Kanwal Arora

Trauma and Recovery

On the evening of January 26, my mother went for a walk, and accidentally tripped and fell face first to the ground. Her nose was bleeding profusely and her face was bruised and swollen; not unlike it would’ve been if she had been a victim of violence.

We rushed her to an almost empty emergency room, where two young doctors inquired (almost disinterestedly) as to what had happened, and sent her for an X-ray which revealed a fractured nose.

It surprised me that not once did anyone at the hospital really try to find out the cause of her injuries. Now, it’s possible that they were experienced enough and knowledgeable about the injuries sustained in beatings and how they’re different than those cause by accidents; but given their indecision as to the course of treatment, I would think it unlikely.

This got me thinking about the laws for reporting of domestic violence in hospitals and clinics in India and around the world. In the United States, only 5 states have mandatory reporting laws related to domestic abuse. [1] In India, the 11th five year plan (2007-2012) published by the Planning Commission talked about the Protection of Women from Domestic Violence Act and stated:

“Violence Against Women will be articulated as a Public Health issue and training will be provided to medical personnel at all levels from public health facilities to premier health facilities. It will be included in medical education because the medical and health establishments are often the first point of contact for women in a crisis situation. Training and sensitization of health personnel will include recognizing and dealing with injuries resulting from violence against women and providing psychological support.” [2]

However, talking out of experience, I would say not much has changed. It turns out that healthcare professionals are not required to ask questions in such a situation. They are not trained enough to identify domestic violence and neither do they recognize it as part of their professional duties.

It is a popular opinion that mandatory reporting of suspected domestic abuse by hospitals and healthcare professionals is not a good idea due to various reasons. One, it might discourage battered women from seeking care in the first place or lying to their doctors about the extent of injuries suffered. Another reason being it may lead to retaliation by the batterer as typically domestic violence worsens when the victim tries to get outside help. This may be true, but we also must recognize that educating health care providers about domestic violence is one of the most important means of enhancing the health care system’s response to domestic violence. Mandatory domestic violence education must be provided in hospitals, and in cases of “suspected” abuse, the healthcare provider should be able to provide to them information and referrals for counseling and legal and social services.

Having said this, while researching on domestic violence in India, I came across quite a few successful initiatives which have cropped up for supporting violence victims.

One such success story is that of a public hospital-based crisis centre for women facing domestic violence in Mumbai – Dilaasa, which was established in Bandra Bhabha Hospital, Mumbai in 2001. It aims to sensitise health care providers and train them to understand domestic violence as a health issue, besides which it also provides psycho social support to victims, so they can make decisions on how to stop domestic violence. The initiative has received recognition from the United Nations Development Program (UNDP) as one of the best practices in Gender Mainstreaming. [3]
Another initiative is Mobilise! As of September 2014, 30 primary healthcare centers in Bangalore were testing this program, which helps nurses identify women at risk of violence and promote disclosure. Suneeta Krishnan, an epidemiologist is heading the research of this program and is evaluating whether the model can be replicated in other parts of the country as well. [4]

Sources:
1. futureswithoutviolence.org
2. Planning Commission (2008). Eleventh Five Year Plan – Inclusive Growth (2007 – 2012), Vol. 1, New Delhi: Government of India
3. The Dilaasa Model – 2001
4. Population Reference Bureau

Kanwal Arora
Kanwal Arora

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