There is need for a more enabling environment, in which the victim/survivor of sexual crime can feel comfortable, and able to voice her/his feelings.

A murder has been committed. The victim and his blood stained clothes present at the scene of crime, will provide clues to detect the criminal and the weapon. A six-year old boy’s pitiful little shalwar has been sent from the hospital for examination of semen stains. A sample of stomach wash for analysis has arrived from Badin; it’s from a woman who died by poisoning. What was the poison? Was it suicide or murder?

Besides crimes such as these, there are suicide bombings and bomb blasts, all common enough occurrences in this violence-prone city, and all in a day’s work at the Medico-legal Sector, and the Chemical Examiner’s Office in Karachi. The detection of crime is a complex process, and its complexity adds to the possibility of pitfalls and shortcomings, which in turn can seriously impair the course of justice.

The forensic sector in Karachi comprises Police Surgeon (PS), Assistant Police Surgeons (APSs) and medico-legal officers (MLOs). Together with the Chemical Examiner’s Office, they play a pivotal role in the collection and analysis of crime-related evidence. The first group involved in crime detection are the police. Then starts the search for criminals, the examination of the scene of crime and of the victim/s.

This requires everything from examination of ballistics results to medico-legal evidence to analysis of material labeled ‘criminal property’ — this last may be blood-stained weapons, clothes or items stained with other body fluids, fingerprints, parts of the body, murder weapons or body fluids. The MLOs at major public hospitals provide the victim with the necessary medicare and also obtain samples which, on further scrutiny, can yield valuable information at the Chemical Examiner’s Office.

The NGO Aahung recently undertook a study of the medico-legal sector in Karachi, specifically because of increasing concern about crimes of sexual violence, which have registered a two-fold increase over 2000-2004. In fact, women and children form a large proportion of victims of sexual assault: adolescents are the most vulnerable, 85 per cent of sexual abuse survivors being girls and women below the age of 19. However, the number of reported cases for boys in the under-10 age group is also extremely high statistics from January-June 2007 obtained by Madadgar are frighteningly high: 240 children were raped and 192 sodomised. In the same period, 53 women were raped and murdered; 376 were raped and as many as 114 were gang raped.

Associated groups WAR (War Against Rape) and the HRCP (Human Rights Commission of Pakistan) also faced difficulties in helping victims to avail quality medico-legal services. Their findings are incorporated in Aahung’s comprehensive report.

Despite the fact that the report covers only crimes of sexual violence, it suffices to shed light on the numerous challenges faced by the medico-legal sector -- challenges that can delay or possibly alter the course of justice.

Findings indicated that the available facilities in Karachi’s medico-legal sector do not meet even the minimal WHO-prescribed medical and forensic science requirements. The PS, 5 APSs, and 51 MLOs cater to the needs of nine public hospitals, a contingent drastically insufficient for a population of at least 14 million (reportedly as high as 17-18 million) Karachiites. The female MLOs, who range in number from two to eight at any given time, are woefully inadequate to deal with the rising incidence of sexual and other crimes against women, particularly since women can only be examined by female MLOs.

Reported cases are only a fraction of the total sexual violence crimes actually committed. The reasons for this are multifaceted: there is shame and guilt, fear of retribution or of being blamed for the crime, lack of confidence in the police and medico-legal workers, and most importantly, the fear of stigma. Despite the fact that the Women’s Protection Act 2006 is now a valid instrument for protection of women, fear still exists in many minds that if rape results in pregnancy, the victim may be further victimised under the Hudood Ordinance.

An extremely disturbing fact is the lack of awareness among rape survivors of the need to be medically examined as early as possible at an authorised public hospital. This is essential so as to obtain the vital evidence of semen stains, which can be grouped, just like blood, and can help pin-point the criminal. These valuable clues are easily destroyed with passage of time.

