On a recent winter's night, a young college student sits waiting in a hospital emergency room in Ashland. The police are just outside.
There was a party. Alcohol. Someone she knew, not a friend, really, an acquaintance, suddenly had become a predator.
As details begin to come into focus, Jane (not her real name) begins to feel the full impact of what happened. There are no overt signs that she was raped, no obvious injury. She sits alone on the edge of a hospital bed and waits.
In 2009, Ashland Police Department detectives investigated nine rapes, 14 sexual abuse cases and three sexual assault cases.
According to "Rape in Oregon: A Report to the State," by D.G. Kilpatrick and K.J. Ruggiero, published in May 2003, of the 1.3 million adult women living in Oregon, 230,000 were raped at least once in their lifetimes. More than 12,000 of those women were from Jackson County. Five percent of Oregon women ages 23-55 (more than 38,000 women) were forcibly raped in the previous five years.
A string of sexual assaults has plagued Ashland recently, with seven being reported in December and January. Though stranger rapes make headlines, sexual assault more commonly is perpetrated by someone the victim knows.
Jane won't be waiting alone for long. Thanks to the Sexual Assault Response Team, a specially trained nurse examiner will arrive soon to conduct the exam and interview, and an advocate will offer emotional support and provide information that will allow Jane to make informed decisions about what to do next.
SART has been helping victims of sexual assault countywide since 2005, when law enforcement, medical providers, advocacy groups and prosecutors consolidated services for victims after identifying barriers preventing them from coming forward and establishing protocols for providing compassionate care. They created the Sexual Assault Nurse Examiner program, in which nurses are on call to help victims through those first hours and the emotionally difficult examination for evidence. The needs and wishes of the victim are taken into account first by all agencies involved.
SART also offers a Sexual Assault Survivor's Healing program, in which support groups meet every other week in Ashland and Medford. Counseling, medical and mental health after-care services now are being considered as part of an expanding effort to address the needs of victims of sexual assault.
"There are huge barriers for a survivor of sexual assault to come forward for care and report the crime," says Susan Moen, SART executive director. "Studies have shown that the quality of care the survivor receives during her first interaction with the response agencies will have a huge impact on her willingness to move forward with either the legal process or her own personal healing journey.
"For some survivors, being able to tell their story and say, 'This happened to me, this was not my fault,' may be the only form of justice she or he ever receives."
When the nurse examiner, Leah, who asked that her last name not be used, arrives at Ashland Community Hospital, she speaks first with the police officer and the attending nurse, then enters Jane's room and introduces herself, noticing that Jane is both tense and chatty.
"A client's reaction to what has happened to them is very different from person to person and it often changes from moment to moment," says Leah. "I have had cases where the person is joking one moment and crying the next. They can be scared or detached."
Leah discusses Jane's options.
She can choose to have a complete medical assessment, which includes evidence collection (urine, hair samples, vaginal swabs). She will be given medication for sexually transmitted infections and a morning-after pill to prevent pregnancy. For the complete medical assessment to be effective, the assault must have occurred within 84 hours. Jane is well within that time frame, the assault having occurred 10 hours before.
She can choose to remain anonymous. In such cases, the Oregon State Police takes custody of the evidence until the victim decides whether to report.
She can choose a partial medical assessment, in which evidence is not collected but a medical history and urine sample are taken. She will receive medication for sexually transmitted diseases and information for follow-up care. This option typically is utilized if the assault occurred beyond 84 hours.
Jane decides to have a complete medical exam and learns that because of a Sexual Assault Victims' Emergency Medical Response Fund, her hospital visit will be paid for and will not involve her insurance.
"It is usually a huge relief for them to hear that they will not receive an ER bill on top of everything else that has happened to them," Leah says.
By this time an advocate has arrived to give comfort as needed. "I maintain a distance from the client," Leah explains, "so I can maintain objectivity, especially if the case goes to trial."
"The level of involvement (for an advocate) depends on the case," says Wendy Anderson, an advocate and group facilitator with SART. "For some, it's just being in the room. Others want to hold my hand, and some want to talk. I often bring sweats, socks and underwear for those times when clothes are collected."
Leah conducts a pelvic exam, collects Jane's clothing, takes pictures, hair samples and DNA, and scans Jane's body with an ultraviolet bulb called the Woods lamp.
"Having a stranger, even a medically trained stranger, look at your naked body from head to foot can be very disconcerting, especially after such trauma," Leah says.
Jane is given medication for sexually transmitted infections and a morning-after pill. The advocate also hands Jane a packet containing information about counseling and victims advocacy groups in the area as well as suggested follow-ups with a doctor to get tested for HIV and other sexually transmitted diseases.
Because of SART, Jane did not have to spend a long and difficult night alone.
If you find yourself the victim of a sexual assault, call SART at 541-779-HELP or 888-609-HELP. Also, all hospitals in Jackson County adhere to SART protocols and can help you get the assistance you need. For more information about SART, see www.jacksoncountysart.org.
Chris Honoré is a freelance writer living in Ashland. Reach him at firstname.lastname@example.org.