National Indian Country Clearinghouse on Sexual Assault

SafestarSAFESTAR: A Unique Model of Healthcare for American Indian/Alaska Native Communities





The Office on Violence Against Women, United States Department of Justice has partnered with the Southwest Center for Law and Policy and the International Association of Forensic Nurses to develop and Implement Sexual Assault Forensic Examinations, Safety, Training, Access and Resources (more commonly referrred to by the acronym SAFESTAR)


Specially selected and qualified women participating in the SAFESTAR course learn the skills necessary to:


conf1 Deliver emergency first aid to sexual assault survivors

Provide referrals for follow-up medical and other care

rough a virus

Educate communities on the harm caused by sexual violence and lead the way back to healthy, respectful ways of living rough a protozoan
conf1 Collect sexual assault forensic evidence "rape kits" to promote judicial accountability for perpetrators


What is a “SAFESTAR”?

A SAFESTAR is a specially selected woman who has successfully completed the approved, 40-hour, intensive SAFESTAR training course. She is trained and qualified to provide emergency first aid, health care referrals, ongoing support, and forensic healthcare examinations to sexual assault victims. SAFESTARs also take a stand against sexual violence in their communities and support all victims of sexual violence.

What does the SAFESTAR course cover?

The 40-hour course covers emergency First Aid (utilizing the American Heart Association's curriculum); anatomy; an overview of the prevalence, dynamics and responses to sexual violence in American Indian/Alaska Native communities; forensic evidence collection (“rape kits"); health care referrals; confidentiality; federal and tribal sexual assault laws; service referrals; and community outreach.

How was SAFESTAR developed?

SAFESTAR was developed by the Southwest Center for Law and Policy in collaboration with the International Association of Forensic Nurses, tribal and federal victim advocates, criminal justice professionals, and health care experts. The curriculum incorporates many of the same components of the Sexual Assault Nurse Examiner (SANE) certification course, but is designed for laypersons in American Indian/Alaska Native communities.


Is the SAFESTAR curriculum recognized or approved by any federal agencies?

Funding for SAFESTAR is provided by the United States Department of Justice, Office on Violence Against Women. The SAFESTAR curriculum has been approved by the Federal Bureau of Investigations, the Bureau of Indian Affairs, the Indian Health Service, and the United States Department of Justice.


Can SAFESTAR-collected evidence be used in tribal, state, and/or federal criminal prosecutions?

Yes. The SAFESTAR forensic evidence collection kits have been approved by the FBI Crime Lab and may be analyzed by that crime lab or by state crime labs (depending upon your jurisdiction). Following the completion of the training, federal, tribal (and in some jurisdictions, state) criminal justice professionals meet with the SAFESTARS to develop specific protocols for transportation of kits to the appropriate crime lab; to discuss discovery and mandatory reporting issues; and to ensure a seamless, collaborative implementation of the program. SAFESTARS may testify as "fact witnesses" or "eye witnesses" as to the evidence that they observed and collected. Utilizing a SAFESTAR


Can SAFESTAR-collected evidence be used in tribal, state, and/or federal criminal prosecutions?

Every victim of sexual violence deserves the same "gold standard" of health care treatment and forensic evidence collection. Sexual Assault Nurse Examiners are indeed the “gold standard” and every victim should have access to a culturally competent SANE 24 hours a day, 7 days per week. However, at this moment in time, most sexual assault victims in American Indian/Alaska Native communities lack any meaningful access to Sexual Assault Nurse Examiners.
Until universal SANE access becomes the norm in Indian Country, SAFESTAR can provide an important healthcare link to mitigate the long term, adverse consequences of sexual violence.

It is important to note that the SAFESTAR program can complement an existing SANE program.  SAFESTARs are trained to encourage those victims seeking access to criminal justice responses to access Sexual Assault Forensic Examinations conducted by a SANE.


Who can become a SAFESTAR?

The successful candidate must be acknowledged as a respected person of her community and must not have any felony convictions, or convictions for “crimes of moral turpitude” (such as shoplifting or theft). She may not be employed by law enforcement, prosecution, or the courts and must be a compassionate, trusted woman dedicated to improving safety, health care, support and justice for sexual assault victims and their families. For a more detailed discussion of selection criteria, please contact the Southwest Center for Law and Policy.


Who teaches the SAFESTAR course?

SAFESTAR is taught by a team of committed, experienced women dedicated to eradicating sexual violence in American Indian/Alaska Native communities and to supporting victims, families, and communities. SAFESTAR instructors include Sexual Assault Nurse Examiners (SANEs), lawyers, Native community health experts, victim advocates, traditional healers, and experts on tribal governance and community organizing.







Other Resources - 1


Featured Publications


International Association of Forensic Nurses Position Statement on SAFESTAR


International Association of Forensic Nurses Position Statement on SAFESTAR













This position paper, published by the International Association of Forensic Nurses, articulates the organization's support of the SAFESTAR project.





Where is the SAFESTAR course taught?


The SAFESTAR course is delivered on-site directly to American Indian / Alaska Native communities.


How much does it cost to bring the SAFESTAR course to my community?

Qualified participants pay no cost to attend the SAFESTAR training. SAFESTAR is funded through the U.S. Department of Justice, Office on Violence Against Women and is free of charge to Alaska Native/American Indian communities that have successfully completed the application process. American Indian/Alaska Native communities may also elect to self-fund the SAFESTAR course.


How can I bring SAFESTAR in to my community?

You may contact the Southwest Center for Law and Policy at 520-623-8192 and speak to Program Director Arlene O’Brien (Tohono O’odham Nation) to begin the SAFESTAR application process.

The most serious viral STIs are human immunodeficiency virus (HIV, the virus that causes AIDS), hepatitis B, genital herpes, and genital warts.  There are no known cures for these diseases; once a victim contracts one of these diseases, she will have it for the rest of her life.  There are medicines to manage the symptoms of these diseases or to stop the spread of these diseases.  For example, a person can have genital herpes, but he can manage to not have a “flare-up” of herpes sores for several years because of medication available.  Left untreated, these diseases may lead to more serious health concerns such as a higher risk of cancer. Moreover, if HIV is left untreated, it can lead to the victim’s death.

Trichomoniasis (or “trich”) is a very common sexually transmitted disease (STD) that is caused by infection with a protozoan parasite called Trichomonas vaginalis. Although symptoms of the disease vary, most women who have the parasite cannot tell they are infected.  This disease is easily treated through medical intervention, usually a single dose of antibiotic medication.  Trichomoniasis increases the victim’s chances of contracting other STIs.  Also, if the victim decides to have a baby later, her baby is more likely to be premature and suffer a low birth weight.

Victims can also contract STIs from other organisms.  These include crabs/pubic lice and scabies.  These organisms are actually little animals that live on the victim’s body.  Although these diseases cause the victim a lot of itching and discomfort, they are easily treated by topical creams.

The most common symptoms of STIs across the board are no symptoms at all.  Thus, a victim should be encouraged to get tested for STIs after a sexual assault, regardless of whether she is displaying any symptoms.  Then, if she develops symptoms down the line, such as itching, pain, discharge, bleeding, sores, or lower abdominal pain, the victim should be encouraged to seek medical help.

National Indian Country Clearinghouse on Sexual Assault, a project by the Southwest Center for Law and Policy © 2013

This project was supported by  Grant No. 2011-TA-AX-K045 awarded by the Office on Violence Against Women. Points of view in this document are those of the author and do not necessary represent the official position of the U.S. Department of Justice. All rights reserved. | Privacy policy