Open access peer-reviewed chapter

Sexual Assault Crisis Center: The First Interdisciplinary Effort in Turkey

Written By

Taner Güven, Sotirios Kalfoglou and Ersi Kalfoğlu

Submitted: December 8th, 2021 Reviewed: March 16th, 2022 Published: April 15th, 2022

DOI: 10.5772/intechopen.104531

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Abstract

Sexual violence and assault has a wide range of negative consequences that affect the victims for the rest of their lives. Proper medical as well as psychological care is essential for the survivors who have experienced a traumatic process. One-step institutions that deal with all related issues following the victimization are established in various countries. We took the responsibility to organize such a center for the first time in our country. The designed “Sexual Assault Crisis Center” is active in legal history taking, medical-forensic examination, professional evidence collection by trained personnel, and detailed evidence analysis (DNA, drugs of abuse, trace evidence, etc.). Thus, the victims do not have to go to various institutions one after the other to prove the case. Care providers, law officers, and the legal system are satisfied with the outcomes. An organized collaboration of different organizations is archived to the benefit of the sufferer. Furthermore, a training program for four different related parties, such as medical doctors, nurses, psychologists, and healthcare managers, has been developed in order to train other personnel for the sustainability of the project. The basic aim is to develop this first model as a prototype and contribute to its spreading throughout the country.

Keywords

  • sexual violence
  • evidence collection
  • forensic examination
  • multidisciplinary forensic practice
  • rape victim
  • Turkey

1. Introduction

Sexual assault can be characterized as gender inequality, power imbalance, and hatred that generally results in violence against women. This fact does not exclude children, male, and LGBTI+ victims. Based on surveys on violence against woman performed in the USA, approximately 8 million of women and 3 million of men have experienced rape once or more in their lifetime [1, 2]. In most of the cases, the perpetrators are known to the victims, and false notations like “rape happens to young- and good-looking women” or that “it is committed by mentally problematic people” are incorrect. Likewise, rape does not frequently occur in places that are not properly illuminated or uninhabited remote areas as it is generally acknowledged, but mostly happen in very familiar setting like the home of the victim or the offender. Attractive sexy clothing is never considered a reason for rape [3].

There is a series of well-reported problems that survivors of sexual assaults suffer, in the short and long run following the rape. Medical impacts on genital organs because of physical traumas, pregnancy and unsafe abortion, and sexually transmitted diseases are complications seen in the short run, whereas anxiety, depression, post-traumatic stress disorder (PTSD), substance abuse, suicidal behavior, eating disorders, and even dental health problems affect the victims in the long run [4, 5, 6, 7]. PTSD influences the sexual life of the sufferers in a long run too. Considering rape in war, genocide, prisons, and police stations, the magnitude of the problem increases tremendously [8]. Nevertheless, it is well reported that millions of women are affected all over the world regardless of their age, socioeconomic position, and economic or educational status [2, 9, 10].

In a detailed study that was undertaken in Turkey, while women constitute 35–40% of victims of sexual assault, the proportion of children is 50%, and the average age of these children is 11.5 years. The youngest child was a girl of less than one year of age and a 1.5-year-old boy. We see that 5% adult males, 5% mentally handicapped individuals, 1–3% elderly people, and 90-year-old senior ladies are also victims of this crime. Boys and girls exposed to sexual abuse are equal in number. The reasoning for the attempts was reported as the victim was responsible for the attack, the aggressor was sexually aroused, and that this act was the result of sexual provocation. The way that a 1-year-old child provokes the aggressor has no valid explanation [11].

The study in mention revealed that the rate of realization of sexual attack in desolate and dark places is around 10% only. The riskiest environment seems to be the home of the attacker or the victim, with a rate of 60%. The rate of attack in a different house is around 20%. Another misconception is the belief that the victim of sexual assault must have suffered extensive physical injury. In practice, physical damage can be detected only in one-fourth of the cases. The reason for this is that physical violence is used in only half of the cases, and detectable damage occurs in half of them. Again, while the aggressor is mostly thought to be a stranger, victim screening studies show that 75% of the perpetrators against women and 90% against children are familiar people [11].

Resolving the case, identifying the perpetrator and desiring his/her punishment is an expected reaction of the victims, families, and the societies. Yet, conviction rates for sexually committed crimes are considerably low. There are various reasons that prevent victims to disclose rape cases, the main of them being the possibility of the shift of the blame toward themselves and the disbelief by the legal system. Sufferers think that both police and their families will disregard their claims and disbelieve them.

