Tag Archives: Law

The Taboo of Domestic Violence

One of the great privileges of being a paediatric doctor is the frontline seat we have on humanity. Of course we only see this great variety of human life and get to share in their stories because the NHS is still at the point of need free. We get to see how the very poor live their lives and also how the more affluent live theirs. Stereotypes abound within medicine and on the whole they ring true but we doctors and other frontline staff are constantly amazed and shocked by the unexpected. Life is certainly unpredictable as a doctor in the NHS. This is one of the reasons why I love the NHS so.

One of the greatest sorrows I have faced is when I come across a mother and or child who is being abused by the man who is supposed to love her and protect her from the rest of the world. One of our babies has been taken into foster care recently because the mother is being abused and has chosen that option for herself and her baby. I wanted to weep (still do) because I cannot imagine the horror that the mother has gone through and must be going through to carry a baby to term, labour to deliver her beautiful baby and then feel she must give that baby up. Heart breaking! In this case, the abuse is on-going and the father of the child not only threatened the mother with further abuse, he has threatened to kill the baby if she takes it home. Isn’t there something we can do for her I hear you ask? Of course there are ways in which we can help her. We have offered her every viable option including the one she has taken: giving up her child for fostering or adoption. She weighed up her options and came to a decision to give up the baby. Some of us are worried this is not a rational decision but unfortunately, within the law as she is an adult without any mental illness to cloud her judgement, we have to accept her decision whether it appears rational or wise or not.

Unfortunately, this case is not unique. In my 4 years of paediatrics, I have seen far too many cases of domestic violence and its many victims. 1 is too many but there have been dozens in my short time in the NHS. Bearing in mind that I have only worked in 7 NHS Hospitals and have seen but a tiny snippet of what is going on out there, this is a massive problem that is rarely talked about. Even within paediatrics and obstetrics where this is a major concern, we only talk about it when we get a case. Then it gets filed in the back of our minds until the next unfortunate case. Today I want to highlight the evil that is domestic violence and in my little way encourage anyone directly or indirectly affected to do something about it. What we need is more awareness and everyone who can do something to do a little bit so we can get some change happening.

As you may know, my mother is a feminist so I have always been aware of domestic violence in its many guises and how ugly it can get. As a young feminist, it was always one of those issues I was passionate about and I even wrote a radio drama aged 14 on the topic which got aired in Lagos in 2000. From a very early age, my mother taught me to have zero tolerance to domestic violence. I have always said that the minute a man raises his hand to hit me, unless it is in retaliation after I hit him first, that relationship is done and dusted. Some of you may think this is extreme but if you knew what I know, you would understand that zero tolerance is the best way to go about snuffing out domestic violence.

In medical school (here in Birmingham), I opted to do a module on Domestic Violence in my 4th year of study. It was a short module but the quality of teaching delivered voluntarily by the staff from the local Women’s Aid was fantastic. It was sobering to realise that the knowledge I had from what was happening in my hometown in Yola was mirrored in Britain. Britain may proclaim how forward thinking it is but just the same with Yola in Nigeria, their response to domestic violence is still inadequate and there is very little actual protection for the victims. Majority of the work is done by the voluntary sector trying to safeguard those who seek for help. By the very nature of this service provision, victims do not have access to help and unfortunately, many will continue to be victims until they end up in intensive care or even worse in early graves.

Here are some facts and statistics from Women’s Aid (http://www.womensaid.org.uk/domestic_violence_topic.asp?section=0001000100220041&sectionTitle=Domestic+violence+%28general%29) by way of introduction:

  • Domestic violence is any incident or pattern of incidents of controlling, coercive or threatening behaviour, violence or abuse between those aged 16 or over who are or have been intimate partners or family members regardless of gender or sexuality. It is not just physical violence. It can be verbal, sexual or neglect. It can be against a partner, a child or an older relative.
  • The vast majority of the victims of domestic violence are women and children, and women are also considerably more likely to experience repeated and severe forms of violence, and sexual abuse.
  • Women may experience domestic violence regardless of ethnicity, religion, class, age, sexuality, disability or lifestyle.  Domestic violence can also occur in a range of relationships including heterosexual, gay, lesbian, bisexual and transgender relationships, and also within extended families.
  • The majority of abusers are men, but in other respects, they vary: abusers come from all walks of life, from any ethnic group, religion, class or neighbourhood, and of any age.
  • Abusers choose to behave violently to get what they want and gain control. Their behaviour may originate from a sense of entitlement which is often supported by sexist, racist, homophobic and other discriminatory attitudes.
  • The estimated total cost of domestic violence to society in monetary terms is £23 billion per annum. This figure includes an estimated £3.1 billion as the cost to the state and £1.3 billion as the cost to employers and human suffering cost of £17 billion.
  • The first incident of domestic violence occurred after one year or more for 51% of the women surveyed and between three months and one year for 30%.
  • Amongst a group of pregnant women attending primary care in East London, 15% reported violence during their pregnancy. Nearly 40% reported that violence started whilst they were pregnant, whilst 30% who reported violence during pregnancy also reported they had at some time suffered a miscarriage as a result (Coid, 2000).

