CLINICAL MANAGEMENT OF RAPE(CMR)- PSYCHOSOCIAL AND LEGAL ASPECTS 2 ND MEETING OF THE MENA REGIONAL IAWG WORKING GROUP ST MARCH 2012, CAIRO, EGYPT North Darfur- Sudan UNFPA - because everyone counts.

CMR Objectives To increase skills for responding in a sensitive and holistic way to survivors of violence. To establish system for the proper management of the Sexual and Gender based Violence in health facilities (establish referral pathway) To establish link between the health centers and women societies for psychosocial support to the cases of the sexual and Gender Based Violence. To increase knowledge of the legal rights of survivors of rape. UNFPA - because everyone counts.

CMR training 2010 CMR training 2011 Darfur CMR Training 2010 – Health Providers Darfur CMR Training 2010 – Health Providers

Psychosocial Aspect The SGBV is traumatic sensitive experience and most of women for various reasons difficult to express it, so, the health providers needs special skills to facilitate the communication about the experiences The time spent by the health providers is not enough for the survivors to build the trust. The psychosocial interview is more open and flexible UNFPA - because everyone counts.

Lesson learned of Psychosocial Aspect The following competences HP need to be trained identified in Assessment Assessment Post Traumatic Stress Symptoms (PTS) Communication skills (Counselling attitude, listening, questioning techniques, confidentiality) Explanation of psychosocial symptoms Explanation of assessment and referral procedure UNFPA - because everyone counts.

Legal aspect Form 8 is a criminal medical form, Form 8, to be completed by the examining doctor (Medical Assistant) in relation to possible court proceedings. Form 8, is an attempt to ensure that standard elements of evidence are collected during the investigation. From 8 consists of three parts:- Part one, should be fill by the police. Part two, Should be filled by the prosecutor Part three, should be filled by the doctor. Any authorized doctor (Medical Assistant) is allowed to examine, treat victim and fill in form 8.

Best Practice CMR manual endorsed and launched by Federal Ministry of Health on CMR services available 24hours/7 days in some hospitals,16 in ND CMR training contents; Medical, PSS, Legal part and targeted HW(MD,HV.MW) Trained midwives helped on referral of cases to the nearest health facilities Established a comprehensive management system for survivor Strengthened multi-sectors coordination between the GBV actors. UNFPA - because everyone counts.

Best Practice New legislation exempted the survivor to do Police report prior to the treatment Medical doctor report is accepted in the court Health provider will orient the survivors of their legal rights Survivor might open court case at any time UNFPA - because everyone counts.

Challenges and constrains Community and families having lack of awareness of resulted on delay of seeking medical advice. Most of survivor families focus on having the police report more than the medication and some of them need to keep the issue confidential, because of stigma. Under reporting of cases. Partners are afraid of reporting rape cases particularly after expulsion of NGOs UNFPA - because everyone counts.

Continue Presence of the police in the main entrance in hospitals will affect the survivors accessibility to the services and break the confidentiality. Some of the health managers do not consider the CMR as a top priority issue in their clinics. highly politicization of rape issue most of clinics deny its existence UNFPA - because everyone counts.

Way forward Disseminate the referral pathway to relevant actors. Develop and adapt standard guidelines on psychosocial services. Train all health providers, including community volunteers on emotional support. Strengthened capacity of relevant governmental bodies The importance of refresher trainings. Identify GBV focal persons and equip them with means of communication Link of GBV awareness session with RH sessions UNFPA - because everyone counts.

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