Child Abuse and Forensic Services (CAFS) serves the local community by offering private exams for victims of sexual abuse, many of whom are children. The only one of its kind in Texas, the nonprofit, private facility offers free care to individuals who have suffered sexual trauma, often from chronic abuse. CAFS exclusively dedicates itself to performing forensic medical examinations and other forensic evidence collection. According to Brenda Garison, the program’s director, a registered nurse and certified sexual assault nurse examiner (SANE), her facility has seen thousands of patients.
“We have more than 3,100 case files in our office,” Garison said. “Around 80 percent of those are children. Many of them suffer from chronic abuse that has been going on for six months or more. Around 30 percent of the victims I see here are male.”
Garison has been performing exams on victims of sexual abuse for 19 years. She started off by doing the exams in the offices of local physicians and eventually worked out of St. Elizabeth Hospital. Now, she operates out of her own office on Hospital Drive near Baptist Hospital in Beaumont.
“I saw a need and wanted to fill it,” Garison said. “These cases are some of the hardest cases to investigate. People just don’t want to talk about sexual abuse. People need to talk about it.”
The process begins with a phone call, sometimes from Child Protective Services (CPS) or the police and sometimes from private physicians or emergency room doctors who suspect sexual abuse. If the child or adult patient asserts sexual abuse, CAFS is obligated to inform the police or CPS before performing an exam. Health Information Technician Ursula Henderson works with Garison at the facility and often is the first point of contact with CAFS.
“I’ll set up the appointment,” Henderson said. “Once they get here, if there is sexual trauma, (we) contact law enforcement or CPS.”
When patients arrive at the office of CAFS, they are greeted warmly in a relaxing environment where they can feel safe. A plush love seat, a fireplace and soft light gives the lobby area a homey, comfortable atmosphere.
“Some of the children have asked me if I live here,” Garison said. “We just want them to feel comfortable. When you go into an emergency room, it can feel like everybody’s looking at you, and that can cause some of these victims to not go to the emergency room. We usually only see one patient at a time and can offer privacy.”
After letting patients know what to expect, Garison takes them to the examination room. The room is playfully decorated with a football, chicken puppets and butterflies. Cameras and microscopes are set up around the examination table.
“We do not do an evidence collection kit, formerly known as a ‘rape kit’ on everyone,” Garrison said. “We only use the kit if the attack has happened within the last 96 hours. If we find motile sperm, which is still moving under the microscope, we know there has been a recent assault. Then, we need a brief history from the patient for diagnosis and treatment.”
Garison said that after the examination, clients are offered a shower and fresh clothes as needed. A pregnancy test is performed, and CAFS provides antibiotics to combat STDs, which Garison said are “on the rise” in the area.
“Victims of sexual assault should be treated with expertise. Special expertise is what we give them. There are lass than 300 SANEs in Texas, and some of them don’t even work with children. I have received special training in sexual assault examinations and in working with children. I am certified through the Texas Attorney General’s Office. Our goal is to collect forensic evidence and educate the community.”
Garison said that while she works with law enforcement from 12 or more counties in Texas, she does not exclusively work with prosecutors of a case.
“What we do here is focus on forensic evidence. We are totally unbiased. We are just looking for the truth, whatever that may be. It’s not a witch-hunt. My opinion is going to be based on what the patient says and seeing if that is consistent with the exam or evidence kit. Juries want evidence. I have been subpoenaed in more than 500 cases and testified for defense attorneys as well as prosecutors. We hope to help convict the guilty and exonerate the innocent.”
And according to Garison, nothing CAFS does could be accomplished without the help of a medical doctor.
“Dr. Christopher Dowdy, who is an OB-GYN, is the medical director for the program. He volunteers his time. He has been with the program since February 1999. We have to have a doctor on staff; we are nurses, so we need a doctor. Without him, it would be impossible to have this program. He oversees the center. He takes a very active interest. All I have to do is call him and he’s there.”
At this time, CAFS is capable of collecting and storing DNA samples. Garison said she is currently working on a project to fund a DNA testing laboratory within CAFS. After researching the project, Garison estimates it will take around $2.5 million just for the building and equipment needed for DNA testing. Garison feels the expensive endeavor would be worthwhile.
“It could take a year or more to get back DNA evidence after sending a sample to a lab with testing capabilities,” Garison said. “One police officer told me he would not be able to use the DNA evidence because by the time he got it back, the statute of limitations on that case had expired.”
“This is a very expensive program to operate,” Garison said of CAFS. “We depend on fundraisers and the community to keep our doors open.”
The office for CAFS is open five days a week, but Garison said they are available to help any time or any day.
“We are available 24/7,” Garison said. “One thing that sets us apart from a hospital emergency room or hospital program is that we will go anywhere there is a need. If we need to go to a nursing home or a physician’s office, we will go. We are focused on the patient and beginning their healing process after a traumatic event when they need somebody to be there.”