THE CYCLE OF VIOLENCE AND POWER AND CONTROL

The cycle of violence is a pattern of behaviors which keeps survivors locked in the abusive relationship.

Understanding the cycle of violence is crucial in stopping relationship violence as well as in answering
the most common questions regarding battering.

There are three stages to the cycle of violence:

First is the tension building phase. In this phase, the batterer gets edgy and tension begins to build up.
This is where the battered person may feel like they are walking on eggshells.

Second is the actual explosion phase where the physical abuse occurs. It can last from a few minutes to
several hours.

Third is the honeymoon phase. The perpetrator may be sorry or act like nothing happened; but is still
interested in making up and may even promise never to do it again. However, the tension almost always
starts to build again, thus continuing the cycle.

A survivor of domestic abuse does not need to experience physical abuse to be abused.

Often the psychological abuse can leave someone feeling fearful, helpless and powerless to act on their
own behalf. People affected by domestic violence are rich, poor, married, divorced or single, from all
ethnic backgrounds and economic levels. They can be able-bodied or with a disability, heterosexual or
homosexual, gay, lesbian, bisexual and/or transgender. As someone affected by domestic violence and
battering they will find that they have common issues with many others who have also experienced this
type of violence.

The Power & Control diagram is a particularly helpful tool in understanding the overall pattern of
abusive and violent behaviors, which are used by a batterer to establish and maintain control over their
partner. Very often, one or more violent incidents are accompanied by an array of these other types of
abuse. They are less easily identified, yet firmly establish a pattern of intimidation and control in the
relationship.

Power and Control.png

Power & Control Wheel

EMOTINAL ABUSE
Putting her down or making her feel bad about herself, calling her names, making her think she’s crazy,
and mind games.

ECONOMIC ABUSE

Trying to keep her from getting or keeping a job, making her ask for money, giving her an allowance, or
taking her money.

SEXUAL ABUSE

Making her do sexual things against her will, physically attacking the sexual parts of her body, or treating
her like a sex object.

USING CHILDREN

Making her feel guilty about the children, using the children to give messages, using visitation as a way
to harass her.

THREATS

Making and/or carrying out threats to do something to hurt her emotionally, threaten to take the
children, commit suicide, or report her to welfare.

USING MALE PRIVILEGE

Treating her like a servant, making all the “big” decisions, acting like the “master of the castle”

INTIMIDATION

Putting her in fear by using looks, actions, gestures, loud voice, smashing things, destroying her
property.

ISOLATION

Controlling what she does, who she sees and talk to, where she goes.
https://www.peaceoverviolence.org/iii-the-cycle-of-violence-and-power-and-control

Battered woman syndrome, or battered person syndrome, is a psychological condition that can develop
when a person experiences abuse, usually at the hands of an intimate partner.

People who find themselves in an abusive relationship often do not feel safe or happy. However, they
may feel unable to leave for many reasons. These include fear and a belief that they are the cause of the
abuse.

Abuse can affect people of any gender, age, social class, or education. The Centers for Disease Control
and Prevention (CDC)Trusted Source refer to the type of abuse that occurs within a relationship as
intimate partner violence (IPV).

The CDC note that an intimate partner relationship can take many forms. It includes — but is not limited
to — spouses, people who are dating, sexual partners, and people who do not have a sexual
relationship. Relationships may be heterosexual or same-sex.

According to the National Coalition Against Domestic Violence (NCADV), 1 in 4 women and 1 in 9 men in
the United States experience violence from an intimate partner. Around 15% of all violent crimes involve
an intimate partner.

Psychotherapist Lenore Walker developed the concept of battered woman syndrome in the late 1970s.

She wanted to describe the unique pattern of behavior and emotions that can develop when a person
experiences abuse and as they try to find ways to survive the situation.

Walker noted that the patterns of behavior that result from abuse often resemble those of post-
traumatic stress disorder (PTSD). She described battered woman syndrome as a subtype of PTSD.

What types of abuse can it involve?

IPV can take many forms, including emotional, physical, and financial abuse.
The CDCTrusted Source currently list the following as types of IPV:

Sexual abuse: This includes rape, unwanted sexual contact, and verbal sexual harassment.

Stalking: This involves a person using threatening tactics to cause a person to feel fear and concern for
their safety.

Physical abuse: This includes slapping, pushing, burning, and the use of a knife, gun, or other weapon to
cause bodily harm.

Psychological aggression: Examples include name-calling, humiliation, or coercive control, which means
behaving in a way that aims to control a person.

Coercive control is a legal offense in some countries, but this is not the case in the U.S.

Symptoms

According to the NCADV, a person experiencing abuse may:

feel isolated, anxious, depressed, or helpless

be embarrassed or fear judgment and stigmatization

love the person who is abusing them and believe that they will change

be emotionally withdrawn

deny that anything is wrong or excuse the other person

be unaware of the type of help that is available

have perceived moral or religious reasons for staying in the relationship

The person may also behave in ways that can be difficult for people outside the relationship to
understand.

These behaviors include:

refusing to leave the relationship

believing that the other person is powerful or knows everything

when things are calm, idealizing the person who carried out the abuse

believing that they deserve the abuse

The impact of an abusive relationship can continue long after leaving it. For some time, the person may:

experience sleep problems, including nightmares and insomnia

have sudden intrusive feelings about the abuse

avoid talking about the abuse

avoid situations that remind them of the abuse

experience feelings of anger, sadness, hopelessness, or worthlessness

have intense feelings of fear

have panic attacks or flashbacks to the abuse

Physical abuse can also lead to injuries such as organ damage, broken bones, and lost teeth. Sometimes,
these injuries can be lasting and possibly life threatening.

