Gender violence has become increasingly widespread in Sri Lanka judging from daily reports in the media. No woman is safe at home, workplace or on the roads. As perpetrators stalk their prey on sight, online and chat shows, women and underaged girls are subject to horrendous acts of violence and sexual abuse.
The Sunday Observer asked Senior Lecturer in Paediatrics, Faculty of Medicinal sciences, University of Sri Jayewardenepura and Teaching Hospital Colombo South, Dr. Saraji Wijesekera to draw on her hands on experience with such victims and tell how such abuse impacts their health and how they should be dealt with to ensure safer environments for women.
Excerpts
Q: Violence against women is on the rise and recent statistics show that it is one of the most widespread public health problems across the world. While gender violence has been defined in many ways by different countries, how do you define violence?
A: The ill treatment or harassment in physical, sexual, verbal, emotional and psychological means or threats, coercion, economic or educational deprivation directed at an individual based on the biological sex. This could occur in one’s private or public life.
Q: The United Nations defines violence against women as, “any act of gender-based violence that results in, or is likely to result in, physical, sexual, or mental harm or suffering to women, including threats of such acts, coercion or arbitrary deprivation of liberty, whether occurring in public or in private life.” Can you elaborate on this? E.g. what are the main types of violence that are inflicted on women? Are intimate partner violence and sexual violence included?
A: The main types include physical, sexual, verbal, emotional and psychological harassments. The intimate partner violence by all types and sexual violence by the partner as well as the opposite gender are included.
Q: It has been said that intimate partner (physical, sexual and psychological) and sexual violence cause serious short- and long-term physical, mental, sexual and reproductive health problems for women. According to a WHO report, 42 percent of women who experience intimate partner violence reported an injury due to this violence. Do you agree?
A: Yes of course. Most of these women suffer injury as a result of physical abuse being crippled in the short and long term basis. For example, burns caused by acids and flame may disfigure them for the rest of life and injuries to the vital organs of the body may make them bed ridden.
Not only the physical aspect they suffer from mental and psychological stress that may cause depression and suicidal ideas and they may suffer at infirmaries for their life.
Q: To quote the WHO report again, such violence also leads to unintended pregnancies, induced abortions, gynaecological problems and sexually transmitted infections, including HIV. They are also twice as likely to have an abortion. Your comments?
A: Yes especially the sexual violence by the opposite sex may lead to unplanned pregnancies and illegal abortions with a threat to the life of such a women. The continuation of such pregnancies may lead to poor health in the newborn babies and even cause neonatal deaths. As there are many reports of unwanted babies abandoned on roads, kill and hide them are some of the repercussion of this. These violent unsafe sex could lead to many sexually transmitted diseases including HIV compromising the gynaecological and overall wellbeing of these women.
Q: Depression and low self-esteem? I understand this is a common problem of abused women? Do you agree?
A: Yes. These are serious problems of these women who suffer violence.Whatever the form of violence either physical or sexual or psychological, they ultimately end up with depression and low self-esteem which may affect them in bringing up their own families as well as their work if employed outside their homes in whatever capacity.
Q: The recent slight rise in suicide rates in Sri Lanka has also been found to be linked to violence on women. Your comments?
A: Yes there had been many reports where women committed suicide due to inability to cope with stress of violence and the depressive mindset that makes them feel that they are useless. If timely medical intervention is not given to the above category with severe depressive illness they could easily be tempted to attempt or commit suicide.
Q: Headaches, pain syndromes (back pain, abdominal pain, chronic pelvic pain) gastrointestinal disorders, limited mobility and poor overall health have also been cited as a fallout of violence against women. What is your opinion on this?
A: I believe the psychological disturbance which is an inevitable fall out of violence against women may cause victims to present with different physical complaints and at the home front if she is been subjected to violence may be overlooked. As a result of physical abuse there could be trauma to various areas of the body. At the same time non specific symptoms, such as abdominal pain, chronic pelvic pain could arise as a result of psychological deprivation.
