Sexual Abuse and the Bat Ami Center

Additional Info

• Audio File: hadassah/hd013.mp3
• Doctors: Bauman, Dvora
• Featured Speaker: Dvora Bauman, MD
• Specialty: Director of the Bat Ami Center for Victims of Sexual Abuse at The Hadassah Medical Organization
• Guest Bio: Dvora Bauman, MD is the Director of the Bat Ami Center for Victims of Sexual Abuse at The Hadassah Medical Organization.
  
  Learn more about Dvora Bauman, MD
• Transcription: Melanie Cole (Host): Global estimates published by the World Health Organization indicate that about one in three women worldwide have experienced either physical or sexual partner violence or non-partner sexual violence in their lifetime. Today we're speaking with Dr. Dvora Bauman on this episode of Hadassah on Call.
  
  Welcome to the show. My guest today is Dr. Dvora Bauman. She's the Director of the Botany Center for victims of sexual abuse at the Hadassah Medical Organization. Welcome to the show, Dr. Bauman. Tell us a little bit about yourself and how you came to the Hadassah Medical Organization.
  
  Dr. Dvora Bauman, MD (Guest): Thank you so much for this option. I’m a gynae obstetrician- gynecologist obstetrician, mainly in gynecology, and my specialization is pediatric and adolescent gynecology work where I learned mostly in London. And so doing that I was encountered with many little girls, which some complained about irritation there, et cetera, and part of them were practically sexually abused. So I just was very involved just in the beginning of my test and examination, in those cases of sexual abuse. So finally, I started to be more and more involved in this Botany Center, and I got to be the Director in the end.
  
  Melanie: That's so interesting, and while doing my research for this interview, I noticed that your philosophy is a bit different than what many people might be used to seeing for victims of sexual abuse. Tell us a little bit about your philosophy of care for the very sensitive nature of the work that you do, Doctor.
  
  Dr. Bauman: Yes, thank you for this question which is very important because, you see, what happens with women, I wouldn't say the kids, but the kids as well, but many young women is that when it's very crime in the middle of the street, in the middle of night, it's very clear that it's abuse or rape.
  
  But most of the cases are not like this. About 80% of the cases is something happens in their home, something that happens with their partner, not always happen- could be an intimate partner or something, and the people- the girls the victims, are very confused. They are not sure if the crime was done to them or it's normal. Mostly in children, they don't really know if it's part of life and a part of normal behavior or it's a crime, and they're very confused. And this way of confusion makes the trauma even bigger.
  
  So, I think that the most important thing at the beginning is to make those things clear. To explain to the child, to the girl, to the adolescent, to the woman that love and partnership is something that you have to be agreed. It’s something that you want the same way that the other one and when it's done without your willing and without your permission and without your emotional involvement, it's not right. And from that point, to abuse if the way is very short. I hope I explained that very clear.
  
  Melanie: You absolutely do, and you make it so clear for us to understand. So, tell us about the Botany Center. How did it come about and what used to be the protocol for victims of sexual abuse prior to the Center's opening? Is it the only one in Jerusalem?
  
  Dr. Bauman: Yes, it's the only one in Jerusalem. We have in our country, which counts almost to eight million, we have four centers like that. And our Center, is for Jerusalem and surrounding which is about one million of people of residence. And it's a very special place because, if I may tell a bit of history, is that as you know abuse and rape and everything; those things we have from the Bible, so it's very, very old things that happened, or crime we would say happened. But up to, I would say, the 1980s nobody really knew how to care, how to give care to those people. And what happened that in Israel, for example, many years ago that the young very slim girl came to one of the hospitals before the world centers like that, and so they took care of her. They gave her antibiotics, and they gave her everything, but she was looking so young and so slim that nobody saw that maybe she would be pregnant and finally the pregnancy was discovered when she was on her 27th week, a girl of eighteen years.
  
