The second assault of rape victims by police hospital

Rape victims at the Nagpada police hospital endure crude forensic examinations with no medical treatment; are subject to bullying by cops and callous hospital clerks; and many find the horrendous medico-legal procedures a nightmare as bad as the one inflicted on them by the rapist.

One December evening last year, four-year-old Priya, the daughter of a construction worker, was out playing near her house in Kalwa, northern Thane. They had only recently moved to a shanty there, after the municipal authorities found their house in Vikhroli to be ‘illegal’ and razed it.

A neighbourhood drug addict spotted Priya playing alone. He kidnapped her, took her to a secluded spot, raped her, and dumped her in a nearby swamp. Priya had lost consciousness and her inert body was fished out from the swamp. The rapist was caught by the police. Priya was taken to the hospital for a forensic examination and treatment — and there, she underwent an ordeal that was perhaps as heinous as the sexual assault she had suffered.

After the incident, the family moved back to Vikhroli, with the idea of taking the girl away from a place where she had undergone such trauma, to help her recover. But two months later, Priya still hadn’t stopped crying — she was in tremendous pain. She could not urinate, her genitals burned, she could not walk, and she could not even sit down without slivers of pain shooting through her body. While the sexual assault was the primary cause of all this, equally responsible was the lack of medical treatment at the hospital she had been taken to.

Manisha Tulbule, a lawyer and social worker who is handling Priya’s case, says the hospital did not give the girl even the basic medical attention any rape victim would require. “Priya had been taken to the Thane Civil Hospital immediately after the incident. But the hospital only did a forensic examination for rape. Vaginal swabs and blood tests were taken, but neither did they give her medical treatment, nor did they refer her to another hospital. They didn’t follow the standard procedures for rape victims, such as checking for STDs (sexually transmitted diseases) and HIV infections,” she says.

A solution worse than the problem
The hospital that Priya was taken to is not the only one at fault. In fact, treatment of rape victims in most public hospitals is dismal. The worst, according to activists, is the Nagpada Police Hospital, which receives over 1,000 rape cases in a year.

SM Patil is the police surgeon at this hospital, the demigod around whom the hospital bureaucracy revolves. He is a small man with a big moustache and a big pair of glasses. Bigger still is his brightly-lit office, opening on to a courtyard with a separate driveway. Big man that he is, he is naturally a busy man. He is part of a team that is drafting a new manual on how doctors and cops in Maharashtra should deal with victims of sexual assault.

After initial denials, he eventually admitted to this reporter that he was indeed drafting such a manual, along with members from the home department, the department of medical education, and the directorate of health services. But he wouldn’t talk about it.
Why this strange coyness in talking about what, on the surface, seems like a progressive step?

In February 2010, a public interest litigation (PIL) was filed in the Nagpur bench of the Bombay high court against the state of Maharashtra and the Union government. The PIL was based on a study by Dr Indrajit Khandekar, titled ‘Pitiable And Horrendous Quality Of Forensic Medical Examination Of The Sexually Assaulted Victims In India’. Dr Khandekar had scrutinised the manner in which rape victims were dealt with by police personnel and doctors.

In response, the Maharashtra government tried to ‘rectify’ the problem. So in June 2010, the government came up with a directive asking all government hospitals to use the Nagpada police hospital’s pro forma. The trouble is this ‘official’ pro forma is a source of humiliation all over again: it prescribes the two-finger test, takes a broad consent for all tests (no matter that the traumatised victim may not be comfortable with some specific tests), asks for, among other things, the mental state in which the victim reaches the hospital, and the victim’s build.

Of all these, the most execrable is the two-finger test. Researcher Aruna Kashyap published a study in August 2010, showing how the two-finger test is still being conducted in Indian hospitals. She showed how the defence counsel still uses this information in courts (if two-fingers can be inserted into the victim’s vagina) to term the victim a person of ‘loose’ moral character.
Kashyap is also shocked by other elements in the pro forma.

“What is the purpose of recording the victim’s ‘mental state’ and ‘build’?” she asks. “If the victim is small-built and she comes crying, then apparently there is a good chance that she was raped. But what if she has been raped, but is not of small build and is not weeping? Also, the victim should be allowed to decline certain tests that she might be uncomfortable with. One can’t take a broad consent, as is being done now. For instance, not everyone who has been raped just hours before, would be comfortable with the two-finger test.”

