silencio de las propias mujeres y del entorno social próximo, reflejan una realidad que estremece. En este sentido, estudios vigentes indican que la mujer permanece en la relación violenta una media de diez años antes de denunciar (Echeburua, Sarausúa, Zubizarreta, del Corral, 1990). Abril (1999), Benítez (1998), UNICEF (2000), Watts y Zimmerman (2002) apuntan las razones que contribuyen a redu- cir la probabilidad de denunciar: el miedo a conti- nuar o reanudar la convivencia con el maltratador después de la denuncia, la falta de confianza en el sistema judicial, la dependencia económica, la dependencia afectiva, la resitencia a aceptar el fraca- so en la relación, los sentimientos de culpa y ver- güenza, la consideración de que el problema perte- nece al ámbito privado, entre otras. Corral (2000) resalta la importancia de la dependencia emocional, del aislamiento social y de la dependencia económi- ca de la mujer. Strube y Barbour (1984) el compro- miso matrimonial a aceptar y someterse al marido, la dependencia económica, la falta de empleo y el no tener donde ir. Otros estudios indican que el bajo nivel cultural, -ya que aproximadamente la mitad tiene estudios primarios- y la baja preparación labo- ral, especialización laboral - labores domésticas la ocupación principal- como causas que determinan que una mujer permanezca en la relación de violen- cia (Departament de Benestar Social, 2001).
This is a quanti-qualitative study that had as purpose to understand the limits and the possibilities of action by integrants of family health teams on domesticviolence against women in search of appropriate ways to give visibility to this problem in the scope of the health services. Its specific objectives were: to identify the conceptions of violence by women who had lived in violent situations in the domestic space, to apprehend which could be the expectation of the women when searching the health service after suffering domesticviolence, identify the limits of action of the health professionals dealing withwomen under domesticviolence, and to analyze the gender´s view and the perception of the family health team in relation to the domesticviolence against the woman. In this study the categories gender and type of violence were used as theoretical and methodological referential for the social constructs. For the data analysis it was used the methodology proposed by Bardin and Minayo and the recommendations of Bourdieu for the construction of the histories of the women. The research was developed in two stages. The first one had as subjects pregnant women attended in the Centro de Saúde Padre Fernando de Melo in the city of Belo Horizonte, evaluated through the observation, the application of a closed questionnaire with 64 questions and 12 half-structuralized interviews. The information obtained subsidized the development of the second stage of the research. The second stage was developed through a workshop with fifteen professionals of the family health team above mentioned having as the purpose the perception and positioning of the professionals dealing with situations of domesticviolence against the women. In this workshop information on the limits and possibilities of approaching the domesticviolence in the health services were collected. The results show that women and health professionals when do not recognize the domesticviolence do not contribute to prevent it, what then becomes a present and recurrent problem in the health services. The results also show the potentiality of the workshops in the collection of data for research, articulated to the critical analysis and approach of the domesticviolence in health services facilities and programs.
Rooted in collective memory, physical aggression in the central nucleus also has meaning in the professional practi- ce since it is the most common way for the nurses to recog- nise the victimised woman. Care can assume a clinical natu- re and give priority to treating injuries without observing the subjectivity of women. The perceptions of health workers re- garding the object, however, gain expression and visibility in a more amplified conception of the phenomenon, through the use of the words “contempt” and “humiliation”, and open the possibility of a different representation in the contrast zone, embodied in the term “verbal aggression”.
who had sought help from the authorities or authority ﬁ gures (police department specialising in assisting women, religious leaders, women’s groups, local leaders, refuges, lawyers and social, health and police services) were asked if they would recommend them to a sister suffering domesticviolence. The general police station was that which had the lowest levels of recommendation. These services should offer profes- sionals committed to providing quality service and with the understanding necessary when dealing with the complex phenomenon of violence against women. Of the women in this study who sought help, 23.7% turned to the DEAM. In São Paulo, 16 this was the main
The following data obtained from the medical records of these women were recorded: age; level of schooling level; marital status; profession; location of aggression/violence; previous record of sexual violence; time elapsed (in hours) between sexual violence and medical treatment Caism; whether another health service was sought before Caism; existence or not of police report of occurrence; genre; age of aggressor; existence of a family relationship between the victim and the aggressor; occurrence of penetration (partial or complete introduction of the male genital organ into the vaginal canal) or libidinous act (any act other than penetration capable of producing sexual arousal or pleasure) in sexual violence; existence and severity of personal injuries resulting from sexual violence (this variable follows the definitions of article 129 of the Brazilian Penal Code); occurrence of pregnancy due to sexual violence; infectious diseases caused by sexual violence and whether urgent protective measures were followed; record of psychological or psychiatric disorder resulting from sexual violence; whether the aggressor used violence (physical force) or serious threat (intimidation) to bring about sexual violence; if the perpetrator used deception to reduce or prevent the free expression of will of the victim; if the perpetrator misled the victim by deception, trickery, or any other means of fraud that would reduce or eliminate the victim’s ability to respond to or express desire or intentionality with regards to engaging in sexual violence; if the aggressor had a superior hierarchical condition than the victim; whether the offender obtained or attempted to obtain any economic advantage; record of the type of care received in the period (doctor, nursing, psychological, social assistance, legal/judicial counseling or any other).
