More than half of all sexual assaults on the island are most likely never reported, according to a doctor who works with victims.

Gaynell Hayward-Caesar, the co-ordinator of the Sexual Assault Response Team, is now encouraging sex attack survivors to report incidents and receive support as soon as possible rather than live alone with the “stigma“ of being a victim.

The SART consists of five nurses trained in forensics who are tasked with examining victims to find DNA evidence of assault. Bridging the gap between healthcare and detective work, material collected by team members often features as evidence in criminal trials in which nurse examiners are called on to testify.

The SART is marking its 25th anniversary this year by recruiting and training four new members.

Speaking ahead of International Forensic Nurses Week, which starts on Monday, Dr Hayward-Caesar said that the team typically handles about 12 cases annually, although it has dealt with as many as 24 victims in peak years.

She said that those figures would likely double if all victims reported attacks to the authorities.

Dr Hayward-Caesar said: “We hope that by raising awareness of the SART’s specialised role and the availability of quality forensic services, it will result in more local cases being reported.

“Statistically, those reported numbers are less than half of cases that occur within the community.

“This may be because of stigma, embarrassment and guilt. It is not unusual for the survivor to blame themselves. More than 95 per cent of the perpetrators are known to the survivors, and this raises the discomfort of seeing them on the streets or at meeting places.

“They are also concerned what their family or friends will say about their circumstances. Nurse examiners empower the survivor by restating that ‘it is not your fault’. People don’t walk around with signs on their foreheads that say, ‘rape me’.”

Dr Hayward-Caesar said that the majority of victims — up to 65 per cent ‒ are under the age of 18.

She said: “The number of males is usually young, with very few adult males reporting. Over the past 25 years, SART has seen more than 300 acute cases of sexual assault that include locals and visitors.

“There has been a reduction in cases following Covid. However, the number of cases for this year is approximately ten.”

According to Dr Hayward-Caesar, the number of call-outs increases on weekends, public holidays and through the summer.

She added: “There has been an increase in the number of reported strangulations by survivors, which requires careful assessment of risk for a compromised airway. This may include signs of bruising, swelling of the throat, hoarseness, pain on swallowing or difficulty talking.

“In these instances, the survivor may be referred to the ER physician for additional care and/or diagnostic imaging.”

Although the SART focuses primarily on the physical aspects of sexual assault, it works in partnership with several organisations that can provide long-term emotional support to victims, including the Centre Against Abuse, the Department of Child and Family Services and Ageing and Disability Services.

Dr Hayward-Caesar said: “Following a forensic examination, the survivor may be referred to their attending physician or paediatrician and Department of Health clinics.

“The follow-up is important for STI testing — including HIV — as well as pregnancy testing. The Centre Against Abuse provides psychological counselling to the assault survivors which may include the need to apply on their behalf for a Domestic Violence Protection Order.

“Also, if there is a great deal of injury, the SART examiner may choose to contact the survivor to carry out a welfare check.”

“There is a SART protocol to respond to people reporting cases of sexual assault involving the youth and the adults. The call-out for a SANE is activated by a phone call from the Bermuda Police Service.

“The DCFS or CAA are notified to respond to lend support as well to co-ordinate a follow-up or response for purposes of safeguarding a survivor.”

The intensive training of new SART recruits will start next week.

Highlighting the importance of strength in numbers, Dr Hayward-Caesar said: “For the past 25 years, SART has continued to meet to address operational challenges, quality issues and the provision of education to the new police recruits, CAA volunteers as well as health agencies to raise awareness of sexual abuse and intimate partner violence.

“The five nurse examiners are hidden jewels, and there is a need to ensure sustainability of the SART programme as the trailblazers who started in 1998 have retired or moved on.”