What happens when you go to the hospital after a sexual assault?

Winnipeg is closing in on 10 years of having one of the most advanced sexual assault treatment centres in Canada — just as it sees a 40 per cent spike in victims turning up in emergency rooms.

A victim – man, woman or child – who has been sexually assaulted can go to the city's Health Sciences Centre and almost immediately be taken to a specialized suite – there are no lengthy waits.

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“Usually within an hour we are here, so they don’t have to wait a long time in triage. A lot of times they’re able to put them in a family room, so they’re not sitting with everybody else because a lot of them are very traumatized and crying,” explained Nicole Hines, a sexual assault nurse examiner at the hospital.

The suite is behind two sets of unmarked doors, and most people who work in the hospital don’t even know where it is.

The nurses who work there wear plain clothes, and when the victims get there, they decide what treatment they want.

“A lot of them are wanting the medication. They really want the morning after pill. They’re very afraid of getting pregnant from the assault,” said Hines. “There’s also the sexually transmitted diseases, so they want those antibiotics. They just want to know they’re OK. A lot of them just want to know they’re OK.”

Counsellors from Klinic’s sexual assault crisis program are on call for any victim. Both a specially trained nurse and a counsellor will go over options with them.

“They will come sometimes if the patient is just maybe too nervous. They’ll actually come as well into the suite, just to hold their hands while they do the exam,” said Hines. “Some of the patients just need that extra person to hang onto.”

The treatment is led by the person – forensic exams are optional, and police do not have to be involved.

“Even if it is a domestic assault, we don’t have an obligation to contact police,” said Ashley Smith, one of the co-ordinators of the sexual assault nurse examiner program. “Individuals always have that choice unless they fall under obviously that age of consent for sexual activity. For anyone else, we’ll help them contact police if they wish to, but that’s completely up to them.”

Most hospitals in Canada now have sexual assault programs, which wasn't the case 10 years ago. But those centres are often just dedicated exam rooms -- rather than a full suite with multiple rooms designed specifically to comfort sexual assault victims.

The program has seen a steady increase in patients since its inception -- and now, they're seeing 40 victims on average per month. That's up from the average of 25 they were seeing up until a few months ago. Staff say they don't know what's behind the increase.

120 hours is 'critical period'

For up to 120 hours after an assault, evidence can be collected in a forensic exam. Something that can be painstaking and difficult for victims, but something the nurses have been extensively trained on how to do sensitively.

“There’s no rush in doing the exam. If they just need to sit for half an hour and just talk, then that’s what we do. When they’re ready, we’ll do the exam. We stop the exam any time they feel uncomfortable or just need to take some time,” explained Hines. “If it takes four hours from start to finish, it takes four hours.”

That evidence can then sit for days, weeks, months or even years while a victim decides if they want to pursue charges.

Hines said most women who come to the program – about 350 in total last year – do want to involve police. So the nurses call and request plainclothes officers.

The statement can be given directly in the suite, which is equipped with a small video camera and audio recorder, so victims don’t have to go to the police station to report.

The biggest problem the program faces, Smith said, is victims aren’t aware it exists.

Anything they can do to get the word out helps, she says.

'I can’t take away what happened'

The specially trained nurses in the program are all women, and all work exclusively with sexual assault victims.

“For me on a personal basis, I can’t take away what happened. That assault, that has happened. What I can do, is hopefully help them deal with the assault. Give them that medical care they need. Cover the morning after pill, the pregnancy, the sexually transmitted disease – even HIV,” said Hines. “It’s really hard to explain, but when they leave and they give you a hug you, you know that you’ve done the best care possible.”

The HSC’s program is available to anyone who has been sexually assaulted within the past five days or 120 hours. After that, though, you can still get help at Klinic on Portage Avenue or a number of other counselling centres throughout the province.

Hines said if victims are scared, or unsure, they should just go see her. She urges them to check out the program and talk to someone there and then decide.

“It helps so many people … I wish more people would come forward because I think if you don’t talk about it, and you don’t come and see someone about it, you can’t deal with it,” said Hines. “This is the first step with being able to actually deal with what occurred.”