United Nations Jamaica 76th Anniversary

Responding to Violence against Women and Girls in Jamaica Mainstreaming Gender in the Health Sector Despite the best efforts, the incidence of Violence Against Women and Girls (VAWG) continues to skyrocket across the globe, including Jamaica. Partly to be blamed is the dark legacy of our colonizers’ brutality deeply embedded in our culture which continues to drive our beliefs and attitudes, motivating acts of violence. Many have theorized that social tolerance to violence very often starts from childhood, misuse of corporal punishment, early exposure to violence in the family or through the media. Legislative progress has been made but VAWG remains widespread and widely accepted in Jamaica as indicated in the 2016 Women’s Health Survey. Consider this, according to the Women’s Health Survey 2016 Jamaica, among the women consulted there was a wide acceptance that a ‘proper man’ should be rough. It further states that 28% of women and girls consulted have experienced physical or sexual violence. To reverse this trend, we need to collectively contribute to a society where VAWG is recognized as a human rights violation; based on power imbalance among the sexes and gender inequality. Mainstreaming gender, in particular violence against women and girls (VAWG), has gathered momentum over the last two decades with initiatives focusing on policy reforms, prevention, protection and legislation for sustainable change. Prioritizing VAWG is indeed integral to the region’s commitment to the 1995 Beijing Platform Call for Action and central to Jamaica achieving its maternal health and gender Sustainable Development Goals. VAWG has strong implications on the survivors physical and mental health, and on their control over their health, especially on the sexual and reproductive health. In 2013, the World Health Organization (WHO) estimated that globally, 42% of women who had experienced physical or sexual violence at the hand of a partner had experienced injuries as a result. From the mental health point of view many consequences have also been studies, as an example, women experiencing intimate partner violence were twice as likely to experience depression and it is quite common among survivors to develop non communicable diseases (hypertension and cardiovascular disease) and somatoform disorders (such as irritable bowel, chronic pain, chronic pelvic pain). Accordingly, health facilities are often the first point of contact for survivors of VAWG. This makes it very important to have health providers on the frontline with the adequate preparation in providing proper care and safe referrals to survivors disclosing their situation of VAWG. A proper and immediate response can be very important to prevent violence to escalate into femicides or attempt of suicide among the survivors. Therefore, mainstreaming gender in the education of healthcare providers, including higher learning, can contribute to reversing the negative attitudes and tolerance to violence in society. Preparing the Health Team Health care providers are in a key position to see the effects of VAWG at the acute stage, as well as being witness to the chronic, long-lasting, often inter- generational, impact of violence on those directly affected as well as their families. However, lack of adequate preparation to identify and respond to abuse can do more harm than good; jeopardizing the survivor’s safety. Strengthening the preparedness of our health professionals to respond in a timely and appropriate manner in any setting - from the primary or community level through to tertiary prevention in a hospital - is vital. At The UWI Mona, the Faculty of Medical Sciences is the lead in preparing healthcare professionals including physicians and nurses. Graduates, as they become part of the health fraternity and on the frontline delivering quality care to the community, are expected to be aware of the needs and vulnerabilities of the population they serve. What does ‘quality’ mean when training health professionals to deliver care? Over time the concept of quality has evolved from a landscape that focused almost exclusively on the training of practitioners in using the biomedical model with emphasis on technical skills. Today, greater focus is on the relevance of graduates being a key component of positive health outcomes. In this regard, the service provided by the FMS and its graduates in addressing the needs of individual patients and the population subgroups is accepted as an essential value that contributes to quality of care. In this vein, UWI Mona’s Faculty of Medical Sciences (FMS) is collaborating with the United Nations Population Fund (UNFPA) and the Pan American Health Organisation (PAHO), to implement a vital component of the Spotlight Initiative (SI). Funded by the European Union (EU), SI is a combined effort of global and local agencies to address the widespread levels of VAWG that is wreaking havoc on our Jamaican society. The SI is providing the Faculty with a unique opportunity to address family violence, through the review of its current curriculum and the development of new materials to build the skills of our health professionals to better address three priority areas of vulnerability: child sexual abuse, Intimate Partner Violence and discrimination against vulnerable groups. Discrimination is a factor that very often leads to violence. This consideration and acceptance are supported by the World Health Organization and the Educational Commission for Foreign Medical Graduates, with social accountability as its framework. Social accountability It is imperative that stakeholders contribute to this partnership in social accountability, make a difference on priority issues and help to promote meaningful change. This requires an appreciation of the underlying social and structural determinants that provide the framework for positive health outcomes, of which gender plays a critical role. We are preparing students to meet the health care needs of the population, but the outcomes and desired impact are not always achieved at a population level despite this best intent. The priority health concerns to be addressed as we train future practitioners should mirror the needs of the wider health system. These priorities therefore should be identified jointly by governments, healthcare organizations, health professionals, and key stakeholders including the public. The curricula in a socially accountable school must therefore be adaptable and responsive if true impact is to be achieved. FMS and its partner organizations will be better able to mount a meaningful and relevant response to one of the debilitating health issues of our society, estimated recently to have a direct impact on some 28 percent of women in Jamaica. This is an important advancement as we move to become socially accountable to our students and more so to the broader population that these health teams will ultimately serve. Cynthia Pitter is a Lecturer of Nursing The University of the West Indies, Faculty of Medical Sciences, The UWI School of Nursing, Mona. Contact Cynthia Pitter at: cynthia.pitter02@uwimona.edu.jm Cynthia Pitter, Lecturer - Nursing UWI, Faculty of Medical Sciences THE 76TH ANNIVERSARY SPECIAL FEATURE OF THE UNITED NATIONS IN JAMAICA 12