Wednesday, March 2, 2016

Medical management of domestic violence (2)

A victim of domestic violence had composed this threnody and posted it for the world to see and learn from it ‘’I got flowers today… It wasn’t my birthday or any other special day. We had our first argument last night, and he said many cruel things that really hurt me. I know he is sorry and didn’t mean the things he said…because he sent me flowers today. I got flowers today… It wasn’t our anniversary or any other special day. Last night, he threw me against a wall and started to choke me. It seemed like a nightmare. I couldn’t believe it was real. I woke up this morning sore and bruised all over. I know he must be sorry, because he sent me flowers today. I got flowers today… It wasn’t Mother’s Day or any other special day. Last night, he beat me up again. And it was much worse than other times. If I leave him, what will I do? How will I take care of the kids? What about money? I’m afraid of him and scared to leave. But I know he must be sorry, because he sent me flowers today. I got flowers today… Lots of them…Today was very special. It was the day of my funeral. Last night he finally killed me. He beat me to death. If only I had gathered enough courage and strength to leave him, I would not have gotten flowers today.’’
It is important to note that domestic violence does not always manifest as physical abuse. Emotional and psychological abuse can often be just as extreme as physical violence. Lack of physical violence does not mean the abuser is any less dangerous to the victim, nor does it mean the victim is any less trapped by the abuse.
Some examples of abusive tendencies include telling the victims that they can never do anything right; accusing the victims of cheating; keeping or discouraging them from seeing friends or family members, and controlling every penny spent in the household.

Others are taking the victims money or refusing to give them money for expenses, looking at or acting in ways that scare the persons they are abusing, controlling who the victims see, where they go, or what they do, dictating how they dress, and threatening to hurt or kill their friends, loved ones.
Intimidating the victims with guns, knives; pressuring them to have sex when they don’t want to; refusing to use protection when having sex or sabotaging birth control; pressuring or forcing them to use drugs or alcohol; preventing them from working or attending school, and destroying their property are other examples of abusive tendencies.
Management
Medically, management of domestic violence may take place through medical services, law enforcement, counselling, and other forms of prevention and intervention.
Counselling is a means of managing the effects of domestic violence. For the victim of abuse, counselling may include an assessment of the presence, extent and types of abuse.
Prevention and intervention include ways to prevent domestic violence by advocacy, education and prevention programmes.
Management of domestic violence is broad and entails having a safety plan in which the victims can make informed decision and never pressurised to follow any particular course of action. Only the victims can decide what is right for them in a particular situation. Individual autonomy, self-esteem and self-determination are encouraged and respected. Even if the victims decide to return to the violent situation, they are not likely to forget the information and care given and, in time, this may help them to break out of the cycle of abuse.
Medical support
(a) If the victims do not wish to return to their abusers, it is advisable for them to get the services, which include protective custody from local agencies, Non-governmental organisations offer help with contacting them. If the victims choose to return to their abusers, they are given the phone number of the women’s NGO’s or the women’s group for support.
(b) The victims may be advised to keep some money and important financial and legal documents hidden in a safe place in case of emergency.
(c) The medical team may help the victims plan an escape route in case of emergency.
(d) If children are likely to be at risk, referral may be made to social services or welfare department of the government if possible with the patients’ consent.
Domestic violence is not a respecter of persons as it cuts across the social stratum, wives of pastors, monarchs, doctors, lawyers, political office holders have also being victims of this. Some few ones are read on the pages of newspapers but there are thousands of women out there suffering from such violence.
Women who are victims of domestic violence should be careful of where to go for help. They are advised not seek help in another man’s home. They should not seek help or counselling in a closed place with a counsellor of opposite sex. They do not need to sleep in a pastor or doctor’s house while seeking help. They should not engage in alcohol or drugs as it may cloud their judgment
They should seek help in a professional way in the hospitals, NGO’s, ministry of social welfare, among others. Are you a victim of domestic violence? Call for help before it gets out of hands. Call 112 or 767 (Emergency numbers) or 999 (The police).
This is a clarion call for women to speak out since they are the disadvantaged when it comes to issues of domestic violence. Some women suffer in silence and their cases degenerate to such issues as suicide attempt, psychiatric problems and homicide.
Domestic violence against men happens occasionally, it is often unreported because of social norms and pressure. Those that do report such may face social stigma and denigration of their masculinity. However, such men who are victims of domestic violence are also encouraged to speak out.
Domestic violence is both a medical and legal issue but this piece is largely on the medical aspect

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