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The Podium

Domestic violence is a global public health concern

Physical or sexual violence is a serious public health problem that affects more than one third of all women globally, according to a new report by the World Health Organization. The findings of the report “send a powerful message that violence against women is a global health problem of epidemic proportions,” says Dr. Margaret Chan, director-general of WHO.

The WHO report, “Global and regional estimates of violence against women: Prevalence and health effects of intimate partner violence and non-partner sexual violence,’’ is the first systematic study of global information on the prevalence of violence against women — both by partners and by non-partners. According to the study, 35 percent of all women will experience violence. Intimate partner violence is the most common kind of violence experienced by women worldwide, both in developing and in industrialized countries.

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According to WHO, the prevalence rates for intimate partner and non-partner sexual violence among all women 15 years old or older, are the following: Africa: 45.6 percent; Americas: 36.1 percent; Eastern Mediterranean: 36.4 percent; Europe: 27.2 percent; South-East Asia: 40.2 percent; Western Pacific: 27.9 percent. In high income countries, the prevalence of this problem is 32.7 percent.

Because of the extent of this phenomenon, a global momentum for more effective action is building up, according to the medical magazine Lancet. In March, 103 member states at the Commission on the Status of Women at the UN agreed on the need to end violence against women and girls and to protect their human rights and fundamental freedoms.

Women victims of violence suffer a wide variety of health problems such as organ and bone damage, miscarriage, exacerbation of chronic illness, gynecological problems and sexually transmitted diseases including HIV/AIDS. In addition, they are more susceptible to a variety of mental health problems such as depression, post-traumatic stress disorder, sleep and eating disorders, emotional distress and suicide.

Harmful effects of domestic violence are not limited to the women victims, but they also extend to their children. Children who grow up in families where there is domestic violence are prone to a wide range of behavioral and emotional disturbances. One of three abused children becomes an adult abuser or victim. Domestic violence by a partner has also been associated with higher rates of infant and child mortality and morbidity.

Violence against women has also a high economic cost for society. The Centers for Disease Control and Prevention estimates the cost of the consequences of violence against women in $37 billion annually. This violence results in almost two million injuries and nearly 1,300 annual deaths.

In Russia, more than 14,000 women are killed every year in acts of domestic violence. In China, according to a national survey, one-third of the country’s 270 million households cope with domestic violence.

Domestic violence is also rife in most African countries. According to a United Nations report, domestic violence in Zimbabwe accounts for more than six in ten murder cases in court. In Kenya and Uganda, 42 percent and 41 percent respectively of women surveyed reported having been beaten by their husbands.

Domestic violence as a public health issue has been recognized by organizations such as the World Health Organization and the Inter-American Commission of Women of the Organization of American States. “Health systems should be the main door for detection, treatment and support for victims of violence against women,” states Carmen Barroso, director of the International Planned Parenthood Federation’s Western Hemisphere. However, the response continues to be inadequate. There are more animal shelters than shelters for battered women in the United States.

To end this worldwide scourge, appropriate legislation needs to be passed and seriously enforced. Violence against women is a barbaric practice that has no place in modern societies.

Dr. Cesar Chelala is author of “Maternal Health” and “Adolescents’ Health,” which are publications of the Pan American Health Organization.
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