This care comprises:
- Treatment of physical injuries
- Prevention, treatment and vaccination against infections
- Post exposure prophylaxis (PEP) against HIV infection
- Treatment against potential reproductive tract infections (chlamydia, gonorrhoea, syphilis, trichomoniasis)
- Vaccination against Hepatitis B and tetanus infection
- Prevention and management of unwanted pregnancy (emergency contraception, pregnancy test, safe abortion) or refer to antenatal care for a continuing pregnancy.
- Psychological support, including counselling and provision of, or referral to, more specialised psychological or psychiatric support.
- Provision of a medical certificate to patients, with copies kept as proof of medical care provided and the clinical findings. A medical certificate signed by an authorised medical person is required as proof to press charges against the perpetrator.
Integrated care at first visit
Médecins Sans Frontières centres offer these essential services to all family and sexual violence victims in their first visit, in the one place. This means that integrated medical and psychosocial assistance is provided at the earliest opportunity in ‘one-stop’, so that victims of violence do not have to move back and forth between different service providers. Having to traipse between multiple sites to seek care creates impossible barriers for many victims, forcing them to repeatedly explain and relive the violence they experienced, which can lead to disengagement and re-traumatisation. Follow-up sessions for psychosocial support and medical care are available for each victim.
Coupled with effective community awareness, access to essential curative and preventive care for victims motivates them to seek out help. The presence of relevant treatment in their community increases community-wide understanding that such violence has serious medical consequences and is unacceptable.
Timely access essential
Access to and availability of quality services also encourages more people to present within the crucial 72 hours after an assault, and this is one marker of success for our programs. But at the same time there remain many reasons why victims may not present in this time-frame, and for women or girls who come later, it is still possible to deliver pertinent care.
As our specialists remind, “Timely medical assistance is vital after rape. PEP for the prevention of HIV infection has to begin within 72 hours of the assault, and although emergency contraception can be offered up to 120 hours after the event, it is most effective in the first 72 hours. After this, the success rate halves. However, Médecins Sans Frontières will assist any victim of sexual violence even if the assault took place a long time before. Vaccinations against tetanus and Hepatitis B are relevant for months after the assault and the treatment of some sexually transmitted infections can prevent important long-term health consequences “
For psychological support too, although our counsellors will always wish to see an assault victim as soon as possible, their door is open at any time.