The impact of abuse on a person’s well-being can be severe. For this reason, it is important to
understand that help is available and to seek help if possible.

Stages

Abuse can happen on a single occasion, or it can be a long-term problem. It can happen most of the
time, or only from time to time.

It can also occur in cycles. The list below details some potential stages of an abuse cycle:

Tension building: Tension slowly builds and causes low-level conflict. The person carrying out the abuse
may feel neglected or angry. They may think that these feelings justify their aggression toward the other
person.
Battering phase: Over time, the tension grows into a conflict, culminating in abuse, which may be
physical, emotional, psychological, or sexual. Over time, these episodes may last longer and become
more severe.

Honeymoon phase: After carrying out the abuse, the person may feel remorse. They may attempt to win
back their partner’s trust and affection. The person who experiences the abuse may idealize their
partner during this period, seeing only their good side and making excuses for what they did.

According to the NCADV, people who carry out abuse can often be “charming” and “pleasant” outside
the periods of abuse. This can make it hard for a person to leave an abusive relationship.

https://www.medicalnewstoday.com/articles/320747

The Effects of Violence on Women’s Reproductive Health: Fact Sheet

ARTICLE DETAILS

(August 2011) Violence against women is a pervasive public health problem worldwide. According to the
UN, at least one in three women is beaten, coerced into sex, or otherwise abused by an intimate partner
in the course of her lifetime. Pregnant women have been found to be at an especially high risk of
physical abuse. Though the frequency and severity of violence against women and girls vary across
countries and continents, its harm to the victims and their families is universal.

Key Facts

Women who experience violence by their husband or intimate partner are more likely than nonabused
women to have difficulty using contraceptives effectively. Consequently, they are more likely to have
unintended pregnancies and unsafe abortions, and to become pregnant as adolescents.1

Women who are abused during pregnancy exhibit more depression and substance abuse and are less
likely to gain needed weight or to access prenatal care, compared with pregnant women who are not
abused.2

Children of abused women are more likely to die before age 5.3

Violence during pregnancy has been associated with low birth weight of babies.4

Violence against women has been shown to increase the risk that women will be infected by sexually
transmitted diseases and HIV.5
According to Demographic and Health Survey data, the prevalence of sexually transmitted infections
among women who have experienced violence is at least twice as high as in nonabused women.6

A report on married women in India revealed that women who have experienced both physical and
sexual violence at the hands of an intimate partner have four times greater risk of HIV infection than
nonabused women.7

In Tanzania, young women ages 18 to 29 who have been abused by a partner have been found to be 10
times more likely to be HIV positive than women who have not been abused.

https://www.prb.org/resources/the-effects-of-violence-on-womens-reproductive-health-fact-sheet/
#:~:text=Violence%20against%20women%20has%20been,sexually%20transmitted%20diseases%20and
%20HIV.&text=According%20to%20Demographic%20and%20Health,high%20as%20in%20nonabused
%20women.

References

Jacqueline C. Campbell, “Health Consequences of Intimate Partner Violence,” The Lancet 359, no 9314,
(2002): 1331-336 ; and Lori Heise, Mary Ellsberg, and Megan Gottemoeller, Ending Violence Against
Women (Baltimore: Johns Hopkins University School of Public Health, 1999).

Jacqueline C. Campbell, Claudia Garcia-Moreno, and Phyllis Sharps, “Abuse During Pregnancy in
Industrialized and Developing Countries,” Violence Against Women 10, no. 7 (2004): 770-89.

Kajsa Asling-Monemi et al., “Violence Against Women Increases the Risk of Infant and Child Mortality: A
Case Study in Nicaragua,” The Bulletin of the World Health Organization 81 (2003): 10-18.

Elitette Valladares et al., “Physical Partner Abuse During Pregnancy: A Risk Factor for Low Birth Weight
in Nicaragua,” Obstetrics & Gynecology 100, no. 4, (2002): 700-705.

Sunita Kishor and Kiersten Johnson, Profiling Domestic Violence—A Multi-Country Study (Calverton, MD:
ORC Macro, 2004).

Kishor and Johnson, Profiling Domestic Violence.

Jay G. Silverman et al., “Intimate Partner Violence and HIV Infection Among Married Indian Women,”
JAMA 300, no. 6 (2008): 703-10.

Suzanne Maman et al., HIV and Partner Violence (New York: Population Council, 2002).

Effects of violence against women

Violence against women can cause long-term physical and mental health problems. Violence and abuse
affect not just the women involved but also their children, families, and communities. These effects
include harm to an individual's health, possibly long-term harm to children, and harm to communities
such as lost work and homelessness.

What are the short-term physical effects of violence against women?

The short-term physical effects of violence can include minor injuries or serious conditions. They can
include bruises, cuts, broken bones, or injuries to organs and other parts inside of your body. Some
physical injuries are difficult or impossible to see without scans, x-rays, or other tests done by a doctor
or nurse.

Short-term physical effects of sexual violence can include:

Vaginal bleeding or pelvic pain

Unwanted pregnancy

Sexually transmitted infections (STIs), including HIV

Trouble sleeping or nightmares

If you are pregnant, a physical injury can hurt you and the unborn child. This is also true in some cases of
sexual assault.

If you are sexually assaulted by the person you live with, and you have children in the home, think about
your children’s safety also. Violence in the home often includes child abuse.1 Many children who
witness violence in the home are also victims of physical abuse.