Q: Media reports of young girls in early adolescent age being victims of sexual abuse and rape are seen on a daily basis in Sri Lanka. They are also victims of on line abuse. Just a few days ago three young men had been caught ‘selling” a 15-year-old girl to different partners after she unwittingly joined a chat show and her parents had come to know about it much later. What are the adverse health impacts of such abuse on these adolescent girls?
A: Unfortunately many of them divulge this only after having been repeatedly subject to sexual abuse. Mostly the abuser is a known person to them and there are threats to the girl if this is divulged that there could be repercussions to her or her loved ones. So these girls hide the fact that they are being abused.
As a result the young girl’s physiological functions of the body that are not yet ready for sexual relationships may be physically damaged and more so the psychological impact and the psychological trauma they undergo is immense. Ultimately they may become pregnant when their bodies are not yet ready for the physical change and the pregnancies end up with many complications.
Q: Judging from very recent news reports of even teachers, tuition masters abusing children in their own homes, members of the clergy and close relatives participating in this evil abuse across Sri Lanka this violence seems to have gone out of control. It appears there are hardly any safe places for a young girl to take refuge. What is the role of the health sector in curbing this violence?
A: As mentioned the perpetrator is a known person to the woman/girl.
Although the family believe that the girl is in a safe environment it may not be so.
As a health worker I suggest that the education on sex and violence should be part of the school curriculum, so that girls get a sound knowledge as they grow up and the opposite sex is aware that this type of violence is not tolerated by the society.
The victim should not be victimised by having to reveal their privacy. Child welfare authorities should build a good rapport with them and try to prevent any further horrendous acts.
Q: Many young girls are reluctant to talk to an outsider about their problems. As the first person of contact with them how do you deal with this problem in your work place?
A: One should not look at them as they have committed a major crime and or as a victim. We should approach them in a place where privacy is maintained and in some instances should talk to them without the parents/caregivers. Once you develop a good rapport with them and they feel that they are safe with you the chances are that they will divulge their problems and this will be a good opportunity to help with their psychological problems as well.
Q: Most parents are often the root cause for ignorance on basic reproductive health matters on the part of their children. Do you encourage parent participation in the rehabilitation process?
A: It depends on the relationship with the parents and the girl. In most instances in my experience there is no good rapport with them and parents seem to be detached from the children. However I feel it imperative that you get the support of the parents to inculcate the basic knowledge from very early childhood (preschool age) in both sexes as an example ‘not to let anyone other than your caregivers to touch your private parts etc,’ to prevent violence at any age.
Q: What in your opinion are the gaps in curbing and rehabilitating female victims of violence in Sri Lanka? How would you like to see them filled?
A: Once the truth is divulged many are worried that they may be not safe in the society they live in as the powerful perpetrator/s may try to take revenge on them. Hence the Rehabilitation process should be multipronged. The doctors, psychologists, lawyers, social services and Police should be part of the team providing support. A victim should feel comfortable enough to walk-in to such a service and be able to get help.
Q: The Progressive Women’s Collective (PWC) has last week issued a statement that the absence of proper legal mechanisms silences sexual victims. It has thus stressed the need to work on building safe environments to allow women for whom there are safe spaces to be able to speak of their traumas and fears without intimidation fear and re-intimidation , especially women who cannot access platforms where they can speak out. Your comments.
A: I feel that this is a timely and very good move forward. In my work I see a lot of children, adolescents and mothers of children with disability or children who have suffered some form of violence. Especially with sexual abuse they feel intimidated to talk about it unless they are in a safer environment. The most important aspect is to protect their privacy and assure them in order to relieve their stress.
Q. Have you a message for our readers who right now may be experiencing some kind of violence?
A. You should be aware that any form of gender based violence at home, workplace or society as women is not something that we should suffer and tolerate. Make a noise about so that it will relieve you of your stress as well. Support is available to you in the community. If you witness someone suffering silently guide them to these support services. Silent sufferers undergo immense psychological stress and needs to be stopped completely
A support guideline has been published by the World Health Organization in relation to violence at home during the Covid-19 pandemic that if you suffer from violence at home reach out for supportive family, friends or neighbours, call a helpline or access online and reach out for local services.