Interpersonal Violence Towards Women

CHAPTER 51 Interpersonal Violence Towards Women


Violence pervades the lives of many around the world. A review of domestic violence suggests that it happens to women of all socioeconomic and educational backgrounds, in all types of communities, including egalitarian societies and among different groups and countries. However, there is little research about this issue among different ethnic groups and among economically disadvantaged communities.1 In this chapter we will concentrate on violence, which is one of the most frequent traumatic stressors for displaced, immigrant, and refugee women. Violence is many things, including a social issue, exemplified by statements from the World Bank and United Nations (UN). In November 2004, World Bank2 President James Wolfensohn concluded in a workshop to mark the International Day for the Elimination of Violence Against Women: ‘The workshop made it clear that violence against women exacts enormous cost to economies, to women’s health and to women’s rights, and that we need to join forces to combat this pressing development concern … women should no longer have to live in fear, their children should no longer witness daily acts of violence, and men should enjoy the dignity and freedom from want that enables them to use peaceful means to resolve conflicts.’ The former UN Secretary General Kofi Annan3 has called violence against women the most pervasive, yet least recognized, human rights abuse in the world. To stay out of harm’s way some may be able to lock their doors; others have no possibility of escape. The threat is behind the closed doors (Brundtland foreword WHO World Report on Violence,4 Beijing Declaration; see Box 51.1). Frequently hidden from the public eye, interpersonal violence is permeating the lives of a large proportion of women. Rape and sexual assault of women are also used as weapons of war and interpersonal violence. Such violence is a social issue and adversely influences general health, mental health, ability, and successful adaptation and integration. The violent abuses exacerbate discrimination against women, e.g., by intensifying women’s exclusion from the public sphere and rendering access to social and health services more difficult.6

Setting the Scene

Types of violence against women

According to the UN Declaration on the Elimination of Violence Against Women, violence is defined as: ‘… any act of gender-based violence that results in, or is likely to result in, physical, sexual or psychological harm or suffering to women.’7

It is important to bear in mind that women are exposed to different kinds of violence and that violence may be rooted in gender inequality. The fact that women are frequently economically or emotionally dependent upon their perpetrators has implications for the dynamics of the abuse and ways to deal with it.4 This report discusses two kinds of interpersonal violence: family violence and community violence, i.e., violence outside the home. The first kind relates particularly to women, but, in areas of war and conflict, women are also more likely to face threats of community violence outside the home. There is increasing recognition and understanding of the particular risks that displaced and refugee women are facing in zones of conflict, in refugee camps, and in asylum centers8 as they are disproportionately affected by violence. Women who seek shelter from the hardships of armed conflicts and strife may end up experiencing further harassment in what, from an outside perspective, should be a safe environment. According to findings by Basoglu et al.,9 fear of threat to safety and loss of control over life appear to be the most significant mediating factors for PTSD and depression. Therefore, these findings highlight the importance of the combination of political action against impunity and attention to mental health consequences. Both from a public health as well as a judicial point of view these are issues requiring further attention.

Prevalence of violence

Violent acts against women and girls are reported worldwide. Numerous surveys have consistently demonstrated a high prevalence of physical assaults by intimate partners. Prevalence figures typically rely on self-reports and it is well known that in some cultures violence is frequently kept hidden from outsiders. This may be related to traditional views of a man’s right to punish his wife, with victimization often being considered part and parcel of the daily burden of women. As a consequence, the violated women may be reluctant to identify themselves, as it may bring shame on the family and more victimization.4

According to Amnesty International,10 ‘domestic violence is the major cause of death and disability for European women aged 16–44 and accounts for more death and ill-health than cancer or traffic accidents. In South Africa more women are shot at home in acts of domestic violence than are shot by strangers on the streets or by intruders.’ In other words, ‘the prevalence of such violence suggests that globally, millions of women are experiencing violence or living with its consequences.’11

Unfortunately, many health professionals are not trained to discover consequences of violence. Thus, despite women’s visits to health facilities, many incidents may go unnoticed.

