Strengthening State Accountability and Community Action for Ending Gender-Based Violence in the Caribbean

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Health Consequences

Introduction

The most common form of violence experienced by women globally is physical violence inflicted by an intimate partner. On average, at least one in three women is beaten, coerced into sex or otherwise abused by an intimate partner in the course of her lifetime.[1] Within the Caribbean, violence against women is pervasive. The 2001 Caribbean Regional Tribunal on Violence against Women Report observes that far from being a haven – a place of peace- the home for many women is a dangerous place. Women unlike men are more likely to be beaten and sometimes killed, not by a stranger but [by someone they know intimately] by a husband, a boyfriend, a partner. Gender-based violence affects a cross- section of women. It is not confined to specific groups of women in society and must be placed within the larger context of gender-inequality.

Defining gender-based violence

Gender-based violence has been defined by the Committee on the Elimination of Discrimination against Women as ‘violence 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.’ It is a form of discrimination that seriously inhibits women’s ability to enjoy rights and freedoms on a basis of equality with men. [2]

The Inter-American Convention on the Prevention, Punishment and Eradication of Violence defines violence against women as ‘any act or conduct, based on gender, which causes death or physical, sexual or psychological harm or suffering to women, whether in the public or the private sphere.’[3] Gender-based violence takes many forms – domestic violence, sexual abuse, sexual harassment, all of which disproportionately affects women. However, the expression gender-based violence should be understood as including some types of harms experienced by men.

Prevalence of gender-based violence in the Caribbean

The pervasiveness of violence against women in the Caribbean has been highlighted in a recent report by the United Nations Office on Drugs and Crime and the Latin America and the Caribbean Region of the World Bank.[4] According to this report, violence against women affects a significant percentage of women and girls in the Caribbean. Three of the top ten recorded rape rates in the world occur in the Caribbean. While the worldwide average for rape was 15 per 100,000, The Bahamas had an average of 133, St. Vincent and the Grenadines 112, Jamaica 51, Dominica 34, Barbados 25 and Trinidad and Tobago 18. The report further pointed to a survey which revealed that in nine Caribbean countries 48 percent of adolescent girls’ sexual initiation was ‘forced’ or ‘somewhat forced’.

Women who experience abuse are often blamed for the abuse. They are thought to have provoked the violence and are somehow deserving of it. They are abused for being disobedient to the man, not having meals prepared on time, questioning the man about money or girlfriends, going somewhere without the man’s permission or refusing to have sex.[5] Most acts of physical and sexual violence by an intimate partner reflect a pattern of continuing abuse. The abusive partner tends to exhibit controlling behaviour such as preventing the woman from seeing her friends, restricting contact with her family of birth, insisting on knowing where she is at all times, getting angry if she speaks with other men, or often accusing her of being unfaithful.[6]

Culture of silence

It is widely acknowledged that police statistics do not present the true picture as regards the incidence of gender-based violence, since many persons do not report it to the police. This is a major challenge. Many women tell no-one about the abuse they experience and in many instances other persons who are aware of the abuse fail to make a report to the police. Original research conducted by Elsie Le Franc and others, on interpersonal violence in Barbados, Jamaica and Trinidad and Tobago, found that approximately sixty-eight percent of the 3,401 respondents were victims of violence perpetrated by a relationship partner. The findings suggest that there were very high levels of tolerance among victims and that a culture of violence and of adversarial intimate relationships may be well entrenched. [7]

Effects of gender-based violence

Despite the culture of silence the negative effects of gender-based violence are felt by society every day. Gender-based violence disrupts families, affects women’s economic viability and puts women’s health and lives at risk. It has negative effects on children as children who experience domestic abuse or sexual abuse may have lifelong health and development effects, such as depression, low self-esteem and poor school performance.[8]

Health Implications

Violence against women affects women’s physical, mental, sexual and reproductive health. The effects range from bruises and cuts, to life threatening physical and psychological conditions.