What are the long-term physical effects of violence against women?

Violence against women, including sexual or physical violence, is linked to many long-term health
problems. These can include:3

Arthritis

Asthma

Chronic pain

Digestive problems such as stomach ulcers

Heart problems
Irritable bowel syndrome

Nightmares and problems sleeping

Migraine headaches

Sexual problems such as pain during sex

Stress

Problems with the immune system

Many women also have mental health problems after violence. To cope with the effects of the violence,
some women start misusing alcohol or drugs or engage in risky behaviors, such as having unprotected
sex. Sexual violence can also affect someone’s perception of their own bodies, leading to unhealthy
eating patterns or eating disorders. If you are experiencing these problems, know that you are not alone.
There are resources that can help you cope with these challenges.

How is traumatic brain injury related to domestic violence?

A serious risk of physical abuse is concussion and traumatic brain injury (TBI) from being hit on the head
or falling and hitting your head. TBI can cause:4

Headache or a feeling of pressure

Loss of consciousness

Confusion

Dizziness

Nausea and vomiting

Slurred speech

Memory loss

Trouble concentrating

Sleep loss

Some symptoms of TBI may take a few days to show up. Over a longer time, TBI can cause depression
and anxiety. TBI can also cause problems with your thoughts, including the ability to make a plan and
carry it out. This can make it more difficult for a woman in an abusive relationship to leave. Even if you
think you are OK after hitting your head, talk to you doctor or nurse if you have any of these symptoms.
Treatment for TBI can help.
What are the mental health effects of violence against women?

If you have experienced a physical or sexual assault, you may feel many emotions — fear, confusion,
anger, or even being numb and not feeling much of anything. You may feel guilt or shame over being
assaulted. Some people try to minimize the abuse or hide it by covering bruises and making excuses for
the abuser.

If you’ve been physically or sexually assaulted or abused, know that it is not your fault. Getting help for
assault or abuse can help prevent long-term mental health effects and other health problems.

Long-term mental health effects of violence against women can include:5

Post-traumatic stress disorder (PTSD). This can be a result of experiencing trauma or having a shocking
or scary experience, such as sexual assault or physical abuse.6 You may be easily startled, feel tense or
on edge, have difficulty sleeping, or have angry outbursts. You may also have trouble remembering
things or have negative thoughts about yourself or others. If you think you have PTSD, talk to a mental
health professional.

Depression. Depression is a serious illness, but you can get help to feel better. If you are feeling
depressed, talk to a mental health professional.

Anxiety. This can be general anxiety about everything, or it can be a sudden attack of intense fear.
Anxiety can get worse over time and interfere with your daily life. If you are experiencing anxiety, you
can get help from a mental health professional.

Other effects can include shutting people out, not wanting to do things you once enjoyed, not being able
to trust others, and having low-esteem.1

Many women who have experienced violence cope with this trauma by using drugs, drinking alcohol,
smoking, or overeating. Research shows that about 90% of women with substance use problems had
experienced physical or sexual violence.7

Substance use may make you feel better in the moment, but it ends up making you feel worse in the
long-term. Drugs, alcohol, tobacco, or overeating will not help you forget or overcome the experience.
Get help if you’re thinking about or have been using alcohol or drugs to cope.
Who can help women who have been abused or assaulted?

After you get help for physical injuries, a mental health professional can help you cope with emotional
concerns. A counselor or therapist can work with you to deal with your emotions in healthy ways, build
your self-esteem, and help you develop coping skills. You can ask your doctor for the name of a
therapist, or you can search an online list of mental health services. Learn more about getting help for
your mental health.

Victims of sexual assault can also talk for free with someone who is trained to help through the National
Sexual Assault Hotline over the phone at 800-656-HOPE (4673) or online .

Violence against women has physical and mental health effects, but it can also affect the lives of women
who are abused in other ways:

Work. Experiencing a trauma like sexual violence may interfere with someone’s ability to work. Half of
women who experienced sexual assault had to quit or were forced to leave their jobs in the first year
after the assault. Total lifetime income loss for these women is nearly $250,000 each.8

Home. Many women are forced to leave their homes to find safety because of violence. Research shows
that half of all homeless women and children became homeless while trying to escape intimate partner
violence.9

School. Women in college who are sexually assaulted may be afraid to report the assault and continue
their education. But Title IX laws require schools to provide extra support for sexual assault victims in
college. Schools can help enforce no-contact orders with an abuser and provide mental health
counseling and school tutoring.

Children. Women with children may stay with an abusive partner because they fear losing custody or
contact with their children.

Sometimes, violence against women ends in death. More than half of women who are murdered each
year are killed by an intimate partner.10 One in 10 of these women experienced violence in the month
before their death.

Sources

Centers for Disease Control and Prevention. (2015). Intimate Partner Violence: Consequences.

Modi, M.N., Palmer, S., Armstrong, A. (2014). The Role of Violence Against Women Act in Addressing
Intimate Partner Violence: A Public Health Issue. Journal of Women’s Health; 23(3): 253-259.
Smith, S.G., Chen, J., Basile, K.C., Gilbert, L.K., Merrick, M.T., Patel, N., et al. (2017). The National
Intimate Partner and Sexual Violence Survey: 2010-2012 State Report. Atlanta, GA: National Center for
Injury Prevention and Control, Centers for Disease Control and Prevention.

Defense and Veterans Brain Injury Center. (2016). Recognize TBI and Concussion .

