4.2 First Steps at the Health Center

In some areas, if a survivor goes to the emergency room for medical care after sexual assault, a trained healthcare provider will do an exam to collect forensic evidence that can be used to prosecute in court.

Even if the healthcare provider in your area is not trained in how to do this, the material that follows can help a healthcare provider collect evidence that could be used in court.

When the survivor arrives at the health center, depending on the context, a nurse may do a quick examination to make sure they are not suffering from immediate injuries like bleeding or broken bones.

Usually, the survivor is not considered urgent and will be sent back into the waiting room with strict instructions not to eat, drink or use the toilet while they are waiting so that they do not destroy any evidence.

At this point, the survivor may feel embarrassed, uncomfortable, ashamed, hurt and many other intense feelings. They are surrounded by the chaos of an emergency waiting room where they may wait for hours until an exam room becomes available because of staffing or space issues.

Without an advocate present to ensure that they are prioritized, the survivor may leave the health center after waiting for hours, before receiving treatment of any kind.

Obviously, we want to avoid this situation.

If you are an advocate volunteering directly with a health center to support survivors of sexual assault, it’s important that they know how to call you or your organization any time, day or night, when an advocate is needed.

This is the case even if the survivor says that they do not want an advocate to come because once you have an opportunity to introduce yourself and your role, the survivor may change their mind.

When you are arranging to volunteer with health centers, be sure to give them an approximate response time based on how long it will take you to arrive at the health center.

It’s best if advocates can arrive at the health center within 30 minutes.

Advocates support the survivor in the process that they are going through at the health center.

They help explain to survivors the care and treatment available to them as well as the survivor’s options regarding evidence collection and law enforcement.

If you are connected to other follow-up services in your community, you can also refer the survivor to those services.

Often, survivors are concerned about payment for health center services.

Because sexual assault is a crime, in many countries a survivor need not pay for medical services.

Your country may not yet have these policies in place, or you may need to remind healthcare providers of this policy so that it’s enforced.