The negative attitude of the society, the fear that the claim will not be taken seriously, the thought that the aggressor will not be punished, care for the perpetrator himself (in case of close relatives or friends), and the perpetrator’s possibility of retaliation can be counted as the reasons for such a low rate of reporting the event. However, the “fear of not being able to prove the incident” forms a serious obstacle for the victim to apply to the court.

It is necessary to discuss the reasons for refusal to notify in Turkey because the society approach is interesting. For many years, the concept of honor was related to sexuality for women and not for men. The veil of honor was present in legislation until 2005. Forced sexual intercourse was not considered a crime, and the abortion with the promise of marriage was legal. All these show that the laws perceived this crime as an act of sexuality only. In this case, the woman’s dress and behavior have always been questioned, and the investigation of the victim’s responsibility in the attack has been discussed on both social and legal grounds. The criminal law has been changed in 2005, and it has been stated that sexual assault is a crime motivated by domination and control, and it is not a sexually motivated action. However, the negative societal conception is still there. As a result, victims in Turkey are truly rejected from their families and their communities following a rape victimization, the sexual aggression remains undisclosed, and the rapist is rarely convicted [11, 12].

The “one-stop center” model for supporting survivors of sexual violence has gained attention in recent years. There are several centers functioning in this aspect primarily in the USA. We established the first full-scale sexual assault center, in which we provide confidential support to survivors with specially trained staff over a wide range of services. Apart from performing forensic medical examination, evidence collection, reporting to the police, providing medical care, making a police statement, and giving psychological support are within the scope of the establishment. Although it is not very easy to establish and operate, not surprisingly, there are many positive benefits for survivors. We hope that this will be a model for the Turkish legal system and that this effort will form the basis for a national understanding.

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2. Related legislation in Turkey

One of the main actions to be taken in sexual assault cases is the effort to prove the event. This means to determine the signs of physical and emotional damage caused by sexual assault, to determine the existence, degree, and results of sexual intercourse, and to ensure that the attacker is identified.

A new legislation that has been actively used by 2005 has detailed articles related to sexual assault cases and the above-mentioned statements. There is an article that regulates all the activities related to obtaining evidence linked to a crime and legalizes the procedures and principles regarding the various ways of collecting biological evidence, blood, hair, buccal swabs, nails, and similar samples for genetic analysis in order identify the suspect and the accused. According to this regulation, in order to obtain evidence related to a crime, request by the public prosecutor, the judge, or the victim is essential. The decision of the public prosecutor is submitted to the judge or court for approval within 24 hours. The judge or court is obliged to decide within 24 hours.

The internal body examination of the suspect or the accused can be carried out only by the doctor. The external body sample collection can be performed by medical staff (nurses, midwifes, etc.) under the control of a medical doctor.

For the medical examination to be carried out, there should be no foreseeable risk of harm to the person’s health. An examination of the genitals or anus area is also considered an internal body examination.

In cases where mentally retarded people or children are involved, the legal representatives have the right to decide. If the child or the mentally ill person is in a position to comprehend the consequences of the testimony, her/his opinion is also taken. The issue becomes more complicated in incest cases where the legal representatives can be the perpetrators themselves.

The results of the examination made on the samples taken in accordance with the provisions of this regulation are considered personal data and cannot be used for any other purpose. The contents of the case file cannot be given to anyone other than those who have the authority to be involved. The analysis results are sent to the relevant authority by a written and signed expert witness report.

In the presence of the victim’s consent, the prosecutor’s intervention is not required to carry out the analysis. In this case, medical examinations can be performed and samples can be taken to be analyzed. The prosecution and the legal system, in general, are informed following the examination. There are various official institutions that are considered expert witness centers by the law. The Ministry of Justice has its own institution called “The Council of Legal Medicine” and deals with various issues of forensic sciences. It is centered in Istanbul with branches all over the country. Additionally, the departments related to Legal Medicine and Forensic Sciences are expert witnessing institutions by law. Furthermore, the hospitals have the right of collecting evidence and reporting to the court in all related cases [13].

