Best interests of the child survivorThe best interests of the child survivor are always a priority and each case must be dealt with on its own merits. the future treatment and rehabilitation of the child will depend on how the trauma is treated at the time of crisis.Relationship between professionalsThe health care practitioner is part of the multidisciplinary team, including medical, police and justice personnel. It is essential that a close working relationship and liaison is maintained at all times between the professionals and the community.No one may be turned awayA child survivor must not be turned sway or referred to another health care institution.All child survivors of abuse, whether male or female. must be medically examined. Consent for minorsInformed consent (for examination, treatment, collection of specimens for medical and forensic purposes, disclosure of medical information and the HIV test) must be obtained from the parent/legal guardian on the prescribed form or recorded in the patient record.Any patient over the age of 14 years can consent to the medical examination. Interviewing the child survivorA social worker or the sister in charge must interview the child survivor and accompanying parent/legal guardian with sensitivity in a private room a the health care facility , It is not necessary for a Police Officer to be present at the medical examination of the child survivor.Medical AssessmentIf the child has sustained serious physical injuries, these must be assessed and treated a the nearest Casualty/Trauma unit. The Casualty Officer may there-after refer the patient to the CCC or admit the patient.Under NO circumstances must an injured victim be referred back to the referring institution for the forensic assessment. Timing of the Medico-Legal ExaminationThe medico-legal examination must be done after the medical assessment has been completed and ideally within two hours of the patient presenting at the institution, especially if the patient was sexually abused. |
Second OpinionWhen the examining health care practitioner is unsure of the medical finding, a second opinion may be sought from another health care practitioner or paediatrician.It is the responsibility of the doctor who first examined the child to complete the J88, after consulting with the second doctor/specialist. Consider admitting the child survivor to the ward in order to
Making a statement to the PoliceIt must be established whether the matter was reported to, and a statement taken by, the Police. If not, the social worker or sister must make the necessary arrangements with the Police to come to the health care facility to take the statementRecord keeping and notification of abuseThe report must be comprehensive and all the information must be recorded in the patient's file immediately.The results of the forensic examination must be recorded on the prescribed form (J88). The original J88 form must be handed to the Police and a copy/photocopy of the J88 retained in the patient's file. The health care practitioner is required in terms of the Child Care Act 1983 to notify all child abuse cases to the relevant regional welfare authority. The clinic or hospital is responsible for ensuring that the notification reaches the relevant authority. Post Trauma Counselling and SupportThe child survivor should be referred for trauma counselling and support of if necessary to a psychologist or psychiatristMedical Management and Follow-upThe health care practitioner must routinely take ano-genital swab(s), urine and blood samples. The health care practitioner must prescribe medication for the prevention of STD's and pregnancy.Follow-upAll cases require follow up within 48 hours, but the giving of further medication is dependent on the circumstances of each case and must be assessed accordingly.In the majority of cases follow up investigation are at 3 and 6 month intervals, and my include:
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