2023-08-04 09:00:00
The Montreal General Hospital has asked the Ministry of Health and Social Services (MSSS) to review the protocol that forces it to refer Francophone sexual assault victims to another hospital center.
Currently, Francophone victims of sexual assault presenting to the Montreal General Hospital outside office hours or on statutory holidays are redirected to Notre-Dame Hospital. This intervention protocol was established in 1977 with certain Montreal hospitals.
The Montreal General Hospital indicated that it had recently contacted the Center for Sexual Assault Victims of Montreal (CVASM) and the MSSS to ask them to revise several aspects of the protocol, including the reorientation of patients according to their language. “We hope this work will begin soon,” said Gilda Salomone, spokesperson for the McGill University Health Center (MUHC), of which the Montreal General Hospital is a part.
A protocol for supervising victims of sexual assault in the health network was requested in 1975 by the Montreal Urban Community Police Department, the Rape Victim Assistance Center and the Council for the Status of Women. . The protocol finally saw the light of day two years later, in 1977.
Today, this protocol invites victims of sexual assault aged 18 and over to go to the GMF Clinique Medic Elle, located in downtown Montreal, Monday to Friday from 8 a.m. to 5 p.m. Bilingual service is offered. In the evenings, on weekends and on statutory holidays, French-speaking victims are referred to Notre-Dame Hospital and English-speaking victims to the Montreal General Hospital. Minors have access to two other designated centres.
A French-speaking victim refused
Despite this protocol, the Montreal General Hospital says it does not refuse to treat victims who prefer to stay in their establishment. However, a recent article by The Press reported a case where a French-speaking victim was refused by the hospital, leading to his redirection to other establishments.
« [Au] first hospital, I was told that they could not give me service in my mother tongue, ”the victim testified in September 2022 during a trial. A story confirmed by the police officer of the Service de police de la Ville de Montréal (SPVM) who took charge of her that night.
“We’re headed to the Montreal General [l’Hôpital général de Montréal]. Unfortunately, since the lady speaks in French, Montreal General decides to refuse us and decides to redirect us to the CHUM where, subsequently, we are told that they do not have a kit and directs us to [l’hôpital] Notre-Dame,” said agent Marc-André Lacroix.
After the publication of several media reports, the Office québécois de la langue française opened an investigation into the availability of services in French at the Montreal General Hospital.
Following the controversy, the hospital posted a note next to nurses’ workstations in the ER triage reminding them of the importance of explaining to French-speaking patients that referral to Notre-Dame Hospital is suggested. according to protocol, but is not mandatory. The hospital, however, acknowledged that this note could be misinterpreted by patients and has since removed it.
Simplify procedures
Me Sophie Gagnon, executive director of Juripop, believes that the current protocol can hinder access to justice for victims.
PHOTO MARTIN CHAMBERLAND, ARCHIVES LA PRESSE
Me Sophie Gagnon, General Manager of Juripop
It is possible that a person has used all his mental, material and temporal resources to come to a hospital and that the need to move to another hospital could defeat his efforts. This is a situation that must be avoided at all costs.
Me Sophie Gagnon, General Manager of Juripop
Me Gagnon points out that for a medico-legal kit to be effective following a sexual assault, it must be produced within five days. “Not all victims are able to present themselves to a hospital within five days of the traumatic event. This is even more true for people who have one or more precarious jobs and who have difficulty asking for leave, ”she illustrates.
She therefore underlines the importance of the resources on the ground collaborating to simplify the path for the victims. “It is in this perspective that the protocol should be reviewed,” she judges.
With the collaboration of Louis-Samuel Perron, The Press
An arduous path to the forensic kit
PHOTO ALAIN ROBERGE, LA PRESSE ARCHIVES
The forensic kit, which allows, among other things, to take DNA samples from the victim of sexual assault that will serve as evidence, can only be used within five days of the assault.
Using the forensic treatment kit for victims of sexual assault can be fraught with pitfalls, as illustrated by the recent case of a woman who was turned away from the Montreal General Hospital because she spoke French. , a situation made public after a criminal trial.
The accompaniment
Designated centers are the only hospitals that have the equipment and trained staff to collect physical evidence of sexual assault.
