Domestic Violence

Domestic violence (DV) takes many forms. As very broad definition sees it as a pattern of inappropriate, oppressive and coercive control that one person exercises over another within a sexual relationship. But in recent years, the definition of DV has been expanded to include not only physical violence, but psychological or emotional mistreatment, financial abuse, and the violation of individual rights, aswell (Davison, 1997, P632)

The aim of this essay is to analyse the support which is available for the survivors of DV, one shall concentrate more on the Muslim women.

Although the personal significance of violence against men in relationships should not be devalued, DV remains overwhelming a problem for women and can be usefully seen as a direct product of the subordination of women both within marriage and within society as a whole. Lyndon (1996) argues that research suggests that 95% of DV is committed by men against women.

Home Office (1999) argue that domestic violence is rarely a one off event. Physical and sexual abuse tends to increase in frequency and severity overtime, sometimes ending only when one person has killed the other. Women experience DV regardless of their social group, class, age, disability. sexuality and lifestyle. The abuse can begin at anytime - in new relationships and also after many years spent together. The work of Adams (1998) suggests that DV is deeply rooted in the British society and its here to stay unless something active is done to solve it.

Myths associated with DV, have become accepted explanation for the causes. For example: it only happens in low income families: abusers grow up in a violent homes: the woman provokes violence: some women are attracted to violent men and choose them again and again: it is caused by drunken or jealous behaviour: or it can be blamed on stress at work or just plain bad temper (Lask, 1998 & Moss & Taylor, 1991). Such myths and prejudices make women who suffer abuse afraid to seek help and whatever the cause violence is violence. There is no set time, date nor the place when DV occurs, it can occur at any time. Research by Bewley & Gibbs (1992) suggested that pregnancy is the time when physical abuse is precipitated or exacerbated. Abused pregnant women have been all but invisible in society in part because of historical myths and a contemporary societal view that is romantic and ideal (Noel & Yam, 1992) and had been an hidden issue but given time women have started to report cases of DV, through professionals or self referrals.

When it comes down to what services are available for the survivors of DV, there are numerous, but the reality of these services come to live when women use them, but the question is how much is available for the Muslim women?

Bewley (1994) argues that there are practical difficulties to be faced. Women are often financially dependent upon their partners, they may not have nowhere else to stay, and there may be children dependent upon them. The women may not seek help and leave because the practical and psychological risks are so great and continue to remain in a violent relationship. The continous social pressure forces then to tolerate as long as possible and results in further deterioration in the victims self-esteem until its absolutely intolerable that they are forced to leave the violent relationship, but even then it is very difficult for some Muslim woman to leave due to the fear that her husband may divorce her and take away the children.

This should not be perceived by the health professionals that these woman don't require help but they don't often directly ask for it. It is therefore, very important that helping agencies who come into contact with women are alert to the cues which signal DV. We have seen why DV arises, we now need to explore and analyse the services which are available.

Davison (1997) suggests that it is important to identify the victims/survivors of DV and health professionals must be familiar with common signs. The key to good assessment lies in allowing the woman of abuse ample opportunity to talk about their injuries, but bearing in mind that not all may present with traumatic injuries.
Lyndon (1996) argues that the first port of call for a woman with injuries caused by domestic violence may well be the accident & emergency department: care is free, there is 24 hour access and the woman can remain anonymous. But the disadvantage of such departments is that majority of the times, lack of training and time constraints, professionals don't interfere but instead patch the woman up and send her back and the cycle begins once more. And because lack of space and the demands of A & E, there is no privacy for women, with just a curtain separating the patient from the rest of the world and the staff are often pressed for time. A environment like this would not allow the women to be open about their injuries and talk about their abusive partners.

Before attempting to help these women, especially the non-English speaking women, we must have a sensitivity towards their cultures and values, educate ourselves, and be non-judgmental. The A&E should have trained counsellors and interpreters whom they can talk to. Its so easy to patch someone up physically but psychological help is needed to, physical scars heal, a broken arm mends but psychological trauma gets deeper and deeper.