The commonest question people who have not been victims ask is ‘why doesn’t she leave?’ To understand the answer, you have to try to understand how they become victims in the first place. The typical victim starts out as a happy vivacious young woman, often pretty with very social personalities. They meet and fall in love with a man who at first glance is perfect. Often these men are older, more experienced who charm the girl with their confidence and assertiveness. Once the young woman/girl is ‘in love’ and moves in with the abuser, he (often he but not always) will begin to isolate the girl from her friends and family. It often starts innocently but becomes more pervasive. Often the man will complain about some character flaw in one friend and systematically will find a way of making her cut ties with majority if not all of her social support network. He will often start with small acts of violence like physical restraint if she wants to go out and he doesn’t approve, seizing her shoes so cannot leave the house or calling her ugly when she dresses in a way that she would normally and in the way he would have previously approved. Then once he starts to isolate her, he will chip away at her confidence and withhold praise so that she begins to modify her behaviour to please him and to get approval. To please him, she often has to isolate herself from her friends and family and cater to his every whim. Despite that, he will find fault with all she does and he will start by criticising her. Eventually, he will physically punish her for not doing what she should. Mentally, because of the slow insidious way of grooming her into becoming a victim, she starts to believe that whenever he abuses her verbally or physically it is because she has failed to do something.

Eventually, she is truly a victim and she stops to see herself as a victim and him as an abuser. She begins to blame herself for everything that befalls her and see him as her saviour. Most will come to believe their abuse is an act of love. What it often takes for her to begin to see her thinking is faulty is either when she ends up in hospital because he has lost control and beaten her so badly that he ‘allows’ her to seek medical help or she has children or other family members she feels responsible for and they get harmed. Even then, these victims will often go back time and time again. Sadly, some will go back one too many time and end up dead. Or their child will end up dead or permanently damaged. Here are some statistics to back that fact:

  • Women are at greatest risk of homicide at the point of separation or after leaving a violent partner. (Lees, 2000)
  • 60% of the women in one study left the abuser because they feared that they would be killed if they stayed. A further 54% of women left the abuser because they said that they could see that the abuse was affecting their children and 25% of the women said that they feared for their children’s lives. (Humphreys & Thiara, 2002).
  • The British Crime Survey found that, while for the majority of women leaving the violent partner stopped the violence, 37% said it did not. 18% of those that had left their partner were further victimised by stalkingand other forms of harassment. 7% who left said that the worst incident of domestic violence took place after they had stopped living with their partner. (Walby & Allen, 2004).
  • 76% of separated women reported suffering post-separation violence (Humphreys & Thiara, 2002). Of these women:

– 76% were subjected to continued verbal and emotional abuse.

– 41% were subjected to serious threats towards themselves or their children.

– 23% were subjected to physical violence.

– 6% were subjected to sexual violence.

– 36% stated that this violence was ongoing.

Lest I forget, I will mention the even more invisible group: male victims of domestic violence. I was heartened to see a poster the other day in a public toilet (female) offering male victims some help. This is just as important because we know that many perpetrators of (domestic) violence were once victims their selves. The man might be the victim in some cases. Learn to expect the unexpected.

So what do I suggest? For anyone who reads this, please share so that we can raise some awareness. If you suspect anyone you know might be a victim, please talk to them and point them towards the Women’s Aid website for help. Do not allow your friend or sister or mother to isolate herself. If you feel you are being pushed away and this is out of character for your friend, please persevere and remain friends with them even if it is only from a distance. Do not cut all ties as you may be tempted to do. Lastly, be watchful. Personally and for everyone you love. If you suspect something is amiss, draw them closer and be there so that if they need help, you might be that link that keeps them real and potentially saves their lives. If you are with a partner who is exhibiting some of the behaviours above, talk to someone you trust about it and ask for help. This help could come from Women’s Aid or even a trusted friend. If you are in a place where Women’s Aid or similar do not exist, turn to friends and family and seek for help early. No man is worth losing your dignity, sanity, health or life for.

