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Violence and Health

Books and Report
Articles and Papers

Books and Reports

87. Establishing a Comprehensive Health Sector Response to Sexual Assault. Mumbai: CEHAT, 77 p., 2012 [ISBN: 978-81-89042-63-9]

This report is based on the experience of establishing a comprehensive health care response to sexual assault at three public hospitals in Mumbai, in collaboration with the Municipal Corporation of Greater Mumbai. CEHAT is the first institution in India to have directly engaged with the public health sector to develop a model to respond to sexual assault. The model includes development and implementation of a gender sensitive examination proforma, operationalization of informed consent and provision of medical care along with crisis intervention services. The report presents ways in which such a model can be run within the existing resources of the hospital.

The report presents ways in which health professionals were equipped to provide emergency health care, recognize voluntary reporting by survivors to hospitals and document sexual assault related findings sensitively. The model also empowered health providers to formulate medical opinion and interpret negative medical findings. The report also presents profile of survivors and challenges faced by them in reporting sexual assault. Analysis of case records and medical records of survivors throws light on the dynamics of sexual violence, nature of health consequences and limitations of medical evidence - which have not been studied to a great extent in the Indian context. Specific recommendations for different agencies such as child welfare institutions , police machinery , community based organisations and so on are discussed in order to create a multipronged approach to respond to sexual assault. Download full report

84. Ethical Guidelines for Counseling Women Facing Domestic Violence. Mumbai: CEHAT, 32 p., 2012 [ISBN: 978-81-89042-60-8]

This document lays down ethical principles and guidelines (translation of these principles) to inform counselling practice in the best interest of the client. Ethical principles include Autonomy, Beneficence, Non-maleficence, Veracity and Fidelity and Justice. The guidelines have been evolved through a process of consultation with an expert committee. The purpose of this document is to sensitize counsellors, protect and promote rights of the clients; to promote standards in counselling through observation of ethics and self regulation; to improve quality and credibility of counselling, and to make ethics an integral part of counselling practice. The universality of the core principles of ethics allows the present guidelines to be used by all counsellors and stakeholders engaged in domestic violence work in general, and domestic violence counselling, in particular. These include psychologists, social workers, protection officers, community development officers, and the like; as well those involved in private practice (including the individual counsellor). Organizations or institutions that provide counselling services, education, and/or training can endorse them and, make them applicable to their staff.Download full report

83. Manual for Medical Examination of Sexual Assault (Revised after Criminal Law Amendment Act, 2013). Mumbai: CEHAT, x,64 p., 2012 [ISBN: 978-81-89042-59-2]

This manual aims to equip health care workers with an appropriate understanding of sexual violence and the needs and rights of survivors of sexual violence, and to highlight the dual responsibilities-both medical and forensic-health care workers have toward survivors. Health administrators, educators, obstetricians, gynaecologists, paediatricians and forensic medical examiners to read this manual and adopt its approach in their practices. Reducing health risks faced by women and ensuring respect for the dignity and autonomy of each woman is central to the realization of the right to health. This manual provides critical support for these endeavors and is thus a welcome contribution to the promotion of women's health and the right to health in India....Download full report

81. Contractor, Sana... [et al]. Responding to sexual assault: A study of practices of health professionals in a public hospital. Mumbai: CEHAT and New Delhi: SAMA, 58 p., 2011 [ISBN: 978-81-89042-57-8]

The study showed that there are several gaps in both the medico-legal as well as therapeutic response of the hospital to sexual assault survivors. As far as the medico-legal role of health providers is concerned, we find that there are no uniform protocols for seeking consent, history, conducting examinations or for evidence collection and hence there is a lot of variation between the practice of various doctors. There is no protocol for how, from whom and for what consent needs to be sought and coercion was evident in certain types of cases. Doctors also articulate the lack of skills vis-à-vis seeking history from children and building rapport with survivors which serves as a barrier to eliciting thorough history. The study also suggests that health care providers, in cases of sexual assault, perceive their role to be largely medico-legal rather than therapeutic... Download full report

77. Deosthali, Padma and Rege, Sangeeta. Feminist Response to Attempted Suicide: A Model for Public Health Intervention. Working Paper No. 2. Mumbai: CEHAT, 36 p., 2010 [ISBN: 978-81-89042-53-0]

