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Healthcare & Domestic Violence: Institutional Collaboration & Good Documentation Key to Efficient Protection

20150310 122722 CopyThe last of the seven workshops concerning the role of healthcare in protecting women from domestic and partnership based violence has been held today in Novi Sad. The Vojvodina Public Health Institute hosted around thirty representatives of primary healthcare units, hospitals, the Public Health Institute, patients' rights protectors and members of the Healthcare Councils with the local self-governments in the South Backa District.

The introductory presentation of the Assistant to the Provincial Secretary of Healthcare, Welfare and Demographics Danijela Stankovic Baricak, MD, addressed the domestic violence indicators, healthcare implications and options for its prevention. If they want to provide adequate support and prevent this phenomenon, healthcare staff, esp. those dealing with women's health, must be well introduced to all these and recognize them as a consequence of violence, a process not always straightforward. A research survey of the Provincial Secretariat concerning the response of healthcare in the Autonomous Province of Vojvodina (APV) to domestic violence indicated a need for education of healthcare staff in applying the Protocol for documenting violence cases and initiating further proceedings. Only timely detection and detailed documentation of domestic and partnership based violence cases will provide for a better comprehension of the consequences and proportion of this phenomenon and efficient implementation of prevention measures. 

After the 2008-2012 Strategy for Protection from Domestic Violence, Vojvodina is the implementation area of the 2015-2020 Program for Protection of Women from Domestic and Partnership Based Violence, presented by Biljana Delic, the Head of Planning and Analysis Section in the Provincial Secretariat. The significance of these strategic documents is in their specification of institutional measures to undertake at the regional and local level, the ones that the persons experiencing violence usually address first. Reflecting on the measures pertaining to healthcare, Delic pointed out that, as of this year, the Program should provide for application of the Protocol in healthcare services and systematic documenting of domestic and violence against women.

Vasa Petrovic, MD, PhD, the General Manager of the Primary Healthcare Unit in the Municipality of Indjija, holds that women addressing doctors for domestic or partnership based violence should be addressed and treated as emergency cases because they are under a high health and security risk. Along with good practice examples in protecting women experiencing domestic violence, Petrovic spoke about practical aspects of determining the type of injuries and circumstances under which the violence occurred. Documenting these data in the primary healthcare units and collaboration with other authorities and services in charge are preconditions to consolidation of a functioning victims' protection system and their empowerment to report violence at all. The example of Indjija, with its primary healthcare unit providing prevention and women's empowerment educational programs to over 8.000 women over the course of the last couple of years, is also an illustration of the potentially crucial role of healthcare in the women's education both on their rights and mechanisms of protection from violence. In a responsible society, this is the way to send a message both to the perpetrators and the wider community that violence, esp. domestic and partnership related, must and will not be tolerated.

The provincial 'Life without Violence' network, coordinated by the Provincial Protector of Citizens - Ombudsman (PPCO), has substantial experience in dealing with complaints concerning handling domestic violence affected people by the healthcare. The Gender Equality Deputy Ombudswoman Danica Todorov holds that healthcare units are withheld in their response to domestic violence. In spite of significant steps forward over the last years and very good examples of efficient handling and supporting violence victims by the healthcare, it is evident that healthcare staff does not realize the significance of their role in detecting and documenting domestic and partnership based violence cases. Experience has shown that victims addressing the healthcare first often refrain from reporting these incidents to the police. Once Andrijana Covic, the PPCO Associate, has presented examples of the institution's acting upon complaints of women experiencing violence mishandled by the healthcare, it has been concluded that it is necessary to improve on the collaboration among the healthcare and welfare services, the police and the prosecutor's offices constantly in order for violence victims to gain trust in the institutions and get empowered to face it.

The discussion among the workshop participants tackled the interrelation between lifestyle, including diet, and domestic violence. Lifestyle is affected by the society's value system, so the seemingly higher number of documented domestic violence cases against women in our society is a result of victims' reporting the incidents more frequently nowadays rather than that of increase in the incidence of violence itself. Violent model of behavior is being tolerated and insufficiently, inadequately prevented and sanctioned in our society. The victims ask for help because they cannot stand it anymore, fearing for their own and lives of their family members and not necessarily because they are aware of their rights or consider violence against them as women - or individuals with less power - unacceptable. This is why education about non-violence from the earliest age is so important. It should focus on the detrimental effects of violence for the society in general, as well as on the specific steps to be undertaken when meeting a person who has experienced violence. Education is necessary both to the staff of the institutions in charge, women and other people experiencing it themselves and, finally, the general public.

The awareness raising campaign aimed at healthcare staff and addressing their role in combating violence against women brought together a total of around 200 people participating in workshops in Pаncеvo, Kikinda, Subоtica, Sоmbоra, Srеmska Мitrоvica and Zrеnjаnin. The campaign has been implemented by the Provincial Secretariat of Healthcare, Welfare and Demographics supported by the district Public Health Institutes and in collaboration with the PPCO.