Violence against women: Where are the solutions?

“If all men are born free, how is it that all women are born slaves?” Mary Astel 1668-1731: Some Reflections upon Marriage (1706 ed.) Dear friends, I am deeply honoured by the trust you have reposed in me and elected me to the highest office of the Indian Psychiatric Society. At this point of time, I would like to pay my respects to my revered teachers and seniors who taught me the ABC of psychiatry, mentored and blessed me all along my journey to this point. I salute (Late) Professor BB Sethi who admitted me to psychiatry. Dear Sirs, Prof. A. K. Agarwal, Prof. N. Lal, Prof. S. C. Gupta, Prof. Mata Prasad, Prof. C. K. Rastogi, Prof. A. K. Tandon, Prof. Prabhat Sitholey, and Dr. Ashok Trivedi, I thank you all wholeheartedly for all that you have taught me. I would like to give the credit to you all for this achievement. At this moment, I would like to remember my father (Late) Pandit Harish Chandra Sharma, a practicing lawyer at the Allahabad High court, for the enthusiasm he infused in me and for his lofty ideals, a few of which I have imbibed. I would like to dedicate this address to him. I have chosen “Violence against Women: Where are the Solutions?” as the theme of my address on the following accounts: Violence against women is a social, economic, developmental, legal, educational, human rights, and health (physical and mental) issue. It is a preventable cause of morbidity and mortality in women The relationship between violence against women and mental illness has not been adequately explored. Application of laws related to violence in the setting of mental illness is difficult Despite the social and religious sanctions against it in all cultures, it has continued. Responses by communities, religious institutions, government (various commissions), international conventions, stringent legislations and penal measures have failed miserably in containing the menace. The recent gang rape of a medical student on 16.12.2012, by 6 persons (under the effect of alcohol) in a bus (the safest transport), in the presence of her friend (a male), during busy traffic hours (9.30 pm), for an extended period (>1 h), in the National Capital Region, whose Chief Minister is a lady, and with a lady as the president of the ruling party has rocked the country. Violence against women is on the national agenda. Government is making frantic efforts to find solutions. The Justice JS Varma Commission has been set up. The world has entered into a new millennium, but from the dawn of civilization till date, the woman of the patriarchal society of India continues to be oppressed and ill-treated. She is dependent, weak, exploited and faces gender discrimination in every sphere of life. The gender-based violence that threatens the well-being, dignity and rights of women, extends across social, cultural, economic and regional boundaries. Instances of violence against women in ancient India are mentioned. Mahabharat cites the violence meted out to Dropti. Yudhishtir staked his wife Dropti in gambling and lost her, following which Duryodhana ordered his brother Dushasan to strip her in the royal palace and he attempted to do so, but Lord Krishna came to her rescue. Kans killed seven newborn babies of his sister Devaki. In modern societies also violence against women is a major public health problem affecting women and children. While deliberating on violence against women and mental illness two cases deserve mention. First, the “Bobbitt” case[1] of an American couple, whose difficult relationship gained worldwide notoriety for an incident in 1993 when the wife severed her husband's penis with a knife. The penis was subsequently surgically re-attached. The wife stated that her husband sexually, physically, and emotionally abused her during their marriage, flaunted his infidelities, and had forced her to have an abortion. Her defense attorneys maintained that she was suffering from clinical depression and a possible bout of posttraumatic stress disorder due to the abuse. The jury found her not guilty due to insanity causing an irresistible impulse to sexually wound her husband. As a result, she could not be held liable for her actions. Second, is AM,[2] a high profile rape case from Orissa. She was driven out of her house by her husband, disowned by her parents and brutally raped in front of her friend in 1999. She accused the former advocate-general of Orissa to have attempted to rape her and to have played a role in the incident of gang rape. Mishra alleged that her husband tried to prove her insane so that he could divorce her. She was admitted to a psychiatric nursing home in Rourkela, where she received six ECTs. Thereafter, she was admitted in Central Institute Psychiatry for over 9 months. However, mental disorder could neither be confirmed, nor refuted. WOMAN'S PLACE IN SOCIETY Indian Society has always revered women. In Hinduism, man and woman represent the two halves of the divine body. There is no question of superiority or inferiority between them. Hindu history is