Health professionals launch initiative to battle sexual violence in Puerto Rico
By Obed Betancourt
SAN JUAN — Dr. Rebecca Ward, director of the Rape Victims Help Center (Cavv by its Spanish acronym), warned that eliminating sexual violence requires efforts from all levels—individual, interpersonal, community, and sociopolitical levels.
Sexual aggression is still a widely spread type of violence, and statistics show 95% of older adults don’t report cases to agencies or programs, Dr. Ward explained during the practice certification ceremony for 42 forensic nurses in pediatric sexual assault, held on Thursday. Sexual violence can include sordid rape, incest, child pornography, lascivious acts, spying, sexual harassment in the workplace, spousal sexual aggression, and dishonest expositions.
Although complaints to police for sexual aggression have been declining since 2010, the 1,057 cases reported on 2015 remain alarming, since Puerto Rico has lost 500,000 people due to this type of violence.
The most common act of sexual violence, according to 2014 Police reports, were lascivious acts, with 55 percent, while sexual aggression was 38 percent (31% technical rape, 5% rape, and 2% sodomy).
Meanwhile, incest occurred on 2 percent of registered cases, and up to 5 percent were spousal sexual aggression cases.
Contrary to public perception, 92 percent of sexual violence cases on the island are perpetrated by somebody close to the victim, with 35% being family members, 38% someone on the victim’s surroundings, and up to 19% are the victims’ partners.
Ward observed that the island’s vigilance systems indicate there are an estimated 80,000 adult people who have been sexually abused at any given moment in their lives, and over 106,000 have been victims of lascivious acts; 12,000 adolescents, according to epidemiological surveys from the Health and Education departments, and 1,400 minors identified by the Family Department, out of which 717 cases went to emergency rooms. 5.6 percent of high school students (around 6,821 by 2013) revealed to have been victims of some type of sexual violence.
On another hand, the most vulnerable ages, as attended in emergency rooms, are children aged 10 to 14, followed by ages 15 to 18, 5 to 9, and lastly, 0 to 4.
“The reality of sexual violence in the country and the whole world is alarming and it merits collaborative efforts to eradicate it. […] We must work all levels of the socioecological model,” she maintained. In addition, “it is necessary to offer primary prevention services,” educating the community to change social norms that promote gender violence.
Secondary service involves “immediate attention once the event occurs,” such as emergency rooms, Integrated Service Centers for Child Victims of Sexual Assault (Cimvas by its Spanish acronym), and emergency lines. Meanwhile, the tertiary service is treatment to face the impact of sexual violence on victims.
The five attention areas on the long-term agenda, as defined by the United Nations (UN) and the Economic Commission for Latin America and the Caribbean (Cepal by its Spanish initials), are gender equality; cultural equality or celebration of diversity; participative democracy on political organisms; and sustainable and inclusive development, exemplified through economic independence.
The program of forensic nurses in pediatric sexual assault joins other Cavv initiatives launched during the past 15 years; among them, adopting the Sane-Sart model, which trains specific sector for victim intervention. Nonetheless, changing old intervention models has required a “long trajectory of identifying ideal capacitation resources, staff capacitation in all the island’s hospitals, and modifying public policies and rulings to incorporate the role of forensic nurses on victim-intervention protocols on health facilities.”
Similarly, “nursing faculties had to be capacitated to develop academic certification, the participation in interagency committees that promoted Act No. 158-2013 to create Cimvas -in which we have Sane-P nurses-, capacitation on the pediatric modality in 2015, and the continuous intercessory so this personnel’s expertise is recognized on an island level,” informed the Cave director.
The forensic nurse must improve empathetic, adequate, and timely attention to victims, “and the evidence recollection process to increase probabilities of prosecuting offenders,” she explained.
The nurses, who must still take a certification exam from the International Association of Forensic Nurses, have been capacitated to document physical injuries, preferably by photographs perform the vaginal test to recollect forensic evidence; and in collaboration with the doctor, offer preventive treatments for sexually transmitted diseases (STDs) and pregnancy, in addition to evaluating suicidal danger situations, and domestic violence situations.
The new Cavv-Cimvas centers for minors in Fajardo and Mayagüez have forensic nurses in sexual aggression to perform evaluations. However, they must still wait for the Nursing Board to validate the Health Department’s certification, Ward commented.