Part of combating a problem in the community is raising awareness about its very existence, even when the subject is something most people would rather not talk about.

One group of law enforcement officers, staff from the District Attorney’s Office and specially trained nurses at Waldo County General Hospital known as the Sexual Assault Response Team are addressing the problem of sexual assault. The S.A.R.T. panel meets quarterly to discuss local trends, look at ways to improve the services they provide and keep lines of communication open.

Meg Hatch, a S.A.R.T. advocate who works with the Sexual Assault Crisis and Support Center in Winthrop, said it’s crucial to make the public aware of how broadly sexual assault is defined in state law. For starters, she said, the offense is not limited to encounters that involve sexual intercourse, and the law itself contains more than three pages describing the various acts that constitute a sexual assault.

“It’s any unwanted sexual contact that occurs without someone’s consent,” she said.

Men, women and children who have been subjected to such crimes are not referred to as “victims,” stressed S.A.R.T. member and WCGH-based Sexual Assault Forensic Examiner Susan Dupler.

“We call them ‘survivors’,” she said.

The use of the term “survivor,” said Dupler, is a way to acknowledge the struggle a person faces in deciding to reach out for help after a sexual assault, and the courage necessary to come through such a traumatic experience.

“So many people don’t come forward for many reasons: they don’t want to be embarrassed, or they feel ashamed. Maybe they had been drinking, and they think on some level they may have deserved it,” said Dupler.

“Some people carry that secret their whole lives,” said WCGH S.A.F.E. nurse Teri Blackadar. She said when elderly survivors come forward decades after a sexual assault has occurred, the years of staying silent typically have taken a toll throughout their lives. For those survivors, she said, experiences that many would view as some of life’s happiest milestones were marred by the memories of the abuse they had endured years earlier.

“It affects many of the aspects of their lives, like their parenting, their childbirth experience and their marriage,” said Blackadar.

In each of those situations, particularly with childbirth, survivors of sexual assault might liken the pain and lack of control to the feelings they experienced when they were assaulted.

Just because a survivor finds the courage to obtain medical treatment doesn’t necessarily mean criminal charges will come out of the case. That, said Hatch, is left up to the survivor.

“We’re there to provide support to the survivor, and to encourage that survivor to make well-informed decisions,” she said. “We don’t say to someone, ‘You have to report this to the police.’”

Hatch’s role as an advocate is to provide support to the survivor, and her job begins the second she is contacted by a S.A.F.E. nurse informing her that a sexual assault may have occurred. Hatch travels to WCGH to meet with the survivor, and remains at their side throughout the forensic exam.

Later on, Hatch said, she may assist the survivor with filling out paperwork necessary to obtain a protection order, or offer moral support when and if the survivor decides to contact police. The advocate would also be a source of support for the survivor during the criminal trial, should the matter get to that point.

The services that the S.A.F.E. nurses provide, from the time a survivor appears at the emergency room until the forensic examination is completed four to six hours later, are completely confidential. Blackadar said adults seeking S.A.F.E. services can have the results of their examination stored at the hospital under an anonymous number rather than their name, and each completed forensic crime kit is held for up to 90 days. This allows the survivor time to decide whether or not to pursue criminal charges, and should they opt to contact police, the kit would then be turned over to law enforcement for use as evidence.

It is not unusual for a survivor to need some time to come to terms with what has happened, Blackadar said, let alone to make decisions about reporting the incident to law enforcement.

“Right away a person may be so overwhelmed,” said Blackadar. “Especially when, most times, people are being sexually assaulted by someone they know.”

The decision to press charges is almost always left up to the survivor, Blackadar said, with the only exception being when a child is believed to have been victimized. In that instance, S.A.F.E. nurses must report the findings to the state Department of Health and Human Services.

Blackadar said that as a precaution, survivors are also treated for sexually transmitted diseases before they leave the emergency room. Should a survivor come in with injuries, Blackadar said, an X-ray might be ordered. But no matter what the survivor goes through at the hospital, the same S.A.F.E. nurse remains at their side at all times.

Dupler said a forensic exam often could produce DNA samples from the attacker even if a survivor does not visit the emergency room immediately after an assault has taken place.

“DNA can be found up to two to three weeks following a sexual assault,” said Dupler, noting that skin cells, hair, blood and other body fluids are all ways to link a perpetrator to a crime.

“A person’s body is basically the crime scene,” added Blackadar.

Ideally, a survivor should report directly to the emergency room without showering, brushing their teeth, using mouthwash or eating. It is also advised that the survivor bring the clothes that they had on at the time the assault occurred, as they may be used as evidence. Additionally, the presence of most date-rape drugs can only be detected if the survivor seeks medical attention within hours of the suspected sexual assault.