According to Lyndon (1996) nurses on A&E should be educated to help, but its up to them to take the initiative in addressing this issue and it cannot wait for guidelines and policies, giving out useful numbers of relevant agencies i.e. Womens aid, but this in itself can have problems (to be discussed later). Bewley (1994) argues that DV, is a sensitive issue and in a social climate which is more likely to conceal than reveal the issue, screening and intervention are difficult in the absence of a systematic, articulated framework. A non-judgmental approach by professionals is important, by taking each case individually, to provide holistic care. It is important that we remember not to hold an attitude and assume that its only Muslim men that are violent and Muslim women are the survivors, but acknowledging that DV is an issue across the board, but ethnic minorities i.e. Muslim women whose English is not their first language may need little extra support. The A&E, is not the ideal place to discuss problems such as these because it would not allow women to be open about anything, fearing that the patient in the next cubicle may be someone they know. When visiting a local A&E department, the writer found that there was no evidence of support, but leaflets on various other issues i.e. contraception were available, so therefore there is much room for improvement.

If there are language barriers then interpreters should be used, but the disadvantage to this maybe the she too is from the same community, the woman may hesitate in anything just in case it gets back to the family. Research by Frost (1997) argues that health professionals often fail to identify domestic violence or provide appropriate support, this time placing more emphasis on health visitors. This is because they lack understanding, take a judgmental approach and fail to ask probing questions or fail to refer to appropriate agencies. Midwives too, see more of these women than anyone else, if DV escalates during pregnancy which has life threatening consequences for women and babies (Bewley, 1994) then they need to be tuned in and be aware of approaching the problem sensitively and be familiar with the services available for the Muslim women.

The work of Bewley (1994) suggests that awareness could be raised among midwives and mothers by displaying posters in ante-natal clinics and women toilets, raising issues in parent education classes and also discuss DV sensitively during the booking visit educating the Muslim women to realise that DV violence is a criminal offence and help them to put a stop to it. By having a resource folder with vital information may also be beneficial bearing in mind that they are translated in different languages.
Some Muslim women with superficial ties to Islam, don't know that abuse is unacceptable due to their weak faith, poor Islamic knowledge and lack of interaction with the Muslim communities, so this area needs to be worked on by the Muslim community and religious leaders along with other services (Q-News, 1999, Al-Khattab, 1997 & Abadalti, 1993).

Although, DV is no longer a hidden subject in the West but it is still a taboo subject in the East and the little help that is available is often ignored. Research by Moss & Taylor (1991) criticises the services and the professionals in delivering appropriate care. They continue that misinformation, sexist bias, the structure of the medical model and disbelieving the women's stories are added problems when they turn up to help. The literature keeps suggesting that, it is lack of training on the professionals part that fails to provide adequate support, maybe it is time for professionals to attend training sessions where they can polish their practice (Bewley, 1994). Frost (1997) highlights in her work that there is limited research on how the practitioners see DV, which prevents them from doing something active.

Bewley & Gibbs (1992) suggest that professionals needs to adopt a more systematic approach. They need to develop positive strategies for identification and intervention to help women in violent relationships, and acknowledge the difficulties faced by women when talking about cases in a society which has traditionally condoned the chastisement of wives.

The Muslim women need to have support which caters for their needs, there is a service called Bharosa which is funded by the social services (1996). Bharosa provides a culturally and linguistically sensitive counselling service both by phone and face to face, which allows the women to express and explore their feeling and identify options available to them in order to enable them to make an informed choice/decision, but even so Muslim women are still held back in approaching these services.

The reason behind are not research based but when talking to one of the ex-employees recently about there services she had difference of opinion. She informed that majority of the helpers are of Asian background and women who have approached them for help are gossiped about, the information somehow leaks out and the problem has get worse. These services also hold the attitude that it is the womans own fault that they are subjected to DV. The argument here is that some Muslim women simply won't seek help. They are more afraid that if their situation became public they will lose their honour and they fear that the abusers will get more hostile with them when the negative publicity gets back to them (Q-News, 1999).

The Q-News Muslim Magazine (1999) also argues that those women who actually reach a breaking point and seek help from religious leaders, many Muslim women are turned away and asked to pray for the abuse to end, rather than doing something active and making referrals. The reason for not doing so isn't that they cant be bothered its because the Muslim communities remain male-dominated, the issue of DV remains a taboo subject among the all major Muslim organisation. It is a sad fact but today there isn't even one refuge for abused Muslim women throughout the country, so therefore this is an area where health professionals and the Muslim community should unite and help this to establish so that the Muslim women have some place to turn to if problems arise.

