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Abstract
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Assessment and examination of adult survivor of sexual violence
Eugenius Phyowai Ganap
Background: Sexual violence can be happened in every culture in every country in the world. Data from national and local surveys show that in at least some parts of the world, one in five women experienced attempted or actual intimate partner violence at some point in their lives. Sexual violence can take places within variety of settings and can begin from childhood or adolescence to adult. It makes negative impacts on the health of the population. When caring for victims of sexual violence, patient health and well-being must always be a top priority. A thorough physical examination of the victim of sexual assault must be done. It is inevitably annoying and time consuming. If possible, a physical examination and forensic evidence collection should be performed simultaneously to avoid multiple tests and further stress on the patient. Treating victims of sexual assault with respect and compassion through investigations will contribute to their recovery.
Objective: To improve professional medical services for all survivor of sexual violence specially for adult women, hope that we can increase the knowledge and skill to deal with survivor of sexual violence, have standards for providing medical and forensic services and guidance on setting up health and forensic service for adult survivor of sexual violence.
Examination and assessment of sexually abused children
Sitaresmi, Mei Neni
Introduction: Child sexual abuse is prevalent. A comprehensive assessment should be conducted by an experienced child abuse team. Except an urgent evaluation is needed, it should be performed in a calm, quiet environment and proceed at a pace tailored to the child's needs. An urgent evaluation is warranted for victims who present within 72 h of the incident, have obvious forensic evidence on their clothes or bodies, have continued risk of harm from the perpetrator, and report other emergency complaints (e.g., genital or anal injuries), or psychosocial effects (e.g., suicidality). The goals of medical assessment are to identify injuries that require treatment, screen for sexually transmitted infections, evaluate for and, if possible, reduce the risk of pregnancy, and document findings of potential forensic value. In addition to an assessment for sexual abuse, each child must receive a thorough general medical evaluation that may identify unmet medical and psychological needs.
Medical Assessment: Comprehensive assessment consists of history taking, physical and laboratory examination, as well as psychological evaluations. Developing trust-rapport, respecting privacy, and a patient-family-centered approach is essential. Unbiased history, using open-ended questions, is the most essential evaluation part. It should be obtained separately from non-offending caregivers and the child if possible. However, the caregiver's presence during the child's interview can be an opportunity to observe parent-child interaction. The history should be comprehensive and include the child's current and past medical problems as well as social and family histories. The caregiver and the patient, especially adolescents, should be convinced that their information is confidential.
Sexual assault against women and children: Treatment and follow up care
Soerjo Hadijono
Aim: Abortion in Indonesia is a prohibited medical procedure. According to Indonesian Constitution Number 362009, there are exceptions to the prohibition, namely for main indications as: (1) medical emergencies detected at an early age of pregnancy, both those that threaten the life of the mother and/or fetus, who suffer from severe genetic diseases and/or congenital abnormalities, as well as those that cannot be repaired so that it is difficult for the baby to survive outside the womb and (2) pregnancy due to rape which can cause psychological trauma for the rape victim. According to Article 285 of the Criminal Code (KUHP), rape is an act of sexual violence perpetrated by a man against a woman by force and against the woman's will.
Methods: Komnas Perempuan Indonesia (2020) reported 2329 rape cases that occurred in the personal, community and incest cases. An online survey of Lentera Sintas Indonesia (2016) with 25 214 respondents, reported that 93% of individuals who had experienced rape never reported the incident because of shame, fear, or worry that there was insufficient evidence. There are no data in Indonesia on the rate of rape- related pregnancy (RRP), but studies abroad estimated the incidence of pregnancy due to rape is 5%. Pregnancy that occurs as a result of rape is a complex issue, because it is related to social, reproductive health and criminal problems. Government Regulation No. 61 2014 concerning Reproductive Health states in Article 34: "Pregnancy due to rape as referred to in Article 31 paragraph (1b) is a pregnancy resulting from sexual intercourse without the consent of the woman in accordance with the provisions of the legislation." Pregnancy due to rape as intended is proven by (1) gestational age in accordance with the rape incident, which is stated by a doctor's certificate; and (2) information from investigators, psychologists, and/or other experts regarding the alleged rape...
Language: en |