Immigrant and refugee women, as well as those displaced within their own countries, are not beyond experiencing this kind of violence. But they are subjected to further atrocities as the nature of war and violent conflicts has changed, and an increasing proportion of reported casualties are no longer soldiers but civilians. Thus, such women may experience violent acts as seen in recent conflicts, including the ongoing one in the Darfur region of Sudan, as well as in the former Yugoslavia, the Democratic Republic of Congo, Rwanda, Sierra Leone, Liberia, northern Uganda, Chechnya, and the Russian Federation.12 A global view starts to be evident among different UN organizations and non-governmental organizations (NGOs): in areas of conflict, ‘because of the sensitivity of the subject, violence is almost universally under-reported.’11 Conducting research on these sensitive matters (i.e., sexual violence) is an extraordinary challenge even in relatively stable settings. During conflict and related crises, when there is a lack of stability and disruption of family and community support, such research may be impossible.13

Types of violence

Violence has many faces, and Watts and Zimmerman11 have reviewed the magnitude of some of the most common and severe kinds of violent acts against women: intimate partner violence; sexual abuse by non-intimate partners; harmful traditional practices; trafficking; forced prostitution; exploitation of labor; debt bondage of women; physical and sexual violence against prostitutes; forced marriage; sex-selective abortions and dowry murders; and rape during war. Characteristically, women living in abusive relationships may be the targets of multiple acts of violence over time. The violence typically involves physical, psychological, and social aspects and frequently involves sexual abuse.4

In refugee women, experiences of sexual violence during armed conflicts are commonplace. The aggressor may use sexual assault to show superiority, to humiliate, to force abortions or to force pregnancy upon women as a strategy of war towards another ethnic group.14 Women may also feel forced to render sexual services to survive, in return for assistance or to protect their children. Traditionally, abusing the conquered women has been seen as part of the realities of war, and it was not until recently that rape in times of war was recognized as a war crime. Many women may face the threat of ostracism by their own families if sexual assault is revealed, leaving the women in question vulnerable and fragile. Women in armed conflicts are at extreme risk of sexual violence8 and, therefore, impunity for rape and sexual violence must end.

Influence of culture and sociopolitical context on interpersonal violence

Culture influences the interaction of risk factors with social support and protective psychological factors that contribute to symptoms. While some studies suggest that acculturation decreases the likelihood of interpersonal violence,15 recent studies find that acculturation actually increases this likelihood.16 Increased opportunities for the woman may make the man increase his control in order to keep power in the patriarchal family model. This is a method of exerting control over and disempowering women.

Culture can confound diagnosis and management of care by influencing definition of diseases and delineation of abuse or symptoms. Culture also influences help-seeking patterns, perspectives on and expectations of the role of healthcare providers, and patient–practitioner communication. A recently arrived refugee woman may, for instance, expect a hierarchical relationship with a health professional and experience a sense of stigma and shame when confronted with the more egalitarian, consumeroriented clinical model in Western society. The health staff must, in this context, evaluate the culturally relevant aspects of stress and encourage the protective factors in the present life of the abused woman.

Women of immigrant and refugee background are heterogeneous groups and do not share a common background or similar problems. What they may share are common influences of interpersonal violence within a sociopolitical and structural context.

Usually, migrant women carry a triple burden because of their gender, class, and ethnic background, and they often experience different kinds of psychosocial challenges due to prejudice and discrimination.17 Women in minority communities may experience sexism from within their communities based on cultural values, beliefs, practices, etc. In addition, as members of minority communities, women may be affected by institutional racism from the dominant culture, ‘as expressed through institutional policies, culture norms and prejudicial treatment.’18 According to Sorenson,19 institutional racism and sexism are not mutually exclusive; rather, the intersectionality of their multiple identities complicates immigrant and refugee women’s experiences of violence.

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Aug 11, 2016 | Posted by in INFECTIOUS DISEASE | Comments Off on Interpersonal Violence Towards Women

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