  So it was a really dramatic disaster and from that on, people decided that for these victims, we have to have real protocols like in all medicine, you know? And so the protocols were involved with Minister of Health and today we work according to very clear guidelines. When a victim came, after having psychosocial approach and everything, we do the medical examination, we do the forensic examination, and we give them a medical treatment to prevent sexual transmitted disease, to prevent unwanted pregnancy, and of course we follow-up them to see that they stay healthy. At least in my part, it's mostly I would say the medical. We have also social and psychosocial therapists who are taking care to follow up with psychological trauma and everything.
  
  Melanie: Are all your victims women or are some men also victims of this type of abuse?
  
  Dr. Bauman: Most of them, of course, women. I will tell you a bit of statistic that below the age of ten, the victims are the same number boys and girls, so in the young population, we have just the same. In the older population, let's say after puberty, adolescence, it's mostly women. In our center, the statistic shows that 88% are women and about 12% are men, but that's not the statistic we know because the statistic we know, as you said, one in three or four women is a victim of sexual abuse, and one in six men is a victim of sexual abuse.
  
  So the point is that we see so few men, it’s still a problem that disclosure in this population of men is very difficult because as you can understand it, I'm not a psychologist, but a man mainly in Israel, in many countries, which the man feels he is a soldier, is combat soldier, he's a strong person to come to this center and to say, “I was abused.” They feel still that maybe it shows them like not strong enough.
  
  Melanie: That's such an interesting analysis, Doctor. So, tell us a little bit about how you assess the level of trauma and is the victim's recovery influenced by how soon after the assault that the victim is seen? Give us a little of the multidisciplinary care that these victims receive when they are coming to see you.
  
  Dr. Bauman: Our Center, Botany Center which is placed in Hadassah, works like emergency room. We have staff on call which has three disciplines. It's always a social worker, a nurse, and a medical doctor, mostly gynecologist, and for children under the age of ten to twelve, those are pediatricians. So we have always a team consisting of three disciplines.
  
  Once the person is coming to the emergency room, she or he doesn't have to go to the big emergency room, they just go in the beginning and they say, “I came to Botany.” Immediately they are taken to this special center. Once you are in Israel- Jerusalem, you should come and see our Center. And they come to the center which is a small nice office, close to the emergency, but really very in a discreet place. And then our staff is called, we are working twenty-four hours, seven days a week, 365 days a year. So we just give our assistance every minute in the whole year.
  
  And once this victim comes today at the center and we come, so we start to work as a team. The social worker is really starting to- what is called to interfere in the trauma, to prevent post-traumatic stress disorder, to talk to them and to give them back their confidence. Because I would say that the main trauma they have, it's not physical. I mean the physical is really big trauma, but the most trauma, they're traumatized psychologically because we are talking about a very intimate part of your body that you always cover and you decide to open them just the people that you really trust them and you love them and what happen is that somebody who didn't ask your permission, who didn't wait to see if you agree for that and he really raped you. That's the word.
  
  Melanie: This is such an interesting topic, Dr. Bauman, and the way that you approach it is also heartening to hear. All the things that you're doing for these victims. Around the world, we're hearing about "Me Too" campaign, it's very top of mind these days. Are we relating this conversation in a way? Are you seeing this happening in Israel? Are more women speaking up? Do you feel that there's more of an empowerment that's going on in Israel that might kind of be affecting globally?
  
  Dr. Bauman: Yes, thank you so much for this question, because when I'm teaching students, we do like a discussion. “What do you think about ‘Me Too’? What are the advantages and disadvantages?”
  
  So of course, there are few disadvantages and if you agreed and start from few disadvantages is that it is feeling like more feministic side that more women are involved and I'm looking more for the men, although in the space, there are also some men that can stand up for this movement. But in Israel, it's mostly women and it's my feeling that there is less place for men, which I'm still looking for them because they are disappearing. We don't see them. But that may be the only one disadvantage.
  
