Violence Against Women

(VAW)

Presented by:
Belinda Jubilo-Santos
UP-PGH Women’s Desk
 A Background on Violence Against
Women (VAW) Here and Abroad
 According to UNICEF, more than a million infant girls
die on account of being female.
 Female genital mutilation is still a prevalent practice
in African countries. Approximately 90 million
women are affected by this practice.
 In Burma, 10,000 women and girls are trafficked
into slavery in Thai brothels.
 6 studies in the US suggest that between one in five
to one in seven US women will be the victim of a
completed rape in her lifetime.
 In recent years, mass rape in war-torn countries
have been documented.
 More than 20,000 women have been raped in
Bosnia since the fighting began in 1992.
 In the Philippines, PNP statistics in 1994 reveal the
occurrence of rape at one every six hours.
Manifestations of Gender Bias
 Marginalization
 Subordination
 Multiple Burden
 Gender Stereotyping
 Personal Dehumanization
 Violence Against Women
Recognition of VAW by the International
Community
 1993 World Conference on Human Rights-Vienna, Austria- VAW
was internationally recognized as a grave form of human rights
violation and such, a serious obstacle to development and
peace.
 1995 World Conference on Women-Beijing, China- Beijing
Declaration: All States are obligated to prevent and eliminate all
forms of violence against women and girls.
This gave rise to
 UN Declaration on the elimination of Violence Against Women
 Convention on the Elimination of all Forms of Discrimination
Against Women (CEDAW)
 VIOLENCE AGAINST WOMEN (VAW)
 transcends culture, socio-economic strata,
ethnicity/race, religious background
 manifestations of historically unequal power
relations between men and women leading
to domination over and discrimination
against women by men.

-Breaking the Silence, Sylvia H. Guerrero

UN Declaration on the Elimination of
Violence Against Women
 act of gender-based violence
 physical, sexual or psychological harm or
suffering to women
 in private or public life
 coercion
 threats
 arbitrary deprivation of liberty
Philippine Response to the Call for
Action
 Republic Act No. 8805 of 1997- This made provisions
for the assistance and protection of abused women by
establishing a crisis center in every province and city.
 RA 7877: The Anti-Sexual Harassment Act of 1995
 RA 8353: The Rape Law of 1997
 RA 9262: Violence Against Women and Their Children Act of
2004
Health professionals are in a
strategic position to be of
service to victims of abuse
and violence.
 Detect victimization
 Assess risk of vulnerable groups
 Prevent further violence
 Provide health services for survivors
 Assist in the reintegration of rehabilitated
victims and survivors into the family and
community.
3 MAIN ROLES OF HEALTH
PROFESSIONALS IN THE
MANAGEMENT OF ABUSE
CASES
 Detection/Recognition
 Medical/Crisis Intervention
 Referral
Physician Barriers to Recognition
• Lack of awareness of prevalence, means of
identification, severity of the problem, and
social and psychological costs of abuse
• Believing that recognition, identification,
referral of abuse is not part of the
physician’s roles
• Not knowing how to intervene or help
• “Blaming the woman” and feeling angry
why the woman does not leave her
abusive partner
Physician Barriers to
Recognition
 Disbelief because the assailant is present and
seemed very concerned and pleasant
 Concern that discussing psychosocial issues will
take time
 Difficulty in dealing with feelings evoked by the
interview
“It’s never easy…” Patient
Barriers in Disclosing Abuse
 Held captives with no means of
transportation
 Childhood experience of violence and
abuse
 Fear of jeopardizing her safety
 Shame and humiliation in the way she is
being treated
 Still protective of their partner
 Lack of awareness
Clinical Recognition
Consider the possibility of abuse in the
following:
 The patient’s PE findings are incongruent
with the explanation of the injury
 If there was a delay in seeking medical
attention
 Pregnant woman with injuries
WHO Suggested Questions

 Are you ( Have you ever been ) in a

relationship in which you have been
physically hurt or threatened by your
partner?
 Are you ( Have you ever been ) in a
relationship in which you were
treated badly? In what ways?
WHO Suggested Questions
 Has your partner ever destroyed things
that you cared about?
 Has your partner ever threatened or
abused your children?
 We all fight at home. What happens
when you and your partner fight or
disagree?
WHO Suggested Questions
 Has your partner ever forced you to have
sex when you did not want to?
 Does he ever force you to engage in sex
that makes you feel uncomfortable?
Framing clauses
 Violence in the home is very common
and can be very serious. Therefore, I
routinely ask my patients whether they
are experiencing domestic violence,
because no one should ever have to live
in fear and because there is help
available.
Framing clauses
 Whenever I see injuries of this type, it is
often because someone hit them with a
fist. Is that what happened to you?
 Many women experience some type of
physical abuse in their lives. Has this
ever happened to you?
Responsibilities of the Medical
Staff
 The physician will review with the patient the
history of her complaints and previous
medical history
 The physician will assess the patient’s
physical & emotional status & document
findings
 Follow-up is provided
Responsibilities of the Medical
Staff
The physician will clearly document all injuries &
complete the Assault Diagram
 Describe the size, shape & location
 only one PE is made
 Report objectively. Do not give summary
statements, inferences or conclusions about
the circumstances of the assault.The record
should quote the patient when possible.
Essential Information for
Battered Women
She needs to know that:
 she is not alone
 there is help available for her
 she does not deserve to be beaten
The UP-PGH Women’s Desk
Republic Act No. 8805 of 1997

 The UP-PGH Women’s Desk was

established in 1998 to address the
need for a help desk to assist women
survivors of violence seen in the
hospital.
Referring a VAW
Survivor to the
Women’s Desk
FLOW CHART FOR CASE HANDLING

Victim of abuse referred by:

• Community Walk-in patient to PGH ER
• NGO
• Self or family

Victim of abuse Consults at ER

Patient as possible victim of abuse detected at ER

Patient presents with a Patient does not present with a

life threatening medical or life threatening medical or
surgical condition surgical condition

Appropriate medical or Referral to Women’s Desk

surgical service for emergency
management given
Appropriate medical or
surgical service for emergency
Referral to Women’s Desk management given

Women’s Desk Management: HOLISTIC CARE

Physician Counselor/Social Worker Assessment by

Complete History & PE •Crisis Intervention Police
Physical Evidence & •Family Counseling
Specimen Collection •Debriefing of Family Members
Continuation of •Psychiatric Evaluation
Legal Services given
Medical/Surgical Care •Spiritual Counseling
if needed

Admission to Appropriate Activation of Support Transfer to a Shelter

Ward Group/Organization

Medical/Psychosocial Follow-up
 When you encounter the
Survivor on your ER Rotation...
 Avoid judging the patient.
 Be discreet in your dealings with the patient.
 Provide as much privacy as is allowed during PE.
 Fill up all necessary fields in the chart, the Women’s Desk form,
and the anatomical diagram.
 Provide the patient with a Provisional Slip if applicable.
 Make sure that the patient has a Patient’s Intake Chart.
 Please refer to Medical Social Service-DEM if the case was seen on
holidays, weekends, and after office hours.
Thank You Very
Much!