Where can sex-assault victims go?

June 19, 2005

KATE GOLDEN/Frontiersman reporter

MAT-SU - A Valley woman is raped. Unlike the estimated 84 percent of women nationwide in her situation, she reports it.

The dispatcher asks her whether it happened in the last three days and whether she has showered, and thus determines whether she may be still carrying evidence on her body.

She chooses to undergo a forensic exam as invasive as the trauma she just underwent. (Prosecutors will tell her that it will significantly bolster her credibility to jurors who often only have he-said/she-said testimony.)

She chooses, in the presence of a nurse, a victim advocate and a law-enforcement officer, to relive and recount her story in as much detail as possible.

But the six-hour exam by the Sexual Assault Response Team won't happen in the Valley.

Instead, a law-enforcement officer will escort the woman to a suite on the Alaska Regional Hospital campus. The team will be up and running within an hour of receiving the dispatch report.

"At this time we are able to accommodate the demand for SART services," said Mark Butler, a spokesman for the Anchorage Department of Health and Human Services, which oversees the program.

Others, however, said that victims sometimes have to wait many hours.

Rachel Gernat has prosecuted sexual-assault cases for the Palmer district attorney's office. She said that for the prosecution, while it's easier to work with nurses and advocates locally, it doesn't make a huge difference whether the exam is done in the Valley or in Anchorage.

It matters, however, for the victim who is transported to an unfamiliar environment, said John Papasotora, commander of the Alaska Bureau of Investigation.

It matters for law enforcement, he added, not only because of the extra resources they spend making the trip. Anchorage is not an Alaska State Trooper resource space. Troopers or Valley police must channel their subjects through an additional level of bureaucracy. Meanwhile, the evidence deteriorates quickly.

"It's better for the investigators and it's better for the victims if they can do it as close to home as possible," Papasotora said.

SART experts in court

Public defenders question the scope of SART nurses' ability to testify on whether sex was consensual.

But the question in court - especially in alcohol-saturated Alaska - is often whether two people had sex at all.

"This type of testimony can be potentially pretty devastating in a sexual assault case, where it's a 'he-said-she-said' kind of situation," said Dan Lowery, an Anchorage public defender.

Gernat said the exam bolsters the victim's credibility in court.

"No one's going to go through that ordeal of having to have a rape exam if it (the report) is false," she said.

ER versus SART suite

The Department of Public Safety is mandated to pay for forensic exams, but the law doesn't say where the exams have to take place.

"You can just have somebody in the ER take a swab," said Dave Parker, an Anchorage child-abuse investigator and former SART coordinator. "But I'd sure hate to prosecute this case."

It's not only that the emergency room is a busy place where a violated person may be pushed and pulled and made to wait.

A nurse cannot leave the side of a victim until the multi-hour exam is over, lest the evidence be invalidated.

"From a staffing point of view, it's unsustainable," said Valley Hospital spokesperson Elizabeth Ripley.

And there, the victim may have to tell the story three different times: to law enforcement, to the advocate and to the nurse.

The SART suite, in contrast, is a quiet place with snacks, a couch and a very specific set of protocols. There, a woman tells her story only once; that's beneficial to her and to her questioners, each of whom are allowed and need to ask different types of questions.

"It's very good for us to have our investigation start from there," Gernat said.

And there, the victim has time to think about whether to choose to take each next step in the process.

In the exam, she will be examined from head to toe. Her teeth may be flossed for evidence. Special equipment will help nurses identify traumas and microtraumas, DNA samples and other body fluids. Her injuries will be photographed.

If she is bruised, she will have to return the next day.

Nurses also have a responsibility to treat any acute conditions they see, according to Anchorage SART coordinator Angela Morris.

The patient will be screened for HIV and other sexually transmitted diseases, given Plan B emergency contraception and preemptive treatments for chlamydia and gonorrhea. She'll get referrals to any other medical care she needs.

"I tell everyone that it's certainly the most difficult thing that they'll probably ever go through," Morris said.

"It's certainly not fun Š but it starts giving them control back by choosing to get the exam, to assist the investigation. And it might not feel like it at the time. They might just feel swallowed up."

Where are the nurses?

In Anchorage, each exam costs between $1,500 and $1,800 at bare minimum, according to Parker.

Grant funding for Mat-Su area SART exams ended in January, which every concerned agency deplored.

But money isn't the only reason Valley exams stopped, according to members of an informal, multi-agency domestic violence group that began to meet this year to address SART issues together. The group includes people from prosecution, victim advocacy, the hospital and every police department.

"We will continue to provide advocacy services even if we have to do it totally at our cost," said Donn Bennice, CEO of the Palmer-based victim- advocacy agency Alaska Family Resource Center. "The nurses are the big piece."

"It's a hard job," Parker said, what with the emotional drain of countless call-outs.

Right now, there are none trained, and none willing.

Ripley said a sustainable Valley team would need seven or eight people.

But last year at Valley Hospital, Pat Smith, the lone SART-trained nurse at Valley Hospital, did all 32 exams.

Smith, therefore, in addition to her regular job as obstetrics manager, was on call - as a volunteer - 24 hours a day, seven days a week. This year, she finally threw in the towel. She instigated the formation of the domestic violence task force.

She was on vacation last week and could not be reached. But all others in the victim-services web sympathized with her situation.

"If I had to do everything, I sure as heck would be tired of it," Bennice said.

Solutions

Proper care for victims takes a multi-agency cobbling that, according to all sides, has seen a remarkable amount of cooperation. For instance, the Wasilla-area The Children's Place, which has two SART nurses, is taking some older clients than usual.

As for SART and victim-services funding, Papasotora said, politicians need to pony up.

"These are political issues," he said.

Valley Hospital, for its part, donated a space and administrative help and will do so again, Ripley said.

Ripley said she is also currently querying private sources for funding, though she didn't name them.

But she said the SART program may not resurface as the same old phoenix; its structure is a question that's coming up around the state. Ripley is pushing for prevention.

"Just because it's always been done one way doesn't mean it's the best way," she said. "Think of the resources you're putting into 32 people."

Contact Kate Golden at 352-2284.