Going to hospital

Medical Examination and Forensic Evidence Collection

Forensic and Medical Sexual Assault Care (FAMSAC)

FAMSAC is a specialised service for victim-survivors of sexual violence at Canberra Hospital. It is staffed by trained doctors and nurses who can provide medical assistance to victim-survivors within 5 days of an assault. FAMSAC can also collect forensic evidence from a victim-survivor which can be used as evidence if police investigate the matter.

​FAMSAC is available to victim-survivors aged over 15 years and operates 24/7. It is recommended that victim-survivors be examined as soon as possible after an assault. This is to ensure their immediate health and safety and to allow the best chance for forensic evidence to be collected.

You do not have to make a police report to access FAMSAC. If you are over 18, staff will not contact anyone without your consent, including police. FAMSAC can collect forensic evidence with your permission on a ‘just-in-case’ basis (called a JIC Examination), meaning that any evidence collected will be saved for 3 months in case a victim-survivor decides to make a report later. FAMSAC records are kept separate to other Canberra Hospital records, meaning that non-FAMSAC staff will not be able to access your information.

​FAMSAC can provide the following services where appropriate:

• Emergency contraception to prevent unwanted pregnancy

• Screening and provision of antibiotics for STIs such as chlamydia and gonorrhoea and blood borne viruses like hepatitis B, hepatitis C and HIV

• Collecting urine samples in case of drug-facilitated incidents (for example, if your drink was spiked before the assault)

• Documentation and photography of any injuries you may have

• Collection of forensic evidence from your body and clothes via swab

• Referral to sexual assault counselling services.

​A support person may accompany you to the hospital but cannot enter the room where the samples are collected (to prevent contamination of evidence). When you arrive at the hospital, attend the emergency department so that staff can determine whether you need urgent medical assistance. You will be asked for your name and other contact details. The medical staff will explain the process of looking after your medical needs, such as testing and treatment for STIs, providing you with emergency contraception and managing any injuries. The medical staff will explain the types of evidence that may be collected. The examination may take up to two hours. The examining nurse can also organise follow up with FAMSAC, your GP or another service. You can stop the examination, take a break or ask questions at any time throughout this process.

FAMSAC services are free of charge and the facilities are wheelchair accessible. If possible, it is recommended that you, the police or CRCC contact FAMSAC before attending. This will ensure that there are staff present, the examination room is cleaned and ready for use and that you will spend less time waiting in the emergency department.

​Child At Risk Health Unit (CARHU)

CARHU provides medical examinations for children aged 0 to 14 in the ACT and NSW who may have experienced child abuse and neglect, including sexual violence. CARHU is based at Canberra Hospital. Referrals for a medical assessment can only come from statutory authorities, like the police and child protection services, or medical staff from Canberra Hospital and North Canberra Hospital.

​CARHU also has a team of allied health professionals (social workers and psychologists) available to assist those with concerns about child abuse to navigate the health system and address concerns about a child's safety and wellbeing. These allied health staff also offer counselling for children and young people who are victim-survivors of child abuse, as well as their parents, carers and families.

​Medical examinations at CARHU are child focused, family centred and are conducted by specialist children’s doctors. The purpose of the medical examination is to tend to any injury a child or young person may have and to record or document any evidence of harm. Written and verbal consent may be required from a person with parental authority in order to conduct an examination and to ensure that the medical examination will not be conducted in the presence of an alleged perpetrator. Often a chaperone (such as a CARHU nurse or counsellor) will be present with the victim-survivor during a medical examination, as well as protective family members or other trusted people.

​CARHU staff must report all instances of child abuse and neglect, including sexual violence, to Child Protection Services. CARHU services are free for Medicare and Asylum Seeker cardholders and are bulk-billed where eligible. You do not need a Medicare card to access this service. Note: If you are a temporary visa holder, access to hospital services may require payment.

Sexual Health Care

While not all victim-survivors will experience physical injuries or medical problems, the physical impacts of sexual assault can include:

• Damage to the sexual and/or reproductive organs

• Increased risk of contracting STIs

• Unwanted pregnancies

• Ongoing gynaecological problems

• Psychological trauma, depression and anxiety (which can manifest as physical symptoms).​

Sexually transmitted infections (STIs)

STIs can spread from person to person during sex (vaginal, oral or anal) or close intimate contact. Common STIs include chlamydia, genital herpes, genital warts, gonorrhoea, hepatitis B, HIV and AIDS, pelvic inflammatory disease, pubic lice, syphilis and trichomoniasis. Not all STIs cause noticeable symptoms so it is important to be tested and treated as soon as you can.​

An STI test usually involves giving a urine sample or having a genital examination. If a victim-survivor has experienced sexual assault involving the mouth or anus and no form of contraception was used, a throat swab or anal swab may be required. Some STIs, such as hepatitis, syphilis and HIV require a sample of blood taken from the arm.

​Treatment of common STIs is recommended and offered to all victim-survivors at the time of exam regardless of symptoms. It is not mandatory to undertake testing in order to receive preventative treatment. If there is any risk that the perpetrator is HIV-positive, specific medication called 'post-exposure prophylaxis' (PEP) can be provided to the victim-survivor.

​Emergency contraception

Emergency contraception is most effective in preventing unplanned pregnancies if taken within 72 hours of a sexual assault, but can be given up to 5 days after an assault. The most common form of emergency contraception is the oral ‘morning after pill’, which is a safe and effective way (when taken as directed) of preventing pregnancy. It is available over the counter at most pharmacies or at sexual health clinics. Some forms of emergency contraception, including the copper intrauterine device (IUD), can be used within 5 days of an assault and are inserted by a doctor or nurse. Emergency contraception methods do not prevent STIs. It is important to seek medical advice and assistance if you are worried about being pregnant following a sexual assault.

Support services

Canberra Sexual Health Centre

The Canberra Sexual Health Centre is a specialist clinic that provides free testing and treatment for STIs. This service is by appointment only. Victim-survivors do not need a Medicare card or referral to access this service. Canberra Sexual Health Centre is open 8:30am-5pm, Monday to Friday.

​Sexual Health and Family Planning ACT (SHFPACT)

Sexual Health and Family Planning ACT (SHFPACT) offers free STI testing and treatment services, free unplanned pregnancy counselling and can provide information about options including medical terminations.

Meridian

Meridian provides primary health care and social support services to people with diverse sexualities and genders, HIV positive communities and sex workers. Meridian promotes sex positivity, harm minimisation and safe sex. Meridian provides HIV and STI testing and treatment at their premises in Turner, outreach at brothels and studios, and HIV self-testing kits. This service is supported by partner organisations including Canberra Sexual Health Centre and SHFPACT.

​Medical termination

ACT residents can access free medical and surgical abortions at up to 16 weeks gestation. Free long-acting reversible contraceptives will also be made available, if wanted, at the time of abortion. In the ACT, medical abortions up to nine weeks gestation are available through a trained GP, telehealth services or MSI Australia (formerly known as Marie Stopes Australia). MSI Australia also offers surgical abortions up to 16 weeks gestation. Surgical abortions for up to 12 weeks gestation are available at Gynaecology Centres Australia, Queanbeyan (depending on surgical risk) at a cost.