The Australian Federation of Medical Women (AFMW)

 –  AFMW represents all the Medical Women’s Societies of Australia. The Medical Women’s Societies aim to further the professional development of medical women by education, research and improvement of professional opportunities. It promotes the health, welfare and human rights of all people, particularly women and children, at a national level and also internationally, through Medical Women’s International Association (MWIA).

 –  AFMW arranges conventions and conferences, and is linked with the MWIA.

 –  AFMW regards Violence Against Women and Children (VAW&C) as a serious health and social problem.

–  AFMW is aware that the leading cause of death in women in first world countries such as Australia, aged 20 to 40 is male violence, and 1 in 3 women report sexual abuse at some stage in their life,

AFMW aims: 

1. To improve the education and training programs in medical schools, including specialist training programs
2. To support all other training programs in Health and Allied Care, in implementing adequate training in VAW&C issues. 
3. To be part of raising community awareness of the issue. 

AFMW aims to lobby for the inclusion in all health training programs, education on:

1. Causes of VAW&C as they are currently understood
2. The severity and extent of the problem of VAW&C, and its profound health and social consequences
3. Appropriate responses by health professionals and all allied health providers
4. The available resources for timely response, reporting and most importantly follow up care
5. Current research in effective management strategies.

These aims are consistent with stated resolutions published by the Medical Women’s International Association (MWIA). (Please see appendix for complete list of resolutions concerning Violence Against Women and Children (VAW&C