Delara, M. (2016). Mental Health Consequences and Risk Factors of Physical Intimate Partner Violence .
Mental Health in Family Medicine; 12: 119-125.

Jina, R., Thomas, L.S. (2013). Health consequences of sexual violence against women. Best Practice and
Research: Clinical Obstetrics and Gynaecology; 27: 15-26.

Beijer, U., Scheffel Birath, C., DeMartinis, V., Af Klinteberg, B. (2015). Facets of Male Violence Against
Women With Substance Abuse Problems: Women With a Residence and Homeless Women. Journal of
Interpersonal Violence; Dec 4. pii: 0886260515618211.

National Alliance to End Sexual Violence. (2011). The Costs and Consequences of Sexual Violence and
Cost-Effective Solutions.

Goodman, L.A., Fels, K., Glenn, C., Benitez, J. (2011). No Safe Place: Sexual Assault in the Lives of
Homeless Women . National Resource Center on Domestic Violence.

Petrosky, E., Blair, J.M., Betz, C.J., Fowler, K.A., Jack, S.P.D., Lyons, B.H. (2017). Racial and Ethnic
Differences in Homicides of Adult Women and the Role of Intimate Partner Violence – United States,
2003-2014. MMWR; 66: 741-746.

https://www.womenshealth.gov/relationships-and-safety/effects-violence-against-women

The role of primary healthcare physicians in violence against Women intervention program in Indonesia

Nuretha Hevy Purwaningtyas, Guswan Wiwaha, …Insi Farisa Desy Arya Show authors

BMC Family Practice volume 20, Article number: 168 (2019) Cite this article

Abstract

Background
Violence against women (VAW) has many impacts on health, but the role of the primary healthcare
physicians in the intervention program is lacking. This research aimed to explore the primary healthcare
physician role in a comprehensive intervention program of VAW in Malang City, Indonesia.

Methods

This qualitative research was conducted using a phenomenology approach. A focused group discussion
followed by in-depth interviews were carried out involving six primary healthcare physicians in
Puskesmas (Primary Healthcare Center) and two stakeholders. Legal document related to VAW was
reviewed to measure up the role of the primary healthcare physicians.

Result

Our study revealed that the role of physicians in primary healthcare centers on the VAW intervention
program was limited. This was due to the insufficient knowledge of the physicians on the VAW program,
physicians’ constraint on counseling skill, unsupportive infrastructure, and a limited number of
physicians in Puskesmas. Some barriers related to the VAW program management were also discovered
and needed intervention at the decision-maker level.

Conclusion

The role of primary healthcare physicians in the comprehensive intervention of the VAW program is not
optimum. The source of the problem involves the physician capability and program management
aspects in all levels of decision-makers. Local government awareness and commitment are needed to
improve the overall management of the VAW intervention program in this city.

The health sector is supposed to be one of the entry points for women who survive from violence to
seek treatment [2, 6]. The role of the health sector varies, starting from preventing to responding to the
case of VAW, such as advocating for a public health perspective, identifying and providing a
comprehensive intervention, developing, implementing, monitoring, and evaluating VAW program
intervention in health sectors [2]. Research conducted in Sao Paulo, Brazil, found a high utilization of
healthcare services by survivors of VAW, particularly for repetitive IPV, which was also confirmed by
another study in Brazil [7].

Health sector response needs a strategic direction since it cannot stand alone. WHO in its global plan
action to address interpersonal violence stated that there are 4 strategic directions, as follows: [1]
strengthening health system leadership and governance, [2] strengthening health services delivery and
health workers/providers’ capacity to respond, [3] strengthening the prevention program, and [4]
improving information and evidence [2]. Research regarding health sector responses to VAW
intervention showed varied results. A research conducted in the UK showed that only less than 50% of
health providers (nurses or physicians) gave counseling or education related to VAW, nor referred to
specific VAW service providers. It showed a poor situation among health providers in responding to
VAW [8]. Supporting the result, a systematic review by O’campo et al. showed that a successful
intervention program of VAW needs a comprehensive program approach, significant institutional
support, effective screening protocol, thorough initial and ongoing training, and immediate
access/referral to onsite and/or offsite support service [9].

Many types of research on physician role in responding to VAW have been conducted overseas, but very
little in Indonesia. Hence, this study was trying to explore the physicians’ role in Primary Healthcare
Center (Puskesmas) in responding to the violence against women cases.

Barriers faced by physicians in managing suspected cases of VAW

This research also explored the barriers experienced by the physician when working on VAW cases.
There were six identified problems both in the FGD and the in-depth interview session, explicitly:

No training is available

According to the physicians who participated in the FGD, they have never attended training related to
VAW case management at the Puskesmas. On the other hand, the confirming person from P2TP2A
mentioned that their unit had conducted a regular meeting annually to introduce and raise the
awareness of the VAW intervention program to Puskesmas staffs, but she was not sure whether the
DHO had a specific training related to it.

“We never had counseling training before, how to search for deeper information… not yet, and we also
don’t know what to do when we get the case, there is no such pathway …”. (R2).

“Oh... if it’s socialization, I have conducted it previously, but if it’s training from District Health Office,
when I asked the DHO program manager, they said they did it. But perhaps for MCH dept, perhaps the
midwives… “. (CP2).

Standard operational procedure (SOP) is not available/not recognized

Physicians in the Puskesmas did not recognize any SOP related to the VAW intervention program. This
situation was also strengthened by the physician from Puskesmas that have managed the VAW case.
However, the confirming person from P2TP2A said that the SOP existed, and she had shared it with the
Puskesmas staffs. Her statement was argued by all physicians.
I had socialized it (the SOP) to the head of Puskesmas; there was also the intervention pathway… it is
(existed), so if we got the case, we know where we have to go, like that.. (CP2).