Should anyone accept blatant injustice and a distinct lack of appreciation?

Question I often get asked: would you push your children down the route to become a doctor?

Answer before graduating medical school: yes if they expressed interest in medicine, I would encourage it.

Answer now: Not unless medicine was the only thing they want to do (like me) but I would encourage them to look at other career pathways and think about the quality of life they might be signing up for. I would tell my child (and indeed any other child that asks) that there are plenty of ways of helping people, not just medicine. I would say that unless they have spoken to many doctors, read blogs/articles written by a wide variety of doctors and done a good period of shadowing of a full time NHS junior doctor, maybe consider something like law or better yet engineering if they want a profession or even become a journalist, photographer or best of all a human rights activist. Other healthcare roles are available and evolving with incentives and support to train in those pathways. A physician’s assistant is better off than the physician, not just in terms if salary but expectations and quality of life. Nurse Practitioners (specialist or advanced) certainly have a better work life balance and earn more for their hours.

Maybe in the 20th century, doctors’ pay and the respect they got compensated for the gruelling backbreaking hours of hard work and sweat and not getting to see daylight for days on end. But not now. Not in the NHS in England

Government threatens the NHS in England
Government threatens the NHS in England

anyway. I dread to think what the state of affairs will be in 2022 when a baby being born today would be making that career decision 😐

P.s my answer in short: no save yourself, do something else

Freedom

Freedom comes in many forms. As does oppression. Before I launch into my tirade against hard-headed hard-line judgmental people and narrow-minded stereotypes, I have a confession for you. I am a feminist. And I am proud to be one. My mother is a feminist, the first in my family and I am proud to say I will carry on that tradition and pass it on as far as wide as I am capable. Feminism for me is all about freedom. People who know nothing or small bits about feminism immediately think a feminist is a woman who hates men, wants them all to suffer and is probably lesbian or at best bisexual. I am writing this to set those people straight of their misconceptions.

First of all, I know of feminist men. Misconception number 1 banished. 2nd misconception is that feminists hate men. The ones I know don’t. We all have things we don’t like about people, be they men or women or even children. We even have the odd people we hate like the wife-beaters and child rapists. Yes most of those are men but there are evil women too and we feminists hate them with as much passion as we hate the men. 3rd misconception is that we want men to suffer. That one is easy – if you read anything about feminism proper, you’ll know that what feminists actually want is for women NOT to suffer because of the things men do to them. Last misconception is that feminists are lesbians. Well, I am married and I love my husband. And I can tell you that when I go to bed with my husband, I am not looking to fondle breasts or play with his hair. My mama, despite the 1st disastrous outing with my biological father, remarried and I know it wasn’t all chat. So there. Feminists are not all women, we do not hate all men, we do not wish to harm all men and we are not all lesbian.

I was born into feminism. Like I said, my mother is a feminist so from infancy, I was exposed to a lot of grown up things. Things that she tried to shield me from but as I said in another blog, I loved to sit with my mum and would often refuse to leave or would hang around even when they wanted privacy so I heard a lot. And part of my contradictions as a child was that I listened and never forgot anything I heard. I would always come back to my mama at a later date having thought about what I heard and ask her to explain the whys and the whats. To her credit, incredible woman that she is, she would patiently explain and give me leaflets and books to read to help me understand.

One of the first things I learnt from my mama is that in a Yola marriage, a woman has to put up with a lot of crap. A lot of that is linked to the fact that in Yola when I was growing up, most women were housewives (two-thirds I would guess). Which meant that women were dependent on their husbands for all their material needs. This gave many men the license to use and abuse their wives. Women in Yola are strong, by Yola women I mean the Fulani women. They are so strong that they think crying/complaining of pain whilst in labour is a sign of weakness (rightly or wrongly). I know this for a fact because I worked in FMC Yola for nearly 5 months a few years ago and as a paediatrician, I was in the children’s wards which were right next to the maternity wards and I swear I probably only heard labour ‘sounds’ 5 times in the whole time I was there. And those women were probably not Fulani and had complicated births. I digress but you get the point. That is why I know how badly they must have been treated. Because they came crying. Weeping like they had lost a child or a parent. My mama was like the agony aunt with legal and financial aid at her NGO.

