HEALTH: WHO Issues Global Appeal to Prevent Violence

By Gustavo Capdevila Reprint | | Print |

Gustavo Capdevila

GENEVA, Oct 3 2002 (IPS) - Violent behaviour, a universal scourge that claims 1.6 million lives each year, is often shrouded in secrecy or taboo, or ignored because it is considered inevitable, a reality the World Health Organisation (WHO) proposes to change.

With this aim, the WHO produced its first report on health and violence, released Thursday, expressing profound concern about a phenomenon that extends — without exception — throughout all countries and all communities.

Violence is among the leading causes of death worldwide for the population aged 15 to 44, and is responsible for 14 percent of deaths among men, and seven percent of deaths among women.

The WHO’s “World Report on Violence and Health” states that half of violent deaths are from suicide, 30 percent are homicides and the remaining 20 percent from violence related to war. In addition to death, violence has other negative consequences for public health, such as injuries, psychological consequences, functional disorders, and reproductive problems such as transmission of HIV/AIDS or sexual transmitted diseases in cases of rape.

There is an enormous financial cost in addition to the human cost, reaching as much as five percent of gross domestic product (GDP) in some countries, says one of the report’s authors, doctor Etienne Krug, director of the WHO’s Department of Injuries and Violence Prevention.

The health services costs resulting from violence reached five percent GDP in Colombia, 1.9 percent in Brazil, 4.3 percent in El Salvador, 1.3 percent in Mexico, and 1.5 percent in Peru, according to a 1996-1997 study by the Inter-American Development Bank.

In the United States, a 1992 report estimated the direct and indirect costs of injuries from firearms at 126 billion dollars annually.

Great social inequality is a factor present in the locations with the highest rates of violence, stated Alexander Butchart, scientist and team leader at the WHO’s violence prevention department.

In 2000, the rate of violence-related death in lower-income countries overall was more than twice that in high-income countries, said Butchart, though he noted that rates vary between regions and even within each country.

WHO official Krug pointed out that most crime statistics omit an “enormous amount of violence,” such as violence in the home: child abuse, violence against women, elderly abuse. In many countries, these do not constitute crimes, but they certainly constitute violence, he said.

Other forms of violence — in the school, against oneself, suicide, self-inflected injuries — are also generally left out of such statistics.

The suicide rate in 2000 reached 18.9 per 100,000 men and 10.6 per 100,000 women worldwide. Homicide rates that year were 13.6 and 4.0 per 100,000 men and women, respectively.

But these rates fluctuate a great deal from region to region. In Africa and the Americas, the homicide rate was nearly three times that of suicide. But in Southeast Asia and in Europe, suicides surpassed homicides by more than two to one.

In the Western Pacific region, the suicide rate was almost six times higher than the homicide rate.

The report by the WHO, a United Nations agency, describes violence in a very broad manner. “We talk about violence that occurs in the family, against children, against women, against the elderly,” explained Krug.

The document also covers violence that occurs in communities (referred to as “youth violence” because it mainly involves young men), and the violence that happens in an organised or collective form.

Krug noted that the research found that in some countries up to 70 percent of women said they have been abused by a husband or boyfriend.

And in some countries as many as “30 percent of women report that their first sexual intercourse was forced,” as do 20 percent of men.

This proves that rape is not only a widespread crime against women, but also against men, Krug said.

The statistics accompanying the WHO report state that in 1997, 69 percent of the women surveyed in the capital of Nicaragua said they had suffered violent treatment at the hands of a husband or boyfriend.

In Papua-New Guinea, that percentage was 67 percent in 1982. In the Netherlands, a 1986 study indicated that 21 percent of women had been physically attacked by their spouse or boyfriend, and that 11 percent suffered serious physical abuse.

As far as sexual abuse perpetrated by an intimate partner, 7.7 percent of women surveyed in the United States in 1995-1996 said they had suffered attempts or the consummated act of forced sexual relations.

That figure reached 10.1 percent among women polled in 2000 in the Brazilian city of Sao Paulo, and eight percent among Canadian women in 1993.

With respect to the effects of globalisation, the WHO report says the process has brought some benefits but also created new obstacles for violence prevention.

One of the positives of globalisation is an improvement in the scope and the quality of data collected on violence.

“Where globalisation has raised living standards and helped reduce inequalities, there is a greater possibility of economic interventions being used to lessen tensions and conflicts both within and between states,” according to the WHO.

In contrast, societies with great social disparity, in which the gap between rich and poor is widening as a result of globalisation, “are likely to witness an increase in interpersonal violence,” states the report.

Furthermore, the elimination of market constraints and the increase in incentives for profit resulting from globalisation could lead to “freer access to alcohol, drugs and firearms, despite efforts to reduce their use in violent incidents.”

The WHO makes it clear that it cannot tackle the issue of violence on its own, and will seek to work with other sectors on violence prevention.

Among its recommendations, the WHO calls for the development of “national multidisciplinary or multisectorial plans of action.”

“Most countries don’t have a plan with clear objectives in place, one which would allow the different sectors to work together,” commented Krug.

The UN agency also seeks improvements in gathering data about violence. In spite of the advances made, “there is still a huge amount of information lacking,” said the official, citing the example of the scarcity of data about suicide in Africa.

The WHO urges all countries to collect more and better information on the causes of violence, as well as on successful prevention programmes. Krug noted that many such initiatives have been implemented, but very few are evaluated.

Another recommendation involves improving services for victims of violence, providing not only a response to medical needs, but also a more comprehensive response that attends to the social needs, psychological problems, legal assistance, and financial services.

In addition to launching its report, the WHO launched a global campaign for violence prevention Thursday. The 18-month effort aims to focus international attention on the report and to work with countries and NGOs to implement the recommendations for curbing violence and improving the world’s health.