Dear Members,
I do agree with you that counseling for men to end violence is so important.
Male violence against women is about an abuse of power and control. Male
violence will continue to be a daily experience for women for as long as
some men believe it is their right to control women's lives and confronting
these attitudes. In somewhere, man regards his wife as his property and
thinks that a man is important and the woman is not important. It is obvious
that education for men is the heart of action anti-violence.
Being aware of this, RaFH completed the study on "domestic violence against
women and attitudes, practices of health workers" in Ninh Binh and Hanoi
(North of Vietnam) in 2000. Based on the finding from the study, RaFH have
just organized a workshop named "Prevention from violence against women"
with participants of domestic and international authorities, policy makers,
researchers, scholars, experts, mass organization and other relevant organs,
in Hanoi, the capital of Vietnam, on December 10th, 2001. The workshop
started with a general discussion and drew out planning actions for
intervention and focussed on men's involvement. Actions for responding the
sensitive issue reveal that it is significant to establish a bottom- up
system of intervention including central level (disadvantaged women's aids
center), local level (violence prevention station) and the community level
(counseling team). The functions of the system are to launch IEC
(information, education and communication) programs and activities, to
provide counseling services, and to support victims (health support,
economic support and awareness support) as well as to set-up hotline for
intervention. [***You will find a copy of the study at the end of this message,
Mod.***]
Now we plan to formulate up an intervention project based on promoting men's
involvement and responsibilities of ceasing violence against women. To do
that, education and counseling on human rights, reproductive rights and
gender equality is needed for men. Furthermore, men clubs and gatherings as
well as campaigns against violence are also need to be held regularly. The
activities will create opportunity for men to directly change their backward
and violent thinking, attitude and behavior.
In the efforts to realize the planning actions, we are looking for funds for
combating the violence. We hope to act for the more safe, peaceful and
happier world for everyone. If you are interested in ours actions, please
contact with me! On the occasion, I would like to send you the enclosed
summary report of our study on domestic violence against women. I would
highly appreciate if you could support ours intervention actions anti-male
violence against women.
With best regards
Nguyen Thi Hoai Duc
Director of RaFH
--------------------
The study on "DOMESTIC VIOLENCE AGAINST WOMEN AND ATTITUDES, PRACTICES OF
HEALTH WORKERS" was conducted in Hanoi and Ninh Binh provinces in September
2000, and funded by NewZealand Embassy.
Contents
Introduction
About the study
1. Objectives
2. Methodology
Sampling
In-depth interviews
Focus group discussion
Researchers and Guideline
The concept of violence
Additional explanations about topic selection and difficulties or
limitations which can affect research findings
1. Why did we choose to study on health workers' attitudes and
practices towards violencel against women
2. Difficulties which may limit research findings.
Avoidance of discussing about violence against women
Researchers' limitations
Findings
Part 1: From victims to witnesses. Is that the acceptance of violence ?
1.1. Who cause(s) violence? The nature of violence.
1.2. Are there any kinds of faults which deserve beating?
1.3. An example about violence duration and degrees
1.4.Violent behaviour's coverage of impacts.
1.5. An image of victim women. Why did they have to hide being
beaten ?
1.6. Responsible people's attitudes through their direct answers and
victims' words.
1.7.Recommendations from interviewees. Community cautions.
Part 2: The road from home to medical care units
How did victims and rescuers think and act?
2.1. What did women think and where did they go when being beaten?
2.2. Health worker attitudes and practices. Victim treament equality
2.2.1. Negative impacts on culture and social attitudes.
2.2.2. No training of technical skills and unavailable resources
for support.
2.2. 3. Medical system's limitations
Conclusions
Discussions
1. Research issues
2. Study methodology
Recommendations
References
Objectives of study
This study was to focus on a) reactions of victims, social communities and
institutions to the real situation of domestic violence; b) health workers'
attitudes and practices towards victims of family violence against women.
Specifically, study guideline was designed to:
� review different violence patterns and nature and examine the influential
degrees of violence evil.
� describe community attitudes, analyse reactions and solutions by social
institutions and organisations such as precinct officials, Women's Unions,
police, mediation committee, etc...
� explore various reasons that will affect a women victim's decision of
going to health centres or not when she is ill-treated. Examine how women
think and take their actions to deal with violence evil.
� explore the attitudes and practices of health workers acting as a social
group who is directly responsible for overcoming consequences made by
violence evil.
� determine social solutions that will be able to help violence victims -
women are provided with better care in a medical system and cooperate with
their communities to limit and prevent violence as well as to protect them
on a wide scale.
Summary about health worker attitudes and practices.
"Cure of diseases but no people" and subsequently giving no special
treatment to victim women are the main attitudes of nearly most of
interviewed health workers.
There are a number of other factors, which may dominate health workers's
attitudes and behaviours. These factors can be classified by the following
categories:
* Negative impacts on culture and social attitudes.
* No training of technical skills and unavailable resources for support.
