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.