Years after suffering sexual attack, nurse Pavan Amara suffered a difficult relationship with her body. After conducting research with other women survivors, she found a common problem: the women weren’t accessing medical care. Recognising the need for a specific support of women who have suffered sexual violence, Pavan worked with the NHS to create My Body Back, a project set to grow nationwide specialist clinics for the medical care of women who’ve suffered rape and sexual assault.
Pavan said she felt such a service desperately needed to exist. “If you’ve been raped, you have support which focuses on the emotional aftermath, but even that’s time-limited because of government cuts. My Body Back focuses on the physical aftermath – it’s every woman’s right to access healthcare in a way that makes her feel safe.”
After searching online for her own personal support and finding none – in fact, finding no documentation at all of what she was experiencing – Pavan decided to conduct her own research. She interviewed thirty women from a wide-range of backgrounds. “I knew there would be physical symptoms post-attack that affected all women, and I also knew that people just don’t talk about it. There is a taboo around women’s bodies and sexual violence in this patriarchal society.”
Pavan got in touch with these thirty women through North London Rape Crisis, through social media platforms and blogs, and said she was looking for information on the physical aftermath of rape and how it affects women’s lives. Women were incredibly generous and supportive with information.
When you believe in an idea, you keep knocking on doors.
“All thirty women said it had affected their sex life,” Pavan explains. “Women reported inability to orgasm, guilt around masturbation, some reported not using any contraception apart from the pill while having so many sexual partners that they had lost count. Women reported having rape fantasies that made them feel like they had caused their attack, but a rape fantasy isn’t rape. You’re in control, it’s your fantasy and you’re consenting. It’s just sexual power-play and it’s completely different to rape. But women often demonstrated a terrible guilt over their sexual imaginations. Women’s whole sexual landscape shifts after assault, and they didn’t have a space to navigate this difficult terrain.”
Pavan reported that over half of the women hadn’t been for cervical screening since attack, and quite a large number hadn’t had STI testing. They were frightened that if they told a medical professional what they were experiencing, they’d be forced to go to the police to report their assault.
“But the big concern was that they didn’t want a stranger touching them again. The power dynamic between patient and doctor was problematic for them. They felt out of control of their bodies. The worrying thing was that four of the thirty women stopped going to the doctor completely after being attacked, and three of them had chronic conditions and needed to be going to the GP and getting their medication. It was life-threatening for some women.”
Additionally, women weren’t able to access the right contraceptive care. Having a coil fitted, for example, could cause flashbacks. Many pregnant women got in touch to say that their experiences of assault had affected their health during labour. Women talked of contractions triggering unexpected flashbacks, which led to them falling out of touch with their bodies’ rhythms and signals during labour.
“You’re out of control of your body during pregnancy. You’re pushed and poked and prodded all the time. Women felt it was supposed to be a beautiful experience in their lives, but instead it was ruined. Too often, they don’t feel they have anyone to talk to about what they’re going through because it’s so poorly documented and understood.”
When Pavan asked the women what they wanted, they were clear. They wanted a clinic especially for women who had experienced sexual violence. It was also stated that a consultation with their medical professional prior to treatment, where they could talk about what phrases were triggers, what body positions they were uncomfortable in, would be beneficial. Because the experience was emotionally traumatic for them, they also said they’d like an area to relax in afterwards.
I wanted to do what I knew should be done and what women deserve.
Early discussions with NHS staff echoed the validity of Pavan’s research. “I spoke to lots of NHS staff and they said the issue resonated strongly – it was something they dealt with all the time. We got in touch with St. Barts Hospital and then doctors, nurses and psychologists joined the project. We began brainstorming about how my idea could work. We found a part of St. Barts that wasn’t being used, and thought about ways in which we could use one space to cope with a variety of needs.”
Pavan’s incredible perseverance has paid off and the clinic is now open. “It’s amazing that I had the idea in August 2014 and the clinic started in August 2015,” she says. “Because it’s worked so well, we get emails from women all the time, women from all over the world. Some people have travelled from Europe for treatment with us, which really underlines its need.” The next step is to make the clinics available nationwide, over the next five years.
However, My Body Back isn’t just connected to the clinic. Pavan has also set up a service called Cafe V – a monthly workshop where women who have experienced sexual violence can meet and talk. This was born from the women’s requests during research. There was a strong desire for the development of a safe environment to discuss their experiences, to share with other women, and to learn about how to navigate their experiences as best as they could.
“The Cafe V sessions took six months to set up. They run every month. It’s a safe space for any women – for all women – who’ve experienced sexual violence. We get asked if single women can come to sessions a lot and the answer is definitely ‘yes’. We talk about the ways we can enjoy sex again, and you don’t have to be in a relationship to have a sex life. The sessions are run by our project and a psychologist who works with us – she and I facilitate.”
Pavan’s initiative hasn’t come without challenges. “I was worried about being open about my own sexual assault. I didn’t just want to be dismissed as a woman who experienced rape, which is society’s tendency. I was worried that people would label me. That was difficult.”
She’s also experienced threats. “Being an Asian woman is challenging when doing this kind of work. I have received specific threats that a white woman probably wouldn’t experience – I’ve had threats of acid being thrown in my face. But I’ve had so much support from my friends, who are more like sisters, it’s kept me strong. I would have been a lot more upset by this if I hadn’t had them.”
The clinic’s success is down to Pavan’s determination to create change. “I’m sure in 300 years time, we’ll look back and be totally shocked at how primitive society was in its response to violence towards women and girls. We don’t take the issue seriously. Just like we look back now and think it was ludicrous that women didn’t have the vote, we’ll look back with shame at the way we thought it acceptable for so few services to exist for women who have experienced violent crime. In a way, it’s victim blaming, because it’s expecting women to pick up the pieces for a crime that wasn’t their choice or fault.”