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LATEST NEWS UPDATES | Rape and Medical Evidence Gathering Systems: Need for Urgent Intervention-Amita Pitre and Lakshmi Lingam

Rape and Medical Evidence Gathering Systems: Need for Urgent Intervention-Amita Pitre and Lakshmi Lingam

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published Published on Jan 14, 2013   modified Modified on Jan 14, 2013
-Economic and Political Weekly

Extensive reforms are required so that sexually assaulted women do not feel they are the "accused" when they submit themselves for medical examination and trial. Urgent reforms such as setting up humane rape crisis centres where women can directly approach women counsellors to tell their story, lodge a complaint, and get examinations done at one place are required to improve the situation.

Amita Pitre (amita@oxfamindia.org) is with Oxfam India and Lakshmi Lingam (lakshmil@tiss.edu) is with the Tata Institute of Social Sciences, Mumbai.

While we mourn the death of the Delhi rape victim, the nation is stirred to think of corrective measures like never before. Concrete measures that need to be taken to make public places safer, ensure efficient response of the police, better investigation, swifter rather than delayed judgments, and improved rates of conviction are often suggested. Public debates are focused on the need for changing attitudes of the police, increasing availability of police personnel for patrol duties and investigations, social auditing of police functioning, setting up of fast-track courts, employing more judges and reducing the overall delays in justice. There are clear voices from women condemning societal double standards that attempt to curb women’s meagre freedoms and not question misogyny.

Of all the measures required for guaranteeing conviction in rape cases, the most unclear and understudied aspect is the method of medical examination in rape and its use in the courtroom. It is often assumed that the statement of the woman is enough to establish the crime of rape. Unfortunately, this is seldom the case. Due to the peculiar nature of the crime – one that seldom has an eyewitness and, hence, corroborative evidence – medical evidence and forensic samples are gathered to prove the offence of rape world over. However, this crucial link in the chain of evidence-seeking is often fraught with poorly equipped systems and biased mindsets.

The World Health Organisation has provided “Guidelines for medico-legal care for victims of sexual violence” (2003), which lays emphasis on consent, privacy and women-friendly facilities for medical examination, and suggests guidelines for medical evidence collection as well as a package of essential healthcare services. The rape survivor is supposed to be ensured privacy, comfort and counselling, and be provided with medical treatment, prophylaxis and care. Demonstration models of sensitive and one-stop care and evidence collection models exist, such as the Dilaasa model being implemented at the Brihanmumbai Municipal Corporation hospital at Rajawadi in Mumbai in collaboration with the Centre for Enquiry into Health and Allied Themes (CEHAT), a Mumbai-based non-governmental organisation.

State of Affairs

However, the reality is abysmal and much needs to be done in urban and semi-urban areas to attend to all forms of medico-legal cases, particularly rapes. A thorough audit of police and medical systems has to be undertaken to assess the current status of such facilities. A pilot study1 undertaken with minimal cooperation of the public and police systems in the case of rape and sexual assault cases provided startling insights into the state of affairs. The study assessed medico-legal examination facilities for healthcare and the level of women-friendliness. Five of the six facilities scored poorly on women-sensitive services, and four scored poorly on healthcare.

Healthcare constitutes counselling for psycho-social trauma, emergency contraception, pregnancy and HIV counselling or tests as required, and diagnosis and treatment of sexually transmitted infections. Most of the hospitals did not follow protocols strictly. Lack of in-service training to all key individuals, lack of adequate guidelines, gaps in proper storage and secure handling of forensic samples such as vaginal, oral or semen stain swabs mar the process of detection and evidence collection.

Gender, caste, class, and rural biases permeate the entire process of how a rape survivor is received and treated at the police station and in the hospital. After an episode of rape, women would rarely find the experience at these facilities any less traumatic. Almost all Casualty Medical Officers (CMOs), the persons in charge of the casualty or emergency departments, and the first contact persons are men. The woman is expected to narrate her rape experience to the ­police, CMO, a gynaecologist, and sometimes a forensic doctor if it is a tertiary care facility. No woman doctor or nurse or counsellor is present at the point of contact in any of the facilities.

The potential to tamper with unsecured evidence in a generally corrupt society ensures that the poorest and least privileged find it extremely difficult to pin charges on more privileged perpetrators. Primary Health Centres, often the first points of contact for rural India, are the least equipped centres. In fact, a systematic weakening of cases takes place in the process: women are discouraged to report, feel humiliated during their examination, cannot open up in a hostile environment, leading to poor documentation of evidence, and are afraid to testify multiple times, especially when repeatedly questioned on their past sexual history.

Two-Finger Test

Further, doctors routinely employ the “two-finger test” to determine whether the woman was raped or not. The test is the examination of the woman’s vagina to determine whether it is elastic enough to let two fingers in and if it is, doctors explicitly note in their report that the woman is “habituated to sexual intercourse”. As an expert witness, the doctor also reads out this report in the courtroom. This, then, is considered a proxy indicator of the victim’s “loose morals” and is often enough either to acquit the accused or reduce his sentence considerably.

The test is not only unscientific in the way it is employed but also most demeaning to the woman. The tragedy is that it is routinely employed by most doctors in their examination and the report often leads to character assassination of women in courts. By employing this test, the medical examiners stand by antiquated and colonial notions of a woman’s chastity and morality. The logic of jurisprudence that errs on the side of caution to make sure that no ­person who is innocent is wrongly punished often lets many offenders off the hook due to inadequate, incomplete and inconsistent evidence.

With this range of factors standing between rapists and their conviction, often leading women to abandon testifying in the trial of their own cases, it is not surprising that rape convictions are low. Extensive reforms are required so that sexually assaulted women do not feel that they are the “accused” when they submit themselves for medical examination and trial. Urgent reforms such as setting up humane rape crisis centres, where women can directly approach women counsellors or nurses to tell their story, lodge a complaint and get the required examinations done at one place are needed to improve the situation. The other urgent necessity is to ban the two-finger test.

Note

1 Amita Pitre and Meenu Pandey (2009): Response of Health System to Sexual Violence: An Exploratory Study of Six Health Facilities in Two Districts of Maharashtra, Centre for Enquiry into Health and Allied Themes (CEHAT), Mumbai.

Economic and Political Weekly, Vol-XLVIII, No. 03, January 19, 2013, http://www.epw.in/commentary/rape-and-medical-evidence-gathering-systems.html?ip_login_no_cache=fa399b0b68e1e39703afd021340d4a28


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