most of clinics deny its

existence

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Way forward

Disseminate the referral pathway to relevant actors.

Develop and adapt standard guidelines on psychosocial

services.

Train all health providers, including community volunteers on

emotional support.

Strengthened capacity of relevant governmental bodies

The importance of refresher trainings.

Identify GBV focal persons and equip them with means of

communication

Link of GBV awareness session with RH sessionsUNFPA - because everyone counts.

UNFPA - because everyone counts.