Health Professionals with Huge Role in Domestic Violence

Feb 06, 2012 Letters

Dear Editor,
There is increased prevalence and incidence of domestic violence in Guyana. Notwithstanding this increase, there are some people who may present a different interpretation of genuine domestic violence as some other type of violence. In this way, they reduce the opportunities to intervene, the result of which could be quite serious.
I suspect different cultures and countries may define domestic violence differently, requiring variable interventions to prevent, treat, and care for the victim. Nevertheless, there is some agreement to see domestic violence as coercive control within an intimate or family relationship (Stark and Flitcraft, 1996). And the British Home Office (2006) sees domestic violence as ‘any incident of threatening behaviour, violence or abuse (psychological, physical, sexual, financial or emotional) between adults who are or have been intimate partners or family members, regardless of gender or sexuality’.
I want to dwell on domestic violence in the British context because of institutional infrastructures in place to address this heinous crime, and perhaps, countries like Guyana may want to review such facilities to curb their growing incidence of domestic violence.
Drawing on the Home Office definition, Trevillion et al. (2011) identifies the types of characteristics associated with types of domestic violence – physical abuse, sexual abuse, emotional or psychological abuse, and financial abuse.
They found that physical abuse relates to the following: hitting, pushing or kicking burning, throwing objects, stabbing or shooting, sleep deprivation, non-provision of basic needs; sexual abuse relates to rape, forced prostitution and pornography, cutting or mutilating of genitalia, refusal to have safe sex, not adhering to religious prohibitions; emotional or psychological abuse relates to constant criticism, threats of harm, emotional blackmail, enforcement of petty rules, neglectful behaviors; and financial abuse relates to total control over all finances and financial decisions, no contribution to family incomes, no access to cash and/or credit, coercing a person to engage in illegal activities.
The health services, invariably, may be the first point of contact for victims of domestic violence. Many victims of domestic violence have numerous contacts with health services, yet many professionals within such services are unable to identify their cases as victims of domestic abuse.
Victims suffering the effects of domestic violence may present to the health services acute physical injuries (as bruising, fractures, miscarriage), chronic physical injuries (as constant gynecological problems, HIV, gastrointestinal disorders), and psychosocial problems (as depression, post-traumatic disorder, insomnia) (Trevillion et al., 2011).
And both health professionals and victims of domestic violence present barriers to prevention, treatment, and care. On the part of the health professionals, there is an absence of expertise and confidence to address domestic violence, their concerns seen as being insulting to patients, and indeed, workload priorities ( Agar, 2002, Minsky-Kelly et al., 2005). Victims generally would talk about their abuse if health professionals ask the right questions.
But victims also experience difficulties in disclosing because of apprehension that the perpetrator may know about the disclosure, shame, and the concern that their children may be removed to the care services.
Trevillion et al. wrapped up their research findings by saying that health professional can provide help to victims of domestic violence by putting into action three significant steps – ask, record, and respond. If they effect these steps when a victim presents herself for healthcare, Trevillion et al. believe that health professionals can give confidence to victims to disclose and ease embarrassment, thereby producing a supportive and non-judgmental culture of care.
Prem Misir

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Health Professionals with Huge Role in Domestic Violence

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