witness to the super-women, such as Gargi, Maitreyi and Sulabha, whose faculty of reasoning was far superior to that of ordinary mortals. Many female deities Saraswati, Durga, Laxmi, Kali etc., are worshipped across the country. According to the Mahabharat by cherishing the woman one virtually worships the goddess of prosperity. On the darker side, the patriarchal system has continued since the time of Rig Veda. Customs and values were made by men to favour men. Women suffer this discrimination in silence. Historically, the Indian woman has been made to adopt contradictory roles. The strength of a woman is evoked to ensure that women effectively play their traditional roles of nurturance as daughters, mothers, wives, and daughters-in-laws. On the other hand, the stereotype of “a weak and helpless woman” is fostered to ensure complete dependence on the male sex.[3] VIOLENCE AGAINST WOMEN: THE EVIDENCE Violence against women occurs throughout the life cycle from prebirth, infancy, childhood, adolescence, adulthood to senescence.[4] Most of the data are believed to be unreliable as many cases go unreported. Cases of violence against women are steadily increasing in the country. According to the National Crime Record Bureau, India, there is one dowry death in the country every 78 h, one act of sexual harassment every 59 min, one rape every 34 min, one act of torture every 12 min and almost one in every three married women experienced domestic violence.[5] Studies from India reported violence in 19– 76% of women (75%[6]–76%[7] in lower caste women; 42–48% in Uttar Pradesh and 36–38% in Tamil Nadu;[8] and 19% in an urban slum community of childless women.[9]) In Western India, 15.7% pregnancy-related deaths in the community series and 12.9% in the hospital series were associated with domestic violence.[10] In Uttar Pradesh, 30% men reported beating wives.[11] 22% of woman of childbearing age from a potter community were physically assaulted. 34% of those physically assaulted required medical attention.[12] The population-based, multicenter based collaborative project of the study of abuse in the family environment (India-survey of abuse in family environment) was established in seven sites in India.[13] It looked at the association with poor mental health. A total of 9938 women participated (from rural, urban slum, urban nonslum areas). 40% reported experiencing any violence during their marriage. 56% had self-report questionnaire scores indicating poor mental health. DOMESTIC VIOLENCE The home is often equated with a sanctuary, a place where individuals seek love, safety, security and shelter. For some women, the home is a place that imperils lives and breeds some of the most drastic forms of violence perpetrated against girls and women. Violence is usually perpetrated by males who are, or who have been in positions of trust and intimacy and power e.g. husbands, fathers, fathers-in law, stepfathers, brothers, uncles, sons, or other relatives. The Protection of Women from Domestic Violence Act (PWDVA), 2005[14] defines domestic violence as any act, omission or commission or conduct of the respondent, which includes threat or actual abuse. In the 1996 survey of 6902 men in the state of Uttar Pradesh, up to 45% of married men acknowledged physically abusing their wives.[4] The National Health Survey conducted under the stewardship of the Ministry of Health and Family Welfare, reported that >1/3 of women (34%) between the ages of 15–49 years have experienced spousal physical violence.[15] The adverse health consequences that women experience due to violence are wide-ranging with physical, reproductive and sexual and mental health outcomes. In a community-based study involving 450 women in Gujarat,[16] 42% experienced physical beatings and sexual abuse, and 23% experiences abusive language, belittlement and threats. It is interesting to note that 56% women belief that wife beating is justified. The International Center for Research on Women (ICRW) in multiple centers in India reported that 85% of men admit they had indulged in violent behavior against their wives at least once in last 12 months. 57% of men admitted to have sexual abuse with their wives. 32% of men admitted to committing violence on their pregnant wives. The men indulged in violence to establish their power over the weaker sex. Subtle and insidious forms of violence include repeated humiliation, insults, forced isolation, limitations on social mobility, the constant threat of violence and injury, and denial of economic resources.[17] SEXUAL HARASSMENT AT WORK PLACE A social worker (BD) was gang-raped by a group of the upper class, influential men, because she had tried to stop the practice of child marriage. The accused was acquitted by the trial court. This inspired several women's groups and NGOs to file a petition in the Supreme Court under the collective platform of Vishaka (Vishaka and others vs. State of Rajasthan and others).