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3. The process of medical examination

Following the victimization, the victims need medical, forensic, and psychological support. The suffering person when she/he decides to ask for help has eventually to go to a hospital for treatment and evidence collection. Following these two steps, additional medical and psychological care should be given to the person. However, this very important step is most of the time avoided by the victims and constitutes one of the main reasons for denying reporting the event. There is a perception that the victims will be poorly treated in hospitals at the early stages of the rape examination and treatment [14, 15]. The possibility that the reported sexual assault may not even prosecuted is also a fact. Owing to the possibility of disbelief, the police may not proceed in informing the prosecution or, sometimes, the prosecution does not trust the confession. On the other hand, the event is not considered a very serious crime and it is underestimated, which certainly is not the case. There is a complex medicolegal attitude that should be undertaken starting from the police to the prosecution, to the nurse, and to the doctors. Once the involved group is so big, coordination is essential for the benefit of medical, legal, and psychological well-being of the suffering person.

Systematically stating, apart from the low reporting rate, hospitals generally do not employ forensic pathologists and nurses, they do not have a proper forensic examination setting, the medical personnel is poorly trained in evidence collection, and they almost never are organized for a legal, psychological, and medical support following the examination. There are no proper settings for medicolegal examinations, and the equipment is far from standardized. The sexual rape examination is a delicate issue, and the traumatized victim is deeply concerned. Sometimes, they refuse to be examined by male doctors and that is frequent for our country. Female gynecologists are not always ready in hospitals to perform this kind of examination. A proper solution for this problem lies in the interdisciplinary collaboration of the various parameters that are involved in the assault and violence cases. Turkey has no effective collaborative networks between the stakeholders. The police, the criminal justice system, and the medical care have little coordination [16, 17]. As a result, a suffering victim has to visit all the involved authorities to be able to complete the application for the court and for the forensic examination with evidence collection. The victim has to go to the police to talk about the event; most probably, she/he will be sent to the appropriate department for application; then, the police direct her/him to the hospital; the medical examination may or may not be performed immediately, a waiting period will follow; sometimes, the hospital visit will have to be repeated because of poor evidence collection, and following all these, the suffering person will have to encounter the burden of talking to prosecutor(s).

To overcome these problems, we established a facility in the form of single-step application (the characteristics of which are given below). The purpose of establishing a one-stop Sexual Assault Crisis Center is to guarantee a system where full and real cooperation between different stakeholders (healthcare professionals, lawyers, police forces, etc.) will result to a broad and inclusive rehabilitation with proper care. The main idea of the establishment is developing and improving accessibility to supporting services for victims. Additionally, it is aimed to get a detailed anamnesis and correct physical and biological evidence to help the legal system to tackle the crime and punish the perpetrator. We based the establishment on the already present legislation in our country and to best practice examples globally [17, 18, 19, 20].

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4. Procedures for reporting a sexual assault case in Turkey

The person that has been sexually abused and wants to disclose it, she/he has to go either to the police or to a hospital for seeking help. In case the victim reports to the police, the police, following the history taking, have to decide to which hospital they have to be directed for evidence collection. In the meantime, the police inform the prosecutor for the event. The evidence is reexamined by the doctor in the hospital, and a second history taking forces the victim to talk about the traumatic event. The evidence collected is transferred to the “Council of Forensic Medicine” for examination and report writing. The victim on the other side is in front of the prosecutor for the last history taking being revictimized once more. Then, all the parties wait for the evidence examination report, which is generally delayed. Things get worse especially when there is a need for laboratory examinations such as DNA and illegal drugs for cases under influence. The overall process is distressing and upsetting. The reality is that this is not specific to our country because there are numerous scientific articles complaining about retraumatization and long-lasting periods for the case to be closed.

The second probable way that a victim can choose is to go directly to a hospital for medical examination and sample collection. This is actually not changing the psychological burden for the victim because the hospital has to inform the police, and all the above-mentioned steps are repeated. The victim may not be able to be examined timely, and this is also a problem for the evidence itself that it may be diminished and for the psychology of the applicant. Care seems to be lower for sexual assault victims compared to regular patients in the medical centers. Moreover, although there is a regulation on force as we mentioned above, there are no specific policies and standardized procedures for collecting sexual-assault-related samples as evidentiary material. Therefore, the hospitals are able to collect partly the evidence or sometimes lose them completely by long-lasting procedures or it is possible to contaminate or even degrade the very valuable tool that can be used for justice. However, it is obvious that the biological evidence that is collected from the victim’s body serves as a tool to aid the police investigation in a sexual assault case. This kind of evidence can identify the perpetrator(s), give an idea of the time of the assault, point to the presence of violence if any, and can state whether the assault was drug facilitated [21, 22].