This was a qualitative exploratory study with the objective of identifying perceptions and practices among health professionals in Angola concern- ing intimate partner violence against women. Semi-structured interviews were held with a se- nior health administrator, head nurses, medical directors, psychologists, and nurse technicians in three national hospitals in the capital city of Luanda. The perceptions of Angolan health pro- fessionals towards violence against women are marked by the cultural construction of woman’s social role in the family and the belief in male superiority and female weakness. Despite their familiarity with the types of violence and the consequences for physical and mental health, the health professionals’ practices in providing care for women in situations of violence focus on the treatment of physical injuries, overlooking the subjectivity and complexity of these situa- tions. Recent inclusion of the issue in public pol- icies is reflected in health professionals’ practices and raises challenges for the health sector in car- ing for women in situations of violence.
“I can’t go to my health center, I can’t take my girls there [...] because people aren’t prepared for that, there they’ll just discriminate against me and give me grief: ah! What’s her name there with HIV.” (M5). One of the biggest challenges for primary health care teams is broadening the way they look at the subject receiving care, to include family and community. Looking at the social-historical process of family organization, domestic spaces and care were centered around women, their fear of having the infection revealed and not establishing a trusting relationship with the health care professionals came to limit health care for the family and for their children.
Objective: The study’s purpose has been to understand domesticviolence against women under the perception of Family Health teams. Methods: It is a descriptive study with a qualitative approach, which was performed with 24 professionals from Family Health Units located in a municipality from the Bahia State countryside, Brazil. Data collection took place through semi-structured interviews designed according to the thematic content analysis. Results: Physical and psychological violence were the most common forms of domesticviolence against women, with alcoholism, jealousy and macho culture as triggers for aggression. Gender and power relations were evidenced in the context of violence. Conclusion: Therefore, it is possible to underline the need for training of the Family Health teams in order to identify and adequately handle cases of domesticviolence against women, aiming for comprehensive care.
In addition, one of the main problems about the difficulty that health professionals, particularly physicians, have in dealing with victims of gender violence is the fact that the issue is not adequately addressed during their training. These issues, when discussed at undergraduate level, are usually not politically and socially contextualized, being traditionally approached in the fragmented biologistic model, in which there is no correlation between health and social reality. Thus, professionals feel paralyzed by subjective issues such as emotional frailty and lack of protection, common in victims of domesticviolence 2,16,21 .
PLoS Medicine | www.plosmedicine.org 009 protection reporting, whereby health providers must report such disclosures to child protection authorities. This can lead to an investigation that potentially increases a woman’s risk of exposure to violence, and in some cases of having her children placed in foster care. Research has shown that many of these potential harms are of concern to women when mandatory universal screening and/or reporting protocols are in place . Finally, from a health system perspective, the opportunity cost of not having used this time with the woman to conduct screening or prevention activities for which there is proven benefi t, such as counselling about Pap smears or mammograms, should not be discounted.
The goal of this study is to describe the ex- perience of female victims of domestic vio- lence, who forfeited the lawsuits against their aggressors. The interviews were ori- ented by the question: What was your ex- perience of forfeiting the denunciation of your aggressor? Three themes emerged from the convergence of the testimonies: time passed from the aggression to the de- nunciation and then to the forfeiting; the partner, the family, the women’s precinct; reflecting about the experience, which de- scribed the studied phenomenon. The women expressed ambiguous feelings for their aggressor: affection, anger, humilia- tion and fear. They recognize that they are dominated and humiliated, but notions of justice and equality between spouses do not appear in the testimonies. Forfeiting can be understood in the context of the reproduction of the traditional family struc- ture, conditioned to economic and social factors. Results highlight implications about the role of the Women’s Precinct and the healthcare institutions in the care for women who were victims of domesticviolence.
The newspaper items reveal that Amazon women are victims of violencewith cruelty in the most diverse situations. The media explicitly and clearly describe the events to the whole population and it influences society’s opinions and contributes to its education. This is somewhat indicative of the fact that the perspective of world is more important than words, that is, social facts need to be transformed into information with accessible language to the population and reach diverse places (8) . The reports’ contents indicate that many times women had no chance to defend themselves and were at the mercy of their aggressors, who attacked the most vital body parts, that is, head, chest and abdomen. These aggressions are reported in the newspaper as violence that, depending on its intensity, ended in homicide. It is thus essential to disseminate social problems and rights and the print press is a vehicle that can form public opinion.
