Transforming care for women, victims of rampant violence in India

Published November 26, 2019, 12:00 AM

by manilabulletin_admin


Rampant violence against women has sparked major public health and human rights concerns in India, where every third woman, many of them being children, suffer domestic abuse of various forms.

But health professionals are pioneering a better way to prevent and root-out gender-based violence in parts of the country, according to a World Health Organization (WHO) statement on Monday.

Indian women activists participate in the 'Women March for Change' in New Delhi, India, Apr.4, 2019.  (EPA-EFE/FILE/RAJAT GUPTA / MANILA BULLETIN)
Indian women activists participate in the ‘Women March for Change’ in New Delhi, India, Apr.4, 2019.

The United Nations public health agency claimed that the first response to victims of violence or sexual abuse was witnessing a drastic change in India, where, in the past, survivors seeking medical care were patched up and sent home without further help.

“I remember treating a woman living with violence, all I could do was send her home,” Nisha Jha, a physician at a hospital in the western state of Maharashtra, was quoted as saying in the WHO release.

“Later that night, I wrote a poem about it. I wish I could have helped her escape,” the doctor at the Aurangabad hospital said.

The hospital is one of the three healthcare centers using new methods of responding to women who have been subjected to physical, sexual or emotional violence. The new method is based on the WHO guidelines first drafted in 2013.

Previously, healthcare professionals would throw a barrage of questions, further traumatizing the victims and making it worse than what they had gone through.

“Staff would say, ‘another curse has landed. They do what they want, and then they come to us’,” Shrinivas Gaddappa, head of obstetrics and gynecology at the Aurangabad Hospital said.

“As soon as a woman came in, we would take them for a ‘two-finger test,’ and ask them; ‘How many times did you do it? Did you feel anything?’. But since our training, we’ve stopped doing all that. Today, we treat them with dignity.”

According to India’s National Crime Records Bureau report published last month, police across the country registered nearly 360,000 cases of violence against women in 2017, the latest year surveyed.

The number of such has been increasing and according to NCRB, in 2016, the number was 338,000 while 320,000 cases were registered in 2015.

“Cruelty by husband or his relatives” accounted for nearly 28 percent of the crimes against women while “assaults with intent to outrage her modesty” comprised nearly 22 percent, followed by “kidnapping and abduction” with 20.5 percent and “rape’ with 7 percent of the reported cases.

The WHO said violence against women was a major public health and human rights issue and to address the concern the UN’s health organization is conducting awareness programs for health workers, who are often the first professional contact point for survivors, on how to provide first-line support, treatment, psycho-social support, and mental health care.

In Maharashtra, nearly 250 doctors and paramedics from the three hospitals have been trained so far.

“We have to go through the L.I.V.E.S process slowly. That’s listening, inquiring, validating, and enhancing safety and support,” Anita Basavaraja, head general medicine at the Miraj Hospital, said. “All this gives us time to speak with them and develop a rapport.”

The new methods, according to Pallavi Sapale, the dean of the Miraj Medical College and Hospital, help the health professionals look beyond the visible marks of violence.

“Domestic violence has always been there. Before, we only saw the ones that were visibly bruised, but now we spot the clues. Those that chose to stay under the radar, or didn’t explain the roots of their injuries, were often missed, as we just took things at face value. But now, our staff can pick up the clues.”

The WHO claimed that there has been a big improvement in the knowledge, attitudes, and skills of health workers in addressing violence against women.

The focus is on safety, confidentiality, privacy and sympathetic response to build trust for a continuum of care, and as such, all three hospitals have rearranged their facilities to improve privacy.

With increasing numbers of survivors placing trust in the trained health professionals, women who have been helped are ringing in more survivors.

“The numbers are huge,” said Sanjida Arora from CEHAT – the Centre for Enquiry into Health and Allied Themes, a nonprofit that is assessing the impact of the WHO training.

“In just nine months, they’ve identified and responded to over 500 cases.”