Kilonzo Nduku, Ndung'u Njoki, Nthamburi Nerida, Ajema Caroline, Taegtmeyer Miriam, Theobald Sally, Tolhurst Rachel
Liverpool VCT, Care & Treatment, Nairobi, Kenya.
Reprod Health Matters. 2009 Nov;17(34):10-9. doi: 10.1016/S0968-8080(09)34485-7.
Six sub-Saharan African countries currently have laws on sexual violence, including Kenya, and eight others have provisions on sexual violence in other legislation. Effective legislation requires functioning medico-legal linkages to enable both justice to be done in cases of sexual violence and the provision of health services for survivors of sexual violence. The health sector also needs to provide post-rape care services and collect and deliver evidence to the criminal justice system. This paper reviews existing data on sexual violence in sub-Saharan Africa, and summarises the content of sexual violence legislation in the region and the strengths and weaknesses of existing medico-legal linkages, using Kenya as a case study. Many sub-Saharan African countries do not yet have comprehensive post-rape care services, nor substantial co-ordination between HIV and sexual and reproductive health services, the legal and judicial systems, and sexual violence legislation. These need to be integrated by cross-referrals, using standardised referral guidelines and pathways, treatment protocols, and medico-legal procedures. Common training approaches and harmonised information across sectors, and common indicators, would facilitate government accountability. Joint and collaborative planning and working at country level, through sharing of information and data between the different systems remain key to achieving this.
目前,包括肯尼亚在内的撒哈拉以南非洲的六个国家制定了关于性暴力的法律,另有八个国家在其他立法中对性暴力作出了规定。有效的立法需要切实可行的法医联动机制,以便在性暴力案件中伸张正义,并为性暴力幸存者提供医疗服务。卫生部门还需要提供强奸后护理服务,并收集证据提交给刑事司法系统。本文回顾了撒哈拉以南非洲地区性暴力的现有数据,以肯尼亚为例,总结了该地区性暴力立法的内容以及现有法医联动机制的优缺点。撒哈拉以南非洲的许多国家尚未建立全面的强奸后护理服务体系,艾滋病毒与性健康和生殖健康服务、法律和司法系统以及性暴力立法之间也缺乏实质性协调。需要通过交叉转诊,利用标准化的转诊指南和途径、治疗方案以及法医程序,将这些方面整合起来。跨部门的共同培训方法、统一的信息以及共同的指标,将有助于政府承担责任。通过不同系统之间共享信息和数据,在国家层面进行联合与协作规划及工作,仍然是实现这一目标的关键。