We don’t have official SOP, but at the internal sector meeting, we shared that we have the pathway for
the cases management (DF6).

Physician inadequacy in Puskesmas

Intervening violence cases needed a special approach since the issues were considered sensitive,
particularly for the victim. Puskesmas serves hundreds of patients every day, hence the physicians said
that they do not have enough time to do the anamnesis deeper and to give the patients suggestion
regarding their violence case.

Sometimes it depends…, because there were so many patients in the Puskesmas, and the doctor is only
one, so it’s impossible for us to give education to the patient, it takes too long... and when you are just
alone, you have to handle hundreds of patients, until what time do we have to work?, so that’s why we
never explore deeper, we focus more to the main complaint… (R3).

Lack of infrastructure

Violence case is sensitive, so everyone is not willing to reveal it publicly. The availability of the
counseling room is needed, but not every Puskesmas has it. An examination room at the Puskesmas was
an open room, which was almost always full by medic and paramedic staffs. This situation prevented the
patients from expressing their problems and receiving appropriate supports they needed.

“One room for two programs, that situation made the patient unable to tell us the story. We couldn’t
even determine whether she is “miss or Mrs.,” they became ashamed because there were so many
people in the room, two doctors, nurses, and also male nurses” (R3).

“We take the patient to a special room; we have HIV counseling room, or Nutrition Counselling room,
whatever empty room available for us to be able to interview the patient privately” (DF6).

Visum et Repertum (VeR) or forensic medical examination cannot be conducted in Puskesmas

This issue was brought by the confirming person who compared the situation between Malang regency
and Malang city. The forensic medical examination is one of the legal aspects needed when the victims
of violence want to proceed with litigation. This procedure affected more to the violence victim, not to
the Physician.

Attention scarcity

The violence against women intervention program did not get adequate attention. This was shown
through the minimal participants who attended the FGD invitation. The FGD was only attended by five
physicians (33%) and three people from P2TP2A & Women Crisis Center. The reason stated by one of
the physicians who was not attending the FGD mentioned that many papers on her desk buried the
invitation. During the discussion, one of the participants also stated that violence against women
program was not part of the routine meeting agenda since it was not a priority program.

“It is not included in the meeting because it’s not a “sexy program,” so it’s neglected a little bit” (CP2).

Discussion

The health sector holds an important role in intervening the violence against women cases since the
survivor who had physical injury will most likely access healthcare services [12]. Unfortunately, in
Indonesia, the health sector pays little attention to VAW intervention programs, and the lack of
coordination adds to the catastrophic conditions.

The guideline released by UNFPA and several other UN agencies in 2015 mentioned there were six
points that can be provided by essential healthcare services, namely [1] identification of survivors of
intimate partner violence, [2] first-line support, [3] care of injuries and urgent medical treatment, [4]
sexual assault examination and care, [5] mental health and assessment and care, and [6]
documentation. Those services will be able toprovided by any health provider who
WHAT YOU CAN DO TO PREVENT VIOLENCE AGAINST WOMEN

While both men and women can be victims of violence, violence against women, often at the hands of
men, is a unique category of violence that relies on the historical and current unequal balance of power
between men and women, boys and girls. Violence against women is the crucial element that reinforces
men’s power and control over women throughout the world. On some level, most of us participate in
the culture that supports and encourages violence against women and girls, in both small ways (like
telling our friends to “man up” when they have to do something difficult) to large ways (beating and
raping women and girls). Here are some small and big ways we can work to end it, or at least interrupt
it, every single day.

For everyone:

Educate yourself on violence against women; learn the facts and the prevalence

Believe survivors

Contact your local legislators and political leaders and advocate for tougher laws against perpetrators of
violence against women

Know that dating violence & sexual assault affects 1 in 3 girls and 1 in 6 boys by the time they are 18

Contact your local school board and ask them to address sexual harassment in schools

Speak out against all forms of violence

Question gender roles and assumptions

Respect and embrace diversity

Respect a person’s-even a child’s- right to say no

Respect your partner’s right to disagree or have their own opinion

Don’t blame victims, and reinforce that rape is never the victim’s fault

Strive for equality for everyone

Understand that putting boys and men down by calling them “ladies” and “girls” hurts everyone

Speak out against the media’s portrayal of violence

Learn how racism, sexism and homophobia are connected

Acknowledge that it does happen in your own community

Learn about power and control tactics

Attend Take Back the Night events

Ask permission before pursuing physical or sexual contact with someone

Realize that sexual violence is about power and control, not sex

Teach kids that respect is the minimum in a relationship, and lead by example

Advocate for victim’s rights

Ask your priest, rabbi, pastor, cleric, or spiritual leader to hold a special service to raise awareness and
promote safety for victims and accountability for perpetrators.

