The aftermath was almost as traumatic as the incident itself. After Miu was sexually assaulted, she spent 13 long hours with emergency services. A social worker from local sexual violence crisis centre RainLily had accompanied her to the police first where, for eight hours, she recalled the incident in painful detail.
Then, she was shuffled on to the emergency department for two hours for medical treatment, followed by an hour with police to locate the perpetrator. But her ordeal was far from over. She then spent an additional two hours being probed by forensic medical examiners, and another hour at the hospital for a final clinical check-up.
The experience left Miu exhausted. “Being sexually assaulted is not something that someone can talk about lightly, and I hardly wanted to be reminded of it again,” she told HKFP. “But each of these procedures repeatedly asks [me] the same questions. It was mentally traumatising.”
According to police statistics, 65 cases of rape and 1,077 cases of indecent assault were reported in 2017. While 55 cases of rape and 943 cases of indecent assault were reported from January to October in 2018.
Established in 2000, RainLily is a one-stop rape crisis centre for female victims of sexual violence in Hong Kong, providing crucial support to survivors around the clock.
According to a spokesperson, RainLily – set up by the Association Concerning Sexual Violence Against Women – supported 286 new cases of gender-based violence between April 2017 and March 2018, providing counselling, immediate medical support, and necessary pro bono legal advice to plug the gap left by public services.
‘Too crowded and noisy’
In an aseptic wing of the hospital, Miu became overwhelmed by sensory stimuli. “A&E is too crowded and noisy,” she said. “After what happened, I was already in a bad mental and emotional state. A&E only increased my anxiety.”
The bustle of a public hospital can make for an unsafe space for vulnerable survivors of sexual violence to open about their trauma. With bright lights and noisy corridors, A&E was not the essential safe space that Miu needed after her assault.
She explained that the open setting of the hospital floor made it appear easy for others to overhear her intimate conversations with emergency personnel. “A&E just lacks security for survivors like me,” she said.
On average, sexual violence survivors in Hong Kong spend around 10 hours completing reporting and examination procedures, according to RainLily, with each individual providing an account of the incident at least five times: to a uniformed officer in the report room, the Criminal Investigation Division (twice if the report was not made in the district where the incident occurred), the Crime Unit, the forensic doctor, the hospital doctor and nurse.
And to further complicate the procedure, survivors must travel to a hospital with the appropriate facilities for medical treatment and forensic analysis if their local emergency room is unsuitable.
‘Lack of sensitivity’
The impact of recounting an incident of sexual violence to multiple emergency personnel can mean repeatedly reliving the initial attack. “These procedures add trauma to the assault itself because of their prolonged coldness and lack of sensitivity,” Miu explained.
A 20-year-old woman, who requested anonymity, told HKFP that after she was raped last year by a former friend, she spent 18 and a half hours with emergency services between 2am and 8.30pm. Having returned home after the incident, she was forced to travel back to the district where the incident happened to report to police, go to a forensic examiner, then back to the police station to provide an official statement, before being driven to the hospital by an ambulance.
“Throughout the police interview, the three male officers kept reminding me not to provide any false statements, which made me feel as though they didn’t trust me,” she said. “It was mental and physical torture.”
Medical sector lawmaker Dr Pierre Chan told HKFP that in order to reduce the trauma inflicted on survivors after sexual violence authorities must limit the number of times their testimony is taken.
“We are not machines, we are not computers, we cannot tell stories in the exact same wording five times,” he explained.”It affects their emotions and willingness to go forward.”
This proved true for the survivor. “I was afraid of saying anything wrong in the process, and the police warned [me] that I could be charged with perverting the court of justice if any inaccuracies were discovered in my statement. I felt like a criminal,” she said, adding that if the incident were to happen again she would forgo reporting to the police to avoid additional trauma.
Giving up on judicial justice
The process of reporting sexual assault can be so draining that some victims give up on judicial justice. “It is reckoned that there is a very serious under-reporting and delayed-reporting situation for sexual violence cases [by survivors] in Hong Kong,” a spokesperson for RainLily told HKFP. “We believe the provision of a more accessible, reassuring and less traumatising environment for survivors will be able to encourage more to come forward to receive assistance and complete more steps in judicial procedures for case-reporting as early as possible.”
