Briefing on New Service Model in Handling Adult Sexual Violence Cases Forensic Examination for Victims of Sexual Violence Dr SHUM Shui-fung, Bobby Head of NT Division, Forensic Pathology Service, Department of Health

Forensic Pathology Service Department of Health Provides forensic pathology and clinical forensic medicine services to government departments

Operate public mortuaries Attend scenes of crimes Clinical medico-legal examinations Consultation Court proceedings Forensic Pathology Service Scope of Service Sexual offences Serious Wounding Cases Child Abuse CAT (Convention Against Torture) Claimant Victims Suspects

Medical Staff – 15 Forensic Pathologists + 1 Pathologist – FP: 13 male, 2 female Assistants to Forensic Pathologists – 8 Police Officers: 5 male, 3 female Forensic Pathology Service Staff

Public Mortuaries Histopathology Laboratories Offices with Clinical Examination Facilities – HKI (PHQ) Tel – K (KWRPHQ) Tel – NT (NTNRPHQ) Tel Facilities

Forensic Pathology Service 11/F, NTN Regional Police HQ On Po Lane, Tai Po Tel NT Office

Forensic Pathology Service 6/F, Arsenal House West Wing, Police HQ Arsenal Street, Wanchai Tel HKI Office

Forensic Pathology Service 3/F, KW Regional Police HQ Argyle Street Tel Kln Office

Sexual Offence Rape, attempted rape Indecent assault Unlawful sexual intercourse with girl under 13/16 Unlawful sexual intercourse with mentally defective Buggery…

Rape Cap 200 Crimes Ordinance: A man commits rape if- – (a) he has unlawful sexual intercourse with a woman who at the time of the intercourse does not consent to it; and – (b) at that time he knows that she does not consent to the intercourse or he is reckless as to whether she consents to it

Forensic Examination of Victims of Sexual Violence Evidence (physical / laboratory) – Sexual intercourse injury to private parts presence of semen – Non-consensual pattern of injuries toxicological examination

Forensic Examination of Victims of Sexual Violence Medical treatment must take priority SAFETY OF VICTIM COMES FIRST!!

Examination Suite Accessibility (24 hour) Security (restricted, lock) Cleanliness / Comfortableness (warm) Privacy (view & sound, entry & exit) Enough space

Examination Suite Waiting area (family, SW, police) Examination area (forensic pathologists, chaperone / nurse, interpreter) Equipment (couch, lighting, magnifying glass, swabs, specimen containers, water) Toilet

Forensic Examination of Adult Rape Victims Consent History Physical Examination – general examination – genito-anal examination Sample collection Documentation and reporting

Consent

Informed Voluntary Capacity - MIP – guardian – invoke Part IVC – guardianship board

History What signs to look for What samples to take How to interpret findings

History Routine background Medical Gynaecological Sexual What happened – “…The victim should not be asked to describe the assault repeatedly …”

Physical Examination General examination Genito-anal examination

General Examination

General appearance Upper arms, forearms and hands Face, ears, lips Scalp Neck Breasts Abdomen Thighs and Legs Hips and Buttocks

Non genito-anal injuries Bruises and contusions (e.g. inner aspect of thighs, scalp, face, lips); Lacerations (e.g. scalp, forearm); Ligature marks (e.g. ankles, wrists and neck); Pattern injuries (i.e. fingertip marks, scratch marks, bite marks, factitious self-inflicted injuries)

Defensive Injuries

Road Surface Injuries

Lip Bruising

Fingertip Bruising

Genito-anal Examination Inspection, labial traction Swabs Speculum Anal +/- digital +/- proctoscope

Genito-anal Examination

Genito-anal Injuries

Genito-anal injuries

Forensic Specimens Vulval / vaginal / endocervical swabs Buccal swabs – for DNA profiling Other swabs (e.g. anal, oral, breasts) Fingernail (clipping / scraping) Pubic hair Clothing / debris +/- Toxicological samples (blood, urine)

Forensic Specimens

Vulval / vaginal / endocervical swabs Buccal swabs – for DNA profiling Other swabs (e.g. anal, oral, breasts) Fingernail (clipping / scraping) Pubic hair Clothing / debris +/- Toxicological samples (blood, urine)

Forensic Specimens Oral swab: up to 1 day (usually few hours Drugs and alcohol: – blood up to 4 days (usually half-day) – urine up to 7 days Rectal swab: 3 days (usually 1 day) Vaginal swab: up to 7 days (usually < 72 hours) Skin swab: before washing Dry material (panties): before washing

Swab Taking

Arrangement - Availability Through police Office hours (~ 9-5): offices of respective regions – HKI (PHQ) Tel – K (KWRPHQ) Tel – NT (NTNPHQ) Tel Outside Office (after 5, public holidays: Forensic pathologist on-call)

Arrangement - Timing Drug-facilitated cases: ASAP Fresh/recent cases < 72 hours: earliest time practicable (usu. < 2 hours or so) Cold cases: earliest convenience

Arrangement - Place Hospitals (A&ED, Wards - if indicated e.g. admitted/for joint examination) Rain Lily CAIU Examination Suites (child, vulnerable victims) Forensic Pathologists’ Offices (if mobile, esp. cold cases)

Forensic Evidence & FP’s role Factual evidence v Expert evidence Impartial, for court and justice, not for either side Non-judgmental (we are not jurors) Objective, disinterested, independent, uninfluenced Opinion: scientific method applied on available data Limited to field of expertise

Further Reading Available for free download at WHO > WHO sites > Injuries and Violence Prevention > Publications > Violence publications WHOWHO sites Injuries and Violence PreventionPublicationsViolence publications e_injury_prevention/public ations/violence/med_leg_g uidelines/en/index.html

Thank You