Deployed medical professionals learn to conduct sexual assault forensic exams
June 7, 2011
KANDAHAR AIRFIELD, Afghanistan, June 7, 2011 -- Medical professionals across Southern Afghanistan came to Kandahar Airfield to participate in a two-day training course to ensure medical providers are able to conduct sexual assault forensic exams.
Collection of forensic evidence from patients reporting sexual assault is essential. It can be used to identify an assailant, support a report of recent sexual contact and support a report of use of force. It will also assist law enforcement with an investigation.
Medical professionals need to be proficient when conducting these exams, because evidence presented during a court case can be crucial for the victim as well as an accused assailant.
When someone is sexually assaulted, going through an extensive medical exam can be intolerable. The exam can be a lengthy process -- depending on what happened and how much trauma occurred. At a minimum, the exam could take three hours, but can be more than eight hours.
“The idea is for practitioners and nurses to feel confident about performing a sexual assault examination; being able to treat the patient medically and to be able to collect forensic evidence,” said commander Cynthia Ferguson, a forensic nurse examiner, U.S. Navy Nurse Corps, Port Hueneme, Calif.
Sexual assault forensic evidence exams are not as simple as reading the directions in the box, said Ferguson.
“Many people have the impression that it [Sexual Assault Evidence Collection Kit] is something that is dummy proof. It requires training and practice to perform the examination,” said Ferguson.
Anyone can follow instructions on how to put together a piece of furniture or bake a cake, but when conducting such a complex exam as the sexual assault evidence collection kit, hands-on exercises and training are needed.
The practitioners and nurses who participated in the training course role-played to give them practice on how to ask questions and how to note the victim’s response. They were put in two-person teams - one acted as the victim, while the other was the attending physician. They used Department of Defense form 2911, and eight-page form used to document findings from a sexual assault.
As part of the hands-on training exercise, the physicians had to conduct an exam on mannequins. The mannequins were marked with bruises, scars and a chemical to suggest fluid was present. They used an ultraviolet light to inspect the body of the mannequin, and a camera to take photos of the victim. As the evidence was collected the physicians used DD form 2911 to annotate their findings.
“This exercise will familiarize the practitioners with the Sexual Assault Evidence Collection Kit and give them hands-on experience on how to use it,” said Col. Michael Sigmon, United States Forces-Afghanistan, preventive medical consultant. “It will help the providers become familiar with the components of the evidence collection kit, and how to collect samples.”
The exam is very difficult for both the victim and the provider. Physicians have to work with the patient and move at the victim’s pace to ensure that he or she is comfortable. They have to address all issues, not just medically or legally. Treat the victim as a whole person, said Sigmon.
“We want to have them [medical providers] at a number of forward operating bases,” said Sigmon.
He said one of his concerns was that a sexually-assaulted victim may have to fly several hours to get to Kandahar Airfield or Bagram Airfield for medical treatment and forensic examination, and that can be very unsettling for the victim.
By having trained, sexual assault nurse examiners at the forward operating bases, victims can get the care they need in a timely manner, he said. At the same time, the examiners can conduct an examination kit in order to collect evidence of a possible crime.
At the completion of training there will be 40 sexual assault nurse examiners across Afghanistan, to include 17 in the southern region. If there is a crime or suspected crime, the victim will have the option of being taken care of as soon as possible, at a place where he or she can receive medical care from a trained sexual assault examiner.