* Medical system's limitations
1. Negative impacts on culture and social attitudes.
The influences of society's perceptions and attitudes make health workers
believe that violence often happens in the poor and lower educated
families, beaten women are normally unkind or self-willed..so that victims
have their faults. There is a series of reasons, which make men beat women
Most of beaten wives have at least a fault, and these faults can be
educated by different ways. Beating 'frightful' or 'bad' wives is a kind of
teaching them and keeping family disciplines and order. All of thing has a
strong influence on health worker's sympathies and sharing with victims in
hospitals and on their caring activities.
Both female and male health workers don't believe in the existence of
sexual force between husband and wife.
Normally, victims told lies about the causes of their body wounds. However,
even when they told the truth, health workers were suspected and didn't
believe in what they said. Thinking very little of a beaten woman's
business and simplifying violence in general. ( Such a way of statement
makes a number of women feel guilty and regard beating as a normal action
because there may be many surrounding people who are beaten like them. This
thinking way makes victim women's reactions which are already weak and
solitary tend to be again deep in silence.)
Simplifying a beaten woman's business is also reflected through health
workers' manners of taking care of and comforting victims.
Private pharmacies or medical service offices are friendlier and more
careful to receive patients. This may be because of business benefits. But
this way encourages victims to have their treatments on slight pains with
simple medicine. Secret keeping and victim privacy respect attract patients
to come. No woman wishes many people to know about their being beaten by
their husbands. But the demand for sharing with somebody, even a stranger
is needed. The attraction of private pharmacies can be seen in rural areas.
2. No training of technical skills and unavailable resources for support.
Health workers are not ready to answer victim's questions or meet their
demands. They also feel that they will not have time and conditons if
victims need their help. The majority of them have never been provided with
training of behaviours towards violence's victims and that the treament for
these people is not a main activity in their offices.
Health workers think very little of or ignore the scare and dangers which
victims are experiencing.(in big hospitals and in local health centres this
normally happens..).Moreover, they don't know how to deal with if victims
ask for help or support because they have never been in such situations.
The facilities in health centres are too poor for them to support victims
by giving them living shelters.
Health workers's slight and ignorance of doubts and signs which they knew
could be related to violence. (most of other physical damages in sex organ
are ignored if victims don't say anything).The slight and ignorance of
violence-related signs can be one of the important reasons that medical
reports missed out violence's victims. The number of violence suffered
women going to health centres and hospitals is very small.
3.Medical system's limitations
Perhaps, as violence against women in Vietnam hasn't been considered as an
important issue, the identification of, care of and support for as well as
creating safer conditions for victim patients are not the activities under
the direct management of any medical unit. (The delicacy of and different
political view-points on violence as well as victim concealment make the
medical sector's support which is already little more ineffective.)
The attitudes of 'being objective', 'privacy respect' and 'no partiality'
from health workers towards the treatment of the victim patients partly are
from the thoughts that taking care of these patients is beyond health
units' strength or due to 'no wish to involve in others' business'. These
attitudes are also the consequences of the problem that health workers have
not trained, professionally prepared and created favourable conditions, at
least time, to cope with violence related cases. Health workers feel that
they have 'no duty' to deal with this evil which is the responsibly of the
police and Women's Unions...
Most of health management staff and workers think that they can support
victims. But this requires the direction of higher levels and the
implementation at the same time of all health units. They think they need
the called Government or Ministry of Health's 'policy' or instructions on
how to take care of beaten women in the framework of their activities. No
medical unit wishes to 'pioneer' in this aspect. So, an equal institutional
environment for all the activities of health units to support violence
sufferers needs to be firstly established.
Medical sector has no representative(s) in the mediation committees in both
cities and rural areas. This disadvantage makes health workers find more
difficult to continue their further medical examinations for victim and
also does not give them their rights to inform local authorities and police
about victims and to promote their roles in helping, supporting or linking
victims with other assistance sources from the community after treatment
activities complete.
Conclusions
1. Our study has small sample size, doesn't represent locations and only
focuses on a career social group. We have no evidence indicating the
increase or decrease of violence. We also have no figures/data/information
to compare the degrees of violence seriousness between study locations and
other localities nation-wide. However, the study findings confirms the
existence of domestic violence. The impact coverage of family violence is
broad, specific and serious with a long period from 1 to 16 years. The
victims of domestic violence are not only women but also many children who
are very small. We still maintain our own argument that violence
seriousness and negative impacts are not always and necessarily based on
figures.
2. The society and public in Vietnam regard domestic violence as a private
issue and something, which is acceptable in the husband and wife
relationship, especially when women have their faults. In reality, women
are always blamed for every family conflict. This comes from various
traditional concepts in history and culture of a 'preferring-men-to-women'
society in which women are expected and encouraged to swallow and endure
all ill-treatment in their marriages as well as obey and meet all demands
and expectations of men in particular and society in general, regardless of
their own interests.