Both law enforcement officers and healthcare professionals complain about the inadequate services in rape cases. Commonly, the care that is provided to rape victims is lower than other patients. Additionally, there is no attention paid to the psychological trauma of an assaulted person in the emergency departments. On the other hand, the doctors and the rest of the healthcare professionals are not adequately trained to tackle these sorts of cases. They are not familiar with the ways of forensic examination, history taking, and evidence collection. Proper documentation is another serious issue, and if it is improper, even the collected evidence loses value. Moreover, often the doctors themselves beware to undertake rape cases, and they transfer the victims to other doctors or sometimes even to different hospitals.

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5. The establishment of the “One-Step Sexual Assault Crisis Center”

The research team of the university set up a “One-Step Sexual Assault Crisis Center” in order to improve care for victims for the first time in Turkey. This specialist facility is organized in an interdisciplinary approach, where the victims get legal, medical, and psychological care without any additional burden to what they have experienced. The center accepts all the victims who experienced physical and sexual violence. Diagnosis-treatment stages and the medicolegal issues are carried out in a detailed and sensitive manner, within a one-stop facility and 24/7 principle. We have developed an innovative, sustainable, and expandable cooperation model with advanced technology in forensic laboratory infrastructure, based on the cooperation with different organizations that will contribute to the process with a multidisciplinary approach. We intend to develop methods and measures that can be taken to prevent violence by compiling the services to be provided by this center. Similar models have been established in the USA (Sexual Assault Response Team SART) and the UK (Sexual Assault Referral Centre SARC) and in many other countries to establish cooperation between different services for a less traumatic victim care. The main objective of these centers, as well as for our initiative, is to achieve one single application center and save victims from several visits to police, hospitals, and prosecution, the value of which is mentioned in numerous articles [18, 19, 23]. Vulnerable groups, such as children and mentally disabled people, together with all sexually assaulted or victimized citizens can apply for care. The establishment in mention is the first one in Turkey, and we hope that it can form a model for further initiatives. The main idea is to diminish the psychological revictimization of the assaulted by providing proper medical examination and evidence collection together with psychosocial care and follow-up as in several similar facilities globally [24]. This can be achieved by the coordination of professionals from different areas of expertise.

The center that has been established in Istanbul, the most overpopulated megalopolis of the country, is organized in Yeni Yüzyıl University in two interrelated sections: the main center and the hospital. They are both constructed based on one and single functioning protocol. The workload is primarily in the main center, whereas only cases that need serious medical intervention are headed to the hospital.

The first person that the victim encounters in the center and in the hospital is a specially trained forensic nurse who opens the case and organizes the rest of the visit. The steps that are followed in parallel and/or in tandem are shown as follows:

Actions that are taken regarding the victim:

  1. Assigning the case manager

  2. Medical/medicolegal history taking

  3. Medical/forensic examination and evidence collection

  4. Psychological support and follow-up

Actions that are taken regarding the legal system

  1. Informing the prosecution

  2. Recording the history taking

  3. Writing the relevant report for the court

Actions that are taken by the laboratory

  1. Receiving the collected evidence from the case manager

  2. Analyzing the evidence in the relevant laboratory department

  3. Writing and delivering the relevant reports

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6. The first step for a successful approach: medical history taking (anamnesis)

Upon her/his arrival, a case manager is assigned by the medical coordinator to the applicant. The second step is history taking. The medical/medicolegal history is a very important step that is essential for the investigation, and it is taken once and recorded for further use if the victim consents. It is crucial to take this history in the proper way, to make it less traumatic to the victim and organize it so that the victim will not be obliged to repeat it in other institutions (several times to police prosecution, etc.). For that reason, we have organized the availability for law enforcement officers or the prosecution to attend the history taking without being physically in the meeting room. The technical equipment is designed such that the related parties can attend the session by an audiovisual system, either within the center or online. The victim talks to a professional psychologist followed by a forensic doctor and talks once. Thus, the deeply traumatized victim is not obliged to repeat the story to the police, prosecutor, and doctor again and again. In the meantime, following the application of the victim, if the police or the prosecution is not informed, they are being notified by our legal team, and they are invited to attend the history taking if they would like to.

