When an Incident Occurs

field_blues_image

First Steps Post-Assault

  • Ensure your safety first. Go to a location where you believe you can be assured safety. If possible, contact a friend/colleague who may assist you. Ask this friend/colleague to come to your aid in your safe location and to accompany you to various appointments (medical, police, security, etc.) so you are not alone. Do not feel obligated to divulge the details of the incident to that person – even if it’s a family member or a close friend. You may find, however, that speaking with someone close to you can help you feel less alone and more supported. You may choose what to share.
  • Celebrate your survival, and thank yourself for saving yourself. You did it and, unless there was anyone else near/with you to support and assist you, you likely did it alone. That is an incredible feat.
  • Ensure any necessary medical precautions are taken (including to limit any risk of Hepatitis).
  • Ensure that a thorough investigation is conducted of the incident and that the perpetrators are identified, where possible and especially if you wish to pursue legal recourse. Understand the process to make a report, what the police will expect from you, what support you will receive from the police and from your employer, and how the legal process will be conducted for charges against perpetrators. The quality of investigation and reporting by local police may not be what you might expect. Do not rely solely on local police. Advocate for your rights to a thorough investigation and reporting, if you feel comfortable doing so and wish to do so. Seek support from your employer.
  • Ensure forensic evidence is taken at the hospital for investigation and accountability purposes, should you wish to pursue legal recourse or worker's compensation.
  • Remember: It is your RIGHT to refuse to discuss the incident or to share any details with colleagues, other aid workers, journalists, etc. It is, likewise, your right to refrain from reporting from the police. Neither your employer nor anyone else may persuade you to report. It is your choice.

First 72 Hours Post-Assault

  • Take medical precautions to avoid contagions, like Hepatitis.
  • Start counseling – by phone or in person – as quickly as possible to help diminish trauma symptoms and shorten the overall length of time you may be affected by trauma.
  • If you know anyone who has undergone a similar experience, you may find it beneficial to speak with this person to help you to feel understood and to remember that you are not alone.
  • If a staff person is not presented to you, contact your headquarters to understand how to access counseling, complete compensation claims, understand your evacuation, medical leave and work reassignment options, seek career advice, understand entitlements, and seek prompt and appropriate follow-up.

First Steps Post-Assault For Survivors of Rape and Sexual Assault

Understand the cultural context in which the incident has taken place. In some locations, it may be "illegal" to be raped, you may be blamed and/or pursued for reporting a rape, and/or you may be forced to marry the rapist. Given the local context, choose an approach that feels most comfortable to you and try to find a way that you can reach out for help without potentially compromising your safety. This may mean speaking with someone outside your culture and/or outside the local context or the context in which the incident occurred. Whatever measures you choose to take, ensure that YOU are comfortable with them.

  • Ensure your safety first. Go to a location where you believe you can be assured safety. If possible, contact a friend/colleague who may assist you.
  • Ask this friend/colleague to come to your aid in your safe location and to accompany you to various appointments (medical, police, security, etc.) so you are not alone and because dealing with police and investigation officials can be a harrowing experience. Do not feel obligated to divulge the details of the incident to that person – even if it’s a family member or a close friend. You may find, however, that speaking with someone close to you can help you feel less alone and more supported. You may choose what to share.
  • Celebrate your survival, and thank yourself for saving yourself. You did it and, unless there was anyone else near/with you to support and assist you, you likely did it alone. That is an incredible feat.
  • Ensure the PEP Kit (anti-retrovirals, Plan B, other precautionary treatments) is administered as quickly as possible (ideally 2-24 hours) and no later than 72 hours after the incident to avoid risks of pregnancy, HIV, etc. Take any necessary precautions against Hepatitis as well.
  • Ensure that a thorough investigation is conducted of the incident and that the perpetrators are identified, where possible and especially if you wish to pursue legal recourse. Understand the process to make a report, what the police will expect from you, what support you will receive from the police and from your employer, and how the legal process will be conducted for charges against perpetrators. The quality of investigation and reporting by local police may not be what you might expect. Do not rely solely on local police. Advocate for your rights to a thorough investigation and reporting, if you feel comfortable doing so and wish to do so. Seek support from your employer.
  • If you report the incident to the police, you will be required to obtain forensic evidence at the hospital or with a medical provider. A police officer will usually accompany you to the hospital, although s/he will not be present for the examination and will only accompany you to receive forensic evidence and clothing from the examining doctor. Clothing you were wearing at the time of the assault may be taken as evidence.
  • If you opt against reporting the incident immediately, understand that a medical examination at this time is still important to obtain forensic evidence should you wish to pursue a criminal investigation later.
  • Remember: It is your RIGHT to refuse to discuss the incident or to share any details with colleagues, other aid workers, journalists, etc. It is, likewise, your right to refrain from reporting from the police. Neither your employer nor anyone else may persuade you to report. It is your choice.