In fact, the pro forma is just part of the problem. In November 2008, the research and health advocacy group CEHAT observed for 10 days how the Nagpada hospital handled cases of sexual assault. They were shocked. “The clerk who was supposed to take down the victim’s details was actually talking to her in an accusatory tone. He was asking her, ‘How many times did you go out with the rapist?’, ‘Did you do some wrong thing with him?’, ‘Oh you went with him! Very good’,” says Padma Deosthali, coordinator, CEHAT, who was part of the team of researchers.

“And when a doctor was recording the victim’s version, a police constable kept interrupting her, trying to ensure that the doctor’s version matched with what she had stated in the FIR. They had no clue that a victim can change her version; that she may want to confide more to the doctor — it is her prerogative,” says Deosthali.

They also found that none of the victims received medical attention. Incidentally, the World Health Organisation (WHO) has clearly mandated that medical treatment should be given top priority when it comes to dealing with cases of sexual assault. CEHAT documented the procedures that were being followed in Nagpada, and suggested a complete overhaul, but nothing has come of its recommendations so far.

At the police station
The nightmarish experience of seven-year-old Sulekha encapsulates the worst of the police procedures.

Sulekha had been raped anally by a sweet-seller. Though the rapist was caught, the police wouldn’t register an FIR. Tulbule, who is assisting the public prosecutor in the case, says, “They kept telling the parents that ‘what has happened has happened, why do you want everyone to know that the girl’s honour has been lost’.”

When the parents wouldn’t give up and kept insisting, an FIR was eventually registered. In the hospital, the examining doctor tried to shove a finger into the seven-year-old’s vagina. Let alone the absurd idea that a seven-year-old could be promiscuous, the supreme court has ruled that the two-finger test has no scientific basis, that the victim’s habituation to sexual intercourse is immaterial, and therefore this test should not be performed. In any case, what was the logic doing this test when the girl had stated specifically that she had been raped anally?

The FIR, however, only briefly mentioned that there were “injuries to her anus”. No mention of anal rape. And in court, the defence latched on to this point. They argued that such injuries could have been caused by a diseased excretory system.

Tulbule says she has seen far worse forensic examinations.

“Often, something as basic as the taking of nail and hair clippings is not followed. And when samples are collected, they are not handled properly. They are left unsealed and open, leading to loss of evidence,” she says. “The forensic lab is often at fault. In Sulekha’s case, despite the panchnama finding stains of the lubricant on both the victim and the alleged rapist, the forensic report didn’t find any,” adds Tulbule. The report, however, found matching blood and semen samples on both and Tulbule believes it is enough to nail the culprit.

The lab with no chemicals
But who can blame the poor technicians at Forensic Science Laboratory (FSL) in Kalina for not doing their job properly? The lab to which Mumbai police send all their forensic samples for testing doesn’t even have the chemicals to do a DNA analysis — a fact widely reported in the media in October.

It was also reported that the director of FSL only has Rs50, 000 at his discretion for purchases, even though a single kit of chemicals for DNA testing costs a minimum of Rs2 lakh. An official from the DGP’s office had been quoted as saying, “The tendering process takes time. Bids are invited and they are advertised three times. Only then is the purchase order placed.”

Remedial measures needed
Says Dr Khandekar, “Sexual assault victims require support and counseling. We need crisis intervention centres like those in the United Kingdom, the United States and Canada, which are staffed by professionals and focus on the victims’ therapeutic needs. What we have instead is a system where there is no attention paid to a survivor’s trauma.”

Some are hopeful about the new manual being drafted. Dr Nikhil Datar, honorary gynaecologist, Cooper Hospital (one of the three hospitals apart from Rajawadi Hospital and Bhabha Hospital to adopt the progressive pro forma framed by CEHAT on the initiative of Dr Seema Malik, medical superintendent of Mumbai’s peripheral hospitals), says, “Doctors in India are not trained to deal with sexual assault victims. At most, a doctor would have learned something about dealing with sexual assault victims in his/her second year MBBS syllabus. But in western countries, doctors are taken for on-the-field knowledge.

” In any case, examining a victim is not rocket science. Having a common pro forma and manual to guide the doctors is a good step,” he adds.

As for Priya, she received treatment at Rajwade hospital, and later went missing. “Rape victims often go missing because of the shame and humiliation associated with rape.” Tulbule says. “But in her case, it might have had to do with the humiliation after the rape.”

Names of victims have been changed