Deeper probing into the workings of the forensic sector revealed many hurdles. It is unsettling to note that the sector is gravely ill-equipped, a fact that compromises crime analysis. Karachi’s medico-legal system suffers from a paucity of staff, equipment and funds; at the same time, by the very nature of the work involved, access to funds via philanthropic donations, private contributions or grants is not permissible. At the Chemical Examiner’s Office, DNA analysis, which could provide conclusive evidence in many cases, is still not available, perhaps due to high cost.

Staff training facilities are limited. The questions inevitably arise in one’s mind: what do these limitations say for the quality of crime analysis and thereby for dispensation of justice? How often are the real criminals caught? If the MLOs are not fully trained in obtaining, say, high vaginal swabs, can their samples be considered reliable? What about cases where blood, semen or other body fluid analysis has been rendered ineffective due to passage of time or other delays? How can analysis be carried out if the necessary reagents are missing?

Criteria for the post of the MLO specify an MBBS degree with MLO training; for analytical work at the Chemical Examiner’s Office, a master’s degree in the requisite science is necessary. However, in actual practice, a large number of officers have no training. A few have legal training, and others learn on the job. A government memorandum of 2005 specifies a one-week training requirement prior to employment as an MLO, yet many MLOs are untrained and unaware, for instance, of the need for prompt examination of rape survivors, or of the importance of eliciting an assault history. Few MLOs are trained in examination of rape victims. Police crime statistics indicate a rising crime graph, with rapes in 2003 and 2004 totaling nearly 400 per year, and Madadgar’s statistics for this year even higher -- and the MLOs ill-equipped to deal with this increased onslaught of work.

Training for this critical work is essential, so that timely forensic evidence can be obtained. Similarly, eliciting informed consent from the survivor and informing her/him of the nature of invasive examination is also a necessity.

The potential sexual, reproductive, and mental health consequences of sexual violence are numerous —unwanted pregnancies, the risk of STIs (sexually transmitted infections), HIV/Aids, depression, substance abuse, post traumatic stress disorder, psychological trauma, and physical injury, at times grave. No screening facilities are offered in case of STIs or pregnancies. Provision of emergency contraception could reduce the likelihood and fear of pregnancy resulting from rape, but no such facility is available to rape survivors.

Medico-legal training does not include training for dealing with psychosocial trauma associated with assault.

Measures for privacy of survivors were taken in most cases; for example, due to severely limited space, male MLOs would be required to leave the one and only examination room in case a woman survivor had to be examined. Questioning further revealed that sometimes no room was available for such exams, which compromised privacy for the survivor.

Sensitivity towards rape survivors is often missing: their consent is not always taken prior to examination. The MLOs sometimes fail to inform the survivor about the possibility of pregnancy resulting from rape, or of the risk of the STIs. Essential issues like non-judgmental attitudes, legal procedures, client rights, presentation of medico-legal evidence in court, are not specifically identified as issues to be covered in training. While the MLOs have the authority to conduct internal exams, they may not necessarily have the expertise to do so -- yet their findings play a vital role in crime detection Despite the critical nature of their vocation, it is troubling to note that personnel in the medico-legal sector work under extremely trying circumstances. The PS himself listed a lack of incentives, the pressure of possible corruption, bribery, threats, and coercive tactics to issue false reports. According to several APSs, pressures of the job, court procedures, and the need to interact daily with criminals presented major hurdles. Salaries are relatively low, training facilities and upward career mobility are non-existent.

The challenges are many. The sector needs far greater funding, and increase in staff strength. The MLOs and analysts need far more information and training: the curriculum for both is in need of expansion and supplementation with basic legal knowledge; there must also be a component for trained psychological counselors.

Undoubtedly, there is a need for a more enabling environment, in which the victim/survivor can feel comfortable, and able to voice her/his feelings.

Simultaneously, efforts need to be made to remedy not only the current under-reporting of sexual crimes, but also to work for removal of the stigma, which prevents so many girls and young women from coming forward and reporting sexual crime.