Tag Archives: neglect

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.

Advertisements

Neglect Has A Lasting Legacy

I was 5 years old when my sister and I went on a road trip with Baba, our Grandad, up North in Nigeria. It was not normal for just the two of us to go with him. There was usually my grandma too or maybe my mama. However, this time we got to go solo with him. I suspect it is because we begged and it was the holidays and my mother was busy at work with no better plans to entertain us. Whatever the case, we got to go and I remember my sister and I getting bored quite quickly (probably an hour into the 6.5 hour journey). Plus my grandad had taken to listening to boring traditional Hausa music (Mamman Shata and the like). So we sang every nursery rhyme and Disney song we knew. We sang for hours until our throats were sore. Must have driven my grandad and the driver mad but they bore with us.

When we got to the town we were staying the night in, my grandad took us straight to my ‘aunt’s’ home. I say ‘aunt’ because this is not my mother’s sister, my favourite aunty in the whole world aunty Bilky. No, this is someone who grew up with my mum and her siblings and is therefore considered a ‘sister’. I will call this aunty ‘Auntie’ henceforth for easy reference. Now, we had spent quite a few holidays with Auntie and her many daughters in the past so we knew them well enough and were quite happy to be taken to hers. One of her daughters is very close in age to my sister and the youngest was a year older than I was but we usually got on pretty well. I couldn’t tell you if there were any special circumstances at the time we visited but I think not because we would have known. My mama was always upfront if anything major was going on especially if she was going to let us visit. Anyway, out of the car we tumbled, tired and excited. It was well after lunch but not dinner time yet but we were already feeling the first pangs of hunger having had a late breakfast on the road but not stopped for lunch. We were all shown into a living room in their sprawling home and someone showed us to the ‘bedroom’. I use the term ‘bedroom’ loosely because although the large room had beds (I think it was 3 single beds), most of it was clearly a dumping ground for dirty laundry and other clutter and it looked like no one had slept in there for a long time. My grandad left whilst we checked out our lodgings.

My sister and I waited for what seemed like ages for someone to come and tell us what to do with all the mess if we were actually going to be staying in that room. We also waited in vain for someone to offer us a drink or give us a snack. Nothing happened so we eventually picked one bed and cleared it and the area around it. We lay on the bed listening to the noises of muted conversation until all we could hear was our tummies rumbling. The sun began to set and we were soon left in darkness. One of us hunted for the light switch and we resumed our waiting game. We might have dozed off or maybe just lay around in a hungry tired trance but eventually I remember saying to my sister that I needed something to drink. That spurred her into action and she led me hesitantly out of the room and we wandered down the corridors of the seemingly empty house, most of the lights off. We found a kitchen but our hunt turned up nothing to eat. We had some water and sadly found our way back to the bedroom and eventually slept on empty stomachs.

We awoke to the sound of voices outside, going about their morning chores. We could smell breakfast frying…I am not sure now what it was (because we didn’t get any) whether it was fried yam, potatoes or bean cakes (kosei) but the smell was right under our noses and we were so famished we looked at each other in hope. No one came to get us and being nice Fulani girls, we stayed put. I remember asking my sister if she thought they had forgotten we were there. ‘How is that possible?’ She replied so we waited and waited. We waited some more as all the noise died down and the house fell silent again. Had they all gone out without so much as a word to us? Were we home alone in this house we didn’t know, in a town we had maybe visited a couple of times before? We finally ventured out and explored the section of the house we were in. No one was there. We returned to the kitchen, probably assuming that they might have saved us some breakfast. We found evidence of breakfast in the dirty dishes in the sink but not a bite left for us.

