‘You can’t prepare yourself’: What exactly is a ‘rape kit’?

‘You can’t prepare yourself’: What exactly is a ‘rape kit’?

Emily Parsons, 24, survived every woman’s nightmare. Credit:Paul Jeffers

Emily Parsons was 17 when she sat in a high school seminar and learnt about sexual assault for the first time. Two weeks later, she found herself sitting in a Melbourne hospital examination room, having every inch of her aching body carefully inspected. She’d become the victim of the very crime she’d only just been taught to define.

Emily’s experience is the one every woman fears as they race home late at night. It was March 2012 and she was walking back to her father’s house on the Mornington Peninsula.

As she turned left onto her street, not 10 metres from home, she was grabbed from behind by a masked stranger. A knife flashed before her eyes.

“All he said to me was ‘don’t scream’.”

Emily was dragged in the direction away from her home, to a garden area of the high school directly behind the house. She remembers the touch of the dirt on her skin. She remembers feeling like the violence went for hours, not minutes. She remembers gazing helplessly at her home where her family was sleeping soundly inside. And she remembers fearing, the entire time, her life was about to end.

“I was frozen with fear … My main thought was ‘I need to get away from this alive’.”

After the attack, the man fled. She sprinted home.

Her dad woke up and immediately called the police.

After telling officers what happened, they bagged up her clothes and took her to Monash Hospital for a forensic medical examination kit.

It was Emily’s decision to go through with it. But she had no idea what to expect.

“I knew nothing about forensic exams, I had no idea what was coming … until I got there and went through it.”

What is a forensic exam?

You probably know of it as a “rape kit”. But these two words can incite a sense of unease and alarm – and they don’t accurately describe what is involved.

A sexual assault forensic medical exam is a procedure victims go through in the days after an attack to preserve possible evidence left on their bodies, including DNA, and to receive important medical attention. The idea is to verify the type of sexual assault that’s occurred, support a victim’s story, and help identify the culprit. And you’ll never hear the experts call this painstaking, sensitive process a “rape kit” – instead, it’s a forensic medical examination kit or sexual assault investigation kit.

What needs to happen before a forensic exam?

There are two pathways for sexual assault victims to have a forensic examination. One option is to undergo a “just in case” exam to avoid rushing into making a police statement before they feel ready. It’s available in all states except Queensland. Evidence is stored for several months while a person considers whether to pursue a case with the police.

But the vastly more common way is following a police report. When a victim chooses to make a police statement, a discussion follows about whether a forensic exam is appropriate. Timing is one of the key factors. Most exams need to be done within roughly five days of the incident, but this varies depending on the type of assault.

Detective Sergeant Leemara Fairgrieve, who works in Victoria Police’s Sexual Offences and Child Abuse Investigation Team, says the first step when speaking to a victim is to establish exactly what happened and when.

They would also work out if any evidence has potentially been lost since the incident, for example through showering, eating, going to the toilet, or washing clothes.

A forensic physician will then determine whether an examination would be beneficial.

If it's recommended, Detective Sergeant Fairgrieve says investigators explain the process and gently encourage, but never pressure, a victim to go through with it. Handing the victim the power to choose is crucial.

“We explain the benefit of it and we explain it’s an avenue for gathering evidence. But we also explain it’s not what we would solely rely on if they’re not willing to do it, so they don’t feel bad or think we won’t proceed if they say no,” she says.

Once a victim agrees to an examination, a location is decided on. In the capital cities, there are a multitude of spots with forensic examination rooms. Most across Australia will be in hospitals.

For those who live regionally, accessibility can be a problem as there is a shortage of medical practitioners trained to collect forensic evidence in some rural areas. It can involve an hours-long drive to reach a location.

What is a forensic examination kit?

There is, in fact, a kit. And inside it is everything a doctor might need to conduct a sexual assault forensic examination.

The Victorian kit is in a cardboard package a little larger than a shoebox. It’s labelled with a digital tracking number, packed in a sealed plastic bag, and everything inside is single-use and completely forensically clean – meaning it is all free of DNA to avoid any contamination. They don’t cost the victims anything.

The below graphic shows some of the contents of the kit. There are only slight variations between states.

