North Darfur- Sudan
CLINICAL MANAGEMENT OF RAPE(CMR) PSYCHOSOCIAL AND LEGAL ASPECTS
2 ND M E E T I N G O F T H E M E N A R E G I O N A L I A W G
WORKING GROUP
1 9 - 2 1 ST M A R C H 2 0 1 2 , C A I R O , E G Y P T
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CMR Objectives
 To increase skills for responding in a sensitive and holistic way to
survivors of violence.
 To establish system for the proper management of the Sexual and
Gender based Violence in health facilities (establish referral pathway)
 To establish link between the health centers and women societies for
psychosocial support to the cases of the sexual and Gender Based
Violence.
 To increase knowledge of the legal rights of survivors of rape.
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CMR training 2010
CMR training 2011
Psychosocial Aspect
The SGBV is traumatic sensitive experience and most of women for various
reasons difficult to express it, so, the health providers needs special skills to
facilitate the communication about the experiences
 The time spent by the health providers is not enough for the survivors to
build the trust.
 The psychosocial interview is more open and flexible
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Lesson learned of Psychosocial Aspect
The following competences HP need to be trained identified in
Assessment
 Assessment Post Traumatic Stress Symptoms (PTS)
 Communication skills (Counselling attitude, listening, questioning
techniques, confidentiality)

Explanation of psychosocial symptoms
 Explanation of assessment and referral procedure
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Legal aspect
 Form 8 is a criminal medical form,
 Form 8, to be completed by the examining doctor
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(Medical Assistant) in relation to possible court
proceedings.
Form 8, is an attempt to ensure that standard elements of
evidence are collected during the investigation.
From 8 consists of three parts:Part one, should be fill by the police.
Part two, Should be filled by the prosecutor
Part three, should be filled by the doctor. Any authorized
doctor (Medical Assistant) is allowed to examine, treat
victim and fill in form 8.
Best Practice
 CMR manual endorsed and launched by Federal Ministry of Health
on 2007.
 CMR services available 24hours/7 days in some hospitals,16 in ND
 CMR training contents; Medical, PSS, Legal part and targeted
HW(MD,HV.MW)
 Trained midwives helped on referral of cases to the nearest health
facilities
 Established a comprehensive management system for survivor
 Strengthened multi-sectors coordination between the GBV actors.
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Best Practice
 New legislation exempted the survivor to do Police report prior to
the treatment
 Medical doctor report is accepted in the court
 Health provider will orient the survivors of their legal rights
 Survivor might open court case at any time
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Challenges and constrains
• Community and families having lack of awareness of resulted on
delay of seeking medical advice.
• Most of survivor families focus on having the police report more than
the medication and some of them need to keep the issue confidential,
because of stigma.
• Under reporting of cases.
• Partners are afraid of reporting rape cases particularly after
expulsion of NGOs
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Continue
 Presence of the police in the main entrance in hospitals will affect the
survivors accessibility to the services and break the confidentiality.
 Some of the health managers do not consider the CMR as a top priority
issue in their clinics.
 highly politicization of rape issue most of clinics deny its existence
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Way forward
 Disseminate the referral pathway to relevant actors.
 Develop and adapt standard guidelines on psychosocial services.
 Train all health providers, including community volunteers on
emotional support.
 Strengthened capacity of relevant governmental bodies
 The importance of refresher trainings.
 Identify GBV focal persons and equip them with means of
communication
 Link of GBV awareness session with RH sessions
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Thank
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