Rape and sexual assault survivors are often forced to wait for hours among other patients at Mater Dei Hospital before they are examined in their vulnerable state, according to doctors and an NGO that supports victims of crime.
The issue was first flagged to Times of Malta by concerned doctors who spoke about the “urgent need” to address the lack of sensitivity and privacy in the way sexual assault and rape victims are being handled once they arrive at the state hospital.
These views were backed by NGO Victim Support Malta which reported an increase in sexual assault referrals made to them through Mater Dei Hospital this year.
To date, in the first four months of the year, VSM received 12 referrals, compared to 28 throughout 2022, and 11 in 2001.
“We are not even halfway through the year yet and are already almost at half of the referrals which we had last year,” said Kyra Borg, who heads VSM’s Care for Victims of Sexual Assault.
Apart from the 12 referrals from Mater Dei this year, VSM received 13 other reports that have been referred through other entities or self-referrals. Of the total 25 referrals received this year, 21 were women and four were men.
What happens once a victim goes to hospital?
A sexual assault or rape victim is first seen at the hospital’s Accident and Emergency Department. The case is brought to the attention of the most senior nurse and doctor on the floor, according to the health ministry. The relevant specialists are called in to give clinical input on the case, such as treating injuries and addressing the risks of sexually transmitted infections and pregnancy.
If the case is reported to the police, the duty magistrate is informed and may trigger a magisterial inquiry, appointing court experts to collect forensic evidence.
“While such cases are prioritised due to time-sensitivity and the psychological trauma involved, limb-threatening and life-threatening situations still take precedence,” the ministry said.
Borg elaborated that women are directed towards the Obstetrics and Gynaecological Ward, while men are kept at the emergency department and treated with other patients. Once at the Gynae Ward, women must wait in the waiting area with other patients.
“They are usually traumatised and confused and often needing to wait for hours. If the case was reported to police, there would sometimes be police and other professionals from the forensics section around them, which makes other patients curious what is going on.
“Sometimes the police speak to them in the waiting area while there are other patients around, while at other times there is a private room available,” Borg said.
Crises workers not always contacted
The ministry said that every effort is made for the victim to be seen in a closed room where dignity and privacy can be ensured.
“However, in view of the significant caseload at the Emergency Department at peak times, victims sometimes have to wait in the waiting area or outside the gynae admission room until they can be seen.”
As far as possible, the clinicians, court experts and police involved coordinate so that the victim is only required to recount their version of events and undergo intimate examination once to minimise re-traumatisation, the ministry said.
Apart from the medical care and examinations at hospital, the victim is offered the assistance of the 24/7 Care for the Victims of Sexual Assault service.
VSM operates a full service to victims of sexual assault including psychotherapy, psychiatry, legal representation and family therapy.
Through a Public Social Partnership agreement with the Ministry for the Family, Children’s Rights and Social Solidarity, VSM manages a handful of crises workers who are deployed to meet the victim to offer support.
“This in itself, has not been an easy feat as historically, these crises workers have not been contacted, not allowed near the victim or contacted hours after the victim has made the report,” Borg said, adding that in recent months the relationship between VSM and Mater Dei Hospital has grown more cohesive as a result of consistent and regular meetings.
Plans to improve the service
Malta remains in breach of the Istanbul Convention that stipulates that every European country should have one established rape clinic per 200,000 inhabitants.
In the past, VSM has made a number of attempts, with the support of the Ministry for the Family to home a one-stop-shop for victims of sexual assault to include the lifting of forensic evidence and police interview along with the subsequent therapy and related services. But Borg said that once the health authorities got involved, the project was stone walled.
The Health Ministry said it is working on extensive changes that includes two rooms for the assessment of cases of sexual assault, so victims can be seen in greater privacy and comfort.
“This also means that any reviewing specialists giving input on the case will review the patient in this room, instead of the victim having to move from the Emergency Department to another part of the hospital. This has now reached an advanced stage. Training for Mater Dei staff on managing cases of sexual assault is also being prepared.
“Due to the need to amend clinical pathways and inter-agency procedures, these updates necessitate a process of extensive stakeholder discussion and feedback,” the ministry said.
If you have suffered sexual assault and would like to access CVSA services, contact Victim Support Malta on 2122 8333 or email info@victimsupport.org.mt.