Avoid engaging in, supporting or encouraging sexual harassment by speaking up when you see or hear it

Teach kids that violence will not solve problems

Know that most sex offenders aren’t strangers · 86% are known to their victim

Avoid making threats or using coercion and pressure to get sex

Be courageous; don’t be afraid to speak up for those who have lost their voice or dignity

Praise women and girls for something other than the way they look

Speak out against racist, sexist or homophobic jokes

Advocate for more youth violence prevention programs

Get others to speak out against sexual violence

Stop your sexual advances if the other person says no and encourage others to do the same

Avoid buying music that glorifies sexual violence and the objectification of women and girls

Urge your local radio stations to stop playing music that contains violent lyrics

Applaud others who speak out against violence and oppression

Invite a speaker from HAVEN to share with your class, work or community group
Pledge to never commit or condone acts of violence

Stop yourself or others from taking advantage of someone who is intoxicated

Make a decision to become an active bystander by speaking up and calling for help when necessary

Respect the choices victims and survivors make to survive

Encourage your local college and universities to offer prevention education to students

Empathize

Work toward eliminating oppression of all kinds

Think globally and act locally

Hold perpetrators accountable for disrespecting their partners when you see it or hear it

Engage others in discussions about violence against women

Learn about healthy boundaries and don’t be afraid to voice your feelings in your relationship

Notice when someone invades your boundaries

Report it if you witness sexual harassment in your school or workplace

Post awareness materials in restrooms and break rooms for easy & confidential accessibility

Celebrate all aspects of masculinity, including compassion and sensitivity

For men:

Choose your words carefully and respectfully when speaking of women in your life

Show your strength by speaking up to men who are using their strength for hurting

Refuse to let TV, movies, music or other people define what it means to be a man for you

Understand that it takes more than just not being a batterer or a rapist to be a good guy

Treat all women and girls with respect

Don’t patronize sex workers or strip clubs

Ask, don’t assume you know what your partner wants

Get involved with the Men Can Stop Rape movement at www.mencanstoprape.com
Refuse to coerce or manipulate your partner in order to get your way; be willing to compromise

Retrieved from

http://www.haven-oakland.org/wp-content/themes/haven/media/pdf/what-you-can-do-to-prevent-
violence-against-women-fact-sheet.pdf

https://www.marshall.edu/womenstu/stop-abuse/what-you-can-do-to-prevent-violence-against-
women/

Who is considered a child under R.A. No. 7610?

A child one who is below 18 years of age or one who is over 18 years of age but who cannot take care of
himself fully because of a physical or mental disability or condition.

What is child abuse?

It is any act which inflicts physical or psychological injury, cruelty to or the neglect, sexual abuse of, or
which exploits, a child.

What is cruelty?

It is any word or action which debases, degrades or demeans the dignity of a child as a human being.

Is discipline administered by a parent or legal guardian on a child considered cruelty?

No, if it is reasonably administered and moderate in degree and does not cause physical or psychological
injury.

What physical injury is considered as child abuse?

One that causes severe injury or serious bodily harm to child, such as lacerations, fractured bones, burns
or internal injuries.

What psychological injury is considered as child abuse?

One that harms a child's psychological or intellectual functions. This may be exhibited by severe anxiety,
depression, withdrawal or outward aggressive behavior or a combination of said behaviors.

What is child neglect?

It is failure of a parent or legal guardian to provide, for reasons other than poverty, adequate food,
clothing, shelter, basic education or medical care so as to seriously endanger the physical, mental, social
and emotional growth and development of the child.

What is child sexual abuse?

It is the employment, use, persuasion, inducement, enticement or coercion of child to engage in, or
assist another person to engage in sexual intercourse or lasciviousness conduct or the molestation or
prostitution of, or the commission of incestuous acts, on, a child.

What is child exploitation?

It is hiring, employment, persuasion, inducement, or coercion of child to perform in obscene exhibitions

and incident shows, whether live, on video or film, or to pose or act as a model in obsence or
pornographic materials, or to sell or distribute said materials.

Where can I report child abuse cases?

You may report the matter to the:

Department of Social Welfare & Development or to the Child Health and Intervention and Protective
Service (CHIPS) Tel. No. 734-4216
Anti-Child Abuse, Discrimination, Exploitation Division (ACADED) National Bureau of Investigation Tel.
Nos. 525-6028/525-8231 loc. 403 & 444

Commission on Human Rights Child Rights Center Tel. No. 927-4033 (Mon-Fri during office hours)

Philippine National Police Operation Center Tel. Nos. 712-8613/722-0540 & 724 8749 or nearest police
station

DOJ Task Force on Child Protection, Tel. Nos. 523-8481 to 89 or contact the nearest Provincial, City or
Regional Prosecutor

Local Barangay Council for the Protection of Children

https://www.doj.gov.ph/child-protection-program.html

Description:

The Mental Health and Substance Use Unit, in collaboration with the PAHO Caribbean Program
Coordination (CPC) Office, hosted a virtual seminar as part of the Caribbean Mental Health Roster
MHPSS and COVID-19 biweekly webinar series. The topic discussed was violence against women and
children (VAWC) in the context of the COVID-19 outbreak.

Objective(s) of the meeting:

To discuss violence against women and children (VAWC) in the context of the COVID-19 outbreak.

Brief synthesis of the topics:

Globally, 1 in 3 women have experienced lifetime physical and/or sexual violence, with the most
common form being intimate partner violence. The physical and mental health consequences of these
types of violence are substantial. Violence against women tends to increase during every kind of
emergency, including epidemics, making it important for countries in the Region to be aware of and
prepare to address this issue during the COVID-19 pandemic.

In the context of the COVID-19 pandemic, the isolation and physical distancing measures widely
recommended to prevent the spread of the virus have a particularly acute impact on women and
children experiencing family violence. This can be explained by an increase in the risk factors for
violence (e.g. stress, economic worries, alcohol), and a decrease in protective factors, including social
support and access to protection services.

