Victorian victims of sexual assault are being forced to wait in bloodied and soiled clothes, sometimes for more than a day, to see specialist forensic doctors.
On some nights in Melbourne, a city of 5 million people, there are no forensic doctors available to see victims of violent crime, in a situation experts have labelled "dire".
In 2020, Grace Stewart was one of hundreds of women forced to endure the consequences of this shortage.
Ms Stewart alleges she was raped In January that year.
She says it took her hours to comprehend what had happened to her and to muster up the courage to call a rape crisis line.
For 15 hours after that, nearly 30 hours in total, she remained in the same underwear that she was wearing when she was allegedly raped.
If she wanted to see the alleged perpetrator brought before the courts, she couldn't shower or change until she saw a forensic doctor.
That night, none were available.
"That's something that was quite traumatic,'' Ms Stewart told ABC Investigations.
"It made me feel icky. It was definitely gross, because you want to try and get the experience off you."
Experts, advocates and social workers on the frontline describe the situation as a crisis and say the delays are doing untold damage to victims and survivors already reeling from life-changing trauma.
"It actually fills me with horror, to think that someone who's taking the courage to report has to wait that period of time,'' Vanita Parekh, a forensic expert in Canberra, said.
In November, a Victorian Law Reform Commission (VLRC) report into sexual offences found the state's forensic medicine system was failing victims and called for the government to provide greater access to forensic services.
"The system of forensic examinations is in dire trouble,'' VLRC Chair Tony North said.
When Ms Stewart called a sexual assault support service, she expected to be taken to her local hospital in Werribee but was surprised that forensic exams were not offered there.
She was told she could go to Sunshine Hospital, one of the major hospitals that performs adult forensic exams in Melbourne, but a doctor might not be available for hours.
By this time, it was 1am.
Instead, she was offered an appointment at the Monash Medical Centre the next afternoon, which she eventually took.
It was a long drive from her home in Melbourne's west. She says that, for much of the drive, she was on autopilot.
"I think I was just in a bit of disbelief. I was just re-living it over and over in my head,'' Ms Stewart said.
"I could have turned around a lot of times."
'This is a crisis situation' — caseworker
Last month, sexual assault case workers at Western Region Centre Against Sexual Assault (WestCASA) were told by the Victorian Institute of Forensic Medicine (VIFM) that no forensic doctors would be available at all for four consecutive nights.
Usually, there is only one officer rostered per night for the entire city.
"It's failing victims,'' caseworker Karen Woolford said.
"And I think it's failing our medical professionals as well, because they're working in extreme circumstances to support these victims and doing the best they can. But it's not enough."
Ms Woolford said she knew of victims who have gone home rather than wait for a forensic exam.
"We need more. We need the wait times to be non-existent. This is a crisis situation."
The Centre Against Sexual Assault Victoria chief executive Kathleen Maltzahn said its members across Victoria had reported long wait times for their clients.
"Being raped should be the worst thing that happens to you. Right now, however, the lack of access to forensic medical exams can aggravate trauma victims' experience, subjecting them to long waits and travel to access something that should be available quickly and locally,'' she said.
"This also risks compromising the evidence available for investigations and prosecutions. It makes a terrible experience even worse."
The Police Association Victoria secretary Wayne Gatt said the issue must be addressed, with members expressing ongoing frustration that rape victims cannot be assessed in a timely fashion.
"The availability of forensic officers is significantly compromising, causing delays for police and victims measured in hours," Mr Gatt said.
"It is not uncommon for members to report an inability to obtain service after hours, they are regularly told to wait until business hours the next day.
"Obviously our members care deeply for victims of crime, who they worry are then subjected to delay, compounding the trauma they have already experienced."
In most other states, forensic doctors and nurses are part of the health system and embedded in hospitals — but not in Victoria.
Instead, VIFM provides forensic medical officers under a service agreement with Victoria Police, which is currently being renegotiated, with VIFM pushing for more funding to bolster services.
The doctors attend to sexual and physical assault victims when requested, as well as providing assessments of suspects' fitness to be interviewed and expert advice for court cases.
Last year, forensic doctors completed 404 sexual assault exams and 119 physical assault exams.
Victoria's Crime Statistics Agency data shows that, in the same year, there were 4,431 rapes recorded in Victoria and another 5,919 indecent assaults.
Push for a 'health-first' approach
There is a push, supported by experts and the Victorian Law Reform Commission, to move forensic services into the health system.
Former VIFM doctor John Gall says the system would be improved, and access made easier, if forensic officers were embedded within hospitals.
Like many other forensic doctors, he wants a health-first approach because, he says, the current practice is not working.
"There'll be occasions where [police] will dictate to you what's to be done with that person. The police are looking on this person really as a crime scene. Whereas, from a doctor's perspective, this is a person and your primary responsibility,'' Dr Gall says.
Dr Gall, who is also president of the International Association of Clinical Forensic Medicine, says delays also reduce the quality of evidence collected.
The landmark law reform commission report also backed a health-first approach to forensic examinations.
Chair Tony North says it could help improve rates of reporting of sexual assault.
"Examination is the first contact the victim survivors have with the system. And, if that experience is improved, it will have a flow-on effect," Mr North said.
The Victorian government is considering Mr North's recommendations and has already boosted funding in the most recent budget, including money to recruit five more specialists.
Attorney-General Jaclyn Symes said she acknowledged "the pain of survivors and the duty we have to ensure we do not add to that pain".
"We know there's more to be done and we will continue to work with victim-survivors and experts to ensure the system is delivering the services that are needed," Ms Symes said.
The government also wants to expand the use of special multi-disciplinary centres — places that locate police and support services in the same building and include examination rooms.
A spokesperson for VIFM said in a statement that it was supportive of most of the recommendations of the VLRC report and that most police requests for an examination were met within its two-hour target.
"Bearing in mind that some victims require emergency medical care prior to the forensic examination and, if there is more than one request for VIFM services at the same time overnight, this will need to be managed by the available staff on call,'' the spokesperson said.
"We welcome any opportunity to increase our multi-agency engagement and improve coordination and delivery of forensic medical services to better address and combat the issue of sexual violence in our community."
Dr Parekh is a fellow of the Faculty of Forensic Medicine and she set up the ACT's forensic service, which is embedded in the health system and that allows doctors to focus on medical treatment first.
"Health always comes first for each patient, and then the forensic evidence is second,'' she says.
"For all patients that we see, their health needs are always met first."
Workplace watchdog investigating complaint from doctors
Doctors and caseworkers who have spent decades in the sector say the problem has gotten worse in recent years, partly due to COVID but also due to a lack of trained specialists.
Senior doctors at VIFM have lodged complaints with the workplace watchdog WorkSafe Victoria and the Fair Work Commission due to the "dangerous" hours some doctors work, with some staff expected to work a day shift, followed by an on-call overnight shift before returning to work the next day for a normal shift.
WorkSafe has confirmed it is making inquiries, while mediation has begun at the Fair Work Commission.
The complaint to WorkSafe seen by ABC Investigations says that several doctors, who are banned from talking to the media by their employer, have fallen asleep while driving.
Grace Stewart is a teacher who is trained to support students that are victims of assault and abuse. She knows how the system should work, which is why she was even more shocked by the lack of available services.
"It shouldn't be this difficult,'' Ms Stewart says.
"We put all of this emphasis on victims, saying 'Please come forward to do these processes'. It should be a lot easier."