  But if we would talk about advantages, they are huge. It's like a revolution and when there is a revolution, so there is always a bit of blood, there is always a bit of tear, but it's a revolution. It’s a huge revolution because this movement or revolution means that women that were abused or were raped and were ashamed to stand up and to say, “It was done to me,” because they felt they are guilty in something. Maybe in the skirt, maybe in this and that, but they feel some guilt in it and what doing this revolution is that it's changing. It's moving the guilt from the victim today to the person who did it, okay? And that's very important because nowadays, we will understand very much what happened to them. It's not their guilty, it's the guilty of the perpetrator, the guilty of the person who did that and nothing would explain or giving the reason why it was done. There is no excuse for that.
  
  So the rules- so that's what for me, this movement and the ‘Me Too’ is doing that. It changes the real guilty from the woman to the other. So, when the woman feels less guilty and less shame, they can talk about it, they can go to the court, they can do anything and that's for me the most important thing.
  
  Melanie: Wow! That's really amazing to hear. So, as a wrap-up Dr. Bauman, what would you like our listeners to know about how they can possibly help if they know a victim of sexual abuse? How can they help a person get the professional help that they need after such a traumatic experience? What advice would you give someone if they know someone or if they themselves feel that they have been abused?
  
  Dr. Bauman: Yes, so again, it's also something that I discuss always with students in medical school and we're talking about that there are a lot of publications that show that unfortunately most of the victims are not talking with the doctors about what happened, about the past of sexual abuse and on the other side, doctors are usually not asking. And when I'm training with the students, understanding why the doctors are not asking, so the reasons are- the first, they don't know what to do with that.
  
  For example, they ask and the woman says disclose it and says, "Yes, I did have sexual abuse that day in my childhood,” or something. So they freeze and they don't know how to respond. So students and the doctors of the future, I'm telling them that they have to do it very naturally. They have, for example, when they take medical history, we usually ask in medical history do your parents have hypertension therapy to set that right? That's a normal history you have to ask the woman and tell her that's true.
  
  I know one in every three women or one in four women is a victim of sexual assault, and because it affects your health- and that’s true, it's affect the health or maybe if you think about it. So the sentence would be, “And because it affects you, it might affect your head, I would like to know if you had such a bad experience in your life?” So if you put this question as a really routine question, you will find out how many women and maybe men. I'm an gynecologist I don't treat men, but I see a lot of women when I ask this simple question, they just start to talk about it, and when they talk about it, I don't have to become a psychologist at that moment. Usually the second question would be, “Did you talk about it? Did you speak to somebody about it? And if you didn’t, maybe you want now? I can call a social worker, I can call a psychotherapist.”
  
  I'm a very lucky because I’m in a hospital, so have all these facilities and even, for example, if a woman came for routine examination, and we start to talk about it and all these feelings, all the experience of the traumas loading up, so sometimes I tell her, "Listen, I don't mind if we don't do the gynecological examination now. Just relax and come in a few weeks and we'll do it.” So I think it makes the difference.
  
  I think that after disclosure, people feel much better. They seek for assistance, for medical assistance, for psychological assistance. What is very important is that statistic shows that 45% of children who had sexual abuse don't disclose this topic until the age of after twenty-five or thirty. So they live with this information for this trauma and they don't share it with anybody. So we as medical team, as the social team, as a society we have to help those people to disclose things, to try to get to their heart.
  
  Melanie: We certainly do, and we applaud all the great work that you're doing on behalf of all of these victims, Dr. Bauman, because it really is something that's affecting the whole planet, and you are out there helping these victims, and it's just wonderful to see, and I hope that we take heart and hear your good advice because women- we do need to stand up, and not feel guilty, and not feel shame, and thank you for reiterating that. Thank you for encouraging this and for women stepping up. Thank you so much, Doctor, for being on with us today. This is Hadassah on Call: New Frontiers in Medicine brought to you by Hadassah, The Women’s Zionist Organization of America. The largest Jewish women's organization in America, Hadassah enhances the health of people worldwide through medical education, care, and research innovations at the Hadassah Medical Organization.
  
  For more information on the latest advances in medicine, please visit www.Hadassah.org, and to hear more episodes in this podcast series, please visit www.Hadassah.org/podcasts. That's www.Hadassah.org/podcasts. This is Melanie Cole, thanks so much for listening.     
  
  
• Hosts: Melanie Cole, MS