Health care provision for survivors of sexual assault: A study in Bangladesh

Background: The consequences of sexual assault or rape are both physical and emotional and are more damaging in cultural settings where men are expected to be sexually demanding and where women's sexuality is valued by its “purity.” In Bangladesh, 5,816 women and children were raped from 2001 to 2007. Survivors of sexual assault need sympathy, timely medical attention and counseling. Population Council conducted a study to explore service provision for survivors of sexual assault. Methods: The study was conducted in four cities. Interviews were conducted among 32 service providers in hospitals and 38 police officers in police stations adjacent to hospitals. Results: Sexual assault was classified as a medico-legal case. A protocol was said to exist; police officers were not even aware of its existence. There was no uniform service protocol to follow for managing sexual assaulted cases at hospitals. Post-exposure prophylaxis (PEP) was an unfamiliar concept among doctors. Over 90% of doctors reported that sexually transmitted infections management was not given. HIV prevention services were non-existence. Doctors and nurses had no orientation on managing survivors of sexual assault. Most police and medical providers were not sensitive to the needs and care of survivors of sexual assault. Respondents' thoughts were consistent with popular stereotypes: blaming the survivors, emphasizing shame brought to the women's family and lack of sympathy. Conclusions: Training protocols for sexual assault awareness/sensitivity and case management, including skills in counseling and providing PEP, should be strictly implemented in police and health facilities.