Child Monitoring Centers (CMC), in order to minimize the secondary traumatization of children who have been sexually abused, and to ensure that legal and medical procedures are carried out in a center consisting of people trained in this field, at once; was established within our hospital.
A case applying to CMC is first taken to the preliminary interview after it is recorded in the CMC registration document and received. This preliminary interview is conducted by a psychologist or social worker specially trained in this field (Forensic Interviewer Certified Training Program). If the victim is the child's family (excluding the perpetrator in case of incest), they are taken to the family interview by another psychologist or social worker. The information obtained in the preliminary interview and the family interview is shared with the Relevant Public Prosecutor and ASPİM representative. A lawyer request is made from the relevant bar association and a judicial meeting is prepared.
The forensic interview is held in a specially constructed, mirrored room. The forensic interviewer (professional staff certified with the Forensic Interviewer Certified Training Program) conducts the interview with the child, including the way the incident occurred, the identity of the perpetrator, his characteristics, and the details of the incident, in a language appropriate for the child's age, using anatomical pictures, and accompanied by games and toys if necessary. Meanwhile, this interview is recorded with audio and video and is watched live by the Prosecutor, Lawyer, Family Interviewer, ASPİM representative, Child Psychiatrist (if any) in the room behind the mirror. Each institution representative keeps their own records and a written record of the interview is made into a statement and signed. The investigation is initiated by the Public Prosecutor's Office with this report. While a recording of this meeting is delivered to the Public Prosecutor, a copy is kept in the CMC archive. This interview is then turned into a detailed report by the judicial interviewer and added to the investigation file within the legal period.
After the forensic interview, the child is taken to the forensic examination room for forensic examination. In this room, the child is informed about the examinations to be made by the CMC nurse. When internal body examination is required, internal and external body examination is performed by the Forensic Medicine Specialist. This examination is recorded with a video colposcope to prevent repetitive examinations. In necessary cases, necessary samples are taken from clothes, sperm sample, hair, saliva and nails that may be forensic evidence. Blood and urine samples for possible drug use are taken and delivered to the Forensic Medicine Institute. The result of this examination is reported by the Forensic Medicine Specialist.
The Pediatrician (Responsible Physician in İzmir CMC) working at the center evaluates the child's general health status. If there is a situation in the child's history that poses a pregnancy risk, a blood pregnancy test (beta HCG) is requested, or it is planned at the appropriate time. In cases where there is a risk of pregnancy and the sexual abuse is acute (first 72 hours), contraceptives are given urgently. Serological examinations are performed for necessary screenings for sexually transmitted diseases (Hepatitis B, HIV, Hepatitis C, VDRL, etc.). In risky cases, prophylactic antibiotic therapy is given for bacterial infections. The results of these cases are followed up by the CIM nurse. At the end of the estimated prodrome period (3 and 6 months), repeat serological tests are planned and performed. Those who have a deficiency in vaccination status in their serological tests are informed about the booster doses. Adolescents who are predicted to continue their risky sexual behavior are also informed about HPV vaccination. When an established pregnancy is detected, the judicial situation and the preference of the child and his family are evaluated together and he is directed to pregnancy evacuation. Anemia, anti-lactation drugs, etc. health services are offered. During this examination, a routine physical examination is performed, and screening for diseases other than sexual abuse is performed.
Another examination carried out in the institution is the Child and Adolescent Psychiatry examination. The Child Psychiatrist evaluates every child who comes to the institution at least once. Evaluates the acute period symptoms that may occur as a result of sexual abuse and arranges the necessary medical treatment when psychopathology is detected. Makes long-term follow-ups of the cases that he/she detects at risk in the first examination. It reports the findings of this examination and adds it to the investigation file.
In the interview with the child and in the family interview, when there is a risk in the delivery of the child to the family or there is no other place for the child to stay, the child is placed in a suitable home by the ASPİM representative working in CMC. This determination is made by the ASPİM representative working in the institution and instructed by the Public Prosecutor. In addition, families found to have social risks during their interviews at CMC are subjected to Social Inspection by ASPİM representatives and reported in order to provide the necessary social support. Again, with a baby born after an unwanted pregnancy as a result of sexual abuse