After a rape

Few individuals think of sexual assault care as a specialised area and, in the process, scant thought is given to the fact that doctors and nurses involved in the management of rape victims need specialised training and expert knowledge.

As part of the Government Employees Medical Scheme's (GEMS) ongoing effort to educate our members - and future members - on a range of healthcare topics, we would like to inform you how to take the correct steps in the event of you being attacked and how being raped can affect your family and yourself and what to do about it.

This is not only to help the victim but also to ensure the preservation and collection of forensic evidence in order to assist with the conviction of the alleged rapist.

Your immediate actions, the decisions you make and the people you talk to will have a direct impact on your recovery and the successful prosecution of the alleged rapist. It is therefore imperative to know what procedures to follow, should you find yourself in this predicament.

Knowing what to do in the event of a sexual assault cannot be emphasised enough. The following questions and answers will serve as an informative guideline:

What is the first thing you should do, if you are sexually assaulted?
Report the attack to the closest police station to where the incident occurred.

What should you not do?
You should not wash, bath or shower. Do not change your clothing, eat or drink anything and avoid using the toilet if possible. If it is necessary to change your clothes take the clothing that you were wearing at the time of the incident along to the police station and rape crisis centre.

Where should you go first?
Should you go to the hospital or in fact to the police station? Go to the police station closest to the area where the incident occurred. A police officer or a member of the Victim Empowerment Support Group will then escort you to the nearest hospital equipped to deal with sexual assault.

Who deals with you, male or female, doctor or nurse? A female officer would usually be assigned to the case. However, this is not always possible. On arrival at the hospital, a nurse will attend to you. A doctor or a Sexual Assault Nurse Examiner will then do the medical examination in order to collect the evidence.  Unfortunately female medical examiners are not always available in these instances.

What does a rape kit consist of?
A sexual assault crime kit consists of different types of swabs. Certain areas on the body are swabbed to collect evidence and these areas differ from victim to victim, depending on the nature of the sexual assault. 

How important is trauma debriefing, and how does it work?
Critical Incident Debriefing involves giving the victim emotional support during a counselling session with a trained nurse, psychologist or trauma counsellor. This is a once-off session. Based on the health professional's assessment during the counselling session, the victim will usually be referred to a psychologist for further counselling or advised to join a support group.

When it comes to HIV testing and screening, how often should you go, and when? HIV testing is done at the hospital upon the arrival of the victim. This is done to ascertain the baseline HIV result of the victim. HIV testing can only be done with the victim's informed and written consent.  It is normally repeated at three, six and twelve months.

What does anti-retroviral therapy entail? Only if the victim is HIV negative will post exposure prophylaxis (anti-retroviral therapy) be administered. These drugs then need to be taken for 28 days. If a victim gives his/her consent to take the anti-retroviral, he/she makes a commitment to complete a 28-day medication course.

If you should fall pregnant, what are your options? On arrival at the hospital the female victim is given emergency contraception, if appropriate. This will prevent the victim from falling pregnant and will only be administered once it has been established that the victim is not currently pregnant. If, even after this precaution has been taken, the victim falls pregnant due to the incident, a healthcare professional dealing with her case will advise her on what her options are.

Are there any support groups for women that have experienced sexual abuse? POWA (People Opposing Women Abuse) offers support to abused women by running workshops and counselling groups. They have a helpline: (011) 642-4345 and can also be contacted through the web at www.powa.co.za.