The health sector plays an important role in preventing and addressing VAWC during the pandemic.
VAWC services should be framed as essential services during COVID-19 pandemic, and funded
accordingly. Health facilities can identify and provide information about services available locally for
survivors, as well as strengthen online service delivery – including mHealth and telehealth. Frontline
healthcare providers should know the risks and consequences of violence in the context of COVID19 and
how to identify women and children subject to violence, provide first line support and appropriate
medical treatment, and consider mental health assessment and care.

As community members, we must all be aware of the increased risk of violence during this time,
acknowledge that violence is never justified, and support survivors of this violence in safe ways.

https://www.campusvirtualsp.org/en/webinar/violence-against-women-and-children-context-covid-
19#:~:text=The%20health%20sector%20plays%20an,addressing%20VAWC%20during%20the
%20pandemic.&text=Health%20facilities%20can%20identify%20and,delivery
%20%E2%80%93%20including%20mHealth%20and%20telehealth.

Issue and concern in the Philippines

Despite the gains, there is still a long way to go in breaking the patriarchal mindset that normalizes
violence."

The pandemic brought not only health and economic challenges but also heightened tensions at home
that have likely led to an increase in domestic violence.

Recently, the Commission on Population and Development (Popcom) renewed its call for the protection
of Filipino women after a recent Social Weather Stations survey showed that 1 out of 4, or 25 percent, of
Filipino adults nationwide cited violent acts against women as among the most pressing concerns of
women during the pandemic.

Of the 25 percent of Filipinos nationwide, 11 percent mentioned physical violence as a concern, while 7
percent cited sexual violence and 7 percent, emotional violence.

The figure was higher for Manila: 29 percent (13 percent physical, 7 percent sexual, 9 percent
emotional). In the rest of Luzon, it was 28 percent (13 percent physical, 7 percent sexual, 8 percent
emotional).
In Mindanao, 24 percent of respondents gave similar answers (11 percent physical violence, 5 percent
sexual, and 8 percent emotional); in the Visayas, it was 22 percent (6 percent physical, 11 sexual, 5
percent emotional).

While I can’t find violence against women (VAW) crime statistics online for 2020 (the year the pandemic
hit), the Philippine Commission on Women (PCW) said in December last year that calls and emails to
their agency during that period tripled.

PCW Deputy Executive Director for Operations Kristie Balmes said in a Laging Handa briefing that month
that while Philippine National Police (PNP) reports of VAW acts for last year had gone down, “ang mga
barangay po ay nakakapagsabi na tumaas po ang bilang ng VAW reports na natatanggap nila. [The
barangays can say that the number of VAW reports that they received have increased.]

“At ang PCW mismo, meron po kaming VAW referral services, halos naging triple po ang naging dami ng
complaints at sumbong.” [And (at) the PCW itself, we have VAW referral services, the complaints have
tripled.]

It is understandable that the PNP reported a decrease in VAW cases during the extreme community
quarantine (ECQ), because women found it difficult to access the PNP’s services, which were stretched
thin at the time as many policemen were put on lockdown implementation and patrol duty.

It was easier for women, many of whom could not leave their homes as lockdown rules permitted only
one person per household to go out for food and other supplies, to call or email the PCW and other
agencies for help.

Writing for UCANews in October last year, Peter Joseph Calleja cites Quezon City Mayor Joy Belmonte as
having told reporters that from March 17 to May 23 last year, the height of the ECQ, that 602 women,
an average of eight per day, were maltreatred or raped across the country. I would say the actual
number is much higher as many cases went unreported.

Belmonte added in that same interview last October, the QC women and children’s desk “receives at
least 12 complaints of domestic abuse per week” and that before the pandemic, there were around five.

As Vice President Leni Robredo said in her International Women’s Day speech on March 8: “Cases of
domestic violence continue to rise. Under the shadow of the pandemic, reproductive health services
have been hampered, and lockdowns have trapped survivors at home with their abusers, with little in
terms of a lifeline to the outside world.”
For its part, the Commission on Human Rights, as official Gender Ombud of the Philippines, underscores
“the importance of ensuring gender-responsive interventions, including survivor-centered responses to
gender-based violence,” said CHR Commissioner Karen Gomez-Dumpit in her Women’s Day message.

On the other hand, Popcom has also highlighted the gains the country has made in “championing the
cause of women, evidenced by its high worldwide ranking in women empowerment and gender
equality,” said the agency’s Undersecretary Juan Antonio Perez III.

“The World Economic Forum’s Global Gender Gap Index places the Philippines at 16th—the only one in
Asia in its Top 20—as the country is performing excellently in closing the gender gap when it comes to
economic participation and opportunity, educational attainment, health and survival, and political
empowerment,” he added.

However, he also pointed out that “these achievements, however, are counterbalanced by the
prevalence of gender bias, as well as incidences of GBV (gender-based violence) — especially in the time
of Covid-19.”

Despite the gains, there is still a long way to go in breaking the patriarchal mindset that normalizes
violence by men against wives, daughters, and other women in the home. There is no justification for
inflicting harm and abuse on family and household members. None at all.

https://manilastandard.net/opinion/columns/pop-goes-the-world-by-jenny-ortuoste/349238/violence-
against-women-a-major-concern-during-pandemic.html

Five ways governments are responding to violence against women and children during COVID-19

Evidence to Policy Violence Against ChildrenBy Alessandra Guedes, Amber Peterman, Dina Deligiorgis

8 April 2020

While the world may have been caught off guard by the size and ramifications of the COVID-19 crisis, it
should be prepared to respond to the increased risks to the wellbeing and safety of children and
women. Violence against children and violence against women are widespread globally and intrinsically
linked, sharing common risk factors and similar adverse and severe consequences. The literature within
pandemics may be limited, but we have enough evidence to say unequivocally that related factors—
such as confinement, social isolation, increased levels of financial stress, and weak institutional
responses—can increase or intensify levels of violence.

