By: Lance Williams
Evaluating physical abuse prevalence in the developing world is an extremely challenging task in light of several factors. One of the greatest challenges is understanding the differing cultures and cultural values which impact and shape societies tolerance for violence. In the first portion of this paper we will seek to arrive at an acceptable definition for physical abuse. Following, we will attempt to describe the nature of physical abuse and its prevalence in the developing world.
Physical Abuse Defined
While several cultures may define physical abuse differently, for the purposes of research, the World Health Organization definition is very helpful: The intentional use of physical force or power, threatened or actual, against oneself, another person, or against a group or community, that either results in or has a high likelihood of resulting in injury, death, psychological harm, maldevelopment or deprivation. (Krug EG et al. 2002) As we progress, this definition will be helpful to keep in mind.
The Nature of Physical Abuse
Perhaps the starkest example of the current climate of physical abuse in the developing world is the sample question that was posed to women in a recent survey. Women were given six different situations and were asked for each of the situations, whether she agreed that the wife’s behavior justified wife-beating. The top four reasons that were most frequently given to justify wife beating were not completing housework adequately, refusing to have sex, disobeying her husband, and being unfaithful. (Garcia-Moreno, et al. 2005) In light of this stark difference from our own culture, the remaining discussion should be considered carefully.
Children (Birth to age 15)
When considering the nature of physical abuse as it relates specifically to children from birth to age 15, one must examine many factors. In one study, physical abuse was defined as the intentional use of physical force against a child that results in – or has a high likelihood of resulting in – harm for the child’s health, survival, development or dignity. That includes hitting, beating, kicking, shaking, biting, strangling, scalding, burning, poisoning and suffocating. (Butchart and Harvey 2006) In addition to these, neglect is also often considered as a type of physical abuse that ignores the physical, mental, emotional, and developmental needs of a child. (Butchart and Harvey 2006)
Behaviors Associated with Increased Risk
As with other areas of abuse, identifying behaviors associated with increased risk should in no way insinuate that the victim of physical abuse is in any way responsible for the crime that has been committed against them. However, it is helpful to identify consistent behaviors or other factors that place an individual in a higher likelihood to be victimized so that we might avoid them and decrease the likelihood that abuse would ever occur. The following are several examples of behaviors or factors that are associated with increased risk.
- Women who had been separated, divorced, or were cohabitating with a man reported more physical abuse than married women. (Butchart and Harvey 2006)
- Higher education seemed to associate with less violence in many settings. (Garcia-Moreno, et al. 2005)
- In 2000, rates of abuse-related deaths in low to middle – income countries were over two times higher than those in high-income countries. (Krug EG et al. 2002)
- Several other common factors were identified such as: growing up in a violent or broken home, substance abuse, social isolation, rigid gender roles, poverty and income inequality, among others. (Krug EG et al. 2002)
Children (Birth to age 15)
When considering risk factors on a global scale, one is overwhelmed by how many of these factors are outside of the control of those who are born in a particular country. One study identified that the risk of fatal abuse for children is two to three times higher in low-income and middle-income countries than it is in high-income countries. (Butchart and Harvey 2006) In addition, on a personal level, several factors have also been identified.
- A parent who is having difficulty bonding with the child due to birth complications, disappointment with the baby, ignorance regarding proper care, or unrealistic expectations. (Butchart and Harvey 2006)
- An infant with high physical, mental, emotional, or developmental needs. (Butchart and Harvey 2006)
- Communities that tolerate violence, gender and social inequality, lack of adequate housing and support to families to meet needs, and high unemployment.
Prevalence of Physical Abuse
Regarding the prevalence of physical abuse, several studies have provided excellent data that allow us to understand more of the nature of physical abuse in the developing world. One recent study is the WHO Multi-country Study on Women’s Health and Domestic Violence against Women: Initial results on prevalence, health outcomes and women’s responses. Summarized below are significant prevalence figures contained in that report.
- A range of 15% to 71% of women had experienced physical or sexual assault by an intimate partner with most sites falling between 29% and 62%.” (Garcia-Moreno, et al. 2005; Krug EG et al. 2002)
- Regarding the nature of the violence that occurred, most had been slapped, followed by being punched, with most sites reporting between 11% and 21% of the women being hit by an intimate partner with his fist. (Garcia-Moreno, et al. 2005)
- The rate of pregnant women abused during at least one pregnancy was greater than 5% in 11 of the 15 settings where the study occurred. (Garcia-Moreno, et al. 2005)
- Relating to children under 15 years of age, the WHO reported that in 2002 an estimated 31,000 deaths were attributed to homicide among children of that age range. (Butchart and Harvey 2006)
Consequences of Physical Abuse
Domestic violence, and consequently domestic sexual assault, is by its nature often a crime that occurs in private. Unfortunately, it has been recognized by at least one study that by virtue of this fact, these crimes are especially less likely to be prosecuted in the developing world. (Krug EG et al. 2002) As we consider further the consequences of sexual assault, we find several consequences of sexual abuse that impact the individual and the community in which they live. Several of those consequences are listed below:
- Women who had experienced intimate partner abuse were more likely to also report poor or very poor health, often complaining of walking and carrying out daily activities, pain, memory loss, dizziness, and vaginal discharge in the 4 weeks prior to the interview. (Garcia-Moreno, et al. 2005)
- Women victimized by intimate partner abuse experienced higher levels of emotional distress than non-abused women. (Garcia-Moreno, et al. 2005)
- Pregnant women victimized by intimate partner abuse, both physical and sexual, reported more induced abortions. (Garcia-Moreno, et al. 2005)
- Non-fatal violence still produces injuries, mental health and reproductive health problems, and sexually transmitted diseases. (Krug EG et al. 2002)
The only reported data more tragic than the abuse figures themselves are those that relate to the lack of reporting of the abuse to authorities. One study reported that across all the sites they surveyed between 34% and 59% of physically abused women reported that no one had tried to help them. (Garcia-Moreno, et al. 2005) In addition, between 55% and 95% of physically abused women reported that they had never sought any agency’s assistance in their situation, whether for personal or legal support. (Garcia-Moreno, et al. 2005)
One study highlighted the fact that the interview was often the first person that the abused woman had ever talked to regarding her abuse. (Garcia-Moreno, et al. 2005) In light of this, churches with a vision for establishing long-term relationships with developing world communities should prioritize intimate person-to-person contact in an effort to assist in easing the burden so many women are carrying alone and in silence.
Butchart A, Harvey A. Preventing Child Maltreatment: A Guide to Taking Action and Generating Evidence. Geneva (Switzerland): World Health Organization; 2006. [cited 2007 December 14]. Available from: URL: http://whqlibdoc.who.int/publications/2006/9241594365_eng.pdf.
Garcia-Moreno C, Jansen H, Watts C, Ellsberg M, Heise L. WHO Multi-country Study on Women’s Health and Domestic Violence against Women: Initial results on prevalence, health outcomes and women’s responses. Geneva (Switzerland): World Health Organization; 2005. [cited 2007 December 13]. Available from: URL: www.who.int/gender/violence/who_multicountry_study/summary_report/en/index.html.
Krug EG et al., eds. World Report on Violence and Health: Summary. Geneva (Switzerland): World Health Organization; 2002. [cited 2007 December 14]. Available from: URL: www.who.int/violence_injury_prevention/violence/world_report/en/summary_en.pdf