Rape victims search for justice and dignity

Israel has only three examination and treatment centers for sexual abuse victims; the third, in Jerusalem, held a symposium on the grim subject.

Rape victim (photo credit: Judy Siegel-Itzkovich)
Rape victim
(photo credit: Judy Siegel-Itzkovich)
In the bad old days, an adult or child who had complained of having been raped or otherwise sexually abused was sent by taxi for examination at the L.
Greenberg Institute of Forensic Medicine at Abu Kabir in southern Tel Aviv – where the bodies of people who suffered an unnatural death are autopsied.
Then, a decade ago, the first interdisciplinary center for the acute treatment of sexual abuse was established at Holon’s Wolfson Medical Center, followed by another at Bnai Zion Medical Center in Haifa. In May 2009, with help from the Health Ministry, Jerusalem Municipality and private donations, Hadassah University Medical Center in Jerusalem’s Ein Kerem opened its Bat-Ami Center for the Treatment of Sexual Abuse.
Since then, it has cared for 400 people between the ages of two years and four months and 75 years during the critical first 72 hours after the attack, when specimens can be taken and victims can be given drugs to minimize the risk of pregnancy and infectious diseases such as HIV and hepatitis B and C.
But in all of the Negev, there is still no such center, forcing those who report suffering sexual abuse to be taxied to Wolfson (and usually to take the long bus trip home). As surveys have shown that one in every four women has suffered sexual abuse sometime in her lifetime – but only one in 10 actually files a police complaint – there is room for more such centers and information campaigns to encourage victims not to keep it to themselves.
Bat-Ami, headed by Hadassah gynecologist Dr. Sagit Arbel-Alon, is open round the clock and gets the assistance of dozens of doctors, nurses and social workers. To mark its successful first year, the hospital earlier this month held a symposium on treatment of sexual abuse; it was in memory of Hagar Barel, a Hadassah midwife who was one of initiators of the center and previously helped rape victims on a volunteer basis; she died of cancer at 57. The event was attended by Arbel’s mother, Supreme Court Justice Edna Arbel, and by Court President Dorit Beinisch, along with more than 100 medical professionals, social workers and others.
Beinisch recalled that when she was a young lawyer, rape victims were usually put on the defensive and regarded as having “invited” the attack. “Israel was very macho in those days. There was no support for those who complained,” she said.
“The common view then was that if a woman had been attacked sexually, she probably asked for it. That was the common idea then. If not, they reasoned, why doesn’t it happen to everybody?” It’s hard to understand today, she said, “how there was no ability then to handle sex criminals, no support for complainants and no one to promote treatment. There was a total lack of understanding of the victim. In the past, a rape victim had to prove that she physically opposed the rapist to show there was no consent. But today, it has been realized that victims can be so frightened and dependent on the attacker, whom they usually know personally, that they cannot fight back by screaming, scratching or biting.” Only in a minority of rape cases is the crime committed by a stranger in a dark orchard at night, said Beinisch; in seven out of 10 crimes, the victim knows the attacker.
“But in recent years, there has been a social revolution,” she said. “The laws, such as the 1992 Basic Law: Human Dignity and Liberty, have been legislated not only to protect the victim’s body and life but also his or her dignity. Fortunately, there is a different atmosphere today.”
All these changes came about as a a result of the social lobby, she said. “They didn't come from the top but from the field.
Hadassah has taken upon itself heavy responsibility by running such a center, whose responsibility cannot be exaggerated.”
Now that laws protecting human dignity have been passed, she continued, the younger generation of professionals takes the new attitude for granted. Yet the fight for victims is not yet complete, she asserted.
“Society lived in denial.”
While rape victims should not have to be examined and treated in an institute for forensic medicine, rape – it is said – can sometimes be “worse than death,” said Anat Gur, a Bat-Ami social worker who provides patients with emotional treatment after their fresh trauma. “I have been in the field for almost 30 years, but even after thousands of cases, I am still surprised by the seriousness of the damage that rapes cause. Some say that rape is like murder; it might sound exaggerated and a cliche, but if you meet victims and see how much harm it causes them over the years, you can’t deny it. A fifth of women who were raped attempt suicide sometime in their lives, and others constantly want to die. They say they hope that when they cross the road, a bus will run them over. It is very common to hear this.”
Gur agrees with American feminist journalist Susan Brownmiller who investigated rape and argued that the motivation for rape is not really sexual release but to degrade the victim. “It is not a crime of uncontrollable desires but meant to cause fear and degradation, to dehumanize the victim. Prostitution gives men access to the bodies of women and young girls. It is institutionalized pedophilia.”
She noted that rapists are most often “normative people.” In the case of women victims, the rapist is often in the family or at work. Those who rape men and boys are more often known to the victim but not family members or colleagues.
Gur, who researched and wrote a book on rape, also interviewed women prostitutes.
