CLINICAL MANAGEMENT OF RAPE_CMR_- PSYCHOSOCIAL AND LEGAL ASPECTS

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					                 North Darfur- Sudan


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

   2ND MEETING OF THE MENA REGIONAL IAWG WORKING
                         GROUP
            19-21ST MARCH 2012, CAIRO, EGYPT




UNFPA - because everyone counts.
                       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




               aining
Darfu r CMR Tr
               11
    2010 – 20 ders
                 vi
367 H  ealth Pro
                   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




UNFPA - because everyone counts.
  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

UNFPA - because everyone counts.
                        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 prosecutor
   Part 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.


UNFPA - because everyone counts.
                           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




UNFPA - because everyone counts.
            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


UNFPA - because everyone counts.
                                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




 UNFPA - because everyone counts.
                         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 sessions


UNFPA - because everyone counts.
UNFPA - because everyone counts.

				
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