Beyond Awareness-Effecting Change

Are you in a relationship that makes you feel scared? Have you ever been threatened? What happens when you and your partner fight? Has your partner ever shoved, pushed, hit, kicked, choked or hurt you? Does your partner ever force you to have sex?

In screening for intimate partner violence, one must remain non-judgemental while asking such questions. It is not in our position to question, why a victim of physical or emotional violence, remains committed to their partner. We are there to serve the best interests of our patients.
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"Beyond Awareness-Effecting Change" was the theme of this year's 8th Annual Domestic Violence Conference on Saturday in Cole Hall on the UCSF Parnassus campus. This theme was threaded throughout the day-long conference that featured two key-note speakers, a health care provider panel, break-out sessions that addressed how to confront issues relating to domestic violence, and a survivor panel.

Although I attended this conference, I am struggling to define "domestic violence." I think if images of bruised women, helpless children, violent acts against those who can (and will not) fight back, angry perpetrators seeking power, alcohol-induced behavior, psyschological trauma...images that blurr and coalesce to create an image we can not bear to look at or even think about. I wonder about the darker side of human nature that would steep such a low level to cause harm.

But domestic violence, a term loosley used to describe family violence and intimate partner violence, happens and is a reality many women, children and (some) men face. So, we must be prepared to open our eyes to these images.

How do we confront issues of domestic violence as health care providers? The message was clear, we must maintain a high index of suspicion in certain cases, screen appropriately (and do so in a way that does not endanger the family or exacerbate the situation), and rely on an interdisciplinary approach by employing all members of our health care team.

As simple as it is to want to rescue a woman in distress, we must recognize that some woman are still in love with the perpetrator. Especially in countries, like India, a high value is placed on preserving marriage at any cost, even if it comes at the expense of physical or emotional abuse.

Some women may hold on to a twinge of hope that things will change. For this reason, we must meet victims where they are and realize change is gradual and will not happen overnight. But at the same time, we must educate victims about what a healthy relationship looks like, rebuild their shattered confidence, and provide the necessary resources (hot lines, social workers, shelter information, police contacts, etc).

I walk away from the conference with a deeper understanding of how to effectively serve patients, who are victim es of intimiate partner violence. I am still in the infancy stages of learning how to screen for domestic violence and how to procede if a patient confides in me. But I have heightened awareness about an issue that I will sadly confront in the years to come.

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Images: I was the event photographer for the conference. First image: Healthcare Provider Panel.