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Serving Rural Victims
Overcoming Challenges
Rural victims are very visible, in that most residents are at least somewhat familiar with each other. For victims, this familiarity "translates into nearly a total lack of anonymity and little chance for confidentiality."78 If, for example, a sexual assault victim parks her car at the police station, local rape crisis center, or health care facility, the entire community could know it very quickly.
Transportation costs also can an issue. According to Rural America At A Glance, "rising transportation costs may disproportionately affect rural areas because, compared with urban residents, rural people depend more on personal vehicles and tend to travel longer distances to receive services."79
The size and configuration of various rural communities, along with unique cultural characteristics, lack of anonymity, greater physical isolation, informal social controls, scarce resources, distrust of outside assistance, and unclear views of sexual violence can challenge the most resourceful attempts to provide and coordinate SART services. Yet with creativity, expanded alliances, and governmental support, rural SARTs can be successful and sustainable.
Take, for example, the lessons the West Virginia Foundation for Rape Information and Services (FRIS) learned about creating partnerships in rural America to overcome challenges.80 As the only state located entirely in Appalachia, West Virginia faces challenges both economically and geographically. FRIS works with 9 rape crisis centers that provide services to nearly 2 million people scattered throughout 55 counties. Its role is to assist those centers and allied professionals in developing comprehensive services and effective prevention programs.
FRIS found that rural communities can thrive when they—
- Create stakeholders: Small staffs abound in rural areas. By improving the capacity of multiple stakeholders, staffing challenges are reduced.
- Borrow ideas and adapt them: Although guidelines and policies from more urban areas often do not fit rural communities, policies can be adapted and tailored to fit specific rural demographics.
- Build systems: Too often one person constitutes an entire sexual assault nurse examiner program, police department, advocacy center, or campus prevention program. By developing systems' responses that do not depend on one person, SARTs can more consistently provide critical services. System approaches also need to be financially self-sustaining.
- Collaborate statewide: FRIS has developed several statewide partnerships, including a statewide college council, an advisory group to determine best practices for working with people with disabilities, and a SANE advisory board. The board includes a cross section of professionals and has resulted in some amazing projects, including the creation of a CD–ROM with instructions about completing the forensic medical exam kits.
- Partner with assault coalitions: FRIS's role is to help its communities be successful in addressing sexual violence. In addition to the numerous print materials that the coalition has developed, a more recent focus has been on creating multidisciplinary training modules. The coalition provides training templates, informational fliers, and attendance certificates and arranges for continuing education credits for law enforcement, nurses, counselors, and social workers. The local training/SART coordinators provide the training facility, and one county sheriff even provided a lunch of bean soup and corn bread.
- Regionalize services: Small hospitals struggle to maintain enough sexual assault nurse examiners (SANEs) on staff for 24/7 coverage. By pooling SANEs in a region, multiple rural hospitals can have access to that coverage at minimal cost. FRIS initiated such a pilot project in one region of West Virginia that is now self-sustaining. (For more information on this project, see Implementing SANE Programs in Rural Communities: The West Virginia Regional Mobile SANE Project.) Although having more money would be positive, the coalition believes that rural areas have a rich resource in their people.
In creating a project to help build the capacity of SARTs in rural areas, the Texas Association Against Sexual Assault came to understand that rural communities did not need or even want a written model or protocol to help them function.81 Instead, they wanted decisionmakers within state agencies (namely grantors) to understand the challenges they faced. They wanted a more level playing field in the allocations process, one that recognized the significance of time and distance in reaching survivors rather than determining need based on the number of victims served. They wanted their voices heard. They wanted to be at the table so they could help determine and shape strategic directions for developing and delivering sexual assault services.
The association found that rural SARTs have well-developed problem-solving skills, are less burdened by territorial issues, and have more nontraditional allies. In addition, service providers are generally well known and respected within their service areas.
The association addresses rural issues as part of a master plan, not as an afterthought. This plan includes scheduling trainings and technical assistance events in rural settings. The expression "the road runs both ways" is never truer than when scheduling regional trainings, as it is just as easy for providers in the city to drive to the country as the other way around.
