Unit objectives• Define sexual assault• To describe the regional and national magnitude of sexual assault• To discuss the consequences of sexual assault• To describe the role of health service providers in managing young people who have been sexually assaulted
DEFINITIONS• Sexual Assault: (synonymous with sexual violence); is a term covering a wide range of activities, including rape / forced sex, indecent assault and sexually obsessive behaviour• Sexual assault is defined as ‘any sexual act, attempt to obtain a sexual act, unwanted sexual comments or advances, or acts to traffic women’s sexuality, using coercion, threats of harm or physical force, by any person, regardless of the relationship with the victim, in any setting, including but not limited to home, school, prison, the streets and at work’. (World Health Organisation 2003)
RAPE• Rape is defined as “physical forced or otherwise coerced penetration – even if slightly – of the vulva or anus, using a penis, other body parts or an object” (World Health Organisation 2003)Defilement is unlawful sexual intercourse with a young person below the age of 14 years.
What are your personalexperiences on the magnitude of sexual abuse
FACTORS CONTRIBUTING TO THE PROBLEM OF SEXUAL ABUSE IN YOUNG PEOPLEAim of the session• To discuss the factors contributing to the problem of sexual abuse in young people
GROUP WORK• Factors contributing to sexual abuse along the following lines: – Biological – Social – Cultural – Behavioural – Economic
Consequences of Sexual Abuse in Young PeopleAim of the sessionTo describe consequences of sexual abuse in young people
Health Consequences of Sexual Abuse• Unwanted pregnancy• Unsafe abortion• STIs including HIV/AIDS• Sexual dysfunction• Infertility• Pelvic pain and urinary tract infections
Genital Injuries• Typical genital injuries include• Tears• Ecchymosis.• Abrasions, redness and swelling of the genitalia• In women genital injuries are most likely seen in the posterior fourchette, labia minor the hymen and fossa navicularisIn men injuries are generally located around the anus and perineum
HOW ARE PEOPLE WHO HAVE BEEN ASSAULTED CURRENTLY DEALT WITH?Group work
WHAT SHOULD HEALTH SERVICE PROVIDERS DO TO DEAL WITHYOUNG PEOPLE WHO HAVE BEEN SEXUALLY ABUSED? Brainstorming activity
GROUP DISCUSSIONWhat do you think is your role in managing a young person who has been sexually assaulted?
SummaryRole of Health Workers:• Screening to rule out complications such as physical injury, STIs, if screening reveals evidence on sexual abuse, report the matter to police.• Treat complications such as physical injuries, bruises, STIs if any.• Counselling to reduce feelings of guilt, self blame ,shock and fear• Referral for other services e.g. PEP, emergency contraception and psychosocial counselling.• Linkage to other support centres e.g. legal services, victim support unit, law enforcers, human rights organizations, livelihood programs, and life skills.
Role of Health Service Providers:• Follow up client by home visiting or outreach services.• Increase awareness among young people especially boys, parents and the entire community on the effects of sexual abuse.• Sensitize other service providers (untrained) on the prevalence of sexual abuse and how to handle sexually abused young people.• Conducting operational research to improve quality of management of sexually abused young people.• Advocacy for stiffer punishment of perpetrators of sexual abuse and reporting of sexual abuse to police.• Sensitizing parents to be on the look out and observe symptoms of sexual abuse in their children and report to police once evidence is made available.