1. Briefing on New Service Model in Handling Adult Sexual Violence Cases 2007-02-14 Forensic Examination for Victims of Sexual Violence Dr SHUM Shui-fung, Bobby Head of NT Division, Forensic Pathology Service, Department of Health

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

3. 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

4. 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

5. Public Mortuaries Histopathology Laboratories Offices with Clinical Examination Facilities – HKI (PHQ) Tel 28602466 – K (KWRPHQ) Tel 27612405 – NT (NTNRPHQ) Tel 26664224 Facilities

6. Forensic Pathology Service 11/F, NTN Regional Police HQ On Po Lane, Tai Po Tel 26664224 NT Office

18. Forensic Pathology Service 6/F, Arsenal House West Wing, Police HQ Arsenal Street, Wanchai Tel 28602466 HKI Office

24. Forensic Pathology Service 3/F, KW Regional Police HQ Argyle Street Tel 27612405 Kln Office

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

26. 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

27. 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

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

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

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

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

32. Consent

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

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

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

36. Physical Examination General examination Genito-anal examination

37. General Examination

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

39. 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)

40. Defensive Injuries

41. Road Surface Injuries

42. Lip Bruising

43. Fingertip Bruising

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

45. Genito-anal Examination

46. Genito-anal Injuries

47. Genito-anal injuries

49. 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)

50. Forensic Specimens

51. 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)

52. 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

53. Swab Taking

54. Arrangement - Availability Through police Office hours (~ 9-5): offices of respective regions – HKI (PHQ) Tel 28602466 – K (KWRPHQ) Tel 27612405 – NT (NTNPHQ) Tel 26664224 Outside Office (after 5, public holidays: Forensic pathologist on-call)

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

56. 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)

57. 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

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

59. Thank You