The role of the healthcare system in addressing domestic abuse/violence

This article was exclusively written for The European Sting by Mr. Ishwor Thapaliya an enthusiastic fourth-year medical student at Institute of Medicine, Maharajgunj Medical Campus in Nepal. He is affiliated with the International Federation of Medical Students Associations (IFMSA), cordial partner of The Sting. The opinions expressed in this piece belong strictly to the writer and do not necessarily reflect IFMSA’s view on the topic, nor The European Sting’s one.

Domestic abuse, also known as domestic violence or intimate partner violence (IPV), is a pattern of abusive behavior used to gain and maintain power or control over an intimate partner in any relationships. It includes physical, emotional, sexual, or  psychological actions that can lead to severe harm and even death of victims. It can happen to anyone regardless of age, race,  gender, sexual orientation or relationship status spanning different socioeconomic backgrounds and education levels. As per the study by WHO conducted in 2018, it was found that approximately 30% of females, nearly 1 in 3 experience physical or sexual violence by an intimate or non- intimate partner or both in their lifetime (1). 

Domestic abuse can have both short-lived and long-lasting health implications. Short-term effects include physical injuries like broken bones, cuts, and bruises, resulting from direct violence along with health issues such as digestive problems, headaches, and infections (2). More severe abuse  is associated with higher rates of persistent depression and ongoing suicidal tendencies, even after the abuse has stopped. Healthcare professionals are often the initial point of contact for the victims, and they are the individuals’, survivors trust the most for disclosing their abuse due to the doctor-patient relationships. Thus, they can offer essential medical care, treat injuries, and document evidence that may be needed in legal proceedings against perpetrators of abuse. Besides this, they can involve in raising awareness about personal protection orders, mandatory arrests, and insurance policies for survivors (3). 

Addressing immediate health concerns can ensure victims receive vital care, further strengthening their trust in the healthcare system. However, doctors often avoid discussing these issues, considering it intrusive to delve into their patients’ personal lives. Only 34% of those injured by intimate partners seek medical care, often due to shame and fear of retribution (4). Thus, integrating domestic violence services within healthcare settings is essential to bridge these gaps. It’s essential to note that domestic abuse or violence is against the law.  Medical advocacy can support IPV survivors, through effective collaboration between healthcare providers and domestic violence advocates. However, to enhance this support, training is essential, along with research. This can provide a better understanding of IPV’s impact on health and its dynamics, ensuring comprehensive care and assistance for survivors, dealing with abusive situations (5). 

The health impacts due to domestic violence are often linked to chronic and behavioral health issues, including substance abuse. Healthcare system must aim to support survivors with these challenges. Routine screenings and assessments, can help healthcare professionals to identify signs of abuse and violence. Simple, direct questions like “Do you feel safe at home?” can open the door for victims to share their experiences thus, revealing the cases that may otherwise go unnoticed. This  enables timely intervention and support, to prevent further harm or damages to the victim (3).  Preventive measures not only protect potential victims but also help change societal attitudes toward abuses. Collaboration with agencies like law enforcement, social services, and advocacy groups is vital for a coordinated response to domestic abuse. This multidisciplinary approach involves combined efforts and expertise of various professionals and thus, enhances the safety and well-being of survivors. Moreover, their voice is essential in shaping the legal and social framework that surrounds this issue.

In conclusion, healthcare providers are the frontline warriors against domestic abuse or violence. They not only offer medical care and necessary support to victims but also make our society safer and more compassionate for survivors to live in at a time. However, to ensure this, healthcare staff need to stay up-to-date with best practices, emerging research, and evolving policies, so as to provide optimal care and support to the victims.

References

1. Violence against women. COVID-19 and violence against women [Internet]. 2021 Mar 9 [cited 2023 Oct 27]; Available from: https://www.who.int/news-room/fact-sheets/detail/violence-against-women

2. Macdonald M. The role of healthcare services in addressing domestic abuse [Internet]. Available from: http://www.parliament.uk/commons-library|intranet.parliament.uk/commons-library|papers@parliament.uk|@commonslibrary

3. McClure BM. Domestic Violence: The Role of the Health Care Professional. Michigan Family Review. 1996 Jan 1;02(1):63. 

4. Domestic Abuse Guidelines for Health Care Professionals. [cited 2023 Oct 27]; Available from: https://www.emblemhealth.com/providers/resources/toolkit/domestic-abuse-guidelines-for-health-care-professionals

5. MEDICAL ADVOCACY: EMPOWERING VICTIMS OF DOMESTIC VIOLENCE THROUGH CONNECTIONS WITH HEALTHCARE SYSTEMS. 2023 Oct 6 [cited 2023 Oct 27]; Available from: https://caplanc.org/blog/medical advocacy empowering victims of domestic violence through connections with healthcare systems/

About the author

Ishwor Thapaliya is an enthusiastic fourth-year medical student at Institute of Medicine, Maharajgunj Medical Campus in Nepal. He has always been an active member of Nepal Medical Students’ Society (NMSS), affiliated with the International Federation of Medical Students’ Associations (IFMSA). Currently, Ishwor is working as a part of US Embassy Youth Council Nepal (USYCN) as a member under Civic Engagement Project for the term 2022/2023. Ishwor’s interests and aspirations go beyond his medical studies and civic engagement. He is passionate about motivating young individuals, addressing healthcare issues, and expanding his horizons through reading and writing.