Treating victims right; changing India’s protocols on rape

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After being sexually assaulted, usually the last thing a victim wants is to go through a painful, invasive physical examination.  In India, the so-called “finger test” is standard protocol for forensic examinations of women who claim rape or sexual assault.

During the test, the medical examiner inserts fingers into a woman’s vagina to theoretically measure how often she has sex. Although results from the test are legally irrelevant, the procedure is practiced around the country. In a traditionally modest culture like India, such a practice is especially abhorrent and terrifying for young girls.

Now the practice may be on the way out.  Last week, Minister Ghulam Nabi Azad wrote to government hospitals telling them not to conduct the tests without victims’ consent.

The announcement is a positive sign says Sana Contractor, a research officer with India’s Centre for Inquiry into Health and Allied Themes. “We will have to see how [the minister’s directive] plays out in real terms. What we really need is health policy that adequately addresses violence against women.”

Unnecessary and invasive

Contractor’s organization has been working in three Mumbai hospitals to develop protocols for medical and legal care of sexual assault victims. Although more than 21,000 Indian women reported being raped in 2009, many cases go unreported. Rape carries a great stigma in the country. Victims are often punished or ostracized by their communities, and girls who are raped often find it difficult to marry.  

When they do go to hospital for treatment, Contractor says, women's care varies widely. In many hospitals women are only examined for evidence of assault. In some, women are also given medical care and emergency contraceptive pills. Psychological support is almost universally absent, Contractor says. The widely-used finger test can further traumatize a woman, and Contractor says it is forensically unnecessary.

“The two-finger test is used to determine whether a woman is accustomed to sexual intercourse, which has nothing to do with whether she has been sexually assaulted,” she says. “Recent legal rulings have made a woman’s sexual history irrelevant in sexual violence cases, but somehow these things still seem to make it through to court.”

Education needed to make policy stick

It is currently the judge’s decision whether or not to use the results of the test in a given case, says Meenakshi Galguly. She is South Asia Director for Human Rights Watch. Last year her organization released a report on the state of medical and legal care of rape survivors in India, focusing criticism on the test. She says that a statement from the health ministry is not enough.

“It has to be a public education initiative,” Galguly says. “Doctors are taught to do this test in medical school.  It’s taught as standard practice in rape cases. The notice needs to go down to each public hospital, along with instructions to doctors and emergency room workers on how to deal with sexual assault. ”

Sana Contractor says that when a woman shows up in a hospital claiming to have been raped, most of the emphasis is on collecting evidence for possible legal proceedings. Contractor says that any new protocol must emphasize taking care of the victims medically, legally and psychologically. 

Questioning the government’s commitment

Meanwhile, the union government’s 2011 budget has cut funding by 85 per cent for a program to fund compensation and care of rape victims, on the grounds that it was underutilized. Contractor says that the government had no guidelines for how the fund was to be used, and made no effort to let medical professionals and victims’ support organization know that it was available. Both Contractor and Galguly say that bungled programs like that leave them wondering – recent announcements aside – how committed the government really is to giving rape survivors proper care.