Table highlighting the health consequences of intimate partner violence[9]

PHYSICAL

Abdominal/thoracic injuries

Bruises and welts

Chronic pain syndromes

Disability

Fibromyalgia

Fractures

Gastrointestinal disorders

Irritable bowel syndrome

Lacerations and abrasions

Ocular damage

Reduced physical functioning

SEXUAL AND REPRODUCTIVE

Gynaecological disorders

Infertility

Pelvic inflammatory disease

Pregnancy complications/miscarriage

Sexual dysfunction

Sexually transmitted diseases, including HIV/AIDS

Unsafe abortion

Unwanted pregnancy

PSYCHOLOGICAL AND BEHAVIOURAL

Alcohol and drug abuse

Depression and anxiety

Eating and sleep disorders

Feelings of shame and guilt

Phobias and panic disorder

Physical inactivity

Poor self-esteem

Post-traumatic stress disorder

Psychosomatic disorders

Smoking

Suicidal behaviour and self-harm

Unsafe sexual behaviour

FATAL HEALTH CONSEQUENCES

AIDS-related mortality

Maternal mortality

Homicide

Suicide

Economic Costs

The economic consequences of violence are felt by the victim and also by the State. The individual experiencing violence has to consider the costs of medical treatment and legal services. She may have had to take time off from work and have lost earnings. The State has to consider the costs of health care for victims of violence, costs of legal services, costs of policing and costs of incarceration, and costs of caring for displaced children.[10] This is a substantial cost for the State. For example, a study conducted by Mansingh & Ramphal (1993) found thatthe Jamaican government in 1991 paid 90% of the direct medical costs of US $454,000 for treating 640 victims of intimate partner violence and other types of violence at the Kingston Public Hospital.[11]



[1] See Fact Sheet of the UN Secretary General’s Campaign to End Violence against Women, ‘How widespread is violence against women?’ (February 2008) United Nations Department of Public Information – DPI/2498

[2] UN Committee for the Elimination of All Forms of Discrimination against Women, ‘General Recommendations No 19’ in ‘Note by the Secretariat, Compilation of General Comments and General Recommendations Adopted by Human Rights Treaty Bodies’ (12 May 2004) UN Doc HRI/GEN/1/Rev.7
CEDAW Committee General Recommendation No. 19

[3] See article 1, Inter-American Convention on the Prevention, Punishment and Eradication of Violence against Women “Convention of Belém do Pará” Convention (adopted 9 June 1994 at the 24th Regular Session of the General Assembly to the OAS, entry into force 5 March 1995)

[4] Crime, Violence, and Development: Trends, Costs, and Policy Options in the Caribbean, Report No. 37820 (March 2007)

[5] EG Krug et al (eds), World Report on Violence and Health (WHO, 2002) 95

[6] See WHO‘Multi-country study on women’s health and domestic violence against women: summary report of initial results on prevalence, health outcomes and women’s responses’ (2005)

[7] E Le Franc, M Samms-Vaughan, I Hambleton, K Fox, D Brown, ‘Interpersonal violence in three Caribbean countries: Barbados, Jamaica, and Trinidad and Tobago’ Pan Am J Public Health 2008: 24(6) 409-21

[8] UNFPA ‘Strategy and Framework for Addressing Gender-Based Violence 2008-2011’ (2009) 22

[9] Table adapted from EG Krug et al (eds), World Report on Violence and Health (WHO, 2002) 101

[10] N Duvvury et. al, Costs of Intimate Partner Violence at the Household and Community Levels: An Operational Framework for Developing Countries (International Centre for Research on Women Report, 2004); Waters H, Hyder A, Rajkotia Y, Basu S, Rehwinkel JA, Butchart A., The economic dimensions of interpersonal violence Department of Injuries and Violence Prevention, (WHO, 2004)

[11] Waters H, Hyder A, Rajkotia Y, Basu S, Rehwinkel JA, Butchart A., The economic dimensions of interpersonal violence Department of Injuries and Violence Prevention, (WHO, 2004)

 

© 2011 UN Women - Strengthening State Accountability and Community Action for Ending Gender-Based Violence in the Caribbean