Dilaasa, India's first hospital based crisis centre was established to address Domestic Violence and provide services to women within the hospital itself. This counselling endeavour brought to light that several women admitted for "accidental consumption of poison" had essentially attempted suicide, the underlying reason being Domestic violence. In order to address this issue, the centre evolved a counselling model which was informed by feminist principles that challenged the main stream psychiatric model of labeling women as involved in "deliberate self harm" or indulging in "impulsive behaviour" but rather as a reaction to an extremely unbearable situation. This paper presents the feminist counselling methodology and illustrates it with examples from the counselling practice. Thus it makes a case for including a feminist counselling approach in public hospitals to the issue of attempted suicides in women... Fulltext Publication

76. Rege, Sangeeta. Guidelines for Counselling Women Facing Violence. Mumbai: CEHAT, 48 p., 2010

These guidelines are primarily meant for enhancing skills and attitudes of those dealing with Violence against Women at the hospital setup but would be useful to others too. These guidelines provide a perspective on the issue and also has real life examples. These guidelines are developed from the feminist perspective the counselling would enable the women to understand the cause of violence lies external to them and the root of violence are based in patriarchy... Fulltext Publication

74. Dilaasa crisis intervention department for women: a report. Mumbai: CEHAT, 14 p., 2010

Dilaasa was set up in the year 2001 at the K. B. Bhabha Hospital, Bandra as a collaboration between Municipal Corporation Greater Mumbai (MCGM) and Centre for Enquiry into Health and Allied Themes (CEHAT). Dilaasa, which is a hospital based crisis centre, was set up in order to provide the much needed psychosocial support to women reporting domestic violence at Municipal hospitals. It is India’s first hospital based crisis centre for women facing domestic violence... Fulltext Publication

73. Manual for medical examination of sexual assault. Mumbai: CEHAT, x,58 p., 2010 [ISBN: 978-81-89-042-51-6]

This manual has been written based on the experiences of a pilot intervention for developing a comprehensive health care response to sexual assault in two public hospitals in Mumbai.

The manual is an important contribution to strengthening the knowledge and understanding of providers in India on how to respond to sexual assault survivors. It should contribute to better care and better outcomes for victims/survivors, who are primarily women and children. The encounter with the health provider can contribute to the healing process or conversely can be an experience of revictimization. The more providers understand the issues surrounding sexual violence, and the psychological and physical needs of survivors and are able to provide the basic care and psychosocial support, and carry out a sensitive forensic examination when appropriate, the more likely they can help the survivor in the healing process. Where this is not possible, clear referral pathways should be established to ensure survivors can access the necessary care and support... Download Report

72. Jagadish, N.; Deosthali, Padma; Contractor, Sana; Rege, Sangeeta and Malik, Seema. Comprehensive health sector response to sexual assault does the Delhi high court judgment pave the way? Working Paper No. 1. Mumbai: CEHAT, 16 p., 2010 [ISBN: 978-81-89042-50-9]

This first paper in the CEHAT Working Papers series draws from its collective action research experience over the years in addressing the issue of sexual assault. The Paper presents its reasoned conviction on the importance of a multi-sectoral approach to the issue particularly in the context of the Delhi High Court mandate on the responsibilities of the many agencies involved in dealing with incidents of sexual assault. Even as it underlines the fact that only such an approach can make for a humane and effective response to cases of sexual assault, it makes a case for further research on the modalities of expanding the scope of the judicial mandate... Download

71. Rege, Sangeeta; Deosthali, Padma and Contractor, Qudsiya. Challenges in domestic violence counseling. Mumbai: CEHAT, viii, 40 p., 2010 [ISBN: 978-81-89042-53-0]

This case book presents 15 narratives bringing forth fairly common but some of the most complex real-life scenarios in the lives of women’s facing domestic violence. Each narrative has woven together the case scenario as it developed and counsellor’s response to the woman concerned to the unfolding of complex issues with ethics at the centre stage. The perspectives are that of counsellors as they grappled to resolve the ethical challenges involved. Download full report...