The support offered there by the various stakeholders can play a crucial role, not only for the well-being of the victim, but also for the outcome of the investigation. Victim of an assault in the summer of 2020, a young woman, Maude (fictitious first name), testified to The Press the potentially difficult journey to the forensic kit.
In the hours following the assault, Maude was taken by two police officers to the designated center closest to her home, at the Saint-Jérôme hospital, in order to undergo a forensic examination. It was with the accompaniment that things went wrong.
“When I arrived there, I was completely traumatized and I had difficulty understanding what had just happened to me,” confides the young woman.
She says she waited nearly ten hours, alone, before being examined, for lack of trained personnel. She remembers that the policewomen who accompanied her left her alone shortly after she arrived at the hospital.
The day after her attack, the medical-social team of the hospital – a doctor, a nurse and a worker – met Maude.
The doctor proceeded with the examination without really explaining the steps of the kit to me. Luckily the worker stayed with me afterwards to reassure me and explain to me what had just happened and guide me to the organizations that could help me.
Maude (fictitious first name)
The lack of support can harm the construction of the proof, reminds Maude. “I was not guided on what to do, and what was best that I avoid doing. While waiting to be seen by the medical-social team, Maude washed her body with soap. “I was alone and overwhelmed by events. I didn’t realize that I was erasing the evidence that would be useful to me. »
Qualified staff
The use of forensic kits requires specific training. “Teams must know all the measures to avoid altering the evidence and avoiding contamination,” said Marie-Claude Lacasse, spokesperson for the Ministry of Health and Social Services (MSSS).
In some regions, few health professionals are trained in this regard. In particular, the Capitale-Nationale has only 5 doctors, 3 nurse practitioners and 20 qualified nurses for a population of 800,000 people.
If Maude had to wait 10 hours in the emergency room before receiving the medico-legal kit, it is because there were not all the members qualified to do her examination when she arrived at the designated centre.
According to Justine Chénier, of the organization RQCALACS, this scenario is not uncommon. “What we observe is that the hospitals lack a lot of staff to carry out the examinations resulting from the medico-legal kit. »
The weather
After a sexual assault, every day counts. The forensic kit, which allows among other things to take DNA samples from the victim that will serve as evidence, can only be used within five days of the attack.
Before using the forensic kit, the victim should avoid washing, drinking, eating and urinating, to preserve as much evidence as possible.
However, according to the Regroupement québécois des Centers d’aide et de Lutte contre les Agresses sxueles (RQCALACS), the proportion of victims who request an intervention within five days is low.
Most victims come to consult, obtain services or even disclose the sexual assault several months or even several years after the assault took place.
Justine Chénier, RQCALACS spokesperson
After this time, a victim can go to the designated center for a medico-social kit, up to six months after the attack. This intervention is not intended to collect physical evidence, but to document the facts surrounding the sexual assault.
The distance
A victim of sexual assault must go to one of the designated centers in their region, often located in hospital emergency rooms, CLSCs and dispensaries.
However, not every region is equal when it comes to access to designated centers.
For example, in Montérégie, six designated centers serve 1.5 million inhabitants. In Estrie, there are only two designated centers for nearly 500,000 inhabitants. Thus, a person who has experienced a sexual assault in Lac-Mégantic must drive more than an hour to get to the nearest designated center, the CHUS – Fleurimont hospital, but a resident of Longueuil will only have to drive about twenty. minutes to get to the Charles-Le Moyne hospital.
According to Justine Chénier, it is necessary to “allow other hospitals, CLSCs and sexual health resources to perform forensic examinations” to increase access to these services.
The Office of the Minister of Health acknowledged by email the variety of needs of each territory. “One thing is certain, if improvements are needed in certain areas, we will put them in place,” he added in response to our questions.
The statute
Some groups do not have access to the same treatment after a sexual assault.
First, the medico-legal kit is only accessible free of charge to people registered with the RAMQ. This criterion immediately excludes people who do not have status, such as temporary workers or foreign students, underlines Justine Chénier.
Another issue: the language. “Not all survivors speak English or French,” observes Justine Chénier. In an already complex health system, the language barrier is an additional obstacle for allophone people seeking treatment, “hence the importance of offering a translation service in designated centres,” explains the spokesperson. of the RQCALACS.
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