By Dr. Dineshani Hettiarachchi Sirisena
[caption id="attachment_155164" align="alignright" width="431"]
Prof. P. Anuruddhi S. Edirisinghe[/caption]
According to global estimates, one in three women and girls experience violence in the form of physical or sexual abuse in their lifetime. This is usually caused by an intimate partner. These violences can have drastic consequences on sexual and reproductive health choices. We spoke to University of Kelaniya Department of Forensic Medicine Cadre Chair Professor Prof. P. Anuruddhi S. Edirisinghe on health issues related to sexual and gender-based violence (SGBV).
The World Health Organisation (WHO) defines violence as “the intentional use of physical force or power, threatened or actual, against oneself, another person, or against a group or community, that either result in or has a high likelihood of resulting in injury, death, psychological harm, maldevelopment, or deprivation”, therefore is tripartite: interpersonal, self-directed, and collective. Self-directed violence can be in the form of self-harm or suicide and interpersonal violence usually originates within one’s close associates such as the family members, intimate partner, etc. Social, political, or economic factors are usually seen to cause collective violence.
Many factors contribute to SGBV, much like a tree. It has roots, a trunk, and leaves, stated Prof. Edirisinghe. The root causes are embedded in societal norms that encourage men to use “power” over women. These stem from the abuse of power, gender inequality, lack of belief, inequality of human rights for all, etc. Much like the tree trunk, the contributing factors are alcohol and drug abuse, conflict, poverty, impunity, stigma, lack of proper education, etc.
Patriarchal society treats GBV with impunity, thereby condoning acts of GBV:
– Men are more powerful
– Men should control women
– Women should “behave”
Society supports men to use “power” over women when women do not conform to the stereotype.
As such, SGBV is multifaceted and can manifest as domestic violence, rape, verbal abuse, and so on. In Sri Lanka, what we see and hear on the news is just the tip of the iceberg. There are many who suffer in silence. A study conducted in 2018 across five provinces revealed that 36% of female suicides and homicides were related to intimate partner violence, whereas 35% of female homicides were committed by the husband or ex-lover.
When we look at global statistics, women are disproportionately affected by SGBV.
Chart: Sexual offences in SL reported to the Police. Total cases reported per year – 2,500-2,800
There are many facets to SGBV and each case could be different. This is an example of one case, stated Prof. Edirisinghe, which she had encountered during her family interviews.
A daughter of a victim who was killed by her husband had said: “My father is a hot-tempered person who gets angry very easily. So I do not know whether the killing was a planned one or a result of sudden anger. My mother was discharged from the hospital recently. She needed time to recover, but he wanted her to go with him. My mother suffered a lot. I have seen my mother being beaten by my father since my childhood. He used whatever he could get his hands on to beat her. She had fractured arms and legs several years ago. My mother had to go to the hospital this time because my father inserted a pole into her vagina and she was badly hurt.”
Getting timely help
Certain interventions are time sensitive. Hence, getting the care and support needed early can be paramount – for example, in sexual assault/rape, having access to emergency contraception to prevent pregnancy (within 120 hours) and post-exposure prophylaxis (PEP) medication to prevent HIV infection (within 72 hours of possible exposure), as well as presumptive treatment of STIs. Additionally, healthcare services can provide counselling, mental health facilities, rehabilitation, etc.
Timely action taken by community members and neighbours can prevent the escalation of domestic violence as well as sexual abuse. The general public needs to be made aware of the role they can play when women and girls are in vulnerable situations. Young boys as well as girls should be empowered to avoid/intervene in such situations.
Facilities available in Sri Lanka
If you or someone known to you is facing SGBV, there are in-hospital facilities called “Mithuru Piyasa//Natpu Nilayam” for befriending and emotional support. They are also equipped to provide necessary facilities and expertise to those who are in need by referring them for specialised care. It is important to know that survivors of SGBV have multiple and complex needs. Within the confines of health institutions, some of these needs can be taken care of, especially temporary protection to linkages with necessary stakeholders. There are also NGOs such as Sarvodaya and Women in Need, the Complaints Centre at the Ministry of Women and Child Affairs, and other local organisations that provide support.
UnderFig 2: Pathway of care at Mithuru Piyasa
(Source: Family Health Bureau newsletter)
Finally, Prof. Edirisinghe stated that there is much to be done. To quote St. Francis of Assisi: “Start by doing what is necessary; then do what is possible; suddenly you are doing the impossible.”
