Medical management of rape

Medical management of rape

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Rape is now endemic in our society just like malaria. Or how does one explain the numerous cases reported daily by newspapers?

Last week, it was reported that the law enforcement agencies had intensified efforts to arrest a man who allegedly raped a 14-year-old girl and fled his home to evade arrest.

The suspect allegedly had carnal knowledge of the victim and when neighbours caught him, he fled. Since then, he has yet to return to his house.

The suspect reportedly lured the victim into his apartment under the pretence of sending her on an errand. The victim, who had bruises and blood coming out from her private, was said to have received treatment and other medical examinations in a hospital.

Billy Graham once said, “When wealth is lost, nothing is lost; when health is lost, something is lost; when character is lost, all is lost.” Arising from this, rapists have nothing to gain. Rather, they have comfort, family, shelter, peace, among others, to lose.

Even in some African settings, rapists are at a great loss as they are ostracised from those communities.

This piece is a general guide for the public, victims, friends, parents and family members of a person, who has received sexual assault. It is also to assist the public in breaking the tradition of silence.

Rape or sexual assault is any sexual act performed by one (or more) person(s) on another without the victim’s consent. It may include the use of threat or force. In some cases, the victim cannot give consent to have sex because he or she is unconscious or otherwise incapacitated.

The public/victims should seek specific guidance about assault situation from a person who is experienced in the care and management of these victims, such as the doctors, family physicians, general practitioners and gynaecologists, among others.

A stranger, an acquaintance or date, or a family member may rape a person. After being sexually assaulted, rape survivors may have many questions, including: why did this happen to me? Could I have prevented this? Will I develop HIV/AIDS or other infections? Will I become pregnant because of the assault? Who should I call first? Should I report this to the police? Is this not my fault?

Rape Trauma Syndrome

Many rape survivors will experience Rape Trauma Syndrome, a collection of emotional responses to the extreme stress of the sexual assault and may include anger or hostility, confusion, crying or feeling numb, fear, loss of emotional control, nervousness or inappropriate laughter, not eating or sleeping well, tightly controlled behaviour, withdrawal from family or friends. They are also prone to post-traumatic stress disorder. There is the need to support and make victims of rape to understand that the act was not their fault. Any fault or blame is solely on the rapist.

Recommended steps after rape

Find a safe environment away from the assailant
Call a close friend or parents/relatives — someone who will offer unconditional support
Call the police or your health care provider.
Rape is a medical emergency. Call 767 or 112
Seek medical care. Do not change clothes, bathe, douche, or brush your teeth until evidence is collected.
Follow up with a health care provider one to two weeks later
Seek counselling services
It is advisable rape victims seek medical attention early. Rape victims may not be able to say they were raped. Many of them will come to the hospital to complain of other symptoms without hitting the nail on the head.

However, medical care can be at any time. But if some time has elapsed since the event, there will be scanty or no evidence for collection.

Doctors’ role

Doctors’ role is not to determine if rape has occurred because rape is not only a medical term, it is also a legal term. Whether a crime has been committed is to be determined by the courts. The doctor’s responsibilities in an alleged rape involves documentation of how it happened, careful physical examination, prompt treatment of physical injuries, psychological support and arrangements for follow-up counselling, collection of specimen for legal evidence, prevention of sexually transmitted diseases and prevention of pregnancy.

Rape treatment centre

Do you live in Lagos? Do you know of any rape victim? Have you heard of any rape case in your neighbourhood? Kindly refer them to the Mirabel Centre.

The centre is on the premises of the Lagos State University Teaching Hospital, Ikeja. The centre caters to the cost of a victim’s medical tests – those for sexually transmitted infections and pregnancy, among other things – and medication, like contraceptives and antibiotics, free HIV test and the post-exposure prophylaxis.

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