It is all very well for Bharosa and another support group called Roshni to hand out leaflets to Muslim women when there will be no further action apart from counselling and then sending them away and often these women will go back in fear of losing their reputation within their families.

Another problem which some Muslim women face, especially for those whose English is not their first language, is language barrier, these women in turn find it very difficult to access services which are available. Muslim women look at other source of support including family and friends, but again to be told to accept the abuse because by making a big deal out of it, could hurt the relatives family honour and reputation but there are families which are more supportive than others and try to help the woman to reconsiliate with the husband rather than leave him. A refuge would be the last place, a Muslim woman may want to go to, but those who have no choice but turn to shelters run by non-Muslims. Q-News (1999) argues that seeing abused Muslim women in shelters leaves non-Muslims social workers with an ugly picture of Islam. As far as many of them are concerned, Islam is no more just and compassionate than Christianity or Judaism because the Muslim community tolerates wife abuse too. Research suggests that women are scared in going to these shelters in fear of social workers taking the children away from troubled Muslim homes, to keep them safe. Davison (1997) says that no one wants to be abused, but fear of pursuit and retaliation, danger to children, embarrassment, stigmatisation, religious codes, social beliefs and an overwhelming feeling of guilt and failure all provide very strong deterrents against leaving. A Southhall Black Sisters spokeswoman says: most women put up with DV for an average of seven years. But Asian women, on whom there is a lot of cultural pressure to stay with their partners, particularly in arranged marriages, endure violence for an average of ten years (Sadler, 1994, P186).

It is however, very positive to see that Womens Aid, have five case workers who can offer these women advice, information and counselling in four different languages, in the context of their own culture, then network with other agencies, but these services are only available when and if they are approached. If research keeps suggesting that health-care professionals fail to identify survivors of DV and this is often due to their unwillingness to probe, then how is it possible to make referrals to other agencies if health professionals have little or no knowledge around the area?, women therefore, will continue to suffer further. Domestic violence - Break the Chain booklet also makes reference to the role of the police, but the question remains how do they cater the needs of Muslim women? Its all very well to pick the phone and dial but for a non-English speaking woman this can be very difficult and same applies to other services which are mentioned in the booklet.

The DV: Break the Chain was published by the Home Office (1999), doesn't mention the ethnic minority and women who don't speak any English, it highlights all the services which are available but fails to recognise the needs of the minority, cultural sensitivity and language barriers, these issues need to be reviewed. This booklet needs to be translated into different languages. It is the same problem with another leaflet entitled - Surviving Domestic Violence produced by Solihull Domestic Violence Forum. But a positive point about the Bharosa leaflet is that it is translated into several different languages, which allows Muslim women to read the information, but it becomes a problem if she cant read her own language.

It is the increased stereotypical views and fear to becoming involved in cases of DV is becoming more of a problem (Hill, 1999 & Rooke, 1991). Majority of the research has addressed DV in a sense that it applies the same way to every woman, but failed to see that each woman is different with different cultural needs and different perceptions of DV. There needs to be different refuges which cater for all women, not just one collective refuge where every woman would go to, which would make them feel alone and isolated. For once health professional don't hold the attitude nothing is wrong with the services they provide but are inexperienced and fearful in making any moves (Bowes & Domokos, 1996).

Research has got to the stage where they have recognised that DV is an issue which needs to be dealt with, but the major criticism still remains they don't really know how to go about it. Clearly, it is essential that health-care workers learn to assess and intervene in a holistic way, rather than just treat physiological symptoms (Davison, 1997). Midwives and health visitors have a powerful position to deal with DV, most of all they need to organise training sessions or study days to firstly, help themselves on how to tackle DV and then be in the position to help the survivors.

It can be concluded, that DV is an issue which will remain in our societies, despite the race, ethnic background and social status and women will remain the subjects. There are a number of services which are available for women in general, but so little availability of research concerning the Muslim woman indicates that more research needs to done in this field so that more support can be made available for these women.

A message which can be left for health professionals i.e. midwives, health visitors and general practitioners that they need to be tuned into DV, and be able to provide sound information without a judgmental attitude. Another message goes to religious leaders that they too need to be aware about DV and provide services that enable the Muslim women to access without the fear of any stigma attached to them It can be said that due to word restriction the author could not discuss the services available on the Internet, which also has its disadvantages along with advantages.