On Saturday and Monday, The Daily Nation, a leading national newspaper in Kenya, ran a two-page spread highlighting one of the majors hurdles we face when fighting for justice for girls who are victims of sexual assault – the P3 form.

(A few quick facts:  The P3 form is a police document that, according to standard practice, must be filled out in order for investigation and prosecution to proceed in cases of criminal assault, sexual or otherwise.  There is currently one police surgeon who will fill out this form for assault victims for the whole city of Nairobi – that’s one doctor for more than four million people.)

In the past, victims of violence had to go through the painful process of filing P3 forms, but they had no guarantee that this would speed up their quest for justice, especially for sexual assault.

This could change with the entry of the PRC1 form, whose revised version was rolled out on April 22 by Public Health and Medical Services ministries during the launch of the National Reproductive Health Strategy 2009-2015. Gender violence analysts consider Form PRC1 as just what the doctor ordered for victims of sexual violence.

Ms Christine Nkonge, a legal officer with the International Justice Mission says, the beauty of the PRC1 form is that any qualified nurse, clinical officer or doctor can fill it and use it as evidence in court. Curiously, on the day the revised Form PRC1 was being unveiled, Dr Kamau was not sure it would replace the P3 form.

He described it as “a Ministry of Health document”, which he had “never dealt with”. Ironically, officials linked to Kenyatta National Hospital’s Gender Violence Recovery Centre (KNH-GVRC) thought Form PRC1 was already helping Dr Kamau, who was supposed to attach it to the less detailed P3 form.

In is understandable why Dr Kamau, who examines 100 to 120 violence victims a day, would find it daunting to correlate the PRC1 to the P3. In an interview with Dr Gathari Ndirangu, a gynaecologist and obstetrician, who is also a reproductive health and technical advisor to KNH’s GVRC, he extolled the virtues of the new form.

The centre documented 111 cases between January and March, 61 being women. Girls numbered 30, while the rest of the victims, about 20 per cent, were men and boys. Dr Ndirangu stressed the holistic and comprehensive nature of Form PRC1, unlike the P3, which compresses the victim’s details on one-third of an A4 page.

The P3 only catches “the physical state of and any injuries to the genitalia with special reference to labia majora, labia minora, vagina, cervix” and also notes “presence of discharge, blood or venereal infection, from genitalia or on body externally”. However, Form PRC1 is designed with the best interests of the victim in mind.  (More…)

Dr Ketra Muhombe of the Nairobi Women’s Hospital believes it will be a long time before women who have been raped are assured of speedy justice.

Successful prosecution of rape cases requires clinical evidence, which is often elusive in adult women. By the time they are examined by the police doctor, who is supposed to confirm reports from registered medical practitioners, any soft tissue injuries they may have sustained in the attack will have healed.

The prosecution has to rely on incidental and corroborative evidence — “because if you go by clinical evidence, the case is thrown out,” Dr Muhombe says.

According to the doctor, whose hospital was the first to set up a gender violence recovery centre that has since been replicated by a busier one at Kenyatta National Hospital, the best way is to do a DNA test where the rapist is known and samples can be taken for analysis.

Overworked doctor

‘Circumstantial evidence’ tends to be unfair to women, “because it is the victim’s against the perpetrator’s word,” she says.

Given the situation in Nairobi, where rape victims have to rely on one overworked police doctor, Dr Muhombe says: “Sometimes our medical report gives different evidence from the P3; I wonder if the police doctor really examines these people properly. The only time our reports seem to coincide is when it is a child who has had bad tears sewn up. There is no way the doctor can avoid seeing that.” (More…)