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CHILE: Comprehensive Care for Victims of Domestic Violence

Daniela Estrada

SANTIAGO, Mar 31 2006 (IPS) - Experts applauded the Chilean government’s decision to provide comprehensive care for victims of domestic violence, although they warned of the enormous challenges remaining in this country and the rest of Latin America, where a large proportion of women have experienced violence at some time in their lives.

One of the first measures adopted by President Michelle Bachelet after she took office on Mar. 11 was to make the public health service responsible for treating the physical and mental damages caused by domestic violence.

The director of the National Health Fund (FONASA), Hernán Monasterio, explained when he made the announcement that this year a study would be carried out of the population potentially in need of these services, and a treatment plan would be drawn up, including follow-up and rehabilitation for the most serious cases. Implementation of the full programme will begin in 2007.

“Gender-based violence is a public health problem, because it affects not only the health of the woman and her family, but also the whole community,” Dr. Marisa Matamala told IPS.

Matamala, who is in charge of gender and health issues at the Chilean section of the Pan-American Health Organisation/World Health Organisation (PAHO/WHO), said “PAHO has been working for some time with FONASA towards protecting the victims of domestic violence.”

She added that the project has involved the combined efforts of a number of ministries, government services, and non-governmental organisations (NGOs), including the ministries of the interior, planning, employment and housing, the National Service for Women (SERNAM), the courts, and groups of citizens who contribute to the visibility of the problem and provide shelter for the victims.

Meanwhile, FONASA is investigating ways and means of treating physical injuries caused by aggression, such as scarring, disfigurement, loss of teeth, and bone and joint injuries, which require specialised care.

Health Minister María Soledad Barría drew attention to the importance of the government initiative, pointing out that in Chile one woman a week, on average, dies as a result of violence by her partner, former partner, or other family member. Last year 56 women were killed in domestic disputes in this South American country of nearly 16 million people.

María, 46, is just one of the many women who have narrowly escaped what women’s activists describe as “femicide” – gender-based killings. She was married for ten years, and has been separated for 12. She told how psychological and physical abuse undermined her relationship to the point that her life was in danger.

Her husband took a lover, began to go out every weekend with his friends, and started to attack her physically and psychologically. “He would tell me I was ugly, fat, repulsive, and accuse me of cheating on him,” María, a homemaker and mother of three, told IPS.

For two years he beat and kicked her daily, and he tried to kill her several times. “He would drag me around by the hair, he threatened me with a pistol, and threw a lit gas-fire heater on top of me. The last time he hit me I had bruises all over, and my sister-in-law took me to the police station to report him,” she recalled.

“I hadn’t turned him in before because I was afraid he would kill me, and because I had no money to support my children,” said María.

She fell into a deep depression after her husband was forced to move out by a court order. She and her children suffered emotional damage, and attended many therapy sessions.

According to figures from the Ministry of the Interior, women were the victims in 88 percent of the cases of family violence in 2005. In 95 percent of the cases, psychological violence or minor injuries were involved. The group most affected by serious physical injuries was children.

The statistics also reflect an increase in domestic abuse complaints filed by male victims, which comprised 4.4 percent of the total in 1999 and 8.6 percent in 2005.

In Chile, the highest rates of domestic violence complaints are in rural areas, where the levels of drug and alcohol abuse are high.

But while more and more women are daring to report the abuse that they suffer at the hands of their partners, many Chilean women are still immobilised by fear. Soledad is one of them.

Ever since she was married 14 years ago, she has been psychologically abused by her alcoholic husband. “He says he doesn’t love me, that I’m a whore, that I shouldn’t wear make-up because I look ugly. Once he threw me out of the house, and he tells our son that he isn’t his father,” the 39-year-old secretary confided.

“I’m saving up to leave home, but I feel that I won’t be able to manage on my own. I’ve always hoped that he would stop drinking. I’ve never even thought of going to the police,” she said.

“The problem is much the same in all of the countries in the region,” said Matamala. “Only the ways in which it is tackled are different, depending on particular internal features.”

In El Salvador, Guatemala and Mexico, for example, femicide has become a systematic practice, in contrast with the other Latin American countries, “in spite of Central America having been one of the regions where governments and PAHO have done a lot of work on this,” she commented.

In Bolivia, Brazil and Peru, much progress has been made in terms of public policies for holistic healthcare, training of personnel, and methods for running shelters for battered women, she added.

However, “every country needs to improve cooperation between sectors, assign more resources, strengthen preventive policies and training, and improve the connections between state services and NGOs, so that preventive action and comprehensive healthcare can complement each other,” she added.

Similarly, Adriana Gómez, who represents the Latin American and Caribbean Women’s Health Network, told IPS that the Chilean government’s initiative “fills a gap in the health system,” but that its success will depend on the “recruitment and participation of civil society organisations that have extensive experience with these issues.”

Education is another effective method of prevention, Matamala remarked, since it can be used “to eradicate sexism in the construction of male and female roles, and to strengthen women, preventing their subordination and the acceptance of violence as punishment.”

In fact, one of the eight Millennium Development Goals agreed by the United Nations in 2000 involves gender equality and women’s empowerment.

“But the most fundamental shortfall is the lack of integrated information systems at the regional level, that can provide information about the magnitude of the problem as well as the progress achieved,” said Matamala.

PAHO is currently promoting the creation of a Regional Observatory on Violence Against Women, which will include government representatives, experts, and NGOs.