By Jordan Lite
Thursday, October 3, 2002
An unprecedented United Nations report on violence and health is expected to be a powerful tool for advocates wishing to improve their nations' responses to domestic and sexual violence with new legislative and health care policies.
(WOMENSENEWS)--Up to 70 percent of female murder victims worldwide are killed by their male companions and as many as one-third of girls are forced into their first sexual experience, according to a World Health Organization report released Thursday. The report urged countries to no longer treat violence solely as a "law and order issue."
Violence must instead be addressed by preventive public health measures, the agency says. Violent acts are most often committed behind closed doors and go unreported, according to the document, making violence "one of the leading public health issues of our time."
While most of the data in the "World Report on Violence and Health" is not new, the report is significant because it is the first time a United Nations agency has produced a major document that acknowledges the public health implications of violence beyond those of injury and death--particularly domestic and sexual violence that occurs in private, said Etienne Krug, director of the department of injuries and violence prevention at the World Health Organization.
"Violence is often only addressed in the context of war or the context of crime," said Krug, who edited the report. "By doing so we miss some of the violence that is not necessarily crime: violence in the home, bullying, suicide."
The United Nations first declared violence a worldwide public health problem at the World Health Assembly in Geneva in 1996. Now, armed with data on the extent of the problem and nine recommendations to address it, the World Health Organization will conduct an 18-month violence-prevention campaign. Fifteen countries have already invited agency officials to present their findings and review how effectively those countries are implementing preventive measures, Krug said.
Geeta Rao Gupta, president of the International Center for Research on Women, commended the agency for issuing the report, adding that attention to the problem of violence against women "is long overdue by a U.N. agency."
"I hope that this is a sign that WHO and other U.N. agencies will push national governments and the global community to think seriously about how violence against women can be prevented and the significant costs to women's rights and the economic costs to national economies," Gupta said.
The report tallies the ripple effects of physical, sexual and psychological violence around the world, from the immediate deaths and injuries to long-lasting problems including permanent physical disabilities and a range of mental, behavioral and reproductive health troubles.
More than 1.6 million people each year die from violence, which is among the leading causes of death for those ages 15 to 44. In that age group, violence accounts for 7 percent of deaths among women and girls and 14 percent among men and boys. While males are more often both the victims and perpetrators of violence overall,the the "overwhelming burden" of sexual violence and violence at the hand of an intimate partner is borne by women, the report says. In the U.S. for example, only 4 percent of the men murdered from 1976 to 1996 were killed by their wives, ex-wives or girlfriends.
The patterns of abuse women experience are strikingly universal, Krug notes. Most victims of physical aggression experience multiple assaults over time and more than one type of abuse. In 48 surveys from around the world, between 10 percent and 69 percent of women report being physically assaulted by a male partner; in the United States, 22 percent of women report domestic violence. Nearly 25 percent of women may experience sexual violence by an intimate partner during their lives, according to the report.
And these women continue to feel the after-effects of violence long after it's over. Victims of sexual violence can experience unwanted pregnancy, sexually transmitted diseases and other gynecological problems, as well as depression, post-traumatic stress disorder and suicidal thoughts and behavior. Domestic violence victims experience some of these same effects, as well as gastrointestinal problems and chronic pain.
"These statistics are shocking and disturbing," Krug said.
The report also notes the growing recognition of elder abuse, which includes neglect, physical, sexual and psychological abuse. Between 4 percent and 6 percent of all elderly people are abused in the home, and violence that occurs in care facilities may be even more widespread, the report says. Elderly women are at increased risk of abuse in cultures where women have inferior social status, and the type of violence they experience is particular to their gender. In Tanzania, for example, 500 elderly women accused of witchcraft are killed annually, the report says. Older women also may be abandoned and have their property taken when a husband dies.
But "violence is not an intractable social problem or an inevitable part of the human condition," the report says. It advocates that countries establish national violence-prevention plans that involve government as well as health, education and labor organizations. It also recommends steps including the promotion of primary prevention services, such as parenting training and improving firearm safety; strengthening responses to violence, such as improved emergency-response systems and integrating violence prevention into policies to promote gender and social equality.
Jacquelyn Campbell, a professor of nursing at Johns Hopkins University who has been studying domestic violence since 1980, said that women would benefit from the report, which treats domestic violence as a mainstream health issue for the medical profession, rather than a politically marginalized human rights issue.
"I think it will be an eye-opener for people," Campbell said. "When they see the extent of injury and mortality, policymakers are much more likely to address the issue legislatively and through health care. In emergency room departments, providers will perhaps start asking routinely about violence.
"What we've found in the past is that if you address this as a women's health issue, that gets them convinced that it's an important issue--sometimes more so than if you talk about it only as a human rights issue," she added. "Sometimes talking about it as a human rights or women's rights issue, that's where you get a backlash."
But Krug said that the report could strengthen the use of international human rights conventions such as the Convention on the Elimination of All Forms of Discrimination against Women, known as CEDAW, which has been ratified by 170 countries. "We see the collaboration of human rights and public health as a very important one," he said. "I think the report can contribute to the efforts around CEDAW."
Jordan Lite is the assistant managing editor of Women's Enews.
World Health Organization
Violence and Injuries Prevention:
United Nations Division for the Advancement
of Women State Parties to CEDAW:
International Center for Research on Women: