For the past year, Physicians for Human Rights (PHR) has been working in close collaboration with clinicians, administrators, and information technology experts at HEAL Africa Hospital in Goma, Democratic Republic of the Congo (DRC). They have been working to launch MediCapt, a mobile application to collect and securely store forensic medical evidence of sexual violence, at their facility in the DRC. HEAL Africa Hospital officially launched MediCapt at their clinic serving survivors of sexual violence in December 2021. This important achievement marks the first time PHR’s award-winning app has been used with patients in the DRC building upon the successful piloting of MediCapt in multiple facilities in Kenya, starting in 2018.
The launch of MediCapt in DRC finds its roots in years of deep collaboration with legal, medical, and law enforcement professionals in the DRC and Kenya to develop a tool to collect forensic evidence of sexual and gender-based violence (SGBV), based on the articulated needs of end users. In these co-design sessions, multisectoral professionals shared the need for a tool to securely collect, store, and transmit forensic medical evidence of crimes of SGBV. This enhanced process will help ensure that evidence is more easily transferred amongst sectors to increase the likelihood that survivors can access justice. In the years since the initial sessions to co-design MediCapt with partners in DRC and Kenya, we have collaborated with software developers and eHealth experts to develop a mobile application that incorporates sophisticated encryption, cloud technology, photo capture capability, and other critical functions identified by partners. Throughout this process we solicited and integrated input from end users following a collaborative design process that ensures that the tool responds to end-users articulated needs. In 2018, clinicians in Naivasha, Kenya first piloted MediCapt with patients. HEAL Africa is now the third facility to begin using Medicapt, and the first in DRC.
At HEAL Africa, MediCapt is already making an impact. In the first month of the pilot at HEAL Africa, over 70 cases of sexual violence were documented using the application. HEAL Africa staff have expressed enthusiasm for the ways MediCapt streamlined their interactions with patients. A gynaecologist at HEAL Africa clinician, Dr. Cathy Mufunguzu Furaha, reflected on her experience adapting to using MediCapt
“MediCapt has changed my approach to treating and examining victims of sexual violence. With MediCapt all the questions are precise and concise, allowing me to stay on track during exams. […] MediCapt deepens one’s understanding of how to carry out examinations as we are required to ask the patient each time for her/his consent.”
As Dr. Cathy described, MediCapt uses a standardized forensic medical certificate for documenting sexual violence to guide the clinician through the forensic medical evaluation, including important prompts to obtain consent from the patient to proceed to subsequent steps. Some fields in MediCapt require responses for the clinician to be able to submit the final record. All aspects of the app are designed to centre the rights of the survivor and document the maximum evidence to increase the survivor’s case, should they seek justice.
MediCapt offers functions that provide solutions to previous challenges encountered by staff at HEAL Africa. Dr. Nathalie Mungosy of the Victims of Sexual Violence (VSV) Clinic at HEAL Africa spoke of her favourite features of MediCapt: “the best thing about MediCapt is its ability to take photos of injuries and to save them directly on the device.” By offering a way to take pictures on the same tablet the app is used on, MediCapt eliminates the need for clinicians to transfer confidential photographs from personal or widely used devices through insecure internet connections or flash drives, protecting the patient’s confidentiality. Dr. Nathalie went on to say that “…another strong point [of MediCapt] is the guarantee of the confidentiality of patient data. With the paper forms, anyone could have access to the data.” Not only does MediCapt limit the number of potential staff who may have access to a given patient record, it also ensures that all records of SGBV are safe from tampering, destruction, or degradation, and will be available to serve as evidence in justice proceedings for years to come.
Partners at HEAL Africa are optimistic about the future of MediCapt at their facility and the potential impact this tool could have in the larger fight to end impunity for sexual violence in the DRC. Dr. Cathy believes that “MediCapt should be extended to other medical facilities given its usefulness in the treatment of [SGBV] patients.” Clinicians at HEAL Africa have also emphasized the need to make fully functionally a web platform allowing members of the police and justice sector to directly access relevant patient files for their cases. Dr Jeannette Katunga Mafika of the VSV clinic at HEAL Africa underscores this point, “My hope for MediCapt in the future is that it will be extended to other sectors (namely, justice and police) to avoid delays in the procedure.”
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