International Day for the Elimination of Violence Against Women: The Helena Center at Hillel Yaffe - First Response Following Sexual Assault

When the Helena Center, the center for sexual assault victims at Hillel Yaffe Medical Center, first opened, it operated out of a small room in the Gynecology Emergency Room. Today, following the opening of the new Women's Health Center, the facility operates in its own special space with a separate entrance, offering discretion, immediate availability, and great deal of attention to detail, in collaboration with nurses from the outpatient clinics and emergency rooms, as needed. Helena Center serves a large and diverse population spanning from Ramat Hasharon to Atlit in the north, including the entire eastern area and southern Sharon region, even in areas without such centers. To date, the multidisciplinary team has treated and assisted approximately 400 victims. The extensive experience and unique approach used by the center, in collaboration with mental health clinics, community organizations, the National Center of Forensic Medicine, and the police, have made it a pioneering model that has been adopted by similar centers that were established after it.

A personal touch and multidimensional care

“We don't just treat the moment of crisis; we try to create a personalized support and care package while striving for improvement, precision and innovation," said Dr. Renat Raines-Carmel, the director of the Helena Center since its opening. "This is also what makes us unique: we've developed mechanisms that combine meticulous and discreet clinical care, psychological treatment, follow-up clinics, and collaboration with community care providers to offer comprehensive, and not just one-time, support. We understand that anyone who comes to us needs ongoing support. That's why the various additional services are truly our unique development."

Care at the center is provided by a diverse, multicultural team that includes both men and women from Arab and Jewish communities, religious and secular, speaking multiple languages. This multiculturalism makes care optimally accessible to different populations.

Dr. Raines and social worker Biadsa at Hillel Yaffe's Helena Center for sexual assault victims

Follow-up clinic and option for remote appointments

Among the unique services the center offers:

• The option to come into the follow-up clinic without needing financial commitment, Form 17 from the HMO or payment after the acute room visit. This is offered as a choice for victims who would like to receive test results or follow-up on their condition.
• Online/telemedicine visit option: This unique and innovative service enables victims who do not want to collect evidence to receive initial medication therapy and psychosocial support through a secure video call, without needing to physically come to the hospital. This service, which started following the COVID-19 pandemic, is intended for specific cases and is limited to one week from the incident. It enables quick and discreet initial care, lowering the "barrier” that keep victims from coming into the hospital. It was born due to a request for help from a woman who was assaulted overseas, and after consultations with hospital management and legal counsel, a methodology was developed for online care through a secure system. The service is suitable for cases where the victim does not want to collect evidence but needs medication and initial psychosocial support. "This allows access to care for those who cannot or do not wish to physically come to the hospital for a face-to-face meeting,” stated Dr. Raines-Carmel. It's important to note that the service is intended for cases up to one week after the incident and is subject to professional assessment of suitability for the case.
• Psychiatric and psychosocial support – Gefen Clinic: "This involves collaboration with Hillel Yaffe's Mental Health Division," said social worker Hamuda Biadsa. "We set up a special team at the Mental Health Clinic, called the Gefen team, which includes psychiatrists, psychologists and social workers specializing in treatment of sexual assault victims. The team provides initial care within a short time (days to a week), to try to prevent development of PTSD, recognizing that long wait times for mental health treatment can have a negative impact on recovery."
• Professional and comprehensive evidence documentation: The staff has undergone special training on collection of forensic evidence and documentation of findings, including photography and findings across the entire body related to physical violence, not just the genital area. Documentation is performed with sensitivity and using the most advanced technologies, and all evidence is preserved until the patient decides whether to use it in criminal proceedings.

As previously noted, all of this is done with utmost discretion and sensitivity. "Treatment at the center is free and independent of medical insurance or status, fully funded by the Ministry of Health while maintaining confidentiality, with the entire medical file computerized and completely confidential," said social worker Hamuda Biadsa – Helena Center’s Social Work Coordinator. “It's important to us that victims feel as safe and comfortable as possible during the difficult and lengthy treatment process. We do everything in our power to restore a sense of control and strictly maintain confidentiality. As I mentioned earlier, the center's new facility was specially designed with a separate, private entrance and provides a respectful and victim-friendly environment."

Staff mobilization for national crisis – treating released Hamas hostages

Dr. Raines-Carmel's unique expertise was put to the test when hostages began returning from Gaza in November 2023. The Ministry of Health set up special teams to document war crimes, and Dr. Raines-Carmel joined this team at Sheba Medical Center. "No one in the world had done this before us, and we had no idea what we would see," she recounted. "We had to create a work procedure from scratch and modify and refine it as we went along."

The training Dr. Raines-Carmel underwent in collecting forensic evidence following sexual assault and violence enables her to identify and document findings on the body, link them to the type of assault, and determine when it occurred. "Most findings in a forensic examination are not on the genitals, but across the entire body – signs of violence related to the assault," she stated. Her documentation and that of the other teams served as the basis for international reports, including testimony before the UN Secretary-General's Special Representative on Sexual Violence in Conflict, reports that proved the war crimes committed by Hamas.

"For me, treating the hostages was a privilege, and we did it with great reverence," said Dr. Raines-Carmel. "It's one of the most meaningful things I've experienced in recent years. I was awed by their strength of spirit after everything they went through."

Message for International Day for the Elimination of Violence Against Women

As November 25th approaches, International Day for the Elimination of Violence Against Women, the Helena Center staff would like to remind us that combating sexual violence requires professional, sensitive and accessible support systems. "Working with victims is very meaningful work," shared Dr. Raines-Carmel and social worker Afkar. "We're here to provide immediate and sensitive care – professionally and with a great deal of respect and privacy. Hopefully, no one will need it."