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No forensic exams for sex assault victims

VCH taking steps to fill gap in service at Sechelt Hospital
forensic exam
Marie could not get a forensic exam at Sechelt Hospital when she went for treatment after being sexually assaulted.

This is the first of a two-part series on access to health care services for sexual assault victims on the Sunshine Coast and B.C. as a whole.

Marie says when she regained consciousness she went to her friend’s house, who immediately took her to Sechelt Hospital. There, she told staff she had been sexually assaulted.

Marie (not her real name) needed medical attention, and while she wasn’t ready to report the assault to police, as a precaution she knew to ask for a sexual assault forensic exam.

Formerly known as rape kits, trained medical professionals conduct the exams after a sexual assault to document physical injuries and gather evidence, such as clothing, semen and hair, which could be used in a criminal investigation and trial.

After being ushered into a small private room near the hospital’s reception area with the help of her friend, Marie made her request.

“The doctor said he didn’t know how to do them,” Marie told Coast Reporter. He tried to connect with trained staff, but they weren’t on duty. “Long story short, [the exam] never happened.”

Sechelt Hospital has been without staff trained to conduct the exam since August 2019, when the last trained physician retired.

To address the gap, Vancouver Coastal Health (VCH) has put two Sechelt Hospital nurses through training at BCIT to become certified sexual assault nurse examiners – considered best practice in the field. They are expected to be on duty as early as late February. Additionally, up to seven physicians “have expressed an interest” in similar training, according to Gerry Latham, VCH director of services for the Sunshine Coast.

According to a VCH spokesperson, “forensic sexual assault services were available” at Sechelt Hospital up until the trained doctor’s retirement, and “patients still have access to the services at a different site.” The exams are a ferry-ride away in Powell River, Vancouver, and the Sea to Sky region.

But advocates say prior to the current gap in service, the availability of the exam was inconsistent.

“There have been women who have had to leave the Coast to have the kits done,” said Denise Woodley, who manages programs run through Sunshine Coast Community Services that support people whose lives have been impacted by violence and trauma. She also sits on a sexual assault prevention committee that has identified the lack of consistency. “As far as I know, in the last couple of years not much has changed.”

Sarah Start, who also sits on the committee and is a program coordinator for community-based victim services, said the availability of the exam has been unreliable for as long as she has worked on the Sunshine Coast – more than 15 years.

The issue has been raised with VCH, said Woodley. “It is a problem.”

“If you’re in the city and something happens to you, Vancouver General Hospital (VGH) is open 24/7. But we have the water,” said Woodley. “If it happens at 2 a.m., there’s no ferry.”

Taking a ferry presents a unique hurdle for victims, since they are advised not to shower and to keep on the clothes they wore during the time of the assault so as not to disturb any evidence. “The impact of that can be quite traumatic,” Woodley said.

Magnifying the problem are the legal ramifications.

According to Const. Karen Whitby, Sunshine Coast RCMP’s domestic violence and sexual offences investigator, without the forensic exams, “hypothetically … we would be losing important investigational evidence in a criminal trial.”

The burden of taking a ferry, potentially alone, can be enough to deter victims from pursuing the exam. Both Sarah Start and Const. Whitby said they have heard of cases where people who were turned away at Sechelt Hospital chose not to travel to the city.

Marie, whose experience occurred prior to the six-month gap identified by VCH, is one such person.

After the doctor told her he wasn’t trained, Marie asked if he could at least perform a less formal examination. “I just wanted things to be checked out and documented,” she told Coast Reporter. “Perhaps he would see there was trauma or be able to put something down. Maybe not an official kit but document what he could. But that never happened.”

Despite waiting at the hospital for five hours, the doctor never gave her the option to go to the city, Marie said. Instead, another employee flagged her down as she and her friend were leaving. “I was already in the parking lot and she ran out. She told me to call victim services.” Marie was also offered a ferry voucher and told she could try a Vancouver hospital, but by then, a Howe Sound crossing was too daunting.

“I had already been to the hospital. Going again didn’t seem very inviting, not to mention a day trip to the city to do it,” she said. “If I couldn’t come here alone, I can’t imagine I would have gone there alone, either, [and] who’s going to take me?”

According to Staff Sgt. Poppy Hallam, people who report a sexual assault offence to the RCMP are accompanied “via police transport” to hospitals on the Sunshine Coast or the Lower Mainland for a forensic exam if “there is opportunity to collect evidence from the victims.” Because Marie didn’t report to police immediately, that option wasn’t on the table.

Experts say only about five per cent of assaults are reported. That means RCMP statistics should be multiplied by at least 90 per cent, according to Elba Bendo, director of law reform at West Coast LEAF.

RCMP statistics show that between 2015 and 2018, there were three reported incidents of aggravated sexual assault on the Sunshine Coast, one incident of sexual assault either with a weapon or threats or while causing bodily harm, and 56 incidents of “level one” sexual assault – when sexual activity is forced on a person, including kissing, groping or intercourse, but with minimal or no physical injury. There were 30 sexual violations against children reported in that same time period.

With such low reporting rates, barriers to gathering evidence narrows a path to justice that’s already constricted, Bendo said. Research indicates the odds of a case being classified as unfounded increases when an exam is done more than 24 hours after an incident.

“We all have the right to equal access to health care services and also justice,” she said. “And so if both of those rights are being undermined for survivors of sexual assault who are predominantly women or folks from gender minority groups, then that’s an issue.”

The risk, she added, is that other victims could lose trust in the system and avoid seeking justice altogether.

Woodley and Start say sexual assault exams should be available around the clock – even if that means having staff on call.

So does Powell River-Sunshine Coast MLA Nicholas Simons, who attended an intergovernmental meeting in late 2019, where the issue was raised.

“Regardless of the community size, there should be people able and capable of providing that service so that the re-traumatization of people who are victimized doesn’t take place,” he told Coast Reporter.

“When it was obvious that the service wasn’t available 24/7, that’s when you realize this is obviously a need.”

VCH director Latham wasn’t able to confirm whether the service would be available around the clock at Sechelt Hospital once the nurses and physicians are fully trained. Instead, she said it would be provided on an “as-needed basis.” The “logistics of the management of our team has yet to be worked out,” she said.

“This is part of our standard of care, from the VCH perspective, thus why we are supporting the training and why we are wanting to get this service up and running as quickly as possible.”

For Marie, however, it’s arrived too late. “You feel humiliated and embarrassed enough as it is, but you definitely feel worse knowing, maybe I shouldn’t even have bothered coming.”

Next week, the series continues to examine barriers to accessing post-sexual assault emergency services.

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