After taking her/his consent, the victim is asked to give the details of the event, date, location, and any information related to the perpetrator. This information forms a guide for the activities that will be organized to finalize the report of the case. There is a form with a series of structured questions related to the activities that the victim has been engaged in. The history is taken primarily by the forensic psychologist followed by the forensic pathologist or gynecologist. The medical information may or may not be given to the law enforcement or the prosecution, depending on the requirements of the case and the informed consent of the victim. The involvement of the psychologist is essential once the history taking is done to a deeply traumatized person (to a great extent), and it has to be professional in a way that the victim will be least affected. On the other hand, it has to be as detailed as possible because it is the only tool to be used for the investigation.

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7. Medical examination and evidence collection

The characteristics of sexual assaults as well as the victims’ psychological capability are dissimilar and variable. Therefore, special care has to be given to each case individually. The physical examination is performed by a forensic pathologist and/or a gynecologist assisted by a forensic nurse having a master degree in Forensic Sciences. The injuries as well as the points of possible evidence traces are documented by external and internal examination. The victim is informed about her/his right to stop the examination at any point. We have already developed a standard sexual assault kit that is used by our doctors in evidence collection. The kit contains all the required material for a correct collection of evidence. Nevertheless, it is very well known that every rape case may have its own characteristics, and further material may be required [25]. We are in a position to provide any additional equipment to document and collect evidence, both in the laboratory and in the hospital, the function of which will be explained later.

The generally accepted evidence collection period for evidence in sexual assault cases is within 72 hours [21, 22, 26]. However, the evidence identification and individualization techniques that are available today are highly developed, and DNA technology can reveal excellent results for trace amounts of material like a bite mark or even fingerprint [27, 28, 29, 30, 31]. Hence, careful pre-examination is essential for satisfactory collection. Apart from the physical and biological evidentiary material that is collected, samples of blood and urine are taken for further examination of pregnancy and sexually transmitted disease. In case that the blood and urine examination show positive results as for pregnancy, hepatitis, HIV, or any other sexually transmitted disease, the proper treatment is suggested and one-to-one counseling is offered. A regular psychological or medical treatment is given for all the cases for which the diagnosis is positive.

Although the evidence collected is analyzed in the various laboratories within the center, a secure chain of custody is followed [32]. The collected biological specimens are air-dried and placed in containers that are numbered according to the given case number. Cross contamination is maximally avoided [33]. In some cases, the victim is not ready to pursue; in these cases, the sexual assault kit that includes the collected biological material is kept according to the preservation protocol of the related laboratory.

The victim has no obligation to handle the collected evidence and transfer it anywhere. The center undertakes the responsibility to send the collected evidence to the appropriate laboratory for analysis. The laboratories that are functioning in the center are: DNA and biological evidence, toxicology, trace evidence, forensic anthropology, and andrology. The evidence-related report that comes out from the laboratories is sent to court-related services or to law enforcement, depending on the specificity of the case.

There is a well-reported relationship between rape, alcohol, and substance use in recent studies. The sexual assault may be drug facilitated in some cases [34, 35, 36]. The victim in such cases is unable to consent because of drug effects. The alcohol and/or drug use in these cases may be voluntary or involuntary. In both ways, this effect increases the severity of the crime, and its existence has to be indicated by analysis. That is why, a complete toxicology laboratory is established in the center.

In case the victim needs further medical care because of physical injuries, the center collaborates with the university hospital, which is a full-scale multitreatment hospital. All the diagnosis and treatment stages of a person who has been subjected to physical and/or sexual violence are being taken care in this facility. We have established a Forensic Science Department in the hospital supplemented with specially appointed and trained personnel for necessary evidence collection, forensic interview, etc. Anyone who has been raped can access the Forensic Science Department to be directed to emergency services and enter the one-step procedure. The main center and the hospital give a 24-hour telephone information and support. As a result, emergency response, examination, collection of evidence, assault report, giving testimony (history), psychological support, and notification to the forensic units, taking a shower, or providing clothing when necessary are realized both in the main center and the Hospital’s Forensic Science Department. Such an interdisciplinary effort enables the detection of suspects or criminals in physical and sexual violence crimes and supports the victims by providing accommodation after violence, economic support, job opportunities, and legal aid, etc., by a cooperation that has been developed with the municipalities of Istanbul. The municipalities are centers where violated victims apply easily if they do not want to be involved in applying to law enforcement units, and they are the institutions that have the availability to support and protect the victims. Therefore, a close collaboration with them appeared to be vital for helping the victim.

