Image by Aunia Kahn

Women, children, and gender-based violence is the latest most talked about topics currently in South Africa. This is due to the increasing number of reported cases of abuse and death of women and children, not forgetting men and boys who are also abused but cannot report the matter due to them feeling ashamed and the fear of being mocked. Abuse comes in different forms, sexual, emotional, verbal, physical, domestic, and discriminatory and etc. This piece will focus on domestic abuse as more women are admitted to hospitals or die in the hands of the ones who say they love them.

Clinical experience

A 28 year old lady was admitted in hospital following an incident where she was beaten by her jealous boyfriend. Her leg was swollen and became septic and doctors had to do debridement over and over until they had to amputate because there wasn’t enough tissue left. When I first saw her she was motivated to go home and be with her son, which made our sessions productive as she mobilized and continued even when I was not around. One morning, I came to see her and she told me that doctor said they will amputate her leg because she had lost a lot of muscle. We couldn’t do anything that day because I had to address her emotions at that time; she opened up with me about how painful it is not just physically but emotionally too. How would she explain to her child that his father is the reason she doesn’t have a leg, or how she would move forward and work to provide for her child and who would ever want to be with her if she has one leg. Those are all her thoughts that she expressed to me. As a physiotherapist I had to be a psychologist and talk to her, explaining that a lot of people are living a good life with one leg, the prosthesis is also available because she is a good candidate. The difficult part was talking to her about how she can deal with her emotional pain since we address her physical injuries. I could relate to her since I am also a woman but I couldn’t relate to how much pain she had been through before she was hospitalized.

Literature review

According to Agnihotri, Agnihotri, Jeebun, Purwar (2006) domestic violence is the pattern of assault and intimidation through physical, sexual and psychological attacks, by a person against his/her own intimate partner and women are more frequently the victims. Since 1998 only 24.6 % of the cases where women are physically abused by their husbands and ex-boyfriends, this value is of those who were among the 1306 women who were interviewed. There are those cases which are not reported, and it is now 2018, more cases are being reported as women have more platforms to talk about their situations but there is still that percentage that is still suffering in their homes.

Olive (2007) says that WHO (World Health Organization) domestic violence does not only have a profound effect on health but also on an individual’s self-esteem and ability to participate in the world; which becomes worse when it affects them functionally as well. According to Olive (2007) emergency department is where people seek help for their injuries as a result of domestic violence, and this is considered the 3^rd place after friends and family. When patients get to hospitals, a screening is done, this is where health professionals are expected to show empathy, understanding, and respect in order for the screening to be effective and give quality results (Santo, Pohl, Saiani, Battistelli, 2014). As a physiotherapist, it is important to have this skill since we spend more time with them and they put their trust in us to get back on their feet.

Olive (2007) found that “care for patients in emergency and acute healthcare settings who have experienced domestic violence should focus on three domains of:

(1) Providing physical, psychological and emotional support

(2)Enhancing the safety of the patient and their family

(3) Promoting self-efficacy.”

I have learned that skills of being able to build a rapport with a patient who is in an emotional breakdown take experience and time since these are not skills we are taught in class. I know that in the future, I should be ethical when it comes to patient management in cases that are beyond physical treatment. This piece has been very emotional for me to write as I know people close to me who have been victimized by their loved ones. I still have a lot learn with time and experience and with helping or treating those patients who were hit by their spouse because they were defending themselves from that abusive patient without being judgmental and bias.

References

Agnihotri A.K., Agnihotri M., Jeebun N & Purwar B. (2006) Domestic violence against women – an international concern, Vol 16, no.1, Departments of Forensic Medicine, Pathology and Physiology Medical College.

Olive P. (2007) Care for emergency department patients who have experienced domestic violence: a review of the evidence base, vol. 16, page 1736- 1748, Journal of clinical nursing Blackwell Publishing Ltd. DOI: 10.1111/j.1365-2702.2006.01746.x

Santo L.D., Pohl S., Saiani L., Battistelli A. (2014) Empathy in the emotional interactions with patients. Is it positive for nurses too? Vol. 4, No. 2, page 74-81, Journal of Nursing Education and Practice. DOI: 10.5430/jnep.v4n2p74