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Ministry of Health and Family Welfare, Government of India has issued guidelines and protocols for the medico-legal care of survivors or victims of sexual violence. By the introduction of these guidelines the need for the uniformity in approach, treatment and documentation procedures in case of sexual offences may be fulfilled.

These guidelines are specially framed for rape cases, but, in the meanwhile can be used in case of other sexual offences too. The reports say that in India every 1 woman among 3 has suffered sexual violence in her life-time. This is a very alarming situation. Thus, the Ministry has taken this remarkable step towards the sexual violence mitigation.

INITIATION:-

Justice Verma was the first who in his report highlighted the need to standardize the medical evidence collection during the treatment of the victim. By getting inspired by his suggestion Ministry of Health and Family Welfare has drawn up these guidelines.

CONSTITUTION OF THE COMMITTEE:-

The Committee is constituted under the Chairmanship of Shri Keshav Desiraju , Secretary, Health and Family Welfare. The Committee constituted the following members:-

  1. AS(H) & MoHFW.
  2. Joint Secretary (Hospitals), MoHFW.
  3. Ms. Vrinda Grover.
  4. Ms. Aruna Kashyap.
  5. Dr. Sunneta Mittal.
  6. Dr, Shekhar Sheshadri.
  7. Dr. Jagadesh Reddy.
  8. Indira Jaisingh
  9. Dr. Padma Deosthali.
  10. Ms. Renu Khanna.
  11. Dr. T.S. Sidhu.
  12. Dy. Director General(Planning)

AIM OF THE PROTOCOL AND GUIDELINES ISSUED:-

The MoHFW has specifically mentioned the aims of framing the protocols and guidelines in its report:-

  1. Operationalise informed consent and respect autonomy of survivors in making decisions about examination, treatment and police intimation.
  2. Specific guidance on dealing with persons from marginalized groups.
  3. Ensure Gender sensitivity in the entire procedure.
  4. Focus on history by recognizing various forms and dynamics of sexual violence including activities that lead to loss of evidence.
  5. Evidence collection based on science and history, with specific guidance for taking relevant samples and preservation of evidence.
  6. Lay down Standard Treatment Protocols for managing health consequences of sexual violence.
  7. Lay down Guidelines for provision of First Line Psychological Support.

GUIDELINES AND PROTOCOLS:-

In the report, the guidelines and protocols are categorized into various sections:-

  1. Health Consequences and Role of Health Professionals:-

In this section various consequences of sexual violence have been listed. These consequences are categorized as Physical Health Consequences and Psychological health Consequences.

             In the report, the Committee has declared the dual role of the Health Professionals:-

  1. To provide the required medical treatment and psychological support.
  2. To assist survivors in their medico-legal proceeding by collecting evidence and ensure good quality documentation.

           In addition to this, various guidelines have been provided to establish rapport and to facilitate procedure. Guidelines for the Forensic Medical Examination team have also been provided to give their opinion.

  1. Guidelines For Responding to Special Groups:-

This section alerts Health professionals to the specific health care needs of Marginalized Groups like sex-workers, transgender, persons of alternate sexual orientation etc.

In addition to this, the section also provides guidelines for the examination of these marginalized groups.

  1. Guidelines For Responding to Children:-

In this section, some specific guidelines are provided in case of children. These guidelines should be followed along with the other guidelines issued for adults.

  1. Operational Issues:-

This section specifically talks about the Standard Operating Procedure (SOP) establishment in every hospital either govt. or private for the management of sexual violence cases.

  • The SOP should be printed and made available to every staff:-
  1. To provide comprehensive services.
  2. For the smooth handling of the cases and clarity of roles of each staff.
  • To have uniform practice across all doctors in the hospital.
  1. Medical Examination and Reporting for Sexual Violence:-

In this section, guidelines have been provided with the stepwise approach to be used for the medical examination and reporting; like providing First Aid, Evidence collection, History taking, Medical Examination, age estimation, documentation, Packing and sealing of collected evidences and handing over it to the police, Treatment, Tests, psychological Support, shelter and Legal Support etc.

  1. Psycho- Social Care for survivors/victims:-

Guidelines are given to provide Psycho-social care for survivors and victim. For attaining the above the following guidelines have been issued:-

  1. Creating and enabling atmosphere and establishing trust.
  2. Facilitation and demystification the medical procedure of the medical procedure.
  3. Address survivor’s emotional well-being.
  4. Safety assessment must be done.
  1. Guidelines for the interface with other agencies such as Police and Judiciary:-

This section describes the guidelines in 3 heads:-

INTERFACE OF HEALTH SYSTEM WITH POLICE:-

  • It states the duty of the police to aid the survivor/victim to the nearest hospital.
  • Police is not allowed to be present while any medical examination is being done or nay evidence is sought by the survivor.
  • Police cannot interfere with the duty of the health professional.

INTERFACE OF HEALTH SYSTEMS AND PUBLIC PROSECUTORS:-

  • The difference in histories provided to the doctor and to the police should be clarified to the public prosecutor.
  • The doctors must make a dialogue with the public prosecutors.

INTERFACE OF HEALTH SYSTEMS AND THE JUDICIARY:-

  • A doctor should prepare a medical opinion without delay under section 164 of Cr.P.C.
  • Absence of injuries and its reasons should be clarified.
  • Comments on past sexual history must not be made.

INTERFACE OF THE HEALTH SYSTEM WITH THE CHILD WELFARE COMMITTEE:-

  • Health Professional should encourage the child to disclose information to CWC.
  • Consequences of Sexual abuse, importance of provision of complete health care and also the limitation of the medical examination should be communicated to the CWC.
  • MCUs (Mobile Care Units) must include indicators.

CONCLUSION:-

As we all know that the sexual offences in the past decades have taken a giant shape. Statistical reports says that India is among the top states in the world in case of sexual offences.

After the Nirbahya case, various amendments have made in the Indian Criminal Laws. After that, these guidelines and protocols issued y the Ministry of Health and Family welfare are really appreciable.

By Prity Priyadarshini, Law College, Dehradun.