I also learnt that although the Yola community, like many others, hides behind religion and tradition, the religious and traditional leaders know what the truth is and if forced to will admit it. For example, a lot of muslim Yola women are/were under the impression that divorce was the domain of the husband and the wife was basically under lock and key unless he decided she could leave. Actually Islamically the wife has as much of a right to divorce her husband as he does her but tradition meant that the husbands were better educated which then meant 2 things: 1. The husband could write a divorce script and the wife being illiterate could not and 2. The ‘law enforcers’ in customary and Islamic courts were men so unless faced by someone in the know, feminists generally like my mama, they would rule in favour of the men. My mother asked her lawyer friends for guidance and her belief that the wife had a right to divorce as long as she had valid grounds was correct. Then we found out through her NGO’s work that a few Yola women despite being uneducated had realised this a while back and they had successfully filed for divorce. Guess the commonest reason they cited for wanting a divorce: my husband is impotent. And you know why that is? Because the husband was too ashamed to face any questions on his virility that he granted the divorce asap. Good on those women who discovered and shared the secret!

One of my mama’s NGO’s main focus is empowering the girl child and preventing child marriage. Unfortunately, there is still a huge discrepancy in the achievements (economical and educational) of boys and girls in most of the world. But feminists have made huge inroads into improving the situation. I have seen dozens of girls brought to my mama and not one appeal for help was turned down. My mama and her team fought tooth and nail to emancipate every child forced into a marriage. They then tried to provide them with long-term prospects either by sponsoring them to go to school or learn a trade. Many of them have been employed by my mama at one point or the other. Many of them are now fully grown women with careers or atleast a means of making some money so they can retain some independence and support their children should their husbands fail to provide. Many of them become one of my mother’s many children and one of my many sisters and the occasional brothers (through their sisters).

One thing about being feminist is about knowing and appreciating the fact that women and men are physically and mentally different. We do not want to be like men. Most of us do not want to take over the traditional male roles that have evolved into male roles because of the physicality. That is not to say that a woman cannot do the same job but it might take longer or she might need another pair of hands and sometimes it is easier for a man to do. Just as we know that there are men who are very paternal and are very capable of nurturing and looking after a baby’s needs BUT physically it is impossible for them to be as good as the mum because they have not got a uterus to carry the developing foetus for 9 months and they have not breasts to breastfeed with. Just as we know that a woman matures mentally in her 20s to her 30s whereas many men do not get to that level of maturity until they are in their late 30s and 40s. And we know being a mother brings out the tiger in every woman so that when their babies are in danger, they are capable of superhuman feats to save them. Men in general do not have those same instincts however it is well known how protective men can be of their daughters especially. So although feminists want women to have equal (human) rights with men, we recognise and even appreciate the differences in how we are built.

The biggest thing about being a feminist is the issue of how to dress. As a feminist I believe that every woman should be able to dress as she pleases. To please herself that is. Because people accuse feminists of hypocrisy if they are dressed to impress or sexily. The point is feminists believe that the woman’s body is hers to do with as she pleases. If she wants to cover herself head-to-toe in a black Arab gown and gloves and socks, then we are happy with it as long as it is her choice. If the same woman decides that today, she would rather be in a miniskirt and vest top, then that is okay too because it is what she wants. Not what her father or brother or husband or even mother wants. It’s all about the right to choose for yourself as an adult woman. But our people are obsessed with the issue of how a woman dresses so the disagreement continues. Tragically, many uneducated people still subscribe to the fallacy that the way a woman dresses is partly to blame for them becoming a victim of rape. To that I say, why is it that a man can walk around in shorts or topless in the heat and in general no woman tries to rape the man but when the roles are reversed the rapist points a finger at his victim for enticing him? Nothing justifies that barbaric act and its almost laughable that anyone would buy that as an excuse in this day and age. Thank goodness for the Nigerian Constitution stipulating a custodial sentence for all rape and for the NGOs providing the legal aid to ensure more men are convicted of this heinous crime.

Above all to me feminism represents love and freedom. Love because we stand up for those girls and women who haven’t a voice to say no when things are being done to them that they absolutely do not want or consent to. Freedom because that is what we promote no matter what the problem a girl or woman is faced with. Freedom to be born (and not killed solely for being female), freedom to go to school (and not be kept at home to learn to be a domestic goddess whilst your brother goes to school), freedom to have a childhood (and not be raped or married off too young), freedom to learn a craft or study for a degree, freedom to marry or not, freedom to choose who you share your bed and home with, freedom to decide how many children you bear in your own womb and breastfeed and nurture for the rest of their lives, freedom not to be violated or abused, freedom to leave a bad relationship. One day the whole world will realise that feminists are not against men but they are for men and women. That what we want is the world is to be happier and for all groups to be free to live a happy life. What we want is for the world to show some love to each other regardless of faith, tradition, ethnic group, education, class, age and most importantly gender. Peace!