Farrah Khan is the chief executive officer of Possibility Seeds. Beth Lyons is the executive director of the New Brunswick Women’s Council.

Sexual assault is dehumanizing. Access to services for survivors shouldn’t be too.

And yet, in August, a woman seeking a sexual assault forensic exam at Dr. Everett Chalmers Regional Hospital in Fredericton was told that no one was available to conduct it. She was advised by hospital staff to return the next day and to preserve evidence by refraining from showering or changing, and using the washroom as little as possible.

The 26-year-old woman had called the police, who referred her to the Sexual Assault Nurse Examiner (SANE) program at the New Brunswick hospital. After being told to return home by staff, though, the survivor contacted the police again. In the end, a nurse who had recently finished a shift was called back to the hospital to conduct the forensic exam that night.

The survivor spoke out this week about her treatment, hoping that no one else has to endure a similar experience. The government and the health authority have since called this unacceptable, and the latter has committed to reviewing processes and protocols.

Strengthening operating procedures and policies is good, but it’s not nearly enough. We need increased, sustained and equitable resourcing of SANE programs across the country that treats them like the specialized services they are.

There’s a misconception that SANE nurses are “just taking a swab” – but their work is far more involved. They are forensic nurses who provide comprehensive trauma-informed care for survivors, and not just the collection of the Sexual Assault Evidence Kit (SAEK). They provide support and referrals, as well as address health concerns such as sexually transmitted infections and the risk of pregnancy.

Completing a SAEK is not quick, either; it typically takes three to four hours. The process involves the careful collecting of evidence so that it can be used in investigations and trials; samples may be taken from the mouth, genitalia, fingernails and other areas. If there are signs a survivor may have been drugged, a toxicology sample may be collected. The sooner evidence can be collected, the better; within 72 hours is ideal, though some jurisdictions may attempt to collect evidence up to 12 days after an assault. In addition, SANE nurses document any injuries, sometimes using specialized forensic photography, and may also be called to testify as witnesses in trials.

Of course, even when a forensic exam is done, the evidence collected doesn’t guarantee charges will be laid, a criminal proceeding will be held, or the perpetrator will be found guilty. Survivors still have to go through a court process where, too often, their credibility, not the defendant’s, is put on trial. (It’s important to note that one can report recent or historic assaults even if there is no physical evidence. Also, SAEKs may help establish that the assailant had physical contact with the survivor as well as physical impacts, but cannot establish whether there was consent.)

It is appalling that a specialized SANE practitioner wasn’t made readily available to this survivor in Fredericton. Sadly, however, it also isn’t surprising, given that we’re in the midst of a broader health care crisis in Canada. Entire emergency departments, particularly in already under-resourced rural, northern and remote communities, are closing for periods of time because of staff shortages. Institutional commitments to do better in responding to sexual violence aren’t deep-rooted enough to hold under this kind of pressure.

And inadequate access to SANE programs was already often the status quo here: Hospital and community-based services for survivors are woefully and consistently underfunded across the country. This is especially true in areas outside cities. For example, a victim in Elliot Lake, Ont., would have to travel two hours to access their nearest SANE program in either Sault Ste. Marie or Sudbury. This fall, though, Ontario Sexual Assault/Domestic Violence Treatment Centres, in collaboration with the Elliot Lake Hospital, will train clinicians at the local community health centre in the provision of sexual assault care.

Survivors don’t choose to be subjected to sexual violence, but they should get to decide how they want to begin to heal. Access to a SANE program and other services and supports is part of that. But too often, the path forward is determined for survivors based on what isn’t available.

Ensuring survivors of sexual violence have access to SANE programs requires significant, sustained investment from federal, provincial and territorial governments – not just policy reviews and scheduling promises when a crisis emerges. It requires improving working conditions for all nurses, ensuring SANE training is accessible, creating more storage space for SAEKs and prioritizing staffing for SANE programs, at all times.

That’s what survivors deserve. Governments have the responsibility to deliver.

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