At this stage, I thought I was going to die of hunger. It was getting close to 24 hours since we had breakfast on the road with Baba and there was no adult to be seen. We went back to the room and my sister rummaged desperately in the backpack we had brought with us. ‘Look’ she cried excitedly after searching for a while. She brandished a N5 note. N5 (five naira) in those days (around 1990) was actually worth something. We could certainly have breakfast on the street with that. Remember this was a town we were not very familiar with so it was with trepidation that we ventured out of Auntie’s house and into the busy street. Thankfully there was no one out to cause mischief and we were left alone. We followed the smell of kosei to a street corner nearby and found a lady frying the delicious bean cakes seated on a stool by the fire over which she was frying. We gave her the N5 and asked for kosei. ‘All of it?’ she asked and we nodded hungrily. She scooped the freshly fried kosei out into the traditional newspaper wrap, sprinkled on a generous helping of the chilli powder that comes with it and handed it to us. We walked a few metres away before we gave in to the hunger in our bellies and we tucked in. After a few mouthfuls, we felt good enough to continue walking and we ate as we walked back to the house. The portion was decent and we gobbled it all up within minutes. Finally satiated, we chucked the paper in the bin and went in to have a quick wash and get dressed.

When my grandad came for us around lunchtime, we were happy again. Still left to our own devices but happy because my sister had fed us. We looked clean and my grandad was none the wiser. Lunch was served with my grandad so of course we got fed. I remember picking at the food because I was still stuffed from our late breakfast and also because I was so disappointed my Auntie had been so mean. But we said nothing. Just very happily jumped back into the car for the 3 hour trip to Kaduna where we knew we would be treated by my aunty Nafisa like princesses. I was not disappointed!

For many years after that, I did not forget or forgive that episode. The daughters I didn’t blame so much because half of them were young like us. But the 2 older girls were certainly old enough to know that young children visiting should at the very least be given a drink and food. Auntie should certainly have known better. I made up my mind that she was no longer my auntie but only my sister knew this for the next decade or so. I found every excuse not to go back there and mostly, I didn’t.

The next time I went was unavoidable. My mama and I were on the way to Kaduna and from there were to catch a flight back to Lagos where I went to boarding school. I wasn’t really given a choice of itinerary because she wanted to say hi to her ‘sister’. I knew anyway that I would be treated well because my mama was there but the hypocrisy grated. I clenched my teeth and said not a word. The visit was ok-ish. It turned out her daughter was getting married and we had been invited but my mother neglected to mention it. I had nothing to wear for any occasion as I was on my way back to boarding school and being a teenager, it mattered to me. Bearing that in mind, the youngest daughter and her cousin/half-sister on night 2 were in the same room as I was but I was lying on the bed, my head buried in a book as I was usually found in those days. They were whispering loudly about the pre-wedding party they were going to the next night and how much fun it was going to be etc. Being close in age to them, I would have expected them to have the courtesy either to invite me or not to talk about it in front of me. They did not have the courtesy to extend an invitation to me. Party night came and they snuck out when it was time despite being chummy with me all day. What sort of a fool did they think I was? The morning after, they were giggling over events at the party but would fall silent if I walked in a room or turned in their general direction. What grated wasn’t that I didn’t go because to be honest, I wasn’t one for parties at that age and I certainly did not have anything to wear. What sucked was their meanness of spirit and being treated like a fool.

Since that visit, I have stayed well away from most of that family. Although I have forgiven them their neglect and meanness, I doubt I will ever forget. That amongst other things are major character flaws I really wish not to be associated with. I have not considered Auntie my aunty for very many years to my mama’s consternation. I have since told my mama about that episode and several other incidents not talked about in this blog. I know she was dismayed and even sad but perhaps a small part of her is hoping that me and my sister’s account of that incident is overly-dramatized as remembered by our young immature brains. Regardless, I sincerely believe that if we had been her actual nieces, she would not have treated us so carelessly when we were so young. And she would not have allowed that mean spirit to rub off on her daughters.

When I think of her, I think of two quotes:

“When someone would mistreat, misinform, misuse, misguide, mishandle, mislead… or any other “mis”… to others, they’re obviously missing something from their lives.”
― Donald L. HicksLook into the stillness

“I know it’s painful growing,
I bet the changes was painful too.
But nothing is as painful as being somewhere you don’t belong.
Obviously.”
― Touaxia Vang