SEMO-NASV considers medical exam of sexual abuse victims to be best practice

Every child has a story to tell, and if there's a possibility they're being sexually abused, the Southeast Missouri Network Against Sexual Violence in Cape Girardeau believes it to be a best practice to conduct a head-to-toe medical exam.

In one case, a brief exam and a urine sample taken from a teenager by a NASV nurse revealed to forensic interviewers a story the 14-year-old wasn't otherwise willing to tell.

She became pregnant, executive director Tammy Gwaltney said, by her grandfather who had been molesting her. The teen wasn't talking about the incident to a counselor, Gwaltney said and, so, without the exam NASV would have never been able to help her or have grounds to prosecute the family member.

"How are we going to know? They can't tell us with their words," she said. "It is the expertise of the medical examiner that is then getting a story from that child's body."

Since 2009, the facility, which has kept on-site forensic and medical examiners since opening 14 years ago, has performed nearly 1,500 exams, collecting evidence from adults or children reporting sexual assault of any kind.

The figure was compiled by the Sexual Assault Forensic Examination (SAFE) Program, which with state funding reimburses agencies like SEMO-NASV for forensic evaluations. The Cape Girardeau facility represented more than 20 percent of the statewide total, according to SAFE data, and was the only facility in Missouri to be reimbursed more than $1 million from the program.

Missouri lawmakers are reviewing what the reimbursement is paying for and whether there shouldn't be a more standard fee to state facilities.

With or without the state reimbursements, Gwaltney said the facility won't stop what she says is the right thing to do for victims and what years ago medical experts and authorities in the field called a "best practice."

"We're proud of the fact that before someone deemed this a best practice it was something we were already doing," she said. "Early on there was no form of reimbursement; it was never about that for us."

The number of evaluations conducted doesn't necessarily mean there has been an "explosion" of sexual violence in Southeast Missouri, Gwaltney said. The network, unique in that it has certified medical examiners on staff 24 hours a day every day of year, will always have numbers different from other facilities. Kathy Blevins, who helped start the agency in 1997, is one of only a handful of internationally certified nurse examiners in the world, according to Gwaltney.

"The thing that differentiates us is that we have committed to providing medical forensics for everybody that comes through here. Always have, always will," Gwaltney said. "The right thing to do for the victim is to offer them the reassurance that they're OK and if there are medical needs or injuries that those are accurately documented and appropriately treated."

Law enforcement, including prosecuting attorneys in NASV's 10-county coverage area, are supporters of the network's model of offering an exam to victims, whether the alleged instance of sexual abuse is current or happened in the past.

Child sexual abuse cases are the most difficult to prosecute, according to Steven Sokoloff, Dunklin County prosecuting attorney, and having the results of a medical examination is an important piece to moving a case forward.

"Victims are frequently not very articulate and you have jurors that basically, they don't want to believe someone does something like this," he said. "As a prosecutor you have to represent an air tight case in order to be able to convict somebody."

ehevern@semissourian.com

388-3635

Pertinent address:

69 Doctor's Park, Cape Girardeau, MO