Additional items in a kit that aren’t pictured include:
– Hospital gown
– Surgical mask
– Sterile water (for skin swabs)
– Drop sheet and couch protector (to catch evidence that falls off while undressing)
– Alcohol-free wipes
– Pen and pencil
– Sample labels

There’s a separate kit for toxicology (alcohol and drug testing) where needed.

What happens in a forensic exam?

Dr Maaike Moller is one of about 50 practitioners with the Victorian Institute of Forensic Medicine who conduct forensic exams across the state. She doesn’t take her role lightly. She knows full well the magnitude of a sexual assault victim making the decision to undergo an extensive examination of their body within days of an attack.

This is why she says it’s vital the victim feels they are in control, having just been through an ordeal where choice was ripped from them.

Through every single step of the exam, nothing is done without their consent.

Once the examination room is completely clean, the patient enters. Often, they will have chosen to bring a support person with them, for example, a counsellor or loved one, or even an interpreter or therapy dog.

Dr Moller says an exam has two objectives. The first is to provide medical care, which can mean anything from looking after any sexual health needs by testing for pregnancy or STIs to providing prescriptions or simply writing a sick note.

The second is forensic, which means using her medical skills to help the police with their investigation: taking DNA swabs, identifying and photographing injuries, describing emotional state, finding foreign material and running toxicology tests.

After introductions, the first thing Dr Moller does is ask exactly what happened, prompted by a standardised 23-page questionnaire.

She says the answers help determine how to proceed, such as whether to do an internal or external genital examination, or whether to take blood or urine samples for alcohol testing.

Barb Thorne and Maaike Moller both work at the Victorian Institute of Forensic Medicine.Credit:Chris Hopkins

After the questionnaire, the patient undresses – with their clothes potentially taken in for testing – and the forensic examination begins using the kit.

“Generally we start with a top-to-toe surface examination, just to see if there are any injuries that the person might not have noticed themselves,” Dr Moller says.

The doctor then moves on to testing for DNA from sperm or saliva by using cotton bud swabs wherever relevant – this could be orally, vaginally or anally. Internal exams also allow for any injuries in these areas to be described and treated.

Throughout the exam, the doctor is scanning for any potentially stray foreign material, such as strands of hair, debris or threads from clothing. Fingernails are also scraped.

Once all swabs are taken, the victim can shower while samples are packaged up. The examination then ends with a final discussion about any medical issues.

Dr Moller says the entire process usually takes two to three hours.

Her hope is that victims can leave feeling some sense of relief and empowerment.

“If after a couple of hours of spending time with them they feel like they’re able to have a good night’s sleep, they feel a sense of closure or calm, that they’ve done everything they can … that’s [satisfying],” she says.

What's next?

The kit together with all the collected samples is sent to a police lab for analysis. The time it takes to receive the results can vary. If a case is particularly pressing, the forensic report can be pushed through very quickly. But usually it will take a few weeks to be completed.

Analysis of DNA evidence can take weeks.Credit:Cameron Myles

So what exactly are the forensic scientists looking for?

Broadly speaking, semen, saliva, hair and fingernail scrapings are studied for DNA. These can identify a suspect and link them to the victim or crime scene.

Blood and urine can indicate whether a victim was under the influence of alcohol or drugs, and so could not consent.

Injuries can indicate the use of force or violence from an attacker and resistance from the victim.

And foreign material such as clothing fibres, foliage and soil can link a suspect to the offence.

Essentially, police use an examination to gather as much evidence as possible because it’s never known what will be uncovered – even if it’s simply to support and corroborate a version of events.

But Detective Sergeant Fairgrieve wants to stress that if little to no evidence is found, this does not preclude an offence from having happened. For example, while injuries can indicate force, a lack of injuries does not mean an assault did not occur.

Following the analysis, the kit is carefully stored. If it includes wet samples, the entire kit will be frozen.

Detective Sergeant Fairgrieve says the evidence is kept indefinitely and can only be destroyed once a conviction is achieved, the appeal period has ended, and it’s not needed for any other purpose.

How important is a forensic examination?

Most of us are aware of how desperately low the conviction rate is for sexual assault in Australia. The number of sexual assaults being reported to police nationally continues to rise, with 24,957 victims recorded in 2017 – an 8 per cent jump from the year before. But approximately only one in 10 sexual assault cases result in a conviction. And that’s only for the recorded incidents; it’s estimated less than 30 per cent of sexual assaults are reported to the police.

