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Launch of "Immediate medical assistance after rape" at RKH Klinikum Ludwigsburg: a tangible support service for women, men and other genders in the Ludwigsburg district

The comprehensive care service "Immediate medical help after rape" starts on 25 November at the RKH Klinikum Ludwigsburg for all people aged 14 and over who have experienced sexualized violence. At the request of those affected, the service includes legally compliant, confidential evidence collection directly at the hospital. It is not necessary to report the incident or involve the police.

A group of seven women, standing outside the Klinikum Ludwigsburg, are holding colorful posters and smiling. They are dressed in various professional and casual outfits, with a mix of bright colors. The hospital's name is prominently displayed on a sign in front of them.

From left: Cynthia Schönau, Elena Meißner, Elke Karle, Dr. Melanie Burger, Dr. Uschi Traub, Karin Stark and Pia Rothstein.

The project is coordinated by Cynthia Schönau, Equal Opportunities Officer for the Ludwigsburg district. She is actively supported by the project team: Dr. Uschi Traub from the district's health department, Dr. Melanie Burger and Elena Meißner from RKH Klinikum Ludwigsburg, Elke Karle from Silberdistel e.V. and Pia Rothstein from Frauen für Frauen e.V. Karin Stark from the prevention department of the police headquarters is assisting the project team.

In the district of Ludwigsburg, the RKH Klinikum Ludwigsburg will be offering the option of preserving evidence independently of proceedings in cases of sexual offenses from November 25 - just in time for the International Day for the Elimination of Violence against Women. Even in the event of a temporary waiver of legal action, criminally relevant evidence will be collected, documented and secured for later reporting to the police. This means that it is not necessary to report the crime to the police in order to document the evidence with legal certainty. At the same time, care structures have been created to make it easier for those affected by sexual violence to access good medical care.

The service is aimed at young people, women, men and other genders aged 14 and over. The focus is on medical help as well as access to integrated aftercare and referral to the psychosocial support system. In the case of optional evidence recovery independent of the proceedings, the evidence seized is taken to the responsible forensic institute in Heidelberg. There it is available for one year for adults and for minors up to the age of 19 for possible reporting to the police.

It is assumed that every third woman in Germany has been affected by violence at least once in her life. Only a fraction of these crimes are actually reported to the investigating authorities. If sexual violence occurs in a social environment in particular, those affected often do not report it out of fear, shame or a sense of guilt. For the same reasons, they often do not seek medical care. In addition, the victims fear that criminal proceedings could be initiated against their will.

"Immediate medical assistance after a rape closes the gap between the immediate initiation of preliminary proceedings, even against the will of those affected, and the non-reporting of such serious crimes. Victims are now freer to make their own decisions and can seek medical help without hesitation, says Karin Stark from the Prevention Department of the Police Headquarters.

Police Commissioner Burkard Metzgertherefore expressly welcomes this offer of support:

"Many victims of sexualized violence are not in a position to make a decision for or against reporting the crime to the police immediately after the crime. They may then not seek medical care out of concern that someone else might go over their head. The "immediate medical assistance" model not only makes it easier for victims to access emergency medical care. The link with action aids and forensic services also enables them to deal with further steps in an atmosphere of trust, which can lead to conclusive investigation proceedings in the event of a report."

The licensing body for the model project "Immediate medical assistance after rape" is the Women's Emergency Hotline in Frankfurt. It is run by the association Notruf und Beratung für vergewaltigte Frauen und Mädchen e.V., Frankfurt.

In 2020, this pilot project was launched in the district of Ludwigsburg on the initiative and under the leadership of the district's Equal Opportunities Officer, Cynthia Schönau. District Administrator Dietmar Allgaier gave the go-ahead immediately after taking office: "After Ms. Schönau drew my attention to this project, I was immediately convinced of its necessity," says Dietmar Allgaier. In November 2020, the district council unanimously provided the necessary funds. "The hospital management and head physicians were also quick to give their approval," says Cynthia Schönau. A model that keeps one thing in particular in mind: the physical and emotional well-being of people aged 14 and over who have experienced sexualized violence. Due to the high number of victims, the focus is on women. From the point of view of the Department of Health, it is extremely important to offer help in cases of sexual violence against women, which represents one of the greatest health risks. The prevention of sexually transmitted diseases and unwanted pregnancy also play a major role, explains Uschi Traub.

