The Northern Arizona Care and Services After Assault (NACASA), previously known as the Northern Arizona Center Against Sexual Assault, has moved into a new, larger area at North Country HealthCare’s Fourth Street location. Local and state leaders, law enforcement officers, physicians, staff members, nurses, social workers and volunteers gathered in February to unveil the new space.
“We care for those who have been extremely traumatized and injured, often by someone they know,” said Jennifer Runge, NACASA manager. “Victims need specialized care in a safe, quiet and private environment. These folks have been through enough; the least we can do is provide them a comfortable atmosphere to tell their story and undergo a thorough physical exam. Patient care and comfort are the top priority. If it gets to be too much, the patient can stop the examination process at any time.”
The new space offers a discreet entrance and a comfortable living-room style area to talk. The exam room is painted in warm colors, not hospital white. Victims can snuggle up in a soft blanket and sit in a comfortable chair. Medications, including prophylactic medications to help prevent sexually transmitted infections, can be prescribed. There is even a clothes closet with nice items provided by the Assistance League of Flagstaff for those who need a change of clothing following the assault. (Often, clothing is collected as evidence.) A private bathroom and shower are provided for victims to use after the examination.
Even with the attention to privacy, comfort and support, the biggest challenge NACASA faces is getting victims to call and reach out for help and support after an assault.
“Most victims remain silent, absorbing their fear, humiliation and shame,” said Runge. “For many, telling someone about the assault is the first step in the healing process. We want them to know they are not alone and they are not to blame and that this a safe place where they can get the care they need, regardless of whether they chose to report the incident to law enforcement, which is not required by law.”
NACASA offers a Sexual Assault Survivor’s Support Group. The free group, led by a licensed professional counselor with specialized training in sexual assault and post-traumatic stress, is for female sexual assault survivors who are 18 years of age and older.
Physical exams and support services for victims of domestic violence are available.
“Signs of domestic violence can be difficult to see,” explained Beth Otterstein, a nurse practitioner at North Country and NACASA medical director. “Strangulation is one of the most frequent injuries in domestic violence; yet, there often are no physical signs of the aggression or the signs are subtle and downplayed.”
Nearly half of all domestic violence victims report being choked. When strangulation is used in domestic violence, the relationship is 800 percent more likely to progress to a homicide.
Fortunately, new protocols are helping forensic nurses prove injury took place in form of strangulation. Nurses not only look for bruises and scratches but less obvious symptoms such as small red or purple spots on the skin, a hoarse voice, difficulty or painful swallowing, neck pain, hearing and vision changes, cough and headaches. They also ask the victim about the loss of bowel and bladder function, which is an indicator of loss of consciousness during the attack.
“Often, domestic violence comes down to a he-said-she-said scenario, making it hard for the victim to prove the abuse,” said Otterstein. “We are able to help by looking past what we can see to identify other signs of abuse. The goal is to stop the violence and help the victims recover.”
NACASA has 15 medical examiners, a program manager and a volunteer medical director who cover five locations in Coconino, Navajo and Apache counties, as well as the Navajo, Hopi and White River Apache Nations and the Grand Canyon National Park. Exams are available by appointment and can be scheduled 24 hours a day, 365 days a year.
NACASA is primarily funded by the Department of Justice’s STOP grant. Additional funds to run the program are provided by the Arizona Office of the Governor, Assistance League of Flagstaff, City of Flagstaff, Coconino County Public Health Services District, North Country HealthCare, Northern Arizona Healthcare Foundation and the Victims of Crime Act Fund.
Established in 2002, NACASA has cared for approximately 1,100 men and women who have been victims of sexual assault and domestic violence. FBN
By Starla S. Collins, FBN
For more information about NACASA, the support group or how to help victims of sexual assault or domestic violence, contact Chelly Kearney, NACASA clinic coordinator, or Jennifer Runge, NACASA program manager, by calling 928-522-9460.