CLEVELAND, Ohio -- For more than a week this month, five women told their agonizing stories about how serial-killings defendant Anthony Sowell assaulted, raped or brutalized them.

Sowell is on trial in Cleveland in the deaths of 11 women whose bodies were found decomposing in and around his Imperial Avenue home.

But the women's testimony also told a story about how a system may have failed them in many ways -- sometimes refusing to believe their accusations, making them wait for hours to be examined or simply not investigating.

Almost from the minute police discovered the first of the remains in October 2009, the community began questioning how police treated missing-person and sexual assault reports, especially when the victims may have been drug users or considered less-than-model citizens.

The surviving women's testimony was a painful public airing in yet more detail about how law enforcement, hospitals and society treated their reports. And how discounting them may have emboldened an attacker and led to a mounting body count. "I am so sad that it took this tragedy to draw attention to what is wrong with the system," said Vanessa Gay.

Gay, 37, testified she told police that Sowell raped her in 2008 -- before several of the 11 women he is accused of killing went missing. Police didn't take her report seriously until almost a year later -- after the bodies were found, Gay told jurors in the case.

"Who is dropping the ball? Who is responsibility falling on?" she asked. "In my experience the justice system failed me. So who was I supposed to turn to?"

Gay plans to call together the surviving victims and the families of the women who died -- many of whom knew each other in the streets -- for support and to push for change as the way to heal.

Megan O'Bryan, president and chief executive of the Cleveland Rape Crisis Center, said she thinks that after Sowell's arrest, the community has begun to demand better from those who respond to sexual assault.

O'Bryan sat on a mayor's commission that reviewed police policies and made 26 wide-ranging recommendations regarding the handling of sexual-assault and missing-persons reports. There has been progress on many of the recommendations and the center now has a full-time advocate embedded with the department to reach out to victims. "This tragedy has sadly exposed cracks in many systems, and I think there is now a real urgency to identify and sincerely repair these fault lines," she said.

O'Bryan said that the Imperial Avenue slayings have taught the city two important intertwined lessons: That rape and sexual assault are most often serial crimes. And that is exactly why we need to believe and care about all victims who report rape.

"I am absolutely hopeful that if similar stories were reported today they would be given the highest priority," O'Bryan said.

Others have questioned whether enough has been done in the wake of the Sowell case for law enforcement agencies to give victims the confidence to report their sexual assaults.

The women who testified that they reported attacks by Sowell said they felt police did not make them a priority and said they felt alone and unsupported.

A 37-year-old woman, who reported in September 2009 that Sowell raped her, recalled in court that she waited for six hours in a local emergency room to be examined and make a police report. The woman had told police that she was raped and choked with an extension cord.

Despite the brutality, the woman said she had to contact the Sex Crimes Unit after her initial report. Police had said that the woman was hard to contact as well. But it was more than a month after she reported the attack that police got a warrant to search the Imperial Avenue house for evidence When they searched the house, they began finding bodies. The woman is not identified because The Plain Dealer generally does not name rape victims. Those who are named gave their consent.

Since 2009, hospitals have strengthened their cooperation with law enforcement through a countywide Sexual Assault Response Team effort in hopes they can better attend to victims. MetroHealth Medical Center has now joined Hillcrest, Fairview and Marymount as hospitals with specially trained nurse-examiners on call around the clock.

Cleveland police and EMS now are supposed to direct sex assault victims to the emergency rooms with the special services.

A recently revised policy that governs police response to sex crimes now emphasizes that a Sex Crimes Unit supervisor can be contacted and the response can be stepped up when the crime was especially brutal.

Gladys Wade, 42, testified that a sex crimes detective did not believe her when she followed up on her report.

A detective's report said Wade's injuries were inconsistent with her story and noted no visible injuries. But jurors were shown pictures of gouges and scrapes covering Wade's neck taken the day after the attack.

Police officials so far have defended the work of detectives and officers who worked on all of the cases related to Sowell.

They have said that a thorough internal review of how the case was handled will take place after the trial is concluded. An FBI unit has also done a report that the city has said it will release after the case is finished.

Another woman, 52, testified that she escaped from a second-story window after Sowell choked and raped her. Other witnesses testified about how she was nearly unconscious after the fall and men took pictures of her naked body as Sowell tried to get her back into the house.

Yet Sowell was able to climb into the ambulance without question. Witnesses testified police didn't arrive until much later.

Records show an official police report about the incident wasn't generated until after the bodies were discovered nine days later. The woman said she didn't tell anyone Sowell had raped her because he had threatened to kill her.

But Gay did try to tell.

She told jurors that she had to raise her voice three times before authorities listened to her story of being raped for hours by Sowell. She tried to call police after the attack and said she was told to go to the police station to make a report. Gay said that because of her injuries from the rape and lack of transportation she was physically unable to go and make the report.

Almost a year later, soon after the bodies were found and Sowell was arrested, she was picked up on an outstanding warrant for having an open container. She again told police Sowell had raped her. She testified that they laughed at her and made a joke about her wanting to have smoked crack with the now widely known Sowell.

It was only when she went in front of a judge -- and knowing a court reporter was present -- that she again told the story and was finally taken seriously. The judge ordered police to take her statement.

This month, the city created a policy for dispatchers requiring them to recognize the distress that sexual assault victims may be feeling and to make sure they send medical or other help as well as try to determine the whereabouts of their attackers.

It is not clear from the new policies whether sexual assault victims will still be required to go downtown to the Justice Center to make official reports of their attacks or whether other arrangements can be made if they are unable to do so. Gay said her previous experience with the police affected her ability to trust them to take her attack seriously. She had been raped before and her attacker was acquitted after what she said was a shoddy investigation by a detective the city later fired.

She wasn't the only one.

At least three of the five women who said Sowell attacked them said they had been raped before and didn't feel the police or anyone would care about what happened to them. Sowell knew it, too, Tanja Doss testified.

Doss, a 44-year-old former friend of Sowell's and several of the women whom he is accused of killing, said that he told her, "You could be the next crack head dead b---- in the street and ain't nobody would give a f-- about you."

That's why she didn't bother to tell police after Sowell choked her and forced her to strip. And authorities didn't care when she reported an earlier rape, she said.

"I left it alone," she said. "I had been raped before, so I just called it a loss."

With Leila Atassi.

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