The launch of the model will be accompanied by a wide-ranging publicity campaign. From November 23, large advertising posters in the district will draw attention to the new project. Flyers and posters will also be distributed, particularly via the district municipalities and the state education authority. District councillor and managing director Florian Lutz of the Lutz bakery chain has spontaneously agreed to have information printed on 100,000 bakery bags.

"Only if we get the topic of rape out of the taboo zone will change be possible and support services can become visible," commented Pia Rothstein from the counselling centre for sexualized violence (Frauen für Frauen e.V.) and Elke Karle from
the specialist counselling centre against sexual violence against children and young people (Silberdistel e.V.).

"After learning about the lack of confidential forensic evidence collection after rape in the district and the Frankfurt model project, it was clear to me that confidential forensic evidence collection should also be established in the district of Ludwigsburg,"summarizes Cynthia Schönau, Equal Opportunities Officer for the district.

The RKH Klinikum Ludwigsburg plays the central role in this pilot project:

Not only can the measures within outpatient emergency care now take place there, but also all the necessary medical measures during the first visit to the emergency room. This means that a repeat examination in an outpatient practice the next day, which is psychologically stressful for those affected, is generally no longer necessary. At the same time, the hospital sets the course for aftercare and referral to counseling centers. And, if desired, a legally compliant forensic examination can be carried out. Regional Director Anne Matros is convinced by the concept: "I respect and appreciate the commitment of the Clinic for Gynaecology and Obstetrics, the Children's Clinic and the others involved".

While the clinic team provides the medical care, project coordinator Cynthia Schönau and her project team pull the strings in the background and carry out organization, networking and public relations work. The specialist advice centers involved offer those affected personal advice on request. The confidential discussion is based on the needs of the person concerned. The Prevention Department of the Police Headquarters provides support in the form of specialist expertise and coordinates the interface with the police. All departments involved in this project, from the reception desk at the RKH Klinikum Ludwigsburg to the advice centers and the police, must be familiar with the procedures and guidelines. In such an exceptional situation, those affected should be well informed about their options and receive the best possible care and support.

The establishment of the "Emergency Medical Assistance after Rape" is expressly welcomed by the "Round Table against Domestic Violence in the City and District of Ludwigsburg", the Ludwigsburg Child Protection Association and the Board of the Ludwigsburg District Medical Association.

You can find out more or send questions directly to gleichstellungsbeauftragte[at]landkreis-ludwigsburg.de on the project's website: www.soforthilfe-nach-vergewaltigung.de.

After being signed (2011) and ratified (2017), the Council of Europe Convention on preventing and combating violence against women and domestic violence, known as the Istanbul Convention, came into force on February 1, 2018. Germany is thus committed to doing everything possible at all levels of government to combat violence against women, offer protection and support to those affected and prevent violence.

The 2020 security report of the Ludwigsburg police headquarters shows that 1.7% of crimes in the Ludwigsburg district were "Crimes against sexual self-determination" (369 cases; 2019: 312 cases). Statewide, the figure has also risen to 1.7% (2019: 1.4%). Of the 369 crimes against sexual self-determination, 415 victims were affected, 350 victims (84.3%) of whom were female. At just under 50%, the adult age group is the most affected. Of the 369 cases, there were 31 cases of rape/sexual assault (2019: 27). A total of 783 people were victims of domestic violence/partner violence (2019: 699), which represents an increase of 12%. 622 of the victims - the overwhelming majority - were female. Source: Ludwigsburg police headquarters

44 of the 48 (92%) rape victims recorded in the reporting year 2020 in the jurisdiction of Ludwigsburg police headquarters(Ludwigsburg and Böblingen districts) had a previous relationship with the perpetrator. Source: Ludwigsburg police headquarters