Prof. P. Anuruddhi S. Edirisinghe[/caption]
According to global estimates, one in three women and girls experience violence in the form of physical or sexual abuse in their lifetime. This is usually caused by an intimate partner. These violences can have drastic consequences on sexual and reproductive health choices. We spoke to University of Kelaniya Department of Forensic Medicine Cadre Chair Professor Prof. P. Anuruddhi S. Edirisinghe on health issues related to sexual and gender-based violence (SGBV).
The World Health Organisation (WHO) defines violence as “the intentional use of physical force or power, threatened or actual, against oneself, another person, or against a group or community, that either result in or has a high likelihood of resulting in injury, death, psychological harm, maldevelopment, or deprivation”, therefore is tripartite: interpersonal, self-directed, and collective. Self-directed violence can be in the form of self-harm or suicide and interpersonal violence usually originates within one’s close associates such as the family members, intimate partner, etc. Social, political, or economic factors are usually seen to cause collective violence.
Many factors contribute to SGBV, much like a tree. It has roots, a trunk, and leaves, stated Prof. Edirisinghe. The root causes are embedded in societal norms that encourage men to use “power” over women. These stem from the abuse of power, gender inequality, lack of belief, inequality of human rights for all, etc. Much like the tree trunk, the contributing factors are alcohol and drug abuse, conflict, poverty, impunity, stigma, lack of proper education, etc.
Patriarchal society treats GBV with impunity, thereby condoning acts of GBV:
– Men are more powerful
– Men should control women
– Women should “behave”
Society supports men to use “power” over women when women do not conform to the stereotype.
As such, SGBV is multifaceted and can manifest as domestic violence, rape, verbal abuse, and so on. In Sri Lanka, what we see and hear on the news is just the tip of the iceberg. There are many who suffer in silence. A study conducted in 2018 across five provinces revealed that 36% of female suicides and homicides were related to intimate partner violence, whereas 35% of female homicides were committed by the husband or ex-lover.
When we look at global statistics, women are disproportionately affected by SGBV.
- 35% of women worldwide have experienced either intimate partner violence or non-partner sexual violence in their lifetime
- 30% of women who have been in a relationship report that they have experienced some form of physical or sexual violence by their partner
- 47% of women homicide victims were intentionally killed by an intimate partner or family member
- The first sexual experience of some 30% of women was forced. 45% of those under 15 at the time of their sexual initiation report the experience was forced
- Children who grow up in families where there is violence may suffer a range of behavioural and emotional disturbances. These can also be associated with perpetrating or experiencing violence later in life.
Chart: Sexual offences in SL reported to the Police. Total cases reported per year – 2,500-2,800
There are many facets to SGBV and each case could be different. This is an example of one case, stated Prof. Edirisinghe, which she had encountered during her family interviews.
A daughter of a victim who was killed by her husband had said: “My father is a hot-tempered person who gets angry very easily. So I do not know whether the killing was a planned one or a result of sudden anger. My mother was discharged from the hospital recently. She needed time to recover, but he wanted her to go with him. My mother suffered a lot. I have seen my mother being beaten by my father since my childhood. He used whatever he could get his hands on to beat her. She had fractured arms and legs several years ago. My mother had to go to the hospital this time because my father inserted a pole into her vagina and she was badly hurt.”
Getting timely help
Certain interventions are time sensitive. Hence, getting the care and support needed early can be paramount – for example, in sexual assault/rape, having access to emergency contraception to prevent pregnancy (within 120 hours) and post-exposure prophylaxis (PEP) medication to prevent HIV infection (within 72 hours of possible exposure), as well as presumptive treatment of STIs. Additionally, healthcare services can provide counselling, mental health facilities, rehabilitation, etc.
Timely action taken by community members and neighbours can prevent the escalation of domestic violence as well as sexual abuse. The general public needs to be made aware of the role they can play when women and girls are in vulnerable situations. Young boys as well as girls should be empowered to avoid/intervene in such situations.
Facilities available in Sri Lanka
If you or someone known to you is facing SGBV, there are in-hospital facilities called “Mithuru Piyasa//Natpu Nilayam” for befriending and emotional support. They are also equipped to provide necessary facilities and expertise to those who are in need by referring them for specialised care. It is important to know that survivors of SGBV have multiple and complex needs. Within the confines of health institutions, some of these needs can be taken care of, especially temporary protection to linkages with necessary stakeholders. There are also NGOs such as Sarvodaya and Women in Need, the Complaints Centre at the Ministry of Women and Child Affairs, and other local organisations that provide support.
UnderFig 2: Pathway of care at Mithuru Piyasa
(Source: Family Health Bureau newsletter)
Finally, Prof. Edirisinghe stated that there is much to be done. To quote St. Francis of Assisi: “Start by doing what is necessary; then do what is possible; suddenly you are doing the impossible.”