It is recommended to manage GBV according to the six R’s

Realising that abuse is happening

  • Look out for subtle (or obvious) cues and red flags
  • Any disclosure of abuse must lead to action as agreed to by the survivor

 

Recognising and acknowledging patient concerns

  • Perform a thorough health assessment
  • Provide information, including options for further care according to individual needs

 

Relevant clinical assessment to be performed

  • Take a thorough history
  • Ensure that vague and non-specific symptoms are not due to other causes
  • Perform a comprehensive physical examination, guided by the survivor’s  presenting complaints
  • Arrange further investigations as indicated by the clinical examination findings

 

Risk assessment to be done

Ask questions such as:

  • Do you fear for your life or safety?
  • Are you being threatened with serious, personal harm?
  • Are any children involved in the abuse?
  • Is the abuse intensifying?
  • Is there a weapon (i.e. any object that can cause harm) involved?
  • Is substance abuse by the partner prevalent?

In instances where the survivor (or children) is at risk of serious harm:

  • Refer them to a shelter urgently, or keep them at the healthcare facility until such referral can be arranged (with the survivor’s consent)

CRisis plan facilitation

Should the survivor choose to leave their partner, or the residence they share, ensure that plans are in place related to:

  • Leaving with children, when the partner is not around
  • The identification of opportunities / venues where a telephone can 
    be used quickly
  • Carrying a list of emergency numbers at all times (preferably separate from a cellphone)
  • Having an ‘emergency fund’ for transport during an emergency
  • Availability of an extra set of keys for the residence and motor vehicle
  • Keeping a packed bag of clothes (for self and children) at another place (e.g. neighbour or friend)Keeping essential documents at hand (e.g. identifications documents, birth- and marriage certificates, medical aid information, savings

Referral for medical-, social-, psychological- or legal assistance

 

Health Education

Use the following steps as a guideline for people who either phone or arrive at your facility after rape.

  1. Go to a safe place.
  2. Tell the first person you trust about what has happened.
  3. Go straight to a hospital or to a doctor to get the medical attention.
  4. Get medical attention within 72 hours (3 days) of any HIV exposure.
  5. You can still receive medical treatment even if you decide not to lay a charge.
  6. Ask for emergency contraception to stop you from getting pregnant.
  7. If you do fall pregnant from the rape you can choose to have an abortion.
  8. Ask for a medical certificate if you need time to recover.
  9. Report the rape to the police.