So how much does a forensic medical examination increase the likelihood of a conviction? One 2010 US study found where there was a rape conviction, 87 per cent of cases had physical evidence. And an Australian study from 2003 found juries were more likely to find guilt where there was DNA evidence, with 70 per cent of cases that had it acquiring a conviction, compared with 48 per cent for cases that did not.

Dr Moller says the Victorian Institute of Forensic Medicine conducts about 600 sexual assault examinations each year, with only about one in 50 ending with a conviction.

DNA evidence has limitations. It cannot determine anything about consent. It can only identify a suspect and confirm sexual contact. This means it’s particularly compelling in cases where the attacker is a stranger to the victim, but not necessarily helpful when the two are known to each other, such as in family violence cases.

Other forms of evidence, such as injuries and intoxication, can be argued to indicate lack of consent – but these aren’t enough to base a conviction on.

Still, a forensic examination does play a significant role.

For police, it can help build their artillery of evidence and corroborates a victim’s statement. And for juries, forensic evidence can be seen as boosting the credibility of a victim and lending “scientific truth” to their case beyond just their testimony.

“We can’t diagnose a rape, we can’t confirm a rape, and sometimes we can’t even confirm penetration. But what we can do is look after people and collect any information that will help feed into the investigative process to help get those answers,” Dr Moller says.

Detective Sergeant Fairgrieve says gathering forensic evidence is extremely important.

“Every piece of evidence we can gather is very important to a case. The more evidence that we have is extremely beneficial,” she says.

“[But] it’s not the be-all and end-all of an investigation.”

Centre Against Sexual Assault convenor Carolyn Worth has been privy to many forensic examinations as a victim support person. She believes if a victim has the energy and willpower, it is best to go through with one – even if it’s only a “just in case” examination – as it ultimately gives more options.

“I’ve stood at the top end and I talked to them and held their hand,” Ms Worth says.

“The doctors are very skilled at doing these tests, they’re not scary, and they do the minimum amount of intrusive stuff they can.

“As bad as it might be, you’ve had it, it’s done and at least you have the evidence if you need it.”

Emily Parsons, 24, says she is relieved she underwent a forensic examination.Credit:Paul Jeffers

'I was so relieved I went through it'

Emily Parsons, now 24, admits the examination was extremely confronting. She had swabs for semen in all three parts of her body where the assault happened. Her fingernails were scraped for dirt. Her body was searched internally and externally for injuries and abrasions. Leaves were picked off of her.

And keeping in mind this was happening mere hours after she was sexually assaulted – an unfortunate inevitability to ensuring the best possible DNA outcome.

“You can’t prepare yourself for the feelings you get … You’ve got someone poking and prodding down there and touching places you don’t want to be touched because you’ve just had to go through this huge ordeal … It’s terrifying,” Emily says.

It’s for these reasons Emily empathises fully with women who hesitate to go through with it. But she wants to emphasise two things.

Firstly, she says the examiner was gentle and kind, thoughtfully explaining every step of the process and making it as comfortable as possible.

“She talked me through everything, checked I was comfortable, checked if I wanted to back out. She was really accommodating and really looked after me,” Emily says.

“I felt like I was in safe hands.”

Secondly, she now knows the evidence from the examination was “extremely crucial” to putting her attacker behind bars.

Solid DNA was picked up and, following a lengthy investigation, a man in his 30s was arrested. His DNA matched. Two years later, after a guilty plea, he was handed a 10-year jail sentence.

“I was so relieved I went through the exam. It was a big revelation for me; if I hadn’t had done this, he wouldn’t have been caught,” she says.

“The DNA solidified everything. It tied everything together, it was bulletproof.”

Seven years on, she believes coming forward and undergoing the forensic examination was the “smartest thing I ever did in my life”.

Her hope is that other survivors feel encouraged by her story to contact the police and manage to look past how uncomfortable a forensic examination is. Taking that step, she says, can help you feel as if you’re back in control.

“As confronting as it is, it can be one of the most crucial things to catching that person and preventing it from happening again.”

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