Access to emergency medical care by sexual violence survivors through the police systems in Kampala district

Abstract

In Uganda and anywhere else, the police can be a trigger or propeller of ill or good health depending on how Sexual Violence victims are handled. Despite police efforts, violence against women and men still remains pervasive, critical and deeply entrenched in the communities and this could be the reason defining the high prevalence of HIV/ AIDS, unwanted pregnancies, unsafe abortions and high school dropouts, now infertility and colossal expenditures by government in management of unsafe abortions and the like. The study was meant to assess the organization, management and access to emergency medical care services for sexual violence survivors through the police system. This was mainly due to the fact that without urgent redress, sexual violence would not only render the fight against the HIV/AIDS scourge unsuccessful but as well render the future generation unproductive due to ill-health, morbidity and mortality of our population. The study utilized a cross-sectional, descriptive study design in which questionnaires and interviews were administered to 279 police officers, five police surgeons, five police clinics and five survivors,. The Fishers test alongside odds ratio was used to establish most vulnerable gender of sexual violence. The study found out that only four division stations had distinct Sexual Gender Based Violence section within the police station of the Uganda police system where victims are received by the police officers for attention and the police officers have knowledge about what is meant by sexual violence with most officers viewing sexual violence as forced sex. The study found that with a P-Value of 0.000, sexual violence significantly varied between men and females with females 7.2786 times more at risk of sexual violence than the men. Sexual violence is more prevalent amongst women with a prevalence of 88.8% as compared to that amongst the males of 12.2%. However, survivors never had access to emergency medical care from private police surgeons to whom they are sent even after paying the money for examining them and filling the police form 3 that affirms abuse of the survivors but from government health facilities they are referred to and no private police surgeon had post exposure prophylaxis in their clinics. The antibiotics and emergence contraceptives and any other care were to be paid for if they were to be issued. The study found out that all the four police division clinic had no post exposure prophylaxis, emergence contraceptives nor the recommended antibiotic prophylaxis despite having the qualified staff and they had never attended to any survivor and there was no record at all in that line. The study recommends that Uganda police directs efforts towards improvement and maintenance of sexual violence through customized approaches of handling sexual violence and there should be routine training of all police officers on matters of sexual violence that are gender inclusive for effective and efficient survivor management criteria. The study recommends that all private police surgeons should be mandated to issue free emergency medical care to these victims and all police clinics should be upgraded to handle these cases given the health workforce available and also train all the police health workforce in emergency medical care of survivors in thorough equipment of them with knowledge and practice for this tragedy and as well equip the clinics with required apparatus in line with survivor management. It also recommends the need for a clear definition of the referral path way to the police officers and the entire Ugandan community for better health of survivors.