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Breaking the Silence: A profile of domestic violence in women attending a community health centre
Tanya Jacobs
2000-06-02

Violence against women is the world ’s most pervasive form of human rights violation. Gender based violence represents a substantial health burden for women in terms of morbidity and mortality rates and makes a significant negative impact on their physical and mental health (WHO 1997).

Violence against women is the world ’s most pervasive form of human rights violation. Gender based violence represents a substantial health burden for women in terms of morbidity and mortality rates and makes a significant negative impact on their physical and mental health (WHO 1997).

It is endemic in most societies across the world,but remains unrecognised as silent socio-economic, public health and political issue, largely absent from national and international agendas. It has only recently been recognised by the United Nations as a fundamental abuse of women ’s human rights (Human Rights Watch 1995).

The Canadian Panel on Violence Against Women states in the introduction to its report that: It is abundantly and indisputably clear that women will not be free from violence until there is equality, and equality cannot be achieved until the violence and the threat of violence is eliminated from women ’s lives (Canadian Panel on Violence Against Women,1993).

The South African government has expressed a commitment at policy level to eradicate gender violence.

The South African Constitution and Bill of Rights now contains clauses that safeguard and promote women ’s rights as human rights. There is explicit reference to gender violence -clause (12)(1)protecting ‘the rights to freedom and security of the person, which includes the right –(c) to be free from all forms of violence from either public or private sources ’.In addition, the commitment is translated through the establishment of various gender organisations and structures, such as the Commission on Gender Equality and through new legislation that aims to ensure those constitutional rights are not infringed.

For example the new Domestic Violence Act (1998)will be an important legislative tool for women in abusive relationships to attain protection and redress through the criminal justice system, as well as access to appropriate support from other sectors, including health.

United Nations Declaration on the Elimination of Violence (1994)against women is: Any act of gender-based violence that results in, or is likely to result in, physical, sexual or psychological harm or suffering to women, whether occurring in public or private life

Very few studies in South Africa have explored the prevalence and impact of gender violence or generated guidelines for the health sector to respond to this public health problem most effectively. The Breaking the Silence Project addresses this gap y placing the silent epidemic on the public health agenda. It was conducted at a community health centre to determine the prevalence and pattern of domestic violence, as well as to describe the health care workers ’ability to recognise and manage the situation of abuse experienced by patients. The ultimate aim is to provide guidelines for improved health sector service provision for domestic violence patients in South Africa, as informed by the experiences of the abused women. This study is part of an ongoing process of addressing gender violence as a public health issue through research, training and advocacy within the health sector and related sectors.

The study uncovered domestic violence as a serious problem for women in South Africa, evidenced by the high percentage of patients reporting current or past experience with abuse. It was informed by women experiences and makes the following recommendations to improve the current health sector response to abuse:

• Recognition of gender violence as a public health priority in South Africa.
• Implementation of health sector protocols and guidelines.
• Development and implementation of appropriate gender and procedural training for all sectors.
• Institution of comprehensive services.
• Co-ordination of services between the NGO and the government sector.
• Establishment and strengthening of networks.
• Creation of public awareness campaigns.

The proposed integrated and co-ordinated approach to service delivery is essential to effectively address the magnitude and impact of gender violence in South Africa and to identify this problem as a public health and human rights issue.

Find this publication on the web: http://www.hst.org.za/research/violence/

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