PICKING UP THE PIECES
By Mmanaledi Mataboge

More nurses need to be given medico-legal training as this will assist the police in securing convictions in cases of sexual assault

January 27, 2004 – (Mail & Guardian Opinion- Johannesburg) Thabo Tshabalala of Evaton in the Vaal Triangle expects to spend a lot of time in criminal courts in future, but he is not a criminal and he is not a lawyer. Tshabalala is a newly qualified forensic nurse, the only male in a pilot group of 19 nurses who recently completed training in evidence collection in sexual assault cases.

Forensic nurses are trained to perform examinations specifically on victims of sexual assault and to identify, collect and preserve forensic evidence that can be presented in court. They are also trained in trauma counselling and HIV/Aids counselling and testing.

The Gauteng health department is prioritising forensic training in an attempt to assist the police in securing higher conviction rates for perpetrators of sexual abuse. At present less than half of sexual assault cases reported result in a prosecution and only 8% lead to a conviction, according to Lisa Vetten of the Centre for the Study of Violence and Reconciliation.

Tshabalala, who works at the Levai-Mbatha Community Health Centre, has been a nurse for 18 years, but only started working with victims of sexual assault last year. "Not every nurse wants to work with sexual assault victims, but because I am interested in helping them I decided to go for medico-legal practice training," he says.

Victims of sexual assault need to report the case to their nearest police station, where a statement will be taken in a private, specialised victim-empowerment room. A police officer will then escort them, with the necessary documentation and an evidence collection kit, to either the regional family violence, child protection and sexual offences unit or a medico-legal centre. Here a forensic nurse will examine the victim using new techniques to collect evidence. These can include a colposcopy examination to identify minute injuries; a special dye, which stains exposed tissue in cases of fresh injury; and ultra-violet lamps, which expose translucent dried secretions on the body surface for the collection of DNA samples.

Tshabalala says they still experience difficulties with certain police officers who fail to provide all the necessary information, which includes a sexual assault evidence collection kit, a case number and the name of the investigating officer. "One of these things is always missing somehow," he says. Tshabalala tells of how justice was denied to a three-year-old rape victim from Orange Farm. Her mother eventually gave up on the case because on three occasions the police sent her to the medico-legal centre without all the particulars she needed.

"People have to understand the trauma of being a sexual assault victim. Being sent from pillar to post is not an option," he said.
At present the medico-legal centres do not have their own evidence collections kits, and have to rely on the police to provide them with a new kit for each case. Tshabalala believes that if the centres had their own kits they would be better able to provide effective service to victims. Mohau Makhosane, deputy director, medico-legal services in the Gauteng health department, says: "It depends on the relationship between the centre and the local police station. Some medico-legal centres already have evidence collection kits and that makes their jobs run smoothly."

Nurses with medico-legal training can examine victims without having to wait for a doctor - an advantage in understaffed government hospitals, where many rape victims are too traumatised to endure the long wait and go home without laying a charge.

The newly-trained forensic nurses have been placed at dedicated medico-legal centres at hospitals or larger clinics throughout Gauteng.

Makhosane says this will enable evidence of sexual violence to be preserved in a more reliable fashion. "If you do not identify medical evidence and preserve it properly, it can destroy the case because that might be the only evidence that can lead to a conviction.

Because of the phasing out of district surgeons - who were responsible for forensic examinations on sexual assault victims - doctors also need to be trained, says Dr Natalya Dinat, a gynaecologist in Johannesburg.

"Not all doctors know how to do this anyway," she says, "and in rural areas where there's a shortage of doctors, nurses need to be trained."
Another concern is that although the sexual assault evidence collection kit is more user-friendly than the old one, there is a need for even more training of nurses. Dinat says providing training when there are still problems with accessing sexual assault evidence collection kits is of no help.

"The ultimate intention is to have universities and nursing colleges offering this as part of basic training," says Makhosane. The University of the Free State offers a Diploma in Forensic Nursing through distance learning. Medico-legal training is open to any registered professional nurse with experience in general nursing, community nursing, midwifery and psychiatric nursing.

From: http://allafrica.com/stories/200401290572.html