DR AJAZ AHMAD SUHAFF
omestic violence is the most prevalent yet relatively obscured and ignored form of violence. It is an evil that even though so common, it is often overlooked, excused on one pretext or another and , at worst, denied. Domestic violence is universal phenomenon that persists in all societies of the world.
The nature of this form of violence is a power misused by one adult in a relationship to establish the control and fear in a relationship through violence. Violence can be of various types such as physical assault, psychological abuse, social abuse, financial abuse, or sexual assault. Physical violence includes acts of physical aggression such as slapping, hitting, kicking and beating. Psychological abuse includes acts like constant belittling, humiliating, nagging and various controlling behaviours such as isolating a person from their family and friends. Domestic violence involves men, women and children, although most victims tend to be women. It is a major contributor of ill health of women which affects them across the life span from sex selective abortion of female fetuses to forced suicide and abuse.
Violence against women is not a new phenomenon. It is estimated that the lifetime prevalence of women experience abuse / violence at the hands of a partner in India is 40% (still this issue remains underreported). We may deny its very existence but the fact is, it is omnipresent. Very few healthcare professionals will deny attending to such cases like an unexplained cut on right arm attributed to accidental slip by the knife while chopping vegetables by a right handed person, a raccoon eye attributed to walking into the wall accidentally in broad day light, a miscarriage on a flat, soft surface, a sharp cut on scalp attributed to sudden falling of sharp edged utensils from nowhere.
All these “accidental situations” where it is obvious even to a blind eye what it is, are sadly overlooked and ignored, mostly because healthcare professionals often have personal barriers such as: attitudes and perceptions that domestic violence is a private issue, fear of offending their patient, fear of the patients’ abuser, a lack of understanding of abuse, lack of confidence or lack of training on screening techniques. Therefore the indicators of domestic violence often go unrecognized by them.
Domestic violence is now widely recognized as a serious human rights issue, and increasingly as an important public health problem with substantial consequences for women’s physical, mental, sexual, and reproductive health. It is important to keep in mind that not only healthcare professionals have an important role in identifying and responding but victims of violence as well as the society needs to be aware about the indicators, consequences and the laws regarding domestic violence.
Healthcare professionals need to become involved in the prevention and treatment of domestic violence. It is important to recognize the indicators that may be clues to identifying a domestic violence. These include: unexplained or multiple injuries (bruises, burns, lacerations, bites), Injuries at different stages of healing, Injuries hidden by clothing or on central body areas, Delay between injury and care-seeking behavior, Partner present at office visits and/or speaks for the patient, Appearance of low self esteem of victim and Frequent office visits for somatic complaints (e.g, pelvic pain, headaches, gastric upset). Health professionals may become involved in community forums, in offices, in schools, or in the education of other health professionals and increase awareness in the general public regarding domestic violence.
The victims need to confront the abuser and put an end to this vicious cycle. Domestic violence is a crime and it needs to be challenged and not accepted and it is high time to speak against it.
The Community needs to have a strong support system for such victims, be it in the form of a supportive family, friends, NGO’s, government organizations and this support system should be reachable to everyone. The victims should know whom to approach and know that they are not alone. Society needs to help the victims find their inner strength and self-respect and encourage them to come forward and speak against domestic violence. People should be made aware of current legislation within the country regarding domestic violence for protecting individuals experiencing violence at the hands of their partner.
The more we run away from this issue, the more we lose; together we can challenge attitudes towards domestic violence and show that it is a crime and not at all acceptable.
—The author is a Senior Resident at the Department of Psychiatry, SKIMS Medical College, Bemina. He can be reached at: firstname.lastname@example.org