Twenty years ago, when I first started working on violence against women as a trainee doctor, colleagues told me I was wasting my time. Gender-based violence was a social problem, not a health issue, they said.
In those days awareness about violence against women was generally pretty low, particularly in medical circles. On the rare occasion that this kind of violence did surface in a clinical setting, it was treated as something unusual and something to turn away from. Violence against women, by a husband, boyfriend or what we have come to term an "intimate partner," or by anyone else, for that matter, was rarely considered a women's health issue, much less a public health problem.
Today, June 20, we are launching a new report on the global prevalence and the health effects of violence against women by intimate partners and non-partners, which shows that one in three women worldwide will experience some form of physical or sexual violence in her lifetime. We find that intimate partner violence is the most common type of violence against women, affecting 30 percent of women globally. We also discovered that 7 percent of women worldwide will report sexual assault by a non-partner at some point in their lives.
We learned that women who experience violence are twice as likely to be depressed or have problems with alcohol. They are one and a half times more likely to have HIV or a sexually transmitted infection. They have a 16 percent higher risk of having a low birth weight baby.
If violence against women were a sudden new disease outbreak, it would make headline news. Nevertheless, today's report highlights the fact that violence against women represents a major public health issue: "a global health problem of epidemic proportions," says Dr. Margaret Chan, the Director General of the World Health Organization.
This report, released by the World Health Organization in partnership with the South African Medical Research Council and the London School of Hygiene and Tropical Medicine, places each and every one of us face-to-face with violence against women.
Looking at the shocking numbers, it is obvious that even if you have not experienced this directly yourself, you certainly know someone who has. And it is everywhere; there is no region or demographic that can claim that violence against women isn't a problem and, in most parts of the world, a problem on a horrifying scale.
This report is the first systematic review of global data on the extent of this violence. It is also the first time that the World Health Organization is issuing a set of guidelines and policy recommendations on how health systems can provide the services to treat both the physical and mental consequences of violence. They suggest ways that health-care workers individually can help women who have experienced -- and in many cases are still experiencing -- this kind of violence.
Most women are reluctant to talk about their experience of violence. Sometimes they feel shame; sometimes they feel that it is something they have caused; and often they fear repercussions. Too often, they will be afraid that instead of helping them, health workers will judge them. The guidelines emphasize the importance of creating an understanding and supportive environment in which women can ask for, and receive, the support they need. This means that training programs for doctors, nurses, midwives and other health workers must include dealing with violence against women. How else can they know what to do?
We have come a long way since I did my medical training. We have gone from sweeping violence against women under the carpet to elevating it to the global arena.
We have gone from having to prove that this is a problem in the first place to countries acknowledging that this is a problem that needs urgent action. (Just last month, seven countries met during the World Health Assembly, WHO's annual meeting of member states, and agreed to work to put violence against women on the agenda of next year's World Health Assembly.) We have gone from not knowing much about the extent of the problem to having global data and looking at what works to prevent it.
As the UN Commission on the Status of Women recently agreed, it is time for the world to act. A life free of violence is a basic human right, one that every woman, man and child deserves.
At the same time, too many women still continue to suffer, silently. It is one thing to acknowledge that violence is a global problem. It remains much harder to admit that it is something that affects you as an individual.