69. Pitre, Amita and Pandey, Meenu. Response of health system to sexual violence: study of six health facilities in two districts of Maharashtra. Mumbai: CEHAT, x,110 p., 2009

This study focuses on the response of the public health system to sexual violence. This exploratory study is done in six health facilities at various levels of the public health system in two districts of Maharashtra, India it describes the procedures followed in the public health system for women and children who have been subject to sexual assault, and analyses them from a gender perspective. It also attempts a comparative analysis of the procedures, the quality of medico-legal examination and health care, organsiation of services, examination facilities, equipment, medical supplies and medicines in these facilities with the prescribed International and National norms... Download Report

68. Burte, Aruna. Breaking the Culture of Silence: Uniting to fight domestic violence. Mumbai: CEHAT, xii,75 p. 2008

‘Breaking the culture of silence’ places Domestic Violence within the context of the feminist movement of 1980s in India. It highlights the democratic and left movements that created space for raising issues related to women’s rights. This booklet is intended to capture the process that has enabled women to break the culture of silence that has hitherto surrounded their trauma... Download

62. Contractor, Qudsiya; Madhiwalla, Neha and Gopal, Meena Uprooted Homes Uprooted Lives: A Study of the Impact of Involuntary Resettlement of a Slum Community in Mumbai. Mumbai: CEHAT, 267 p., 2006 [ISBN 81-89042-43-2]

This report has revealed the impact of involuntary resettlement of a slum community in Mumbai. This study attempts to capture the nuances of the social experience of resettlement and reflects on its consequences. The issues highlighted in this report pertaining to resettlement are health, education, water, employment and social life from a human rights perspective. Involuntary resettlement most certainly means the disruption of an entire way of life and clearly constitutes a humanitarian crisis. The experience clearly shows that resettlements in the manner in which it has been conducted, violates the basic rights of the people.Download full document

61. Contractor, Qudsiya; Madhiwalla, Neha and Gopal, Meena Uprooted Homes Uprooted Lives: Key Findings of a Study on the Impact of Involuntary Resettlement on a Slum Community in Mumbai. Mumbai: CEHAT, 38 p., 2006

This report is a synopsis of key findings of the study on the impact of involuntary resettlement of a slum community in Mumbai. The key findings reveal the hardships that the community has to face due to its resettlement leading to several problems such as loss of employment, poor enrolment in educational institutes due to lack of schools, health disorders – physical and mental and difficulty in accessing public health facilities and impact on women. The findings show that those resettled have very little bargaining power to influence decisions in situations of urban relocation that violate their very rights to citizenship apart from the basic rights to shelter, livelihood, education, health care and a life of full reportDownload full document

55. Burte, Aruna; Rege, Sangeeta and Deosthali, Padma. Choosing to Live: Guidelines for Suicide Prevention Counselling in Domestic Violence. Mumbai: CEHAT, vi,57 p. September 2005.

Choosing to live is the message underlined in the guidelines compiled for preventing suicides due to domestic violence. The book provides an in-depth understanding to suicidal tendencies, reasons or causes of suicides, means adopted for committing suicides, efforts to prevent such incidences by recognizing risk factors, consequences of such actions and psychological impact of domestic violence. The guidelines for effective counselling and techniques needed for counselling are helpful to those who want to reach out to persons suffering from such tendencies. Download full report Download full document

54. Deosthali, Padma; Maghnani, Purnima and Malik, Seema. Establishing Dilaasa: Documenting the Challenges. Mumbai: CEHAT, vi,43 p., 2005.

Dilaasa is the first hospital-based crisis centre in India for women survivors of domestic violence. It provides social and psychological support to women facing domestic violence. This publication is an effort made towards documenting various challenges posing Dilaasa while it was being established. The chapters such as Dilaasa's Model of Collaboration, Formative Period, Counselling Model and Strategies, Training Model and Strategies and Lessons Learnt and Recommendations consist of detailed information of Dilaasa's development. These experiences are of immense importance to those who want to set up similar centres for victims of domestic violence. Download report

44. Process Documentation of Training of Trainers. Mumbai: CEHAT, xx,134 p., January 2004. [ISBN 81-89042-26-2]

This document gives a detailed documentation of the training sessions that were undertaken to train the hospital staff on domestic violence as a health issue, gender and violence and role of health care professionals in responding to domestic violence. This documentation of the process of training hospital staff as trainers will be a useful resource for those endeavoring to sensitize the health system.

