RAPE

The word rape is derived from Latin rapere meaning to steal, seize or carry away.
Rape is one of the most heinous crimes in the history of the world. Unfortunately, the courts have not properly addressed the problem and for a variety of reasons, little progress has been made in controlling this monstrous crime.
It is estimated that there are about 300,000 rapes and attempted rapes nationwide per year, and that this figure may indeed represent only about 50% of the problem.
Rape is defined as the crime of forcing a female to submit to sexual intercourse.
Sexual assault is a term used to describe manual, oral or genital contact with the genitalia of the victim without the victims consent.
Rape and incest are coital forms of sexual assault.

The primary motive of rape is aggression

Common law rape is defined as unlawful carnal knowledge of a woman not the wife of the perpetrator without her consent.
Statutory rape comprises those crimes of intercourse where the victim is judged incapable of consenting that is where the victim is underage or mentally subnormal. Included in this are women whose consciousness has been altered by illness, sleep, drug or alcohol.
Sexual assault happens to people of all ages, races and socioeconomic groups. But the very young, the very old and those with physical and mental infirmities are particularly susceptible. The typical rapist is a disturbed, compulsive, violent man who becomes sexually excited by the fear of his victims. He is rarely a psychotic.
Rape is usually motivated by a wish to terrorize and humiliate the woman and is really the outcome of a frustrated seduction in the mind of the rapist. It is estimated that up to ten times as many sexual assaults are committed as are reported; hence sexual assault is one of the least reported crimes.
One woman in ten is the victim of an attempted or actual rape during her lifetime in 85% of these assaults the victims is beaten or intimidated with the display of life threatening physical force.
One in four victims are subjected to group rape, and is likely therefore to suffer even more direct physical violence and more extreme humiliation than other rape victims.

Characteristic of Victim and Rapist

The relationship of rapist to victim is: Stranger 43%, recognised person 10%, acquaintances 15%, close neighbour 19%, close friend or boyfriend 6% , family friend 5%, relative 2.5%.

Violence Used: no physical force 15% (but includes threat, display of weapon and intimidation). Roughness 28.5%, beaten before rape 22%, beaten before, during and after 3%, beaten brutally before, during and after 10% and choked 11.5%.

Previous criminal record of rapist: No records before 51%.

Rapist occupations when known includes 50% unskilled labour, student 15%, unemployed 30%.

Sexual aggressiveness in men is often excused by the myth of a spontaneous, uncontrollable sex drive. Most rape is infant premeditated.

Rape Trauma Syndrome

I would outline the rape trauma syndrome under 7 categories.

  1. Acute phase disorganization, which includes shock and disbelief.
  2. Expressed affective impact which includes anxiety, fearfulness, sobbing, shaking and restlessness.
  3. Controlled affective impact which includes: calmness, composure and silence.
  4. Mood swings which include: humiliation, degradation, guilt, shame, embarrassment, self blame, anger, vengefulness and fear of another assault.
  5. Physical and psychological symptoms such as exhaustion sleep disturbances, soreness, bruising, and appetite disturbances.
  6. Thought process problems such as denial, undoing and obsessing.
  7. Long term problems of reorganisation such as reorganisation of life style, mood swings, dreams and nightmares, fears and phobias.

Role of Medical Doctor and the Police

It is important for medical practitioners and the law enforcement agents to remember that rape is a crime. The victims should be treated in a non-judgemental manner. It is unfair to lay blames on the victim and provide excuses for the criminal.
It is also important to remember that sexual intercourse is defined as the slightest degree of penetration of the vulva by the penis. Entry of the HYMEN is not necessary.
If there is a local group organised to aid rape victim, they should be called so that one of their volunteers can come to help the victim.
The history and the examination of the rape victim should be very thorough. It is good practice to have the victim describe the offense by her own words.
This allows her to ventilate. By listening carefully to the victim’s story, she is given a sense that she is safe and being helped.
The history should include a complete description of the perpetrator, the type of sexual contact, the time and place of assault and any witness. The history of the last menstrual period and last voluntary sexual experience. It is important that the physician turns over all the specimen and clothing to an appropriate police officer and gets a signed receipt for medico legal aspects of the case.

Protecting the Victim

In any case of rape, there are 3 problems that the doctor must address:

  • The possibility of venereal disease including HIV infection.
  • The possibility of pregnancy.
  • The immediate and delayed psychological sequence.

The patient should be offered prophylaxis against venereal disease and HIV infection.
The patient should be offered treatment to intercept a pregnancy.
The emotional management of these patients are very important. It is important to supply psychological support over an extended time. There is a change in libido in up to 15% of this patient, and this often has an adverse impact on a victim’s marriage
It is important to refer the victim to a support group.

Rape and the Courts

A rape case boils down to one individual testimony against another. The victim often receives harsher treatment in court than the criminal. The reasons for this are complex; they involve the rules of evidence and their interaction with society’s attitude towards women and sexuality.
Society takes confused attitude towards rape. On one extreme are law that dictate imprisonment for convicted rapists and at the other is the widely held belief that rape is the victims fault.
The Main issue in rape case is to prove that sexual assault occurred and it occurred without the victims consent, that the victim resisted and that the defendant was the rapist. The victim may find her credibility attacked in many ways. Since the defence tactics is to rely largely on the idea that the rape is a woman’s fault, the victim may have her own character and personal life put on trial to such an extent that she begins to doubt or blame herself.

A married victim’s husband may be embarrassed and angry over wife’s wish to pursue the case in court. Many trials end with rape victims, emotional exhausted by their court room ordeal and devastated to see their attackers go scot free.
Rape is a shattering experience for many women. It is not only a sexual assault, but a violent crime maliciously directed against a woman.
Legal and medical professionals working together must recognise the gravity of this crime and treat its victims with all requisite understanding.

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