3. The traditional concepts of gender-based inequalities considerably
dominate collective reactions and actions to fight against family violence
from not only large residential communities but also different
institutions, executive bodies including medical one. Moreover, the
insufficient delicacy of gender issues and limited legal knowledge as well
as inadequate consulting skills of social organisations like Women's Unions
and mediation committees result in women's failure to find out effective
support when they are beaten. This makes their solitary and weak reactions
become weaker and more solitary.
4. Health care and consulting services for domestic violence's victims are
equal to other patients. This caused missing out and thinking little of
identifying, taking care of and assisting victims in communities. This
situation is the consequences of inadequate and not serious attentions from
managers and policy makers in general and those in medical sector in
particular. Of course, it is also the consequence of women's little/no
knowledge about their own rights of being respected and protecting themselves.
Discussions
1. Research issues: We have a feeling that this study touched on major
issues. This study also shows that there are other topics, which relate to
domestic violence against women and need to be started or further researched.
Firstly, the agreements on orthodox viewpoints on violence existence in
Vietnam, clarifications of the roles and power of authorities and social
organisations and different ways to limit and wipe out violence against
women are major issues and require larger studies in terms of sizes and
locations... They also require further research and discussions between
authorities and executive bodies. In order to make the ensuing studies on
this field productive, it's needed to significantly improve reporting and
statistics systems on civil violence cases in relevant organisations and
entities such as the police, court, commune/precinct people's committees
and healthunits.
Secondly, the topic on the roles of health care system and health workers
in identifying, curing, supporting and creating safe conditions for
violence victims is also a big topic in which its interventions, if any, in
this field require the co-ordination of several sectors such as health,
education and legal ones...
Thirdly, gender education for women and the facilitation for women to
fulfil their own rights can only be successful when society's perceptions
about gender roles and responsibilities change. Time is an important factor.
Fourthly, children's rights and destinies are a topic which closely relate
to women's right and destinies. While talking about the consequences of
family violence against women, we cannot separate children from their
parents, especially their mothers. More than victim women, all
disadvantages and losses that children have to suffer in violent families
are immeasurable.
The respect for children's rights, the love for and protection of them must
start from the smallest activities in each families in which adults'
attitudes and behaviours towards children are totally based on their
perceptions and willingness. The society's participation and control can
only be mobilised when those rights are violated. How to stop teaching
children by beating or insulting is a topic which needs to research
seriously. That seems to be little relevant to family violence topic in
general and difficult to be in its place in a society with its long history
and culture about parents' rights and methods of teaching children by
canes/rods. But we still believe that the changes of perceptions about
violence used to educate children will deeply change the thoughts of violence.
2. Study methodologies
2.1. Victim women in this study really shared with the team valuable
information about their family situations, their thoughts and emotions with
much hope about a more peaceful life although they were very worried and
hopeless at that time. Although we knew that there was no beating case due
to our presence at localities or a woman who was beaten due to her meeting
with us and all conditions that local officials created for us were very
good, we still believe that our meetings with victims would be more
productive and information collected would be deeper if they were in a
safer and more private atmosphere. In rural areas and even in the city,
health units will perhaps be most peaceful and appropriate meeting places
for victims and the team because, in the disadvantaged conditions, studies
on violence against women can be openly introduced to households and local
people in different titles like women health, methods of taking care of
children and family planning. Only do women involving in the study fully
understand the nature of the study.
We were glad to know that there were women who found the usefulness of
their meetings and discussions with us. A woman said that she felt a light
heart because she could share with others a burden which had existed in her
heart for many years.
2.2. Through this study, we know the importance of the selection of and
training for the team members. The team members must be provided with
thorough training about not only the study itself but also broader topics
such as basic knowledge of violence, domestic violence, gender issues and
gender unequality... The team members much be trained to avoid
misunderstanding, scare, emotional expressions at wrong time or subjective
judgement/viewpoints during contacts and meetings with victims. The study
team must keep its subjective attitudes and can't give clues or think on
behalf of victims about their solutions or wishes.
Recommendations
1. Educate and encourage women to react to violence and facilitate the
public's and society's support for their reactions.
2. Develop a healthy and violence non-existent social and family environment.
3. Provide education to change men's viewpoints and behaviours through
collective activities.
4. Change society's perceptions and attitudes
5. Propaganda and its implementation
6. Establish powerful local authority with effective operations
7. The participation of health system and workers
References
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and their attitude and expectations regarding medical care of abuse
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Cohen,S ., Devos, E., and Newberger,E. Barriers to physician identification
and treatment of family violence : Lessons from five communities. Academic
Medicine 72, 519-525.1997.
Domestic Violence Advocacy Service. 1991. 1986-1991 The First Five Years
Heise L., Pitanguy H. and Germain A.(1994) Violence Against Women : The
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Hanoi, Vietnam
Le Thi Phuong Mai and Landfield Katharine.1999. "Report on an Intervention
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United Nations.1995. Platform for Action and the Beijing Declaration, Fouth
World Conference on Women, Beijing China 4-15 September 1995.
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