A Webinar Series (25th November to 15th December, 2021)
On occasion of International day for the Elimination of Violence Against Women that mark the launch of 16 days of activism of UNiTE to End Violence against Women (VAW) starting from 25th November, 2021, CEHAT organised a series of webinar on various topics like gender based violence and its impact on health, recognising and responding to signs of VAW, ethics and health care, role of nurses in responding to VAW, LIVES -WHO model to respond to VAW, gender sensitivity in clinical practices, doctors deposing as an expert witness in court. Resource persons for the webinar were expert clinical practioners having experience in handling cases of violence, and have advocated for effective response of health care providers to women and children facing violence. Health care providers, one stop crisis centre staff, medical educators, and NGOs working on VAW from across the country participated in the webinar.
Session 1: Gender Based Violence and its Impact on Health
Date: 25th November 2021
Resource Person: Dr. Priya Prabhu, Associate Professor of Preventive and Social Medicine, Government Medical College, Miraj, Maharashtra.
The one hour session had around 100 participants and it covered different types of violence, its prevalence in India and around the world, health consequences of violence on women and children, health impact on pregnant women facing violence, and about VAW in times of COVID -19 pandemic.
Participants were oriented about concept of Gender-based violence (GBV) that is directed against a woman because she is a woman or that affects women disproportionately. It includes acts that inflict physical, mental or sexual harm or suffering, threats of such acts, coercion and other deprivations of liberty. Resource person explained that Gender-based violence includes physical, sexual and psychological violence such as domestic violence; sexual abuse, including rape and sexual abuse of children by family members; forced pregnancy; sexual slavery; traditional practices harmful to women, such as honor killings, burning or acid throwing, female genital mutilation, dowry-related violence; violence in armed conflict, such as murder and rape; and emotional abuse, such as coercion and abusive language. Trafficking of women and girls for prostitution, forced marriage, sexual harassment and intimidation at work are additional examples of violence against women.
Some frequent questions and myths on GBV were also discussed:
Using a Case Study participants were explained health effects of violence. Resource person talked about health consequences that range from low-birth-weight babies to anaemia, from depression to suicide, from vague bodily complaints to severe illnesses such as pelvic inflammatory diseases, from repeated abortions to chronic pain syndromes, from unwanted pregnancies and unsafe abortions to HIV/AIDS, from pregnancy complications to maternal mortality, from memory loss to heightened anxiety, from fear of sexuality to low self-esteem.
Last 10 minutes of session addressed queries of participants. Questions posed by individuals opened discussion for follow up sessions for the webinar. Resource person answered range of questions that included causes of violence, duties of HCPs in responding to VAW, trainings of HCPs in dealing with cases of violence, challenges in dealing with cases of domestic violence, legal aspects in cases of abortion.
The session was appreciated by participants and received feedback that it was comprehensive in covering GBV and its impact on health.
Session 2: Recognising and Responding to Signs of Violence
Date: 26th November 2021
Resource Person: Dr. Jyoti Rhokde, Associate Professor- Dept. Of Obstetrics and Gynaecology, Government Medical College, Miraj, Maharashtra.
The one hour session had around 60 participants. They were explained about violence against women and children as a public health issue, debunked myths associated with violence, discusses presenting signs and symptoms of a women facing violence and familiarised strategies for health care providers to respond to violence against women and children.
The session started with the ethical obligations of health care providers to provide treatment and first line psychological support to women facing violence along with its importance from a human rights perspective. Enquiring about violence in a sensitive and non-judgemental manner ensuring audio-visual privacy was emphasised by the speaker. The concept of domestic violence as a public health matter rather than private matter and domestic violence a manifestation of power and control in patriarchal society was pointed out by the speaker. The long term and short term consequence of domestic violence like chronic pelvic pain, low birth weight, low maternal weight gain, infections and anaemia were explained.
The session further debunked certain myths about domestic violence like domestic violence is a private matter, women are abused by strangers, men who inflicts violence is either sad or mad rather than bad, violence only occurs in certain types of people, most men who are abusive are alcoholic, she deserves it or she provokes it, it would not be that bad or she would have left him, rape always leaves injuries, absence of medical evidence proves injuries did not occur etc. Resource person spoke about presenting signs and symptoms to each department in the hospital like casualty, medicine, obstetrics and gynecology and the health consequences of violence on women and children. The session concluded with ways to ask questions upon suspicion of violence, direct and indirect questioning techniques were discussed with the participants. The session concluded with a process for health care providers on responding to violence in a health care facility.
Few queries and discussion by participants were:
Last 10 minutes of session addressed queries of participants. Resource person also shared her experience of identifying cases of violence among admitted women in the hospital. CEHAT’s Pan India 24*7 helpline number was shared with the participants to resolve any queries on intervention for VAW.
The session was appreciated by participants and received positive feedback for comprehensive coverage of the topic recognising and responding to signs of violence.
Session 3: Health care providers as expert witnesses in court
Date: 29th November 2021
Resource Person: Dr. Meena Savjani, Former medical Officer at Rajawadi Hospital, Mumbai.
The session was attended by about 55 participants. It provided information on court procedures in cases of sexual violence, how health care providers can prepare themselves to make court room experience better and discussion on commonly/ frequently asked questions to healthcare providers in court.
The information was useful in raising awareness among providers about comprehensive care to survivors of sexual violence and in addressing the fear among providers regarding court calls. Reading case papers, knowing details of the case, collecting all related documents, making notes were some of the strategies discussed during session to help the health care providers to prepare for deposition in a court as expert witness. Resource person shared from her experience that being punctual, having conversation with public prosecutor before hearing, not providing unnecessary details, anticipating possible questions and preparing answers for the same had helped a lot while deposing as expert witness.
Discussion on commonly/ frequently asked questions in court also took place. Some of the FAQ’s are as follows:
Dr. Meena shared her experience of being expert witness in a case where she was questioned for not referring survivor for cardio vascular examination, being questioned for delay in the examination, and alleged for submitting false report.
At the end of the session, participants were eager to share their experiences and ask answers for their questions. Some of the questions asked were what can be done if the examining doctor is not available to depose in the court? how final opinion can be given as there is not report from forensic lab? and so on. The session was well received by participants as it was very informative and interactive.