MEDICO LEGAL AWARENESS

WAR works very closely with both the Police and medico-legal sector in Karachi. WAR collects statistics and case-related data from different government hospitals where medico-legal facilities are available. Often, cases are referred to WAR for legal and psychological assistance from these institutions and WAR provides these services free of cost. Even transport costs to and from the WAR office are reimbursed so as not to put any financial burden on the survivors or their families.

Below is the reporting structure which outlines the function of each stakeholder and the reporting line for each in the medico-legal sector of Karachi.

The main stakeholders in the medico-legal sector comprise of the following:

• Survivor
• Medico-legal Officer (MLO)
• Additional Police Surgeon
• Police Surgeon
• Office of the Chemical Examiner
• Advocate/supporter of the survivor (sympathizer, family member, friend, spouse, NGO representative, etc)

Although there is no clear job description provided to MLOs at the time of appointment, certain responsibilities are generally fulfilled:

• Examining the injured
• Providing treatment to injured/client (basic prophylactics such as aspirin for aches and pains)
• Taking x-rays
• Preparing medico-legal certificates
• Conducting post-mortems/prepare post-mortem reports
• Providing testimony during court proceedings
• Being present at medico-legal centre during duty hours
• Working in close collaboration with law enforcement officials , such as the Police

The Sindh Government’s Health Policy, 2005, issued by the Health Department, Government of Sindh, assures that legislative steps would be taken to ‘revamp’ the ML system in Karachi. It promises that all minor government hospitals in Karachi (six) would be made fully functional and active and that all MLOs would be required to take six-month training before they are recruited. It also asserts that Forensic Science Laboratories would be established at the Police Surgeon’s office and that the office would be equipped with various facilities necessary for an efficient working of the department (for text on the Health Policy for the province of Sindh, click here).

The reality on the ground is, however, a bit different. Here is how the system is actually working at this point in time:

The medico-legal sector in Pakistan is responsible for conducting medico-legal examinations in cases of traffic accidents, alcohol and drug abuse, gun violence, bomb blasts, post mortems of all unnatural deaths (suicide and homicide) and rape/sodomy (of both the survivor and the accused). Medico-legal Officers (MLOs) who can only be found at designated Government hospitals conduct these examinations and issue medico-legal certificates which corroborate the survivor’s testimony in the form of medical evidence suggesting such things as the use of force, coercion or physical violence during sexual intercourse by the perpetrator or resistance by the victim.

There are currently only 6 female MLOs (only female MLOs are authorized to examine female survivors) and 51 male MLOs, catering to a population of approximately 8 million women and 8 million men respectively. ML departments are active for only 3 Government hospitals out of nine in Karachi, namely Civil, Abbasi and JPMC (as opposed to 14 in Lahore, all of which are active), and on average 350 cases of female rape and 50 cases of male rape (sodomy) are reported to the medico-legal departments each year from Karachi.

The medico-legal sector is one of the most under-funded and neglected sectors of Government, especially in Karachi. Not only are survivors late in going for examinations due to a myriad of reasons, words such as “habitual” and “not virgo-intacta” form the crux of the ‘expert’ medical ‘opinion’ expressed on rape certificates. The departments are not equipped with such basic forensic tools such as glass slides, cotton swabs, sealing sticks, weighing machines, glass jars, etc, which keeps them from collecting and documenting vital evidence which may be present on the victim’s person at the time of examination and which incriminates the alleged perpetrator.

There is no legal or psychological support offered through trained counselors by the government at the point of examinations and no medical arrangements made for prophylactic care in case of unwanted pregnancies, Sexually Transmitted Diseases (STDs), Human Immunodeficiency Virus/ Acquired Immunodeficiency Syndrome (HIV/AIDS) and Post Traumatic Stress Disorder (PTSD). Additionally, the Police and medico-legal representatives often misguide complainants regarding the procedure involved in pressing charges against the perpetrators, more commonly confusing them about which lies first in order: the registration of the First Information Report (FIR) or the medico-legal examination.

In rejecting these basic provisions that have been suggested as state obligations repeatedly by various human rights activists at different times, and failing to make clear the procedures involved, policies of the health department are essentially subjecting rape complainants to extra corroborative burden or procedural hurdles in bringing their claims to the court of law. Additionally, the concepts of ‘utmost resistance’ and ‘prompt complaint’ inherent in the corroboration debate are causing mystification of the issue of rape itself and the notion of ‘responsibility’ in cases of sexual assault. These notions are fanning misogynistic and judgmental attitudes in concerned departments leading to the loss of vital evidence and the weakening of grounds for prosecution.