The sample consists of 226 skulls from the Atacameño cemetery of Coyo Oriente (639-910 AD), associated with the Tiwanaku period. The authors analyzed signs of acute trauma typically associated withviolence, and the results were 12% of men and 9.9% of women displaying any type of lesion related to violence. In males, concentration of these non-lethal lesions in the nasal region (10.4%) as opposed to a random distribution over the entire skull (1.6%), suggests that the blows were struck during rituals. The cultural context of this period, with a strong ideological influence from Tiwanaku, supports the ritual hypothesis, since both the ethnographic as well as archeological records point to the existence of non-lethal violent bleeding with ritual beating to the face. Such rituals persist to this day among certain Andean populations. Among women, the most plausible hypothesis for the lesions (3.9% in the skull, 4.9% in the nasal bones, and 0.9% in the face) is domestic con- flicts, since they show a random distribution. Previous studies with other Atacameño samples had indicated the same results for women.
La institución y la implementación del sistema de protección especial establece a través del ENA, en Ribeirao Preto, la creación de programas y servicios de atención a niños y adolescentes en “riesgo personal y social”, siendo efectivos, pues reciben denuncias de violaciones de derechos contra niños y adolescentes, como se evidencia en el análisis del servicio, en donde utilizan estrategias las cuales requieren de un conjunto integrado y articulado de acciones de orden económico, cultural, político, legal, policial, y terapéutico a corto, mediano y largo plazo, tanto para la prevención como para la denuncia, defensa y atención de las victimas, así como con respecto a la responsabilidad de los agresores.
The father enters the silent house late at night. The mother and two daughters, aged 5 and 8 years, are watching TV in the children’s bedroom, in the dark and quietly. They hear the noise of the entrance of the father – the key in the lock, the steps toward the room, and the silence sinks in apprehension. He walks into the room where they are, turns the beds, one of them over the older girl, on top of her nose, which bleeds. Nothing is said, the mood is of muted and paralyzing terror. He leaves. The silence of mother and daughters with the father comes from several days and foreshadows the departure from home. The terror is extended beyond these days and the ones of separation. At the sight of the father, each time, the girls are taken by anxiety and by the desire that this meeting would not occur. One day, in an unexpected meeting in the street, the father strongly holds the younger girl, who struggles with fear, trying to escape from the scary hug. Impossible, as the father is much bigger and stronger. The experience of the child is of des- peration and annihilation. (Oral report collected from family psychotherapy session)
Abstract This article characterizes the services providing care to victims in five Brazilian regions with high violence and accident rates. It analyzes care activities and strategies, the profile of the teams, the conditions of installations, equipment and supplies, integrated care and registration ser- vices and the opinion of health managers with re- spect to the needs and requirements for a better care to the victims. The sample is composed by 103 services: 34 from Recife, 25 from Rio de Ja- neiro, 18 from Manaus, 18 from Curitiba and 8 from Brasília. The still preliminary results indi- cate: lower number of services focusing on the el- derly; scarce investment in preventive actions; the principal actions carried out are social assistance, ambulatory and hospital care and psychological assistance; patients received from Basic Health Units require attention of the communities and families; need for investment in capacity building programs for professionals; precarious registries, data handled manually. The wording of the Na- tional Policy for Reduction of Morbidity and Mortality from Accidents and Violence is not well- known and there is a lack of articulation among and inside sectors and between prehospital and emergency care services. Rehabilitation services are insufficient in all cities.
In the statements above shows the expression of psychological scars. One of the participants speaks with regret of your relationship, sorrows of abandonment and the vile, and disbelief in another relationship. Another brings in depth their feelings and talk about your distress and verbalize the loss of identity and the mismatch with real life. But his strength persists to look at him as a being of value and feel that way, the woman gets you new hope to proceed. The impacts generated by violence are numerous, but what we perceive in the speeches is a gradual change of thoughts that once presented to the present day.
It is important to emphasize that in this work, we do not be- lieve that violence is a personality trait related to male or female sex, much less that genetic traits determine that men are more violent and women more fragile and submissive, as this would reinforce a very common stereotype, still used to justify the current situation of domesticviolence against women. Instead, what we want with this relection, that is to defend the violent streak will form with the construction of gender, which in turn is linked to the way of living and surviving in each society. As already mentioned, the violence is socially and historically constructed. Naturalizing it, therefore, is to deny that there are eicient ways of intervention. In the ield of public health, which is based on the theory of social determination of health-disease process, health and disease are two sides of the same coin. One does not deny the biological ballast that each individual brings, but every social group has the potential of detrition or consequential protection from the forms of production and social reproduction, in which he lives. So we chose to work within the line of reasoning of the concept of vulnerability.
Vários são os fatores a se considerar nos casos de violência contra a mulher, pois em uma sociedade culturalmente patriarcal, em que as meninas são educadas para serem mães e esposas zelosas, ter um relacionamento afetivo estável e “garantidor de felicidade plena” é um sinal social de sucesso na vida afetiva/privada. Contudo, a culpabilidade deste “insucesso” ou “fracasso” no relacionamento é frequentemente imputado à mulher. Neste sentido também, mulheres solteiras são mal vistas socialmente, a elas são imputados termos pejorativos como “solteironas”, “encalhadas”, “infelizes”, “mal-amadas” e que “vão ficar para titia”, o que colabora para que a mulher repense o fim de relacionamentos abusivos ou violentos por conta da pressão social de cunho machista.