Health ministry does away with the controversial test; medicos demand use of rape kit
IN the aftermath of protests against the Delhi gang rape case in December last year, the Union health ministry has drafted a new pro forma for forensic medical examination and treatment of sexually assaulted victims. The pro forma, issued in mid-March, has done away with the controversial two-finger test done by doctors to know the sexual history of the victim. The test, in which two fingers are inserted into the vagina to know its laxity, was being used as evidence against the victim by sugge sting she is “habituated to sex”. “Whet her the victim has had an active sexual history has no bearing on her being raped. It is about consent for a sexual act,” says Pratiksha Baxi, assistant professor, Centre for Law and Gover n a nce, Jawaharlal Nehru Univ ersity, Delhi.
What a rape kit includes
As per a January report by Justice J S Verma Committee, set up to make rape laws stronger in the country, a kit for collecting evidence of sexual assault should contain:
• Detailed instructions for the examiner
• Forms for documentation
•Test tube for blood sample
• Urine sample container
• Paper bag for clothing
• Large sheet of paper for patientto lie down
• Cotton swabs
• Sterile water
• Glass slides
• Unwaxed dental floss
• Wooden stick for fingernail
• Envelopes or boxes for individual evidence samples
Other items needed that can be included:
• Drying rack for wet swabs
• Gown, blanket and pillow
• Med-scope and/or colcoscope
• Clean clothing and hygiene items for the victim after the exam
Though activists and medical experts welc omed the move, they lament the government has not done much to promote the “rape kit” which can make a substantial difference in convicting rapists. Prepared on WHO guidelines, a rape kit is a toolkit which includes sterile swabs and syringes. It costs Rs. 75-100. “Forensic samples are a crucial connection between the victim and the acc u sed, and rape kits give better results. For example, if any cotton is used to collect swabs, it might get infected, leading to multiple DNAs rather than limited ones to be investigated. It is important to use sterile material to collect DNA samples,” says B L Choudhary, assistant professor, department of forensic medicine, Lady Hardinge Medical College, Delhi.
Rape kits not in sight
At present, hospitals only in Delhi use rape kits, which they procure from local manufacturers. The Delhi High Court in its 2009 order had mandated the use of rape kits in the national capital. In Mumbai, only three municipal hospitals have the kits.
Rest of the states use the two-finger test due to the absence of rape kits and lack of training on how to use them. In Madhya Pradesh, the state with the highest number of rape cases, the kits are not widely available. In 2007, the state started a pilot in five districts to promote rape kits and train doctors. Six years hence, only a few hospitals have the kits and very few doctors have been trained. Mumbai-based NGO Centre for Enquiry Into Health and Allied Themes (CEHAT), along with the government, started a project in Indore to promote the use of rape kits in 2008. “We had to withdraw due to administrative delays,” says Sangeeta Rege of CEHAT. The situation is no better in other states. A senior gynaecologist from a Central government hospital in Puducherry says the hospital does not stock rape kits.
According to Choudhary, the use of the rape kit can result in better collection of evidence. “When a victim approaches a hospital at night, it becomes difficult to get all the material at one place, resulting in delay which leads to loss of crucial evidence,” he says. Seema Malik, chief medical superintendent of peripheral hospitals, Brihan mumbai Municipal Corporation (BMC), agrees with Choudhary. “Rape cases at nights are usually handled by junior doctors as they are on duty at that time. They have relatively less training and are scared so as not to lose out on important evidence. A collection of all the requisites like the rape kit gives them confidence. This also avoids ambiguity in collection of forensic evidence,” she says. According to Malik, training is important. But Choudhary points out there is minimal training in forensics for doctors in India. “This is a big impediment in dealing with criminal cases, especially in rural India.”
To tackle this problem, CEHAT and BMC have been training doctors in three municipal hospitals in Mumbai on how to use a SAFE Kit. Prepared by CEHAT, the SAFE Kit, or the Sexual Assault Care and Forensic Evidence Kit, is based on WHO guidelines but is a little different. “We have introduced a gender-sensitive form in the kit which guides the doctors how to sensitively treat the victim and collect evidence,” says Rege. It also has a list of do’s and dont’s, she adds. “The doctors, thus, learn to avoid asking uncomfortable questions.”
Malik says the SAFE Kit has helped gynecologists and forensic experts make stronger case for the victims. “We are going to prepare a policy to introduce the training and the use of kits in all BMC hospitals.”
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