Violence against women especially in the home or in the context of the family is to me one of the most important issues that we could possibly talk about in this class. Violence is a strategy that people in power use to maintain their power. It is central to discussions of women's health and human rights, not only because it is one of the two major causes of illness in women--the other being sexually transmitted infections--but also because it is a major strategy for maintaining power in societies organized in terms of hierarchy. In our hierarchically structured societies, we not only categorize people but we also make the mistake of assigning values to various categories. We learn that strong is better than weak, that bigger is better than smaller, that rich is better than poor. Those higher in the structure expect to wield power and/or feel they must maintain their positions by retaining control. Violence is used at all levels of society to maintain power. A country gets out of hand, and so we bomb it; a child stands up to his parent, and he is beaten; a wife doesn't get dinner on the table on time, and she is pushed across the kitchen. Violence is an issue of the paradigms in which we live--these hierarchical or patriarchal structures--and it is a strategy for maintaining power. The Center for Gender Equity describes violence against women as the most pervasive yet least recognized human rights abuse in the world, as well as a profound health problem. It occurs in all countries and is perpetrated in the vast majority of cases by men against their female partners. The essence of domestic violence is that it is a pattern of assaultive and coercive behaviors, including physical, sexual, and psychological attacks as well as economic coercion, that adults or adolescents use against their intimate partners. Although domestic violence is hard to measure, those who work in the area of prevention of family violence consider such injuries to have reached shocking, perhaps even epidemic, levels. In nearly 50 population-based surveys from around the world 10% to 50% of women report being hit or otherwise physically harmed by an intimate male partner. The first-ever global study on domestic violence was released in 2005 by the World Health Organization. Based on extensive research done by the London school of hygiene and tropical medicine. the report shows that violence against women is widespread, with far-reaching health consequences. The WHO report confirmed earlier conclusions from less extensive studies that about one woman in every three around the world has been beaten, coerced into sex, or otherwise abused in her lifetime. The WHO report included data for more than 24,000 women interviewed in 10 countries. Among other conclusions the report found that women who are physically abused by partners are likely to experience health problems, regardless of whether they live in modern industrialized cities or rural areas in resource-poor countries. They found that victims are about twice as likely as non victims to suffer from poor health, and that such effects persist long after the violence has stopped. This health impact of domestic violence went beyond injuries, as women who had experienced physical or sexual violence by a partner were more likely to have pain, dizziness, and mental health problems. Victims were also more likely to have considered suicide and to have suffered miscarriages. The cost of domestic violence goes beyond the individual costs that we have been talking about. Another WHO study on the economic dimensions of interpersonal violence noted that beyond and in addition to devastating individual families, interpersonal violence also results in major economic costs to societies. Some nations spend more than 4% of their gross domestic product on such violence-related injuries and low income nations may be hardest hit. For much more detail and specifics about this extremely important issue—gender-based violence—and its health consequences, please read Chapter Six of the text for this course. As usual, I direct you to the descriptions at the end of the chapter of groups that are addressing this serious and pervasive health and human rights issue.