[18] It is a landmark case as it was the basis for Supreme Court guidelines on sexual harassment at workplace. DOWRY RELATED VIOLENCE The age-old practice of dowry has persisted and driven many women to suicide.[19] In 50 district court judgments, 1987–1989, Maharashtra, West India, there was dowry related violence. 120 cases of dowry deaths and 20 cases of intentional injury related to dowry were identified. There were intentional injuries, including physical violence (59%), mental torture 28%, molestation by family and and The of death in the women who and It is that the women were of were and 22% had female by on related to dowry as a for poor mental health. It is of the Indian related violence is on the in women are killed by their and who in their for dowry and are not On an women a are and many cases go VIOLENCE AGAINST WOMEN: Psychiatric morbidity of by the husband has been associated with poor mental health of has as a for violence that is across a of for all of as a increasing the of violence by and an to such as and disorder the man to sexual There is from many cases Sharma, that was the in violence against women. has been as the cause of violence against women. and age with of poor women with no of their and urban have been as for domestic violence. Women in and were to be abused women who were or who had to that of Where women have a economic their and are as power to traditional gender for violence is or or in a have been reported to be associated with violence against women. Family to physical during and the father beating the during is a of and of violence against his wife in extended family and family have been associated with and of domestic In the age-old of dowry and for husband and has been found to be related to violence against women in women with mental The Women with mental illness are on three the female and which the For many women, it is a are neither at nor at their women are helpless and suffer from a of that are to Indian such as forced to with the husband she not to her to her parents every time her parents forced to pay for her medical not to her The with to of women with mental illness in India is It has been as the by and women of the presence of mental It is possible to women with mental when there is because most are and it is often possible to the other party with a Despite violence meted out to women, they frantic for of rights for or and violence against female in the It place in in in some of and the and in in and to and with physical In it that there are over have as a and to and women and girls for as as family to dowry and of in the of family In several of the world including and India, women are killed to the of the family due to such relationship or sexual in with a the family which a male of the family to the woman It is that in the penal laws such are the committing the is the age of In India to be on the with or the of the a of violence as it the health and of of were married by age by age and married by age The age for is usually lower for as to In many the age for with is 50 at and with women of gender roles have continued over the The roles for women have been and Women because an or is a The of dowry is in Indian Marriage be In the of marriage, it is that the woman is and her husband. the or continues into with the husband the to and his the has to go to her husband's to to her At her husband's she has to the of an of the which she and be and all of the including those to her. She not her to the nor from is a divine the husband husband or you not the She and from parents on She has of her husband life has no for her. the practice of has is have continued over the years and have women at for forms of abuse. of and have also been have the of the Women are out of the and there is of the two and or is the and are sexual for making is to many on the and other are for with a married or stress of high in and and are the of the The could be a who lives from his and and to for and and and system and to against forms of in and religious values in to many of which to the of violence against women. VIOLENCE AGAINST WOMEN: to violence A few to domestic violence are The and have been by the of in two of Uttar Pradesh and a traditional is by the in West The conducted a in It women. There are a of international to violence against women. The the for the of women's rights of and and of a on to for and human The of that no one be to torture or to or or There have been three world on women. in in the in in and the one in were to gender and for women. were based on three and The for to the human rights of women. It of violence against women in public and life. The a platform for on some of the as to the of of women in the It on such as discrimination against women, violence against women, The on of all forms of against Women to which are is a landmark because it violence against women the of human It female as the for violence and the of gender violence include all of women's Domestic in India The of is on in between men and women by the state is on of or place of is on to to with human The National Commission for Women: It was set up as a in under the National