Each person involved with a sexual assault case may be aware of the others’ roles, but everyone, from the advocate to police officers, works independently of one another. Where an advocate will avoid testifying in a criminal trial in the interest of focusing only on the survivor’s well-being, a S.A.F.E. nurse will avoid communicating with all involved because they may need to serve as an expert witness should a case ever go to trial.

“We work together without talking about the cases,” said Dupler.

While the S.A.R.T. meetings have just recently picked up steam, Dupler said, the effort to improve services for survivors has been ongoing since 1997. At that time, the state Legislature passed a law allowing registered nurses to perform the pelvic exams necessary to complete the forensic crime kits.

In response, the first sexual assault education program was launched at WCGH, and through assistance from local doctors’ offices and the Family Planning Association of Maine, Dupler completed the required 48 hours of training to become the first S.A.F.E. nurse in the state.

In addition to the clinical experience, Dupler said S.A.F.E. nurses also learn about what their potential role could be should a survivor opt to involve the police.

“We attend trials to get an idea of what it’s like to testify, and we spend time with the advocates to see what kind of support they give,” said Dupler.

There have been some changes for the better over the years in the ways of making survivors feel at ease when they arrive at the hospital, Dupler said, particularly in how long they are sitting in the waiting room.

“They’re brought right in now, instead of being made to sit there and wait,” she said. “The survivors have to understand that the hospital is a safe place to come to, and when they get here, they’re brought right into their own room, where it’s private and safe. We also make sure that at the end of it they’re going home to a safe place.”

One change that Dupler, Blackadar and Hatch hope to see is an increased number of volunteer advocates in Waldo County, as there are no trained advocates available locally and Hatch must travel from the Winthrop area to respond to a call.

Advocates, explained Hatch, are subject to a criminal background check and must undergo 42 hours of training, which is free of charge. The training teaches volunteers about sexual violence, the trauma that survivors experience and the process through which they may be guiding a survivor. Advocates are needed to work  in hospital settings, as well as to work the phones for the Sexual Assault Crisis and Support Center’s statewide sexual assault support hot line.

Recovering from the emotional wounds that come with being the target of a sexual assault, said Hatch, can be a lengthy process, even when a survivor does seek out help. Sometimes survivors will volunteer to serve as advocates, only to learn they’re not quite ready to help others with their crises because they are still healing themselves.

For those who aren’t quite ready to be advocates or work the phones, Hatch said there is an eight-hour training available to those who wish to assist with events.

Whatever the level of training for each advocate, Hatch said, the aim of the teachings remains the same.

“It gives people the coping skills they need to deal with the different things that people might experience after a sexual assault, and to validate the experiences a victim could be having and to be able to say, ‘That’s normal’.” Hatch said. “It’s about breaking that silence that’s around sexual assault and sexual abuse.”

Anyone suffering from the affects of a sexual assault is invited to call the Sexual Assault Crisis and Support Center hot line at 800-871-7741. For more information about the Sexual Assault Crisis and Support Center and area S.A.R.T. groups, visit silentnomore.org.

Crime by the numbers

The Sexual Assault Crisis and Support Center and the Maine Coalition Against Sexual Assault report the following statistics:

• Sexual assault is the most under-reported crime in the country;

• On average, 1.3 women are sexually assaulted every minute, and in 84 percent of the cases, the attacker knows the victim;

• In 1996, 31 percent of sexual assaults were reported to law enforcement;

• Seventy-five percent of female victims require medical attention;

• Victims of sexual assault are 13.4 times more likely to develop two or more alcohol-related problems and 26 times more likely to have two or more serious drug abuse-related problems;

• About 92,700 men are sexually assaulted each year in the United States.

• Eleven percent of total sexual assault victims are male, 89 percent are female;

• One of four victims of sexual assault under the age of 12 are boys, and;

• Forty-eight percent of male victims were sexually assaulted by strangers, compared with 28 percent of female victims.

• A recent study found that nearly one in five adult Maine residents report that they have been the victim of rape or attempted rape during their lifetime; 28.5 percent of female respondents and 7.4 percent of male respondents have experienced this crime at some point in their lives.

• Roughly 14,000 Maine residents may be the victim of rape or unwanted sexual activity during any 12-month period.

• According to the Children’s Safety Network and Data Analysis Resource Center, the comprehensive costs of sexual abuse of children in Maine in 2004 were $138,057,000. This estimate takes into consideration future earnings, medical and mental health expenses, and public programs, among other things.