CEHAT successfully completed its ‘National Course on Comprehensive Healthcare Response to Violence against Women and Children’ from November 17-19, 2017, at the YMCA, Mumbai Central, Mumbai. The residential programme, conducted over a course of three days, was attended by doctors, nurses from Maharashtra, New Delhi, Tamil Nadu, Kerala, Telangana, Gujarat, Madhya Pradesh, Goa and Haryana. A few social workers also participated. Resource faculty came from a wide range of fields like medicine, social science and law, to give participants extensive knowledge.
The course began with a background about CEHAT’s engagement with the issue of violence over the past years followed by a round of introductions from the participants.
Dr Seema Malik, former Medical Superintendent of K B Bhabha Hospital, and was instrumental in setting up the Dilaasa crisis centre, set the context by talking about the role of health care professionals (HCPs) in responding to survivors of domestic violence. She also elaborated on the benefits of a hospital-based crisis centre in providing care and counselling sharing her experience of establishing Dilaasa crisis centre as a department of the hospital in providing care and counselling.
Dr Manisha Gupte, founder and co-convenor at Mahila Sarvangeen Utkarsh Mandal (MASUM), explained patriarchal social structures, and the intersection of caste, class, religion, and sex. Participants worked in groups to discuss case studies that involved understanding intersectionality. Dr Gupte traced how gender bias is evident in our lives right from birth, and continues to affect our interactions with others. Therefore as HCPs, they must be aware of their own perceptions and values as that is what plays out in practice. A participating doctor acknowledged, “I learned that gender stereotypes and the compulsion to ‘be a man’ or ‘be more lady-like’ are learnt right from a person’s home. This subconsciously affects the way we interact with patients as well.”
Padma Deosthali brought to attention the link between violence and health by presenting global prevalence rates and also sharing some evidence based on CEHAT’s work on the issue, thereby emphasizing the role that medical professionals in identifying and responding to patients based on their health complaints. The participants were provided with handouts and a pen drive containing reading material on the topics discussed (the material involves concept-building as well, beyond medico-legal role).
The second day started off by a group of participants providing a revision of the previous day’s learnings. Padma Deosthali then explained the social circumstances of sexual violence and abuse after which the CEHAT team provided a session on how HCPs can provide psychological first-aid, since they are often the first point of contact for a survivor. Lunch was followed by Dr Roopa Prasad covering the guidelines provided by the Ministry of Health and Family Welfare on the treatment and rights of a survivor. Participants were encouraged to apply the skills gained over the past two days by engaging in an interactive role-play session on seeking informed consent, history and providing psychological first aid. As one participant wrote, “Providing psychological first-aid to the patient is very important, since it also helps determine any further medical proceedings.”
After a recap of Day 2 by the participants, Day 3 continued with a discussion on legal obligations and practices in medico-legal cases by renowned human rights advocate Vrinda Grover. “Everyone has a tendency to become a mini-judge in medico-legal cases. It is up to us to do our own jobs, and leave the verdict to the appointed judges,” she said. She emphasised that the doctor must be prepared as a medical expert witness and to respond effectively to the questions asked by the defense lawyer providing explanation that clarifies the medical opinion. This was followed by a guidance session from Dr Jagadeesh Reddy, who has expertise in both, the medical and legal field. He spoke of the protocols involved in examination and evidence collection. The participants were also briefed about their rights and duties as expert witnesses in courts of law. This was followed by a group activity where participants were given sample proformas and were asked to frame the provisional opinion based on the given details. “The law and amendments are dynamic. It is very important for us to keep ourselves updated,” a participant reiterated.
We sought feedback from participants; most of them were very satisfied with the course as it allowed them to look at gender and violence with a different perspective. Some were keen on having the course for longer duration as there was so much to learn. “We understood the basic concept of gender bias and domestic violence. The activities with clinical scenarios helped a lot in reconsidering our own thought process,” said a participant.