Intimate partner violence

To the Editor: I would like to make some comments on the issue of domestic violence.1 My understanding of this problem is that it is primarily a social problem that can lead to ill-health risks (physical, mental, emotional and even spiritual) and that it has three components: the perpetrator, the effect on women, and the effect on children.

Gass et al.2 addressed the impact of domestic violence on women. Their study exposes the size of the problem nationally, but does little to enlighten us about the ethnicity and socio-economic strata of the women involved. A community-based research workshop in Cape Town3 addressed issues around recognition and intervention from medical and legal perspectives. The facilitators were a social worker (Rebecca Rees) and a lawyer (Peter Volmink), with participation by doctors, nurses, social workers, childcare workers, church representatives and lay community members (izakha muzi). They discussed pitfalls in applying the Prevention of Domestic Violence Act and how to rectify these. Roleplay by women participants from the townships of Guguletu, kwaLanga and Mitchell’s Plain revealed how domestic violence can be covered up when women seek healthcare for their physical injuries. The multi-disciplinary training espoused by Gass et al.2 could help family doctors to improve screening and detection of domestic violence in women who present in primary care.

We also need to guard against ‘medicalising’ this problem by focusing mainly on the physical effects. I see the medical role in diagnosing bruises, fractures, etc. – an area of family medicine where research is still needed to distinguish between accidental and non-accidental injuries.

Further discussions and research on domestic violence must not only address women but also focus on the male gender and paediatric factors. More focus on children as victims of domestic violence, on the risk factors for such abuse, and the knowledge and skills to recognise signs and symptoms of child abuse,4 are also needed.

E M Mankazana

General practitioner

London, UK

mxomank@doctors.net.uk

1. Bateman C. SA men – time for introspection/renewed action? S Afr Med J 2012;7:597-598.

1. Bateman C. SA men – time for introspection/renewed action? S Afr Med J 2012;7:597-598.

2. Gass JD, Stein DJ, Williams DR, Seedat S. Intimate partner violence, health behaviours and chronic illness among South African women S Afr Med J 2010;100:582-586.

2. Gass JD, Stein DJ, Williams DR, Seedat S. Intimate partner violence, health behaviours and chronic illness among South African women S Afr Med J 2010;100:582-586.

3. Mankazana EM. From Exile to Exile. New York: Authorhouse, 2011.

3. Mankazana EM. From Exile to Exile. New York: Authorhouse, 2011.

4. The Scottish Government. National Guidance for Child Protection in Scotland 2010. www.scotland.gov.uk/Resource/Doc/334290/0109279.pdf (accessed 8 August 2012).

4. The Scottish Government. National Guidance for Child Protection in Scotland 2010. www.scotland.gov.uk/Resource/Doc/334290/0109279.pdf (accessed 8 August 2012).

S Afr Med J 2012;102(10):775. DOI:10.7196/SAMJ.6207