[Violence: a challenge for public health and for all 2001; 55: 597-9]
Women who are abused by their partners are not simply passive victims, new research in the Journal of Epidemiology and Community Health, shows. Those that stay in an abusive relationship often do so because there is no social or practical support to help them, rather than simply as a result of low self-esteem.
International research shows that in some parts of the world between 20 and 50 per cent of women will be physically or sexually assaulted by an intimate partner, and as many as one in five is assaulted during pregnancy. In 1993, The United Nations General Assembly adopted a declaration on the elimination of violence against women.
A cross section of almost 500 women from Nicaragua's second largest city, León, were interviewed about their experiences of domestic violence. All the women were aged between 15 and 49. Of those who were married, 188 had been abused by an intimate partner.
Two thirds of the women defended themselves either verbally or physically and were able to halt the episode of violence. Four out of 10 left home temporarily because of the violence and one in five sought outside help. Seventy per cent eventually left their violent partner, with one in four managing to do so within the first four years of the relationship. Only 13 per cent of those who had been abused reported having more than one relationship with a violent man.
The findings showed that those women whose abuse was less severe tended to "manage" the situation physically or verbally, while those experiencing severe violence were more likely to leave or seek help. But four out of 10 women said they lacked adequate support, including from their own mothers or mothers in law, who frequently advised staying put to keep the family together. Better levels of education, younger age, and no history of violence in their own family predicted faster separation from the abusive partner.
The authors comment that "barriers to leaving abusive relationships are surprisingly similar" throughout the world. But an accompanying editorial notes that while domestic violence is recognised as a crime, little is done about it. "We are still far from broadening the perception that gender violence is not only an individual and family problem, but a society problem as well."
A further commentary in the same issue notes that the countries of the Americas have the highest rate of murders in the world, at more than 15 per 100,000 of the population, with El Salvador and Colombia heading up the list at 90 and 65 per 100,000, respectively. Both countries spend just under a quarter of their Gross Domestic Product on security and violence control.
Dr Mary Ellsberg, Program for Appropriate Technology in Health, Washington,
Tel: +1 202 822 0033
Dr Eunice Rodriguez (Editorial), Department of Policy Analysis and
Management, Cornell University, New York, USA.
Tel: +1 607 255 8013
Dr Alberto Concha-Eastman, Pan American Health Organisation/WHO,
Washington, DC, USA.
Tel: +1 202 974 3890