Rural Hospitals Avoid Sex-Assault Cases, Victims' Advocates Say

All hospitals in Canada have an ethical obligation to provide a “minimum of care” to sexual-assault victims, leading health practitioners say. Nevertheless, it is common for doctors in rural emergency departments to refer these patients to larger urban hospitals, according to health and law enforcement personnel.

Rural doctors and nurses should be able to provide psychological support and treatment to prevent STDs, said Dr. Alan Drummond, public affairs chair of the Canadian Association of Emergency Physicians. He acknowledged, however, that there are logistical concerns about performing forensic examinations.

“If you’re the only doctor in the emergency department and, all of a sudden, you’re taken out of the equation to do a rape kit, that means you’re going to have problems with the ER backlogging with other problems,” Drummond said. “It’s a massive use of resources.”

Sexual-assault kits require a head-to-toe examination to collect and document potential evidence, a process that can last well over an hour. There is also a question of competency: Rural staffers who seldom work with such patients may fear botching the criminal case by poor evidence-gathering, Drummond said. They may also shy away from the resulting justice system-related obligations.

A Mountie in Vanderhoof, British Columbia, estimated his detachment transports sexual-assault survivors to Prince George, an hour away, about eight times a year. A nurse coordinator in Sudbury, Ontario, said her team sees such patients from as far as Timmins, four hours away.

A pilot project is aiming to improve rural sexual-assault services in southern Alberta. Cathy Carter-Snell, the forensic-studies coordinator at Mount Royal University, is surveying police, health and social workers to help develop a web-based training and create real-time phone and video links with specialists.

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