Violence against Women: The Nursing Perspectives Asst. Prof. Nanthaphan Chinlumprasert, Ph D., R.N.

V I O L E N C

Nurses, Always there For You: United Againat Violence (ICN, 2001)

What is violence? The intentional use of physical force or power, threatened or actual, against oneself, another person, or against a group or community that either results in or has a high likelihood of resulting in injury, death, psychological harm, mal-development or deprivation. (WHO, 2000)

Typology of violence 1) Self- directed 2) Interpersonal Suicidal behavior 1) Self- directed Self-abuse Family/partner Violence 2) Interpersonal Community Violence

3) Collective Social Violence Political Violence Economic Violence

Classification of Violence Youth Violence Child Maltreatment Violence Against Women by Intimate Partners Elder Abuse

Sexual Violence Self-directed Violence Collective Violence Organized Violence The inter-human infliction of significant, avoidable pain and suffering by an Organized group according to a declared or implied strategy and/or system of

ideas and attitudes, ……. . Organized violence includes ‘torture, cruel, inhuman or degrading treatment or punishment’ ……. . Imprisonment without trial, mock executions, hostage-taking or any other form of violent deprivation of liberty. (WHO, 1980, Geuns, 1987) The definition includes government repression and also terrorist group violence.

Estimates of Mortality = 2.3 million people died from Violence How big is the problem of Violence? Estimates of Mortality 1998 = 2.3 million people died from Violence 42% (Self-directed) 32% (Homicides-Interpersonal) 26% (War-related)

Tip of the iceberg From National Surveys Physical assaults by intimate partners (lifetime estimates) 5.1 in Philippines 9.5 in Paraguay 22.1 in USA. 29.0 in Canada 34.4 in Egypt

Tip of the iceberg Lifetime estimates of sexual assault among women living in cities or provinces around the world: 15.3 in Toronto 21.7 in Leon, Nicaragua 23.0 in North London 25.0 in One province in Zimbabwe

22% among boys (grade 7) in Sweden Tip of the iceberg Rates of physical fighting in the past year among adolescent males rang from: 22% among boys (grade 7) in Sweden 44% of boys (grades 9-12) in USA. 76% among boys (grades 8-10) in Jerusalem

Injury Surveillance Report on Assaults in Thailand, 1991 (กองระบาด, 2543) Physical Assault Injury = 11, 367 cases (Death = 334 cases) (Data gathered from 10 hospitals)

Victim of Violence Who? Who? Who? Domestic Violence Forced prostitution Homicide Rape/Sexual assault Exploitation Sexual harassment Trafficking

Violence against women The United Nations Declaration on the Elimination of Violence Against Women. “Any act of gender-based violence that results in, or is likely to result in, physical, sexual or mental harm or suffering to women, including threats of such acts, coercion or arbitrary deprivation of liberty; whether occurring in public or in private life.” (UN General Assembly 1993)

4 million/year of women in USA were abused/battered 44% of women (5.4 million) age 15-44 in Thailand 8 million in 15-60+ age group (Archavanitkul et al., 2001)

Violence against women is gender-based violence Scope Dowry - related, female genital mutilation, Marital rape, battering, homicide. Domestic Violence: Violence in Public: Sexual assault, harassment, trafficking, forced prostitution, exploitation, Pornography. Organized Violence: Unfair social treatment , sex discrimination/ gender bias, ignore to women’s right violence perpetrator or condoned by the state.

Root of violence against women - Power inequalities b/w women and men - Patriarchal society

Gender role Socialization Gender role stereotype Gender Bias Gender role Socialization Gender role stereotype Rape Myths Women sexuality Men sexuality

Social condemn / stigma What will victim / survivor of violence face? Blame Guilt Physical / Psychological Health Problems Social condemn / stigma

Consequence of violence - Physical injures / problems - Psychological problems : Post traumaticn syndrome, Suicide - Psychosomatic disorder - Social stigma

What should nurses have in dealing with violence survivals? - Knowledge - Positive attitude - No blame, understanding - Empathy - Strict confidentiality - Respect

Nurses’ roles - Build trust - Screening - Private interview - Holistic approach in caring / nursing - Advocate

Vision of nurse on violence issues. - nurse’s role in development of health services for Violence survivals - nurse’s role in development of body of knowledge on violence against women. - Nurse and self development for providing effective care for any form of violence survival. - Nurse and violence prevention in Thai society.

Thank you