Habiba Ladan

Dr. Nasiru Ahmad Garko is the center manager for the Waraka Sexual Assault Referral center which is located at Murtala Muhammad Specialist Hospital in Kano State.
In a seat down with DPH News, Dr. Garko reveals the function and challenges they have in the referral center, how Covid-19 pandemic affected the referral center and also why Kano state should domesticate the VAPP Act.

DPH NEWS: What kind of sexual assault do you frequently receive in this referral center?

Garko: As the name implies, the center only takes care of victims of sexual assault ranging from rape which is intercourse, with the client consent, the issue of fingering and that of homosexuality.

DPH NEWS: Is there a frequent age range of the rape cases you receive ?

Garko: 90% of the cases received are from those under the ages of eighteen. The most we receive are below the age of 18 and minimum is above the age of 2 years old. We are yet to receive cases of those below two years for now.

DPH NEWS: what are the procedures of consulting and counseling a victim ?

Garko: Depending on the circumstances, most of the time the victim don’t report directly to the center and in almost 90% of the cases, victims report through security agencies like police, Hisba, the civil Defence and other security agencies.
After the case have been forwarded to the center, we have doctors, nurses and counselors who attend to the clients.
The counselors are responsible for talking to the victims while the nurses and doctors will take care of the medical aspect which includes medical examination and forensic reports.

DPH NEWS: Do you admit victims here in this referral center?

Garko: Yes we do, though the center is small but it’s still within the Murtala Muhammad Hospital.
As you can see we don’t have the space that will cater for our clients here as the center only have three offices so we have to use the main hospital.
If we have a case that needs admission, we admit them to the main hospital.
We mostly admit victims that are pregnant and have to be delivered through an operation which is also done in the main hospital.
Also victims that got badly injured as the result of the sexual assault are also admitted at the main hospital for operation where we attend to them and afterwards, we admit them.
All the doctors and nurses here at the center are part of the obstetric and gynecological department.

DPH NEWS: As the head of this referral center, what is your main role and  what has been your commitment so far ?

Garko: As the manager, I basically have two roles in this center.
One is am in charge of the center, I take care of the center through managing how the staffs are discharging their duties, and in short I take care of all the administrative aspect of the center.
Secondly, I also consult victims as a doctor, I have to come to the center and attend to victims and if some needs admission, I admit them at the main hospital and attend to them there.
With all that being said I have to make it clear that am not a permanent doctor in this center, my primary assignment is working in the main hospital and after attending to patient in the main hospital I later come to the center and attend to the victims here.

DPH NEWS: Since the establishment of this referral center, has it be living up to its functions?

Garko: Yes it has been living up to its functions.
Since its establishment, it is been supported by an NGO, Pathfinder to be specific, though the state government has tried by  providing the space for the center and also the staffs.
Now the center is under three Ministries which are the ministry of Health, the ministry of Women Affairs and the ministry of Justice. The ministry of health provided the space for the building and also the doctors and nurses while the ministry of Women Affairs provided the three counselors who work permanently at the center.

DPH NEWS: By your records, is sexual assault on the increase or its reducing?

Garko: By our records sexual assault is on the increase though there’s an increase in awareness about the center.
If I can remember we had about a total 30 cases in November 2016 but now we have about 70 to 90 cases per month even though it’s not the whole number that attend the center as you know during negotiations some family members don’t want the incident to be publicly known.

DPH NEWS: Is there any awareness or sensitization campaigns being created by the state government that whenever a rape or any sexual assault occurs, it should be brought to the SARC?

Garko: There was awareness campaigns, when  the center was established and  supported by Pathfinder, they  supported an awareness campaign on radio that aired two times on the radio station everyday.
During that awareness campaign, more people became aware about the center and we recorded an increase of cases.
This happened in 2019 and we have never had another campaign ever since.

DPH NEWS: have you ever receive cases where rape or sodomy victims become infected with HIV/AIDS?

Garko: One of the responsibility of the center  is screening victims.
They will be tested for any sexually transmissible diseases STDs which includes HIV/AIDS and hypertitis.
In this case we screen both our victims and the perpetrator to do justice for both parties and some times the victims test positive and other times the perpetrators will be positive and sometimes both parties test positive.

DPH NEWS: Are there plans of making this center easily accessible to people in the rural villages 

Garko: There is but like I mentioned earlier the center is supported by NGOs and initially at the beginning every case was being handled for free, even last two month unicef paid for the laboratory service, drugs and even transportation fare for clients.

DPH NEWS: Is there anything that the center lacks that could make it function better?

Garko: I have mentioned that we have only two doctors which is a challenge and these doctors are not permanent doctors at the center.
Most of the time the victims have to come and wait for doctors because the doctors will have to finish their work at the main hospital first.
The center also lacks laboratory to properly carry out tests and also consumables like paper, biros and sanitizers.

DPH NEWS: How do you sustain drugs?

Garko: If there’s any donor from either the NGOs or Government then the drugs will be supplied by them and if there isn’t any we ask the client to pay for the drugs and also the screening tests.

DPH NEWS: How has Covid-19 pandemic affected your work in the referral center?

Garko: During the Covid-19 lockdown not everybody at the center was willing to come to work so virtually the center was closed down and we handled our activities at the main side of the hospital.
We had many cases of SGBV during the lockdown but the problem is it was not reported.
We had at least 5 to 7 victims per day.

DPH NEWS: Do you receive only sexual assault cases  in this center or you handle other forms of assault?

Garko: As the name implies we only cater for sexual assault survivors but we also cater for domestic abuse cases as well as others which does not go into our register.

DPH NEWS: What is the frequent age range for domestic abuse which you cater for?

Garko: In the case of domestic abuse there isn’t really a frequent age-range, sometimes the girls are under the age of 18 and most of the time they are above the age of 18.

DPH NEWS: How many cases of sexual assault have you received today?

Garko: Today is Monday so we have pending cases from the weekend as the center is usually not opened on weekends but only during the five working days.
We have about 20 clients today but we usually have 8 to 9 clients a day.

DPH NEWS: Do you have staff on night shift?

Garko: The center usually opens from 9am to 4pm on working days, all victims will be taken to the O and G department after working hours and will be attended to there if not they have to come back the next day.

DPH NEWS: Do you have a daycare/safe space that underage victims will feel free to discuss what happen to them?

Garko: At the center we have only three offices one of which is designed to sooth children, where they can play and feel safe.
We have toys and charts that make the children feel at ease.

IMG 20210315 165528 518
One of the charts placed in consultation room

DPH NEWS: How do you think the VAPP Act will help in reducing sexual assault cases?

Garko: Base on what I know on the VAPP Act, it is not even domesticated by Kano state government. The Act is undergoing a review and will be adjusted base on the provisions for Kano state residents.
If it’s passed by the state assembly it will help remarkably so that the cases of SGBV will reduce significantly.

DPH NEWS: As the head of this center, is there any case that got you tensed up or even emotional?

Garko: I am a doctor and I’ve seen a lot of things happen and am familiar with almost all the cases I receive, so for me I don’t have any case that made me emotional.
The only case I could think of is of a 13-year-old girl that was impregnated by her cousin.
We delivered the baby through a C-section and both the mother and baby were separated after birth.
The girl was taken back to the village to go back to school while the baby was left in the city. I really felt pity for the mother and the child.

DPH NEWS: How will you advice the Kano state legislative with regards to passing the VAPP Act?

Garko: We are calling on the government to consider the cases we are seeing everyday and create awareness about the number of increasing cases that are reported in the center everyday which is just the tip of the iceberg.
They should use the increasing number and pass the VAPP Act so that the cases can decrease not increase.

DPH NEWS: Since there is no provision for taking the center to the grassroots, will you like to advice the Kano state government and other donors to sponsor or support the creation of other centers in the rural areas or villages to reduce the amount of cases you receive here?

Garko: You know the government had plans for that but the challenge am facing is the issue of manpower, there was a plan for additional centers in the three senatorial zones but the budgeting is one factor that hindered the creation.
We need centers in all the three senatorial zones so at least we can have records to create sensitization and reduce the number of cases that are reported to this center.

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