Report reveals rural, northern sexual assault care gaps

A new report by She Matters finds a survivor's location in Canada greatly impacts their access to justice after a sexual assault.

A new community-based research project, funded by a $530,000 investment from the federal government in January 2024, has detailed significant and ongoing barriers to forensic evidence collection for sexual assault survivors in rural and remote communities.

The findings are outlined in the 131-page report, ‘Does Geography Impact Access to Justice?’ from the Sudbury-based organization She Matters. The report examined factors limiting access to specific resources in the Yukon, northern British Columbia and northern Ontario. The volunteer-led study contacted 700 hospitals and health centres, with feedback from 581 revealing a clear pattern: the more northern and remote a community is, the worse access to essential services becomes.

Building upon a national crisis

Jacqueline Villeneuve-Ahmed, the founder of She Matters, explained to CTV News that this research directly follows their earlier work.

“It is really a study building upon the Silenced Canada Sexual Assault Evidence Kit Accessibility Crisis report that we released in 2021,” she said.

“For this research, we wanted to not only highlight the inability for survivors to equally access forensic evidence collection in their home community, specifically for folks in northern, rural and remote communities, but also to touch upon their ability to access support services as well.”

The first recommendation from the report is to initiate comprehensive training, specifically mandating trauma-wise and culturally safe training for all first responders.

Official response and on-the-ground realities

In response to the issues raised, Brent Ross, a spokesperson for the Ontario Ministry of the Solicitor General, outlined the province’s existing measures.

“The Centre of Forensic Sciences distributes sexual assault evidence kits (SAEKs) to agencies across Ontario based on their requests. The centre works with sexual assault nurse examiners to ensure ordering information and guidance is readily available,” the ministry’s statement reads.

Ross also noted that the province funds 37 Sexual Assault and Domestic Violence Treatment Centres, including nine in northern Ontario, and instructional videos have been developed for nurses in remote locations, if there are no sexual assault nurse examiners available.

Local public health units, however, clarify the boundaries of their mandates.

Public Health Sudbury & Districts, which serves a vast area including Sudbury, Manitoulin Island and Chapleau, stated that while they champion health equity, forensic testing falls outside their scope.

“Through our sexual health clinic, we offer testing, diagnosis and treatment for sexually transmitted infections and blood-borne infections... We do not conduct forensic testing as that does not fall within our mandate,” a statement from the health unit reads.

This delineation of services underscores the systemic gaps identified in the report.

Despite provincial resources, the She Matters report identifies a critical gap between the availability of kits and the consistent presence of trained staff to administer them.

The report calls for an update to the standard of care and the establishment of regional-specific options, which could include mobile or satellite sexual assault care.

“This particular area is very key,” said Villeneuve-Ahmed.

“Ensuring that survivors can access care 24/7. One area that we really identified was not only having the access to the exams – but also having timely access.”

The study heard from many survivors that they were waiting 10 hours or more or having to travel great distances to access care.

The issue of transportation logistics in the north is another critical barrier.

“We have a hub cities model and so when you are a survivor who presents for care and it’s sexual assault, (the) nurse examiner is not there, you then will either have to wait or be transported to another region.” said Villeneuve-Ahmed.

Officials with She Matters said that right now, there isn’t a standard, protocol or practice in place that offers that transportation to a survivor outside of being put in the back of a police cruiser.

Calls for accountability and integrated support

Villeneuve-Ahmed emphasized that focusing on integrated programming and support services, rather than a siloed model of care, is key. She said that addressing these deep-rooted challenges requires a joint effort between federal, provincial and territorial leadership.

“Unfortunately, the topic of forensic examinations and evidence collection falls into… what we call a gray area and we’re seeing kind of a hot potato situation,” said Villeneuve-Ahmed.

“Because forensic collection is housed at present within the hospital setting from the federal perspective, we’re told that it’s provincial and territorial leaders that are responsible for integrating any changes – but then there is also the component of justice within the mix, which is a federal priority.”

The organization said it wants to see not only a national mandate but also provincial and territorial responsibility taken to address the barriers that are facing survivors.

The human impact of these systemic failures is stark, as voiced by the 62 survivors and providers who participated in the study.

Emma, an emergency room healthcare provider, shared a heartbreaking account of the delays faced by victims with She Matters.

“I remember on multiple night shifts seeing super young girls come in for sexual assault, and in the notes section seeing no SAEK nurse till Monday, and this would have been a Friday or Thursday, and that’s not okay because now they’re being held in the emergency department with no support and no access to a kit,” she said.

“That just broke my heart. We have the resources that we need. Why aren’t we using them?”

Renee, an Indigenous families support worker, highlighted the profound unfairness of the situation for victims, particularly children, who are forced to wait for care due to chronic short-staffing.

She said that sometimes you call a hospital or health centre and are told that no one will be available until the next morning.

“(So) this child can’t shower, this person can’t do anything for 12 hours till they’re seeing a nurse,” the support worker said.

“How is that fair to the person?”

While Renee explained that everyone is short-staffed, so they can understand staffing shortages – but for that child, how do you explain to them?

“Sorry, there’s no staff.”

To ensure the report’s critical findings reach a wider audience, She Matters has created a four-part podcast series that shares direct stories from the survivors and rights holders who engaged in the work.

Read the full report here.

RESOURCES FOR SEXUAL ASSAULT SURVIVORS

If you or someone you know is struggling with sexual assault or trauma, the following resources are available to support people in crisis:

• If you are in immediate danger or fear for your safety, you should call 911.
• A full list of sexual assault centres in Canada that offer information, advocacy and counselling can be found at ReeseCommunity.com. Resources in your community can be found by entering your postal code.
• Helplines, legal services and locations that offer sexual assault kits in Alberta, B.C., Saskatchewan, Manitoba, Quebec, Ontario and Nova Scotia can be found here.
• 24-hour crisis line: 1-416-597-8808
• Assaulted Women’s Helpline: 1-866-863-0511
• National Residential School Crisis Line: 1-866-925-4419
• Canadian Human Trafficking Hotline: [phone]
• Trans Lifeline: 1-877-330-6366
• Sexual misconduct support for current or former members of the Armed Forces: 1-844-750-1648

Read about your rights as a victim here.

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