The DVA & Health

Mosaic CourtSupport evidenceMosaic stats confirm DVs negative impact on womens physical, mental, sexual healthPicture reveals that DV is often noisy with accusations, criticising, name calling, and much psycho-logical manipulation (94%) through threats & abuser behavioural problems such as substance abuse. Economic abuse (58%) poses a serious threat to womens survival and health. Alarmingly high is physical abuse (63%) and lastly sexual abuse (13%), which includes forced sex

Physical violence2008/09 stats from 16 DV courts

HEALTH CONSEQUENCESPOPULATION COUNCIL

HEALTH OBLIGATIONS OF THE DVASAPS to arrest if the victim may suffer imminent harm risking her/his healthSAPS to take a survivor for medical treatment Health service provider can also apply for a protection order on behalf of a victimThe court may impose additional conditions to provide for the health of the victim (such as seizing weapon)

HEALTH ISSUES RE DVA

The obligation of the State to prevent, investigate and punish VAW includes the fulfillment of health rights The DVA doesnt provide for psycho-social support The DVA doesnt specify the role of the DOH There is no policy framework attached to the DVA that links it to the VEP & role of health sector & other policies Health policies are fragmented (PHC package, insufficient screening, many problems at emergency units, infrequent referrals)

ATTRITIONMosaic did pilot research with GHJRU on attrition rates. Of the women who didnt return for finalisation of their orders, many mentioned reasons which were related to the physical and mental health of victims and/or their children: 18% were threatened with death by their abusive partners/the abusers if they returned to court

Threats of further violence occurred in 21% of cases

The abuse actually got worse in 10% of cases

In 7% of cases, the abuser threatened to burn down the applicants house

In 10% of cases, applicants were threatened with some form of sexual assault

46% of victims reported the abuse of alcohol or drugs by abusers

MENTAL HEALTH ISSUESShortage of psychologistsBasic lay counsellor skills limited to deal with depression, anxiety attacks, etc.Very often only one or two visits, real individual psycho-social support lackingMental health needs of affected childrenBUT value of counselling (Vogt research)Shortage of shelters where women & children can have time to recoverRef: GHJRU - 2006

Chart4

Excessive crying0.41

Tension or anxiety0.69

Depression0.62

Loss of concentration0.44

Loss of confidence0.35

Fear of abuser0.69

Anger0.77

%

Sheet1

Intimate partner52%

Former intimate18%

Immediate family20%

Extended family6%

Other1%

Unspecified3%

Economic138

Physical236

Sexual53

Verbal309

Psychological302

Threats to Kill145

Symptoms%

Excessive crying41%

Tension or anxiety69%

Depression62%

Loss of concentration44%

Loss of confidence35%

Fear of abuser69%

Anger77%

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SEXUAL & REPRODUCTIVE HEALTH ISSUESAbused women needs special counselling on link between violence and SRH especially ito Treatment of STIs VCT Cervical health & pap smears Pregancy related problems (increased violence) Nutrition (Ungass report should mention)

MOSAIC MODEL: Ecological & IntegratedDVAPOLICY

HEALTH RECOMMENDATIONSHealth Policy on DVTraining of all levels of health workers on DV re profile, screening, referral, etc.Assisting DV clients at Thuthuzela Centres tooProviding for mental health care through subsidising NGOsAddressing the intersection between DV & HIVBetter indicators on DV at all levels