41. Khot, Anagha; Menon, Sumita and Dilip, T. R. Domestic Violence: Levels, Correlates, Causes, Impact and Response: A Community Based Study of Married Women from Mumbai Slums. Mumbai: CEHAT, 62 p., June 2004. [ISBN 81-89042-29-7]

This study brings out clear evidence of wide-spread prevalence of domestic violence within the community, looks at the reasons for the violence and explores what women do to seek help to come out of such a situation. The scope of this study was limited to ever-married women and to violence within marital relationships. Despite its specific limited scope, this research is a significant contribution to the literature on domestic violence in India. Download full document

18. Health Panorama No.1- Violence: A Health Issue. Mumbai: CEHAT, viii,72 p., January 2000.

This is first volume in Health Panorama series devoted to burning topic “Domestic Violence”. The entire volume is dealing with various facts of domestic violence such as socio-cultural, political and economical.

13. Shaheen, Kiran. Portrayal of Police Torture in Hindi Films and Television Serials and its Impact on Children. Mumbai: CEHAT, 48 p., 1999.

Very important study by media experts and NGO's attempts the impact of media violence on children, particularly in the Indian context. Report highlights police torture in films and television serials and its impact on children. Download Report

11. D'Souza, Dilip. Rehabilitation, Eradication, Both or None? Mumbai: CEHAT, 48 p., February 1998

The survey report is a preliminary examination of the human rights scenario and torture in the progressive state like Maharashtra in general and Mumbai city in particular in order to understand need for effective treatment and rehabilitation activity of torture survivors. Download Report

10. Kulkarni, Sucha; Jesani, Amar and D'Souza, Lalitha. Sexual Assault of a Deaf Mute Juvenile in Observation Home, Umerkhadi on September 21, 1997, Mumbai: Forum Against Child Sexual Exploitation, 14 p., September 1998

An expert panel of investigators has given detailed chronology of an incident on sexual assault, which took place in observation home of Umerkhadi. The report throws light on how the unfortunate children of this country are being treated in observation homes which are established for their welfare and care in terms of poor administration, medical facilities, legal aid and procedure, carelessness about survivor, police reporting and suggested need to change in behaviour of all concerned including change in act also.Download full report

Articles and Papers

A 317. Bhate-Deosthali, Padma and Duggal, Ravi (2013).Rethinking gender-based violence and public health policies in India Insights from Dilaasa, Mumbai, India. in Keerty Nakray (ed.) Gender Based Violence and Public Health - International Perspectives on Budgets and Policies 2013, pp. 184-196.

A 307. Contractor, Sana. Reflections on the high court’s dismissal of the ‘TISS rape case’. Indian Journal of Medical Ethics, VII(4), Oct-Dec 2011, pp. 246-247

A 306. Rege, Sangeeta. Medico-legal cases across various hospitals - A review & understanding of procedures. Medico-Legal Update, 11(2), 2011, pp. 67-69

A 299. Deosthali, Padma and Rege, Sangeeta. A study to understand violence faced by female health workers: a need to develop hospital based response. In Second International Conference on Violence in the Health Sector, Congress Centre”De Meervaart”Meer en Vaart 300,1068 LE Amsterdam, The Netherlands. October 27 – 29, 2010, 249 p. (Poster)

A 298. Rege, Sangeeta and Deosthali, Padma. Dealing with spousal violence. Indian Journal of Medical Ethics, October-December 2010, VII(4), pp.246-248

A. 295. Gupta, Rupali and Rege, Sangeeta. Challenges and dilemmas in institutionalising a crisis centre for women facing domestic violence in the public health system. Paper presented in National Bioethics Conference, New Delhi, 2010.

A 294. Sana Contractor and Sangeeta Rege. Need for better governance in responding to cases of sexual assault in the health sector. Paper presented in National Bioethics Conference, New Delhi, 2010.

A. 293. Contractor, Sana and Rege, Sangeeta. Implementation of Protocols to respond to Sexual Assault- Experiences from the field. Paper presented at the International Conference on Gender-based Violence and Sexual and Reproductive Health. February 15-18, 2009, Mumbai

A. 292. Deosthali, Padma. Course on VAW and role of Health Care Providers: Bridging the gap in current medical discourse. (paper submitted for publication) 2009, 6 p.