Indeed, over the past month, reports have warned of the “perfect storm”, manifesting in increased calls
to helplines, online support services, and police reports.

Indeed, over the past month, reports have warned of the “perfect storm”, manifesting in increased calls
to helplines, online support services, and police reports. Multinational organisations quickly took action,
issuing statements warning of increased risk of both forms of violence, while researchers reviewed
evidence from past crises, proposing policy actions to mitigate against potential harm to populations in
situations of vulnerability.

As governments ramp up response to COVID-19, what is actually being done to combat violence?

1. Expansion of helplines and information sharing

Information is being shared widely through guides, resources, and advocacy targeting friends and family
members. Parenting for Lifelong Health has compiled evidence-supported guidance for safe parenting
during quarantine. Helplines and online support platforms are being expanded or established. Italy, one
of the countries hardest hit by the pandemic, is preventing “an emergency within an emergency” by
advertising the 1522 helpline for violence and stalking. Numerous other countries are committing to
keeping helplines and information channels open during and after the peak of COVID-19.

2. Funding shelters and other safe accommodation options for survivors

Numerous countries have acknowledged that additional safe housing is needed during times of
quarantine. Safe accommodation allows survivors (and accompanying minors) to temporarily escape
abusers. As part of its COVID-19 relief package, Canada has allocated $50 million to women’s shelters
and sexual assault centres [March 18]. In France, a €1.1 million funding increase for anti-abuse
organisations included 20,000 hotel nights for survivors to escape abusive partners [March 30]. In
Trento (Italy), a prosecutor ruled that in situations of domestic violence the abuser must leave the family
home rather than the victim [March 28]. Similar rulings have been given in Austria and Germany.
Although a laudable decision, it makes guaranteeing the safety of survivors, who remain at home a
challenge given that perpetrators know where to reach them and may have access to the home.

3. Expansion of access to services for survivors

As quarantine limits personal mobility and freedom of movement, some countries are finding ways to
expand access to violence-related services. France has initiated ‘pop up’ centres in grocery stores, where
women are likely to be already visiting [March 30]. In a number of countries (including France, Italy, and
Spain), a specific ‘code word’ signals to pharmacies to contact the relevant authorities. Some countries
have released or improved concealed apps through which women can seek services to avoid calling in
close quarters with abusers (see Italy, UK, among others). Protection services for women and children
must be considered “essential” and not locked down due to COVID-19.

4. Limiting risk factors associated with violence

Some countries are tackling the negative ways of coping with COVID-19 that may exacerbate the risk of
violence. Greenland has banned alcohol sales in its capital Nuuk to reduce the risk of violence against
children in the home [March 29]. South Africa has taken similar measures [26 March]. While alcohol
abuse and problematic drinking is shown to be linked to more severe violent episodes, the relationship
is complex and there is limited evidence of how alcohol-related policies affect violence. Other countries,
however, have yet to take proactive steps to limit associated risks. Curtailing gun sales, for example,
would limit access to fatal weapons at a time of heightened stress, potentially reducing the risk of
female homicide and child deaths. Smart policy action can reduce risk of harm and facilitate positive
outlets to reduce stress and promote mental health.

5. Modifications to family law and justice systems

Australia has implemented a number of modifications to family law to allow the justice system to better
respond to cases during quarantine [April 3]. First, they allow courts to impose electronic monitoring
requirements for bail and conditionally suspend imprisonment orders. Second, they enable online filing
of restraining orders. Third, they create a new offence, increased fine, and extended limitation period
for restraining orders. As more countries experience extended periods of curtained justice services,
further innovation and amendments are needed to ensure the protection of survivors in challenging
situations.

These actions are commendable, however many countries have still not committed resources to
increase services. Initial policy responses are largely in high-income countries, which may reflect the
reality that many resource-poor settings have limited budgets for addressing violence against children
and violence against women even when there is no crisis.

Where and how should resources be targeted? While reported cases and numbers from existing services
give us a signal of what might be happening, they also give an imperfect picture. For example, in some
settings, calls to domestic violence hotlines have decreased, possibly because survivors are in ear shot of
perpetrators in quarantine and are unable to safely seek help. In others, demand for shelters has
decreased, potentially because survivors are afraid of contracting COVID-19 within close quarters at
shelters. In addition, some routine detection systems are closed, such as teachers or social workers.
Already in the US, several states have reported reductions in child abuse and maltreatment, believed to
be due to a reduction in detection, rather than occurrence.

Further, increased time spent on phones and using computers to communicate in place of in-person
interactions also poses additional avenues for perpetration of new forms of violence online, including
sexual harassment, exploitation, and abuse. Mitigation efforts must address the diverse forms of
violence connected with COVID-19. Actions taken must be continuously monitored to ensure they are
having intended effects, and do not result in unintended harm.

For many women and girls, the threat looms largest where they should be safest. In their own homes.”
As the UN Secretary-General urgently calls for peace in homes around the world, we hope that this non-
exhaustive list of government responses will provide some inspiration for further action. When it comes
to preventing and reducing violence and supporting survivors, everyone has a part to play, particularly in
these unprecedented times.

https://blogs.unicef.org/evidence-for-action/five-ways-governments-are-responding-to-violence-
against-women-and-children-during-covid-19/