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8. The issue of forensic nursing in Turkey

The medical examination and evidence collection is generally assisted by specially trained nurses in the USA, Canada, and some of the European countries [37, 38, 39]. We do not have specially trained sexual assault examiner nurses (forensic nurses) in Turkey. The concept of forensic nursing is present only at an academic level, and the practicing nurses are not aware of how they can collect physical and biological evidence [40, 41]. However, even doctors are not well trained on the issue, and they do not know how to collect, preserve, and transfer the evidence. They certainly lack the information and practice of being sensitive and sympathetic once they are dealing with traumatized patients not only physically but also psychologically [42]. Another obstacle in the proper and effective collection is the absence of standardized sexual assault evidence collection kits and the lack of a consensus between laboratories on DNA identification procedures [43, 44].

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9. Education and training in evidence collection

The basis for this kind of collaboration is a common language that should be developed to share common goals and responsibility for the benefit of the community in general. This needs a specially tailored education and training system in the country because of the lack of standardized educational packages.

The center is accredited by INTERPOL on 4.11.2019 for training in forensic sciences to the police officers in Turkey and globally, and it is also carrying out awareness activities for the prevention of physical and sexual violence.

To train the qualified personnel needed to establish the center, various training programs have been developed and specially tailored for the various parties involved in the victims’ care. The training programs are for the nurses, the doctors, and especially emergency and gynecology experts, the police, the lawyers, the prosecutors, and the judges. Providing necessary training to forensic and law enforcement officials, doctors who will perform as first responders, and other stakeholder representatives are essential. The training programs that have been developed are also targeted to all local governments; that cooperation has been established.

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10. Future projections

Following the establishment of the center, we started another project that aims to establish a collaboration platform with stakeholders via a mobile-compatible integrated web-based domain where members can provide anonymous data entry and information flow related to their field. Within the scope of smart, safe, and healthy urbanization practices, collecting data on physical and sexual violence cases in the designated regions, processing them with geographic information system (GIS), data analytics, and statistical methods, and innovative prevention mechanisms in the regions are the characteristics that we are concentrating on.

We aim to contribute to the increase of the awareness and accessibility of citizens and related parties, especially nongovernmental organizations, to the services provided. We will also establish a pool of volunteer experts to meet the legal and psychological counseling needs of victims of violence, compliance, relevance, location, etc., in the near future. We are expecting that this awareness-raising activity and communication system will develop and spread to all districts, especially within Istanbul.

11. Conclusion

Sexual assault and violence have destructive consequences for the victims starting from physical injuries to anxiety, depression, drug use, tendency for self-harm, suicide attempts, and very many other that have been very well reported [45, 46, 47]. It is reported that at least 20–35% of females are victims [17, 48]. Nevertheless, those that suffer avoid formal help and do not report the criminal activity. The reasons for that are known and may vary in severity in different cultures. The assaulted feel that they have no good communication with the law enforcement units and the health providers and that they will encounter negative attitudes [49]. We believe that interdisciplinary collaboration between different parties that are involved in crime combat is essential. That is the reason why we established a unit under the name of “Sexual Assault Crisis Center” as a one-stop center to prevent victims from the traumatic effects of visiting hospitals, police, and prosecutors for medical examination, evidence collection, and pursuing. The center aims to coordinate policies by the participation of all the actors in combating sexual crime and violence [23, 49]. We already collaborate with police, prosecution, and judges, and we work together as a team with lawyers, psychologists, doctors, nurses, and all the health management responsible. This prototype will also serve as a discouraging effort for the perpetrator, once it will be focused on disclosing the various rape cases by the use of correct evidence collection and evidence analysis. We have also aimed to raise awareness among policy makers and the society in general by collecting, analyzing, and publishing data generated from the activities of the center in the long run. Evidence-based crime combat and prevention is the key element for public safety. Therefore, proper evidence collection with minimum harm to the victim is essential [50, 51].

Acknowledgments

This project has been supported by İstanbul Yeni Yüzyıl University financially and by providing the appropriate resources.

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Written By

Taner Güven, Sotirios Kalfoglou and Ersi Kalfoğlu

Submitted: December 8th, 2021 Reviewed: March 16th, 2022 Published: April 15th, 2022