Of the 2,318 rape cases handled by the NGO between 2000 and last year, survivors took an average of just over 959 days before seeking its help – the longest reportedly being 58 years.
“A&Es certainly does not feel like a place that offers security and safety for a victim; sometimes victims would just like to leave after receiving contraception,” Miu said. “I think the survivor would sometimes prefer to give up on judiciary justice in order to stop the trauma.”
Given their initial reluctance to report the incident, a delay in finding medical care could be dangerous for a rape survivor, as emergency contraception, STD prophylaxes, and forensic examinations are best conducted within 72 hours after the incident.
A police spokesperson told HKFP that officers are trained to handle cases with sensitivity and discretion. “Upon receipt of a report, the police will arrange for a same-sex police officer with relevant training to interview the sexual violence victim, and will try their best to avoid further traumatic experiences arising from the investigation process,” they said.
A ‘one-stop’ service
And so the solution proposed by RainLily is to provide a “one-stop” crisis centre throughout public hospitals in Hong Kong, where police statements and medical examinations can be taken in the same location to streamline reporting procedures and ensure that the survivor is seen by the least amount of people.
In its guidelines for the medico-legal care of sexual violence survivors, the World Health Organisation says measures should be taken to minimise the number of invasive physical examinations and interviews the patient is required to undergo. “Ideally the health care and legal (forensic) services should be provided at the same time and place by the same person,” the agency writes.
But when asked last June about the implementation of a “one-stop” service for sexual violence survivors, the Secretary for Security John Lee provided an unusual response. He said the government had implemented a “24-hour ‘one-stop’ service” since 2007, but that it was not necessarily a physical one.
“The ‘one-stop’ services emphasis[es] not only the location of provision of services to victims, but also offers the victims necessary services simultaneously and in a synchronised manner as far as possible,” Lee said, adding: “I must nonetheless stress that the idea of ‘one-stop’ services can be realised through various means as our ultimate aim is to help the victims as far as possible.”
It was an answer that Chan described as disappointing. “We are providing these services every day but at different locations or time points,” he told HKFP. “You cannot say it is one bus stop but the stop is in different districts. That would be a very large stop!”
According to Chan, when asked whether police statement taking could be done in a hospital, the government said that owing to high occupancy rates and the need for a video recorded statement, the emergency department would not be a suitable facility.
In response, the Hospital Authority told HKFP that it has designated rooms in A&E departments to treat sexual violence survivors. “Through the provision of designated rooms in the 18 hospitals, the current arrangements could render timely assistance to victims who require medical care and other support services,” a spokesperson said.
Chan, with the support of RainLily and eight other organisations, moved a motion last December to set up one-stop crisis centres at three public hospitals: in the New Territories, Hong Kong Island and Kowloon.
“In my speech, I pointed out that I can see a multidisciplinary team without teamwork. That’s why the ‘one-stop’ service is a virtual one, not a real one. We need a real team and a real physical one-stop service,” he told HKFP. “If you have a problem, let’s fix it. That’s the point of my motion.”
The “one-stop” model has proven successful in other countries. In Taipei City Hospital’s Renai Branch in Taiwan, the average wait time at their one-stop crisis centre is seven hours – two hours for medical processing and five hours for police processing, according to Dr Chan Chying-chuan, chairperson of the department of obstetrics and gynaecology at the hospital.
“The provision of [a] further accessible, assuring, less lengthy and less traumatising environment for survivors can allow them to be more confident in seeking medical help and judicial justice as early as possible,” the RainLily spokesperson explained. “Through reducing systematic secondary trauma, we believe more survivors will be encouraged to come forward.”
If you have suffered a sexual assault, dial 999 and contact the RainLily hotline on 2375 5322. If you are suffering from domestic violence, regardless of your age or gender, contact the police, Harmony House and/or the Social Welfare Department on 28948896.