“They told me that ‘men came not for sex but to degrade us. They did so even before they touched us.’ Although they had survived violence, sadism and even torture, the most traumatic thing they had to overcome was the degradation, the loss of humanity, the abuse of their power. The rapist too wants to control another person.
One feels like a prisoner of war.”
Studies have shown that rape is more traumatic than natural catastrophes like earthquakes and fires or like road accidents, and these were not intentional, said Gur, who added that numerous cases of anorexia and various dissociative disorders occur in women who have been raped.
For too long, the community “has supported the rapist more than the victim.
Those who survived other traumas usually get more recognition and sympathy than those who who have been raped. Sometimes they are denigrated, laughed at,” she noted. “There still is stigma. The trauma of people standing by and doing nothing is bad, like the rape itself.”
Tamar Siegel, a young emergency room nurse who for the last year has been chief nurse at Bat-Ami, noted that 72 percent of the victims of sexual abuse who came in were women and 79% over the age of 12.
Most were Jewish and the minority Arabs.
It is not true that rape victims are mostly poor. “Only a third of the victims come from a low socioeconomic background or were disabled,” she said. In only 30% of the cases was the attacker a stranger to the victim. When the victim is dependent financially or socially on the rapist, the victim is less likely to file a complaint. Children may not realize that rape, especially within the family, is a serious crime.
As most of the victims come to the hospital center – which is located in a suite of rooms in a quiet corridor – come in at night and on weekends, their hours are not normal.
Bat-Ami receives an average of 16 cases, including one male, a month. The average age of adults is 27 and of children 11, said Siegel.
When the victim arrives within 72 hours of the rape, she is given the “morning-after pill” to prevent pregnancy and medications to prevent sexually transmitted infections.
Samples are taken to be tested for DNA, and the police test items and semen samples to identify the rapist. The Bat-Ami team protects the identity of the victims from being exposed unnecessarily before their health fund, which is asked to pay the high cost of the medications. The victim, who is counselled, also usually decides there whether to file a complaint with the police.
Social worker Dorit Greenspan added that all the examination, treatment and counselling is provided in one pleasant room by a trained team. A shower is also available, as are clean underclothes. The whole process takes five or six hours. If a minor or helpless adult is involved, a government social worker is called in. A major aim, said Greenspan, is “to help them feel they can regain control over their body and life.”
But this is difficult, she continued, “as we must ask many questions – often intimate – and touch her and perform invasive tests.
Some may feel threatened, as if this were like a rape itself. We encourage filing a police complaint, but don’t force the victim, as it could have a price. She might feel threatened or disappointed that she won’t quickly get her control back. There is a dialogue between doing what we have to and helping to restore her autonomy.”
DNA samples are taken from the victim, and samples are taken of the suspected rapist. Except for identical twins, there is no doubt about the identity when samples are properly taken and tested, said Dr. Ron Gafni, head of the DNA labs at the Criminal Investigation Department of Israel Police. “DNA doesn’t change during one’s lifetime, and it’s in all the bodily tissues. It can be stored even for 15 years and can be multiplied in the lab. One can take saliva, for example, to identify semen samples.
DNA can also be obtained from teeth, hairs with roots and bones. DNA tests can also rule out suspects who are innocent.”
He recalled that only family tried to switch DNA samples to implicate a mentally disabled son who would not be jailed – instead of his brother, who actually did it.
Special training is needed to examine child victims of sexual abuse, said Dr. Yoram Ben-Yehuda, head of the pediatric emergency department at the hospital. “One needs a team to prepare kids for examinations, one for those younger than 12 and another for those after puberty. A nurse must always be present. And it’s very important that the examination is not performed before the oral investigation unless there is danger to life or health and urgent medical intervention is needed.” Sometimes the victim is too young to speak. Sedation is used only when absolutely necessary.
Since Bat-Ami opened, 40 boys and girls with an average age of seven or eight were examined and treated after sexual abuse.
One was a 19-year-old autistic girl suffering from retardation, said Ben-Yehuda. Most of the children were brought in by a parent, and the rest by police or a family doctor.
Some are bleeding, cannot control their urination or defecation or suffer from pain.
Ben-Yehuda could hardly hold back tears when he described some of the worst cases of abuse. “I remember a beautiful 10-year-old girl who had been abandoned by her parents in a basket at a train station in Ukraine. She lived in an orphanage until the age of four and then was adopted and brought to Israel.
But two years later, she was abandoned again and suffered physical and maybe sexual abuse and shown pornographic films. Since then she has lived in a boarding school.
Sometimes the emotional burden on us, the medical staff, is insufferable, and we have nobody outside to share it with.”
But there is help for rape victims weeks, months and even years after the attack on them in the form of the Tamar Center or long term care, headed by Avigayil Frenkel.
MK Rachel Adatto, a gynecologist (and lawyer) by training who attended part of the symposium, said Bat-Ami was doing “holy work. Punishment for rapists should be more severe, and Bat-Ami must serve as a model for other rape treatment centers. It was unthinkable that victims in the whole Negev should have to travel to Holon to be examined.”