2. Sexual Assault Treatment Unit South Infirmary/ Victoria University Hospital

3. Other types of Sexual Assault Aggravated Sexual Assault Indecent Assault

4. SEXUAL ASSAULT Ignorance Fear Myths

5. SEXUAL ASSAULT TREATMENT UNITS IN IRELAND Rotunda SATU in Dublin opened in 1984 Letterkenny SATU opened in 1998 South Infirmary/Victoria SATU opened in October 2001 Waterford SATU opened in September 2004 Mullingar SATU opened in February 2009 Galway SATU opened in August 2009

6. Aims of setting up a S.A.T.U. Holistic care for the victim Supportive, efficient and professional collection of forensic evidence and provision of legal reports Confidential / private area for history /examination Support and training to all staff providing the service

7. SATU Opened 1st October 2001 We see both Male / Female clients over 14 years years of age No time restriction / with or without Garda involvement year 2009: 91 2010:125

8. Core services Provided  Forensic/Medical examination  Emotional and practical support  Liase with the Rape Crisis Centre  Post coital contraception  Follow up screening for Sexually transmitted infections  Answering queries and directing clients to appropriate services

9. SATU - The Unit Interview room -as comfortable and non clinical as possible Examination room -efficient and fully equipped Shower and bathroom facilities-wash kits, track suits Office-secure notesDatabase of clients

14. SATU - Staffing 24 hour service, 365 days of the year Clinical Nurse Specialist/ 0830 – 1630 Forensic Examiner Secretarial cover 0900 - 1230 5 General Practitioners off site - on call service 7 Nurses off site - on call service Crisis Support off site – on call service follow- up clinic weekly

15. SATU - Referrals Referrals can come from anywhere Gardai G.P.’s Emergency Departments Sexual Violence Centre Self referrals contact the unit time set for all to meet at the unit victim support person nurse and forensic examiner +/- gardai

16. Consent Over 18 years (consent for all ages) 14 - 18 years Gardai informed and they provide appropriate person for consent Gardai must co-sign consent as we explain that the examination is to provide forensic information Childcare Act

17. Patient Details Name DOB Place of examination Date of examination Time of examination Persons present at the examination Address and phone No. Age Garda attending Garda station

18. Medical /Gynaecological History Date of Menarche Last Menstrual period Bruising tendency Skin problems Gynaecological problems Occupation Medical/psychiatric problems Sexually active: presently / previous / never Last coitus: Date and Time STD Pregnancy: Previous and outcome

19. Details of assault Date of assault Time of assault Time lapse Relationship to assailant Place of assault Details of assault Site and mechanism of injuries Events preceding assault Drugs / alcohol consumed by victim Damage /disruption to clothing Weapon / implement used Ejaculation

20. Details of assault Digital / vaginal Oral / vaginal Oral / penile Penile / vaginal Penile / anal Digital / anal Lubricant used Condom used Ejaculation?

21. Events following Assault Change of clothes Showered Cleaned teeth Washed hair Vomited Medical treatment since event Activity since assault Bathed Washed genital area Micturated Defecated Eaten food/drank fluids

22. The Examination Appropriate clinical setting: - good lighting - ancillary lighting for the genital examination - magnifying lens for surface markings Gardai to be present in room for continuity of samples Client undresses onto white sheet - all clothes given to gardai Inspection of entire body including mouth Drawing and description of all markings Consider re-examination for bruising 1 - 2 days later Photos - rarely taken and only by gardai

23. Examination - Samples Head hair- combed and pulled Pubic hair- combed (especially any matted area) and cut Nail clippings- swabs and clippings

24. Examination - Swabs Control Mouth sample of saliva external lips internal mouth / gums Vaginal external vulva low vaginal high vaginal Anal external internal Extra swabs any place where client thinks there may be saliva, blood or seminal fluid from assailant

25. Examination - Bloods 1 x EDTA bottle - DNA if blood is not provided, DNA can be obtained from a swab of the inner cheek 1 x blank serum - blood group 1 x Fluoride bottle - alcohol Toxicology if appropriate

26. SATU - follow up Emotional support and counselling Cork Sexual Violence Centre Medical Follow-up of examination e.g. bruises reassessed STI examination at 14 days Gonorrhoea, Chlamydia, Trichomonas, Gardenerella Vaginalis, Hep.B-C and Syphilis HIV counselling/ testing at 3-4 months

27. Referrals2010 Acute cases =109, non-acute (beyond 7 days) =16 (4 Males) 38% of the clients were examined by the C.N.S. LOCATION OF ASSAULTS CORK CITY43% CORK COUNTY30% KERRY17% ABROAD6% LIMERICK CITY4% Alcohol consumed -76%

28. Alleged Perpetrator STRANGER37% ACQUAINTANCE28% FRIEND11% NOT KNOWN10% EX-PARTNER / EX-BOYFRIEND6% PARTNER / BOYFRIEND4% HUSBAND2% BROTHER1% NEPHEW1% COUSIN1% BOSS1%

29. SCREENED FOR SEXUALLY TRANSMITTED INFECTIONS   TOTAL SCREENED44% (of 125)  NON-SPECIFIC INFECTIONS33%  CHLAMYDIA15%  GONNORHOEA2%  TRICHOMONAS2%