Commission for Women to the and for women; of and the Government on all affecting women. The Supreme Court guidelines on sexual harassment at For the time, the Court upon an international human rights the to a set of The Court sexual harassment at place as any or that are sexual in be the of the or other persons in or other to or the commission of of sexual harassment and to the for the or of of sexual harassment by all The to violence against women the Indian and and dowry The Act to all and or the or of dowry is an which is West Pradesh, and the to give it The was found to to the Where the death of a woman is by any or injury or occurs under years of marriage, and that her she was to or harassment by her husband or any of her husband for or in with any of such death be and such husband or be to have her death Indian was for the as to dowry of of child or insane any under years of any insane any any or any in a state of the commission of such be with death or for life or for a not years and also be liable for However, the is that it is the has major mental the of is to the accused and he is of any the commission of such be with of for a which to years and also be liable for of Indian to the as to of The of dowry and of are and A man is to have rape he has sexual with a woman against her and or with her when the man that he is not her husband or when she that he is her or with her when she is of or is by or the However, sexual by a man with his the wife not under is not rape The as it not include rape. against the of with any or is an for which the be for life and also be liable for This is by husband and of The conduct of the husband or his that is to the women to or cause physical or mental to her or harassment of a woman with a to her or any of her to any for would be by for years and This is the most against domestic violence. in in causing death by an act with to cause act was act with to child born or to cause it to and causing death of child by act not to The Family The Act was established with a to and of to and family The of Women This Act the of women or in or in any other is The Commission of This Act is for the and of Protection of Women Domestic Violence The Protection of Women Domestic Violence Act (PWDVA), was to for of the rights of women under the who are of violence of any the family and for It of domestic and not a child or a male and economic violence related to and sexual sexual abuse and The is a woman who has been in a domestic relationship with the The is any male who or has been in a domestic relationship with the and against the has The or any or There is for and There is also for and for medical and The is in many It is to to poor and women; it the woman the rights and many and to against it to the and but not the it the The against is that mental illness in or is from there are few and because they have been abused and are as rape has been it that all measures to violence have in the of of is an of and The be on and by would not because violence against women is a social It is who by social has to in other but is and and that it give that and have as as the sanctions which public to be a Women the by Women men and men women. to the menace. VIOLENCE AGAINST illness Psychiatric illness be and with be in a environment till Many e.g. those suffering from mental or Women with mental illness to be with to the Women but those with mental illness and The problem is not mental but the Many medical in marriage, mental There no a woman the her husband a mental so the husband. be made to that it is to a or with mental the is also A with mental illness also be family the Many women with mental illness prove to be and those mental the husband's family the woman with mental the society also with mental illness be with her Violence is not the illness in the or or be on of There be of in in institutions, public like and The of be The age for be to on are with the of of persons with dependence be on be which violence and of the be on be The sites be Marriage of and girls be in as as so that sexual could be in a the of would act as a The be for and at all and is in set of the This is the of the of India, stated time for to and out deeply patriarchal that stop from to women. the system has to go it in the A High Court in Orissa in his once held was not possible for a to rape a woman in in legislations The Hindu Marriage Act illness be from of Hindu marriage. illness of mental illness not be a for of marriage. and for mental illness be in the so that the mental illness is in the and This violence be legislations is to for of that is by the to a of sexual The be for of the of the of sexual be the The for for violence perpetrated against women with mental of laws in the setting of mental illness This is often such cases have as as medical of conduct of conduct at and with to with persons of be and by parents and teachers is the and of and in of and for and and for in and religious values and teachers to and religious values in and as role but not the are the all to violence against women.