A. 291. Deosthali, Padma and Rege, Sangeeta. Attempted suicide a consequence of Domestic Violence: A Feminist response. (paper submitted for publication) 2009, 16 p.

A. 290. Deosthali, Padma and Malik, Seema. Establishing Dilaasa: A Public Hospital Based Crisis Centre. In NGOs, Health and the Urban Poor. Edited by Vimla Nadkarni, Roopashri Sinha and Leonie D’Mello. Mumbai: Rawat Publications, 2009, pp.140-160

A 286. Deosthali, Padma. Women at Work : Sick and Tired. Agenda Info change, 9, 2007, 46p.

A 283. Deosthali, Padma and Lingam, Lakshmi. Combating Domestic Violence through the Health System: Lessons from Dilaasa: ISSRF Newsletter. A publication of the Indian Society for the Study of Reproductive and Fertility, pp.16-21

A 282. Deosthali, Padma. Role of Health Professionals in addressing Family Violence. Paper presented at the International Seminar on Family Violence organsied by the Department of Sociology, Pune University. 2006

A 278. Pitre Amita. Caring for Survivors of sexual Assault. Indian Journal of Medical Ethics. 3(3), July-September 2006, pp.90-92

A 269 Deosthali, Padma and Maghanani, Poornima. Gender based violence and role of the Public health system for the State of Health Care Report, Mumbai: CEHAT, 2005

A 268. Deosthali, Padma. Should Case Documentations be used for Research? Indian Journal of Medical Ethics, October - December 2005, 2(4), 129 p.

A 254. Pitre, Amita. Case study of an attempt to institutionalize a model ‘Sexual Assault Evidence Kit’ to address care and evidence linked issues. Presented at the conference Lessons learnt from a rights based approach to health, organized by Emory University, Atlanta, USA, May 2005, 7p.

A 253. Pitre, Amita. 'Role of health professionals: What to do in cases of sexual assault? Women’s Global Network for Reproductive Rights Newsletter'' (Update No.4), 84(4), 2005, pp.2–3

A 252. Pitre, Amita. Sexual assault care and forensic evidence kit strengthening the case for use of the kit. presented at the 10th International Women and Health Meeting in New Delhi, India, from 21st to 25th September 2005, pp.6

A 249. Deosthali, Padma. Domestic violence and the health sector. Health Action, 17(9), September 2004, pp.14-16

A 230. Mahabal, Kamayani Bali. CEHAT's PIL for reviewing diet scales in jail. Express Healthcare Management, 1-15 May 2004

A 208. Saha, Shelley. Domestic violence and pregnancy. Health Action, 17(9), September 2004, pp. 11-13

A 207. Balaji, Rajeswari; Dilip, T. R. and Duggal, Ravi. Utilization and expenditure on delivery care services: some observations from Nashik district, Maharashtra. Regional Health Forum, 7(2), 2003, pp.34-41

A 206. Burte, Aruna and Deosthali, Padma. Crisis counselling in domestic violence. October 2003, 12 p. (Submitted to Journal of Mental Health)

A 186. Malik, Seema and Deosthali, Padma. Public hospital based crisis centre: Experience from India. Prepared for the 2nd Asia Pacific Conference on Sexual and Reproductive Health held in Bangkok, September 2003, 9p.

A 179. Rege, Sangeeta. Dilaasa: Creating spaces for women in a public health system. Humanscape E-newsletter, March 2003, 5p.

A 151. Deosthali, Padma. Dilaasa an Endeavour to Sensitise the Public Health System to Domestic Violence, Samyukta- A Journal of Women's Studies, Vol. 2(2), 2001, pp. 327-329

A 118. Menon, Sumita; Khot, Anagha and Doesthali, Padma. Violence and Health Care Professionals: The Crucial Link, Paper presented at the Regional south East Asia Workshop on Impact of Gender based Violence on the Health of the Women held on April 5th -7th 2000, organised by society for Operations Research and Training and CORT), April 2000, 7 p.

A 76. Jesani, Amar. Violence Against Women: Health Issues, WHO Country Profile: India, 1998, 20 p. (Draft Submitted to WHO/VHAI).