Tuesday, August 27, 2013

'Medical tests should be more sensitive to rape victims'

    MUMBAI: Going strictly by textbooks on forensic medicine, doctors should be suspicious of any well-built woman who claims to have been raped. According to the textbooks, "a well-built woman cannot be raped", "most cases are false", and "a working class woman cannot be raped as she can offer resistance".

    Experts say the existing protocols of medical examination of a sexual assault victim place undue emphasis on injury documentation that looks for signs of resistance on the victim's body, examination of hymen, assessment of virginity and two-finger test to determine the size and laxity of vaginal opening, rather than the health problems the victim may suffer from.

    Padma Deosthali, coordinator of the Centre for Enquiry into Health & Allied Themes (CEHAT), an organization which has been working with sexual assault victims, said the medical examinations are part of the whole process which have to be carried out to prove whether the crime was committed. However, many parts of this exercise are not in touch with the reality and circumstances of the victim.

    "The body swabs, for instance, would test positive only if there has been forced peno-vaginal intercourse with ejaculation.
    If the woman has bathed, urinated, douched or if she has washed herself which is often the immediate response to overcome the humiliation, no such evidence is likely to be found. Often, there is also a delay in reporting the crime and thus further delay in reaching a health facility," she said.

    There is also undue emphasis on injuries, which may not be present if the victim has been threatened or sedated. Moreover, during a medical examination, doctors observe the status of the hymen. "The two-finger test ascertains the size and laxity of the vagina and the remarks are made about whether or not the victim is habituated to sexual intercourse. Despite court judgements stating that past sexual history has no bearing on sexual assault, it continues to form an important part of the doctor's conclusion," she said.

    Bangalore-based forensic doctor and lawyer Jagdeesh Reddy, said since police requisition takes time, medical examination of a sexual assault victim, which should be done on a priority basis, gets entangled in protocols. "Not just to save the evidence, but a medical examination should be done as soon as possible to provide care to the victim," he said adding that there are few hospitals earmarked for such examinations, and thus accessibility becomes a problem.

    "While most doctors do not give immediate opinions, government hospitals and labs take time to examine the swabs. The accused gets bail long before the medical evidence is collected and filed with the help of protocols," said Dr Reddy.

    To overcome these problems, a PIL was filed in the Nagpur High Court to make changes in the manual, which guides the medical examination of a sexual assault. But the Maharashtra government has not yet submitted the revised version to the court and the matter has been pending for two years now.

    Practices that need to change

    * Over emphasis on injuries

    * Comment on types of hymen and whether present or absent

    * Comments on nutritional status/ built of the survivor to determine whether or not she could have offered resistance.

    * Definition of sexual assault continues to be convoluted and unscientific.

    * Past sexual, contraceptive practices are documented , which are not relevant.
    Source:- The Times of India

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