_01.jpg)
_02.jpg)
Gender-based violence has global reach; Dr. Deborah Billings is speaking out to save children, adults, families
April 23, 2012
Dr. Deborah Billings recently spoke at
the Universidad del Este (UNE) on the
impact of violence on individuals,
communities and society.
(Editor's Note: April is Sexual Assault Awareness Month.)
"Pervasive and devastating crimes."
That is the description given by the Centers for Disease Control and Prevention to the prevalence of domestic violence, dating violence, sexual assault, and stalking reported in its recent National Intimate Partner and Sexual Violence Survey, which found that 1 in 5 women and 1 in 71 men have been raped; 1 in 6 women and 1 in 19 men have been stalked; and 1 in 3 women and 1 in 4 men have experienced domestic violence.
For Dr. Deborah Billings of the Arnold School of Public Health, the statistics point to a disturbing public health problem that has global reach.
Billings, an assistant professor in the Department of Health Promotion, Education and Behavior, was the guest speaker at the Universidad del Este (UNE) in Puerto Rico for the March 8 International Women's Day, which the university observes with a weeklong series of events. Her visit was at the invitation of Dr. Eduardo A. Lugo-Hernández of UNE's School of Human and Social Sciences and the associate director for the Violence Prevention Component, Project VIAS.
In her talks with UNE faculty and students, Billings discussed the numerous epidemiologic studies, including the World Health Organization's Multi-Country Study on Women's Health and Domestic Violence Against Women, that underscore the fact that "gender-based violence (GBV) exists and is a serious public health problem that affects victims/survivors (mostly women), perpetrators (mostly men), families, communities and societies."
And the reach cannot be ignored.
"The impact is social, political and economic," said Billings, who has a faculty appointment in the USC Women's and Gender Studies Program.
"GBV must be viewed through a life-cycle lens. It happens at all stages of life and has an impact on people across the lifespan -- from infancy through death," she said.
But one thing that cannot be ignored, she said, is that the impact on health is profound -- from fatal consequences (suicide, homicide/femicide) to non-fatal, but serious consequences affecting physical, mental and sexual and reproductive health.
Approaches that aim for primary, secondary or tertiary prevention must use the ecological framework.
Risk factors and protective factors must be understood at all levels -- individual, family, community, society, policies and laws -- so that interventions can be developed at these different levels to diminish risk factors and strengthen protective factors, she said. During her talks in Puerto Rico, she presented results from a multi-country study conducted in four Central American countries highlighting health services' roles in providing comprehensive care to rape survivors, as well as findings from interviews with women who utilized health services post-rape in Guatemala. It is clear that the health sector has an important role to play in secondary and tertiary prevention.
"Primary prevention of GBV is where we need to focus more efforts. This is where a public health and human rights approach alongside a penal approach is needed," Billings said. "Our evidence based on what works, in terms of prevention is still very weak, and evaluation and studies must be conducted to understand what can be done to prevent GBV."
Further, GBV prevention requires a profound social and cultural shift in the ways in which masculinity and femininity are enacted – at the individual, family, societal and political levels, she said. "We must change toward greater equity and equality. For that reason, this is work in which everyone needs to be engaged."
During her visit, Billings also visited an elementary and middle school, Escuela Julia de Burgos, as well as the elementary school, Escuela Amalia Exposito, where a UNE team is collaborating with teachers and community members to conduct community-based, participatory research with children on violence prevention.
At Julia de Burgos, "We met to talk about the program and their efforts to work collaboratively with the students to reconstruct a Peace Corner (Rincon de la Paz), that the school used as a safe space for conflict resolution and workshops before it was destroyed by a hurricane," and at Amalia Exposito, "We met with the school-community committee to talk about progress in the project and for them to discuss with me some of the challenges they are facing." she said.
She also facilitated a continuing education course for members of the Asociación de Psicología de Puerto Rico on the "Prevention of Intimate Partner Violence and Sexual Violence in Latin America." The course was adapted from a longer course that Billings has developed with colleagues at the Pan American Health Organization (PAHO) and WHO.
Billings was interviewed for a UNE web stream, talk show program that focused on GBV and human rights, in the context of International Women's Day.
Throughout her work, Billings said she sees few differences in the U.S. and Latin American views on gender-based violence.
"We have such a diversity of opinions in the United States, some very conservative, some more enlightened. The current wave of anti-women legislative proposals and public statements that have emerged in recent months are forms of GBV and are quite frightening," she said.
"It shows how we must be vigilant and must work on these issues constantly. They are quite threatening to people. Latin American and Caribbean countries have a great advantage over the United States in that their governments have ratified international agreements that focus on human rights and in which GBV is highlighted, including the 1994 Inter-American Convention on the Prevention, Punishment and Eradication of Violence against Women, 'Convention of Belem do Para.'
"Civil society has used this commitment to demand compliance," Billings said. "In the United States, we have not ratified such agreements, and therefore can't use this tool for advocacy."
A board member for Sexual Trauma Services of the Midlands, Billings organized a team from HPEB at the Arnold School and USC's WGST Program to participate in the April 12 event, "Walk a Mile in Her Shoes."
She is continuing to collaborate with colleagues nationally and internationally to research effective ways to prevent violence and also is working with graduate students focusing on the topic. Jean Marie Place, an Arnold School doctoral student, is working with the National Institute of Public Health in Mexico, with Dr. Filipa Castro, to research postpartum depression.
"They have found a strong correlation with experiences of GBV," she said.
Doctoral student Kristin Van De Griend will work in Bangladesh this summer with Dr. Ruchira Tabassum Naved, Research Group Coordinator, Gender, Health, Human Rights and Violence against Women Center for Equity and Health Systems Icddr,b, on better understanding women's care-seeking experiences after being raped.
Visit http://www.elnuevodia.com/atencionmedicaavictimasdeviolenciasexual-1210943.html to read a newspaper article, in Spanish, of Billings' visit at UNE.
The web stream interview with Billings is at http://www.suagm.edu/une/paliqueando.asp.
Visit www.ipas.org for the pdf version of studies conducted in Central America with Ipas and CICAM http://www.ipas.org/Resources/Ipas%20Publications/Mujeres-victimas-sobrevientes-de-violencia-sexual-y-sus-experiencias-con-los-servicios-de-.aspx.
Go to http://www.cdc.gov/violenceprevention/nisvs/ to read more about the CDC's National Intimate Partner and Sexual Violence Survey.