First 72 Hours Post-Assault

  • Start the PEP Kit (anti-retrovirals, Plan B, other necessary treatments), if you have not already done so, to help counteract pregnancy, HIV, etc. Take any necessary precautions against Hepatitis as well.
  • Start counseling – by phone or in person – as quickly as possible to help diminish trauma symptoms and shorten the overall length of time you may be affected by trauma.
  • If you know anyone who has undergone a similar experience, you may find it beneficial to speak with this person to help you to feel understood and to remember that you are not alone.
  • If a staff person is not presented to you, contact your headquarters to understand how to access counseling, complete compensation claims, understand your evacuation, medical leave and work reassignment options, seek career advice, understand entitlements, and seek prompt and appropriate follow-up.

Those Meant to Provide Protection Can Cause Further Harm

A traumatized person is in a particularly vulnerable place. Some people may take advantage of this vulnerability. Others may unknowingly cause further harm. It is important to remember that not all people or agencies have the survivor's best interests in mind. This could include the police, security, even one's employer, colleagues or supervisor.

  • Survivors of critical/traumatic incidents often express a feeling of abandonment - if not in the immediate aftermath of an incident then in the days/weeks/months/years following an incident.

Such a reaction can exacerbate trauma. Not all of the individuals/agencies responsible for causing further harm do so with intent. It is, thus, important for people and employers to understand how their reactions can cause survivors to feel unsupported and even neglected or abandoned and to take measures to minimize this risk (e.g. develop SOPs to help staff respond appropriately and adequately in the aftermath and long-term of incidents). It is also important for survivors to understand the ways in which others may worsen the situation and take steps to help protect oneself from further harm (e.g. through regular interaction with a qualified therapist with whom one feels comfortable and confident, through open communication with colleagues, friends, family, and others, through exercises that encourage a positive self-view - yoga, meditation, positive affirmations and self-talk, etc.).

First Steps Post-Assault

  • Ensure the survivor is taken to a safe location (i.e. where the SURVIVOR feels safe).
  • Help the survivor to feel safe and to find a sense of calm – to the extent possible.
  • Ensure a police investigation is conducted and forensic evidence is collected at the hospital, IF the survivor wishes to pursue legal recourse or worker's compensation.
  • Ensure that someone accompanies the survivor to the hospital and to the police station, where possible.
  • If the survivor is a woman, it is usually best that she be assisted by another woman.
  • Survivors tend to prefer having someone help them who is from the same/a similar culture and linguistic background.
  • Contact relevant emergency staff (including those on call for emergencies, if the incident occurs after hours), security staff, psychological first responders, emergency contacts identified by the staff member - family, partner, children, parents, etc.
  • Ensure basic needs are met (food/water, safe place to sleep, access to a bathroom where the person will feel safe).
  • Ask the survivor to identify other needs, and find ways to meet them.
  • Ensure accountability – where possible – of the perpetrators.
  • Help the survivor to remember that s/he is not to blame.
  • Help the survivor to feel supported and not alone.
  • Seek permission from the survivor to be contacted by a counselor. Then, ensure the counselor contacts the person. Do not put the onus on the survivor. The responsibility to check on the survivor is with the counselor, not the survivor. The survivor is in the survival stage, processing the incident and may even be grieving. The survivor needs to be and to feel supported.

First 72 Hours

  • Ensure the survivor is taken to the hospital and forensic evidence is collected, if this has not been done already and if the survivor wishes to seek legal recourse and/or worker's compensation.
  • Ensure any necessary medical treatment is administered.
  • Ensure an appropriately trained staff person is available to help guide the staff member through the bureaucracy (accessing counseling, helping complete compensation claims, referring for appropriate career advice including an appropriate reassignment, explaining entitlements, ensuring relevant staff are informed for prompt and appropriate follow-up).
  • Ensure the survivor is aware of his/her RIGHT to refuse to discuss the incident or to share any details with colleagues, other aid workers, journalists, etc.
  • Ensure the affected staff person is informed of every action taken/not taken on her/his behalf (security, police, investigations, reporting, medical, psychosocial counseling, legal, etc.).
  • Ensure the person has access to psychosocial support by phone and in person, where possible.
  • Provide the survivor with the space to talk, but do not force it.
  • Listen patiently, but do not share personal judgments (e.g. you should not have put yourself in this situation, it may have been your fault, etc.).
  • Avoid providing any sense of reassurance that may be inappropriate or inaccurate (e.g. saying "at least you are alive").
  • Discourage negative approaches to coping (e.g. substance abuse, isolation, self-harm), which are known to exacerbate trauma symptoms.

Those Meant to Provide Protection Can Cause Further Harm

A traumatized person is in a particularly vulnerable place. Some people may take advantage of this vulnerability. Others may unknowingly cause further harm. It is important to remember that not all people or agencies have the survivor's best interests in mind. This could include the police, security, even one's employer, colleagues or supervisor.

