After she drove home, her boyfriend took her to the Rape Treatment Center's Verna Harrah Clinic, which had just opened in a new space at Santa Monica-UCLA Medical Center, where nurse practitioners had taken over the task from ER staff of examining patients.
Anna met immediately with a female psychologist, who "sat with me and talked to me, getting the facts and also [asking], 'How did it feel?' " Anna recalled. The clinic, she said, "was like being in someone's living room. There was a couch, a lamp, there were no fluorescent lights, there was no one screaming. I felt I had entered a safe place. I was surrounded by extremely compassionate women. A lot of my questions got answered quickly. At every step of the way, I was given options."
Within a week, she began individual counseling, which gave her a chance "to weep and be insecure. I needed to have a place where I could go and get messy."
What a difference between her experience and that of a friend raped in college, who "drove herself to the ER of a hospital and waited four hours. When she was dealt with, she was treated like another medical emergency."
Anna was lucky to go to a center that provided comprehensive services at no charge. But until the 1994 Violence Against Women Act, victims like her often had to pay for their own rape exams, which can cost as much as $700, Flowers said.
Under federal and most state laws, a victim isn't charged for a forensic medical exam if she reports the crime. She may be charged for treatment of injuries and prevention of sexually transmitted diseases and pregnancy. The laws can deter poor women who fear retaliation or being stigmatized, said Dean Kilpatrick, director of the National Crime Victims Research and Treatment Center at the Medical University of South Carolina in Charleston.
Both the 1994 law and the Victims of Crime Act provide money to help pay for exams. However, Aileen Adams, formerly director of the Justice Department's Office of Victims of Crime, bemoaned federal legislation that this year capped VOCA funds to victim programs. "Because of the cap, California lost millions of dollars," said Adams, now secretary of the State and Consumer Services Agency in Sacramento.
However, she said, the state's victim compensation program limits rose on Jan. 1 from $46,000 to $70,000, which can help victims of reported crimes obtain counseling and medical care. "It's still hard to get the kind of comprehensive care the Rape Treatment Center provides," said Adams, "but we're light-years ahead of where we were a decade ago."
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Health Risks
* Physical injuries, including cuts, abrasions, bruises, trauma to the genital areas.
* Sexually transmitted diseases, including chlamydia, gonorrhea, herpes simplex virus, syphilis, hepatitis B and HIV.
* Unwanted pregnancy.
* Psychological trauma, including shock, feeling of numbness and symptoms of acute stress disorder such as detachment, flashbacks, nightmares, avoiding reminders of the trauma, irritability, problems concentrating.
* Long-term medical problems, including stress, anxiety, tension headaches, stomachaches, nausea, back pain, allergies, skin disorders, chronic pain, menstrual and other gynecological complaints.
* Long-term emotional problems, including depression, sexual problems, social withdrawal, suicidal feelings, diminished self-confidence and loss of self-esteem; post-traumatic stress disorder symptoms such as flashbacks, sleep disturbances, difficulty concentrating.
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What to Do if You Are Raped
1. Go to a safe place.
2. If you want to report the crime, immediately notify the police, who will help you get a medical forensic examination to collect evidence. A friend, family member or rape crisis center worker may accompany you during a police interview. Reporting the crime can help you regain a sense of control and ensure the safety of other potential victims. It is never too late to make a police report.
3. Ask a friend, family member or someone else you trust to stay with you.
4. Preserve all physical evidence of the assault. Do not shower, bathe, douche or brush your teeth. Do not eat or drink anything. Save the clothing you were wearing at the time of the assault, placing each item in a paper--not plastic--bag. Do not disturb anything where the assault occurred.
5. Seek medical care at a hospital emergency department or a specialized rape treatment clinic. Local rape crisis centers or police departments can refer you to providers with sexual assault expertise. Even if you have no apparent physical trauma or are unsure about reporting the crime, you should have a medical examination. You may have internal or other injuries.
