Anita Jain on the paradox of rape in India

“For those who care for their country”—the strap line spelt it out for me. As Aamir Khan returned with the second season of his documentary/talk show, Satyamev Jayate, I knew I would be watching. The show stirred the hearts of Indians across the globe in its last run. It had thrown up incisive questions about our society and the functioning of bureaucracy, at large. Did it lead to action and change as hoped? That’s a tough call for a TV show, I’d think. And as Aamir set straight right away, the show is a platform to lay bare and discuss issues we tend to remain silent about, or even shove under the rug, and to identify solutions together.

Indeed, the inaugural episode on the theme of sexual assault rang true to the paradoxical reality of our society. The perpetrators of this crime make up less than 1% of our population, but they weigh heavily on the remaining 99%. Systems intended to support the rape survivor end up aggravating their situation through entrenched insensitivities. The perpetrator roams scot free while the survivor is shamed, blamed, and confined.

The episode depicted the systems a survivor has to navigate through in the pursuit of basic medical care, safety, justice, and restoration of self. Having worked as a crisis interventionist at CEHAT (Centre for Enquiry into Health and Allied Themes), it reminded me of the domains we would intervene in alongside and on behalf of the survivor: hospitals for treatment and medico legal examination, the police for registering a complaint and starting investigation, the judiciary for legal reparation, and importantly, the families and communities to which the survivor returns, to ensure rehabilitation and recovery in the long run.

The experiences recounted by survivors on the show are unfortunately not exceptional instances. Rather they validate the norm of the dismal inadequacies of these systems in delivering on their mere duty to the survivor who has been wronged. The police who dismiss the complaint of the survivor, the doctor who refuses prompt treatment, the lawyer who challenges the moral character of the survivor, and the society who blames the survivor: they don’t just let down, but may be guilty of secondary victimization of the individual.

As Sangeeta Rege shared on the show, CEHAT has been steering change in the health system response by implementing a standardized approach to sexual assault survivors, centred on the principles of dignity, choice, and healing. Sustained advocacy has led to new gender-sensitive guidelines issued by the union health ministry which recognize the needs and rights of survivors, and lay the framework for a holistic approach to their care. The ministry has issued a ban on the derogatory and unscientific two finger vaginal examination. Addressing the medical and psychosocial needs of the survivor is to take precedence. This would need a systemic attitude change among healthcare providers. The ball is now in our court. We need to recognize our role as first responders, whether in the private or the public setor, and view the survivor not with suspicion or as “extra work,” rather as a patient, giving them due importance. A parallel initiative by CEHAT aims to inculcate these perspectives among young doctors through integrating gender sensitization in the MBBS curriculum.

The Delhi gang rape had awakened and united us in condemnation. The protests signified “zero tolerance” to the existing state of affairs. Just as then, the realities that came forth in this episode were hard to swallow. It hurt to know that one among us, a free-willed independent woman of this country, had to endure such brutality. Neither were we able to prevent it, nor salvage her in the end. It reminded me then as it does now, of the promise of our country expressed through Tagore’s lines: “Where the mind is without fear and the head is held high.” We need to make this happen for the girls and women of this country, urgently.

Competing interests: I have previously worked at CEHAT (Centre for Enquiry into Health and Allied Themes) on their sexual assault intervention programme.

Anita Jain is India editor, BMJ.