Health care – a significant link in recognizing and preventing domestic violence
How can doctors help women survivors of violence
September 7, 2023
Women who have experienced violence often meet representatives of institutions for the first time during a health examination, and this is sometimes their only opportunity to confide in somebody, for someone to notice their injuries and recognize the consequences of the violence they are exposed to.
Together with the police, basic public prosecutor’s offices and social welfare centers, health care plays an important part in the system for the prevention of and protection from domestic violence. The role of the healthcare system is defined by the Ministry of Health’s Special Protocol for the Protection and Treatment of Women Victims of Violence. This is a significant guiding document for doctors, not only in terms of detecting and documenting violence, but also for better understanding this problem, as well as approaching and communicating with survivors in a way that shows solidarity and support.
Healthcare professionals can contribute to increasing survivors’ readiness to report violence, and also provide survivors with all the necessary protection and support, in cooperation with other institutions.
“Healthcare institutions are an important part of combating domestic violence, especially preventing it. We have many survivors who have never contacted the police, the prosecutor’s office or a social welfare center, but have turned to a healthcare institution for medical help”, says Gorjana Mirčić Čaluković, Deputy Public Prosecutor and Coordinator for Gender-based Violence at the Higher Public Prosecutor’s Office in Belgrade.
Healthcare institutions possess a range of data, even evidence that can be relevant for initiating criminal proceedings. This is why doctors who report violence are an important link in recognizing and preventing domestic violence.
“This does not only imply information regarding physical injuries, but also other conditions, anxiety, nausea, depression, something based on which healthcare professionals may suspect the presence of violence. When such information is shared with the public prosecutor’s office, we can detect a criminal act”, the Deputy Public Prosecutor explains.
A detailed medical report is not only relevant for supporting the work of the police and prosecution, but also because it additionally protects the violence survivor: testimonies that are recorded can be used in further proceedings, without exposing women to more trauma or secondary victimisation.
Gorjana Mirčić Čaluković was one of the trainers at the workshop dedicated to the role of the healthcare system in preventing domestic violence, organized by the United Nations Development Programme (UNDP). She points out that the involvement of healthcare institution managers is very important, as they are the ones who should organize teams for gender-based violence prevention in their healthcare centres. Small community healthcare centres, those that do not have such teams, can always rely on the support of the public prosecutor’s office, which coordinates the work of Groups for Coordination and Cooperation. These also involve the active participation of representatives of the police and social welfare centers, but they can also include representatives of healthcare institutions, schools, the employment service or non-governmental organizations. The groups have been established based on the Law on Prevention of Domestic Violence, with the task to regularly discuss all newly-reported and active domestic violence cases and plan protection and support measures.
The healthcare system also has an important role in preventing the misuse of firearms for violence against women. It represents the starting point in monitoring changes in mental health, family dynamics and personal circumstances that can be triggers or risks for committing domestic violence. Also, there are many professions that involve carrying or access to firearms, and a medical assessment prior to issuing a weapon permit is mandatory for all of them. This is where the healthcare system is a key partner to the police, believes Police Officer Ivan Radin, another trainer at the workshop.
„Healthcare professionals have a three-fold role in combating violence: detecting violence by recognizing risk factors, reporting evident or suspected violence and proving the act of violence by recognizing and documenting its consequences through high-quality reports. Additionally, they have a control role as they continuously monitor and detect risk of firearms misuse“, Radin points out.
Even before the adoption of regulations and protocols, some healthcare institutions established their own internal processes to better identify and later report violence. Such is the “Dr Vukan Cupic“ Mother and Child Health Protection Institute of Serbia, whose expert team considers reports of suspected domestic violence, implements protection procedures, reports suspected violence, cooperates with other institutions, but also works to train other employees.
„Our team has operated since the 1990s. Then in 2009, the General Protocol for Action and Cooperation of Institutions, Bodies and Organizations in the Situation of Violence against Women within the Family and in Intimate Partner Relationship, was adopted. We decided to form a team because we had reports of violence coming from different doctors, and it was easier for us to network and meet regularly, as different specialists can better see the bigger picture”, explains Vesna Stefanović, a social worker at the Institute, who presented this good practice example to workshop participants.
Author of the text: Jovana Netkovic
This text was prepared based on a series of meetings and training sessions with doctors from throughout Serbia, organized by UNDP in Serbia with the aim of strengthening healthcare institutions’ role in multi-agency response to domestic violence. Answers to dilemmas on possibilities of the healthcare sector to participate in the prevention of domestic violence can be found in the “Together against Domestic Violence“ guidebook (in Serbian).
These activities are part of the project “Reduce Risk - Increase Safety II” implemented by UNDP with the financial support provided by Germany, Sweden, the United Kingdom, France, the Netherlands and Norway, as well as the European Union, through the United Nations’ Western Balkans SALW Control Roadmap Multi-Partner Trust Fund.