"I choose to believe you!" – An international campaign to raise awareness of sexual abuse against children, carried out in forensic medicine services in Romania

Here they are! The places and people they meet, on average, in a month, at least 10 children about whom a suspicion of sexual violence has been registered. It is the forensic services and institutes from which the police and prosecutors request evidence. The information did not reach all counties that in over 90% of sexual violence against children, the evidence is not found on the victim's body. Nor is it justified to examine in the middle of the night a child who reveals a rape after more than 72 hours. The examination rooms for children are imperfect, in some places totally unfriendly, but we can say at least one good and encouraging thing about each one.

I found transparency and honesty. Willingness to change. And, above all, the need to act under the protection of unitary procedures when examining child victims of sexual violence in order to obtain maximum evidence, with minimum stress for the child.

The campaign "I choose to believe you!" arrived this week at:

• Constanța County Forensic Medicine Service;
• Ialomita County Forensic Medicine Service;
• Slatina County Forensic Medicine Service;
• Vâlcea County Forensic Medicine Service;
• Sibiu County Forensic Medicine Service;
• Deva County Forensic Medicine Service;
• Institute of Forensic Medicine Timișoara;
• Arad County Forensic Medicine Service.

Beyond the barriers of the "examiner" profile, the numerous doctors and nurses from the forensic medicine network spoke to us about the weight they feel when they go home to their families... Who sees the child victims, after they are seen by the doctors forensics?

Arad - "For us, the child victims disappear. For me, feedback would help me the most. To know what happened. If there is something I can do better next time. If my work was useful or not. If the case was more believable because I was calm and patient going through the examination, even though I know the chances of us finding the evidence are so slim." I ended the week with Florin, a young forensic doctor from Arada, who was impressed by a mother's gratitude for the way she had interacted with her daughter. He understood once more that his role is not limited to looking for physical evidence, but that he can create a sense of security for children who are going through an experience of sexual violence and their families only with the right attitude of an empathetic professional.

Timișoara - The Institute of Forensic Medicine has a well-built team, based on knowledge and the experience of working together. Awareness of the profound disruption that sexual abuse produces in a child's life is demonstrated by the long-standing concern for finding the best solutions. In Timișoara, I found a teddy bear sitting next to the gynecological examination chair. INML Timișoara is a benchmark for the effort to adapt a limited space to the many operations that forensic doctors have to perform on their patients in a unique consultation space.

Deva - Passionate doctors and nurses open to learning more. In Hunedoara, legal medicine and the police form a common body. The doctor serving Petroșani shared with his colleagues his practical experience after the clinical examination training he attended last fall: "I started telling the little girls that I just want to make sure that everything is fine with their bodies and you know that it works. It may be a small thing, but it is more difficult than anything to place a child in the genital examination position," he confessed.

In Sibiu, forensic doctors refuse to examine children at night. Even more in demand than the clinical examination of children in the context of sexual violence is psychiatric expertise for minors, both victims and suspects. The online grooming cases branched out until they too ended up being analyzed by a team that includes two forensic doctors, a paedo-psychiatrist and a child psychologist from the "Dr. Gheorghe Preda" Clinical Psychiatry Hospital. from Sibiu. Ioana is a woman. And a doctor. And mother. And an important part of his work is carried out within this commission. She claims that she is far from idealistic or enthusiastic, but she is convinced that the world can be a better place for children. He often diagnoses in this committee post-traumatic stress disorders in children and suicidal ideation after abuse. Treat each child with the belief that there is healing, smile and hug. He wishes most of all that all his colleagues would use the same procedures to prevent children from being held responsible for what happened to them. Sibiu is the scene of a unique academic event in Romania, initiated and coordinated by Prof. Dr. Silviu Morar, head of the Legal Medicine of the Faculty of Medicine in Sibiu: Conference of Psychiatry and Medico-Legal Psychology.

Vâlcea, like Arad, has one of the newest workspaces. The Vâlcea forensic medicine service is located in the premises of the County Hospital, in a recently renovated building in bright colors that create a feeling of comfort. The team that welcomed us was open to describing their experiences and concern for improving assistance to child victims of sexual violence. They believe that a multidisciplinary approach is vital to the management of these cases, which is why they constantly try to create links both with the judicial bodies and with the social workers and psychologists with whom the child comes into contact.

In Slatina, forensic doctors work in critical conditions. Access to the premises allocated to the forensic medicine service, located in an old polyclinic, is made through several dark corridors, without electricity, where medical sofas, panels and other pieces of furniture lie abandoned. The only ray of optimism is given by the effort of forensic doctors to continue doing their work, to invest in equipment and in the expansion of consultation premises. The irony is that in the same building, one floor above, the County Directorate of Public Health also carries out its activity.

In order to enter the Ialomita forensic medicine service for an examination, all patients pass by the ramp where deceased persons are handed over to their families. Mothers with baby carriages, people with motor disabilities, including patients who have suffered a trauma and come for casts or orthotics are put in great difficulty because there is no elevator. Once they reach the upper floor with great effort, patients discover an unfriendly waiting hall that is limited in space by a PVC panel, fitted with a counter saw. On the other side is the examination room, offices and a laboratory. The team of doctors and a nurse, made up entirely of women, lives with the hope that things will change for the better after the county hospital building is expanded.

Constanța has a young team working in a makeshift headquarters in an old nursery. The existing spaces are small, but functional, and the medical staff has been waiting for many years for the realization of the project of an Institute of Forensic Medicine, especially since it is a university center and the work spaces must allow access to students - currently impossible. The specialists I spoke with are concerned with solutions and interested in participating in change. The dialogue with the medical assistant of the service was particularly relevant for the constant effort of the doctor-assistant team, when faced with cases that are difficult to manage, such as child victims.

In each county, doctors and nurses responded to an open-ended questionnaire by Janice Ceccucci, a forensic nurse practitioner and professor at UTICA University in New York. The objective of the study is to bring to the fore the problems of the forensic medicine network and the solutions for carrying out the professional activity to the standards required by the international community, such as the guidelines of the World Health Organization.

Doctor and forensic are concepts that exclude arbitrariness and correlate with science, knowledge and curiosity to find the light even in the densest darkness. There are less than 250 forensic doctors in Romania, but few of them know each other, they work according to a law almost as old as the gynecological tables on which not only female victims are often placed, but also male victims.

What do we really want? Let's accept our limits and work together so that a child victim's visit to a medico-legal office no longer represents an additional stress, but a medical visit that provides comfort and safety. Our journey continues with other counties in the North and East of the country.

If you want to talk about sexual violence with a professional ready to help, send an email to: help@asistentavictime.ro