  • Survivors of sexual assault often find that the police meant to protect them take further advantage of them - by blaming the survivor, refusing to report against the accused, or even requesting sexual favors or forcing sex in exchange for "protection".
  • Survivors of sexual assault are confronted by blame, disbelief, and the feeling that they are "dirty" or suddenly "unworthy" - even by those from whom they might least expect such reactions - including humanitarian employers/colleagues, friends, family, the police, security offices, even therapists.
  • Survivors of critical/traumatic incidents often express a feeling of abandonment - if not in the immediate aftermath of an incident then in the days/weeks/months/years following an incident.

Each of these reactions causes further traumatization or re-traumatization. Not all of the individuals/agencies responsible for causing further harm do so with intent. It is, thus, important for people and employers to understand how their reactions can cause survivors to feel unsupported and even neglected or abandoned and to take measures to minimize this risk (e.g. develop SOPs to help staff respond appropriately and adequately in the aftermath and long-term of incidents). It is also important for survivors to understand the ways in which others may worsen the situation and take steps to help protect oneself from further harm (e.g. through regular interaction with a qualified therapist with whom one feels comfortable and confident, through open communication with colleagues, friends, family, and others, through exercises that encourage a positive self-view - yoga, meditation, positive affirmations and self-talk, etc.).

First Steps Post-Assault for Survivors of Sexual Assault and Rape

  • Ensure the survivor is taken to a safe location (i.e. where the SURVIVOR feels safe).

  • Help the survivor to feel safe and to find a sense of calm – to the extent possible.
  • Ensure a police investigation is conducted and forensic evidence is collected at the hospital.
  • Ensure that someone accompanies the survivor to the hospital and to the police station, where possible.
  • If the survivor is a woman, it is best that she be assisted by another woman.
  • Most survivors tend to prefer having someone help them who is from the same/a similar culture and linguistic background.
  • Ensure accountability – where possible – of the perpetrators.
  • Help the person to remember that s/he is not to blame.
  • Help the person to feel supported and not alone.
  • Seek permission from the person to be contacted by a counselor. Then, ensure the counselor contacts the person. Do not put the onus on the affected staff person. The responsibility to check on the staff person is with the counselor, not the staff person. The affected staff person will not feel comfortable calling a stranger and saying “I was raped” or “I was sexually assaulted”. The survivor is in the survival stage, processing the incident and may even be grieving. The survivor needs to be and to feel supported.

First 72 Hours

  • Ensure the survivor is taken to the hospital and forensic evidence is collected, if this has not been done already.
  • Ensure the PEP Kit (anti-retrovirals, Plan B, other precautionary treatments) is administered as quickly as possible (ideally 2-24 hours) and no later than 72 hours after the incident to avoid risks of pregnancy and HIV. Take any necessary precautions against Hepatitis as well.
  • Ensure an appropriately trained staff person is available to help guide the staff member through the bureaucracy (accessing counseling, helping complete compensation claims, referring for appropriate career advice including an appropriate reassignment, explaining entitlements, ensuring relevant staff are informed for prompt and appropriate follow-up).
  • Ensure the survivor is informed of every action taken/not taken on her/his behalf (security, police, investigations, reporting, medical services, staff welfare, legal affairs, etc.).

Issues that May Arise

Initial Weeks/Months

  • Anti-retrovirals must be continued at the same time daily for 28 days.

  • Follow-up support should not be limited to the initial minutes/hours. Maintain contact to ensure the survivor feels supported and to be aware of any signs/symptoms of PTSD or suicidal tendencies.
  • Ensure accountability for inaction from staff who should have taken specific actions (e.g. head of office, security, staff counselor, those responsible for providing access to PEP Kits, etc.).

First Year

  • While you may tend to forget the incident that affected a colleague, your colleague is still living it everyday. It is important to continue showing support in the long-term.

  • Traumatic symptoms may arise belatedly – after 6 months or even years later. It’s important to help the survivor monitor these symptoms, and it’s likewise important to monitor for any signs of depression or suicidal tendencies. Continue supporting the survivor.
  • Ensure appropriate measures are taken to support the survivor: medical leave, counseling, an appropriate work placement (i.e. not conflict zones, not a remote/isolated location, not a location with a high incidence of sexual assault), guidance in future career choices, and – where possible/necessary – continued follow up with any legal action.

KEY ASSUMPTIONS, STATEMENTS, AND BEHAVIORS TO AVOID

OTHER CONSIDERATIONS

RESPONDING IN THE AFTERMATH OF TRAUMA

* "When an Incident Occurs" and "In the Aftermath and Long-term" were written by Shannon in 2013 for the Staff Welfare section of UNHCR in order to help staff departing on emergency deployment prepare for potential traumatic incidents and, in particular, sexual assault. Please note that the text of these sections is, therefore, the property of UNHCR. Neither UNHCR nor the author, however, warrants in any way the accuracy of this information and may not be held liable for any loss caused by reliance on the accuracy or reliability thereof. The advice is provided based on Shannon's firsthand experience but may not be applicable in all situations or contexts. Special thanks to UNHCR for sharing this resource widely and for allowing it to be reproduced on this site. *

If you or someone you know is affected by trauma, do you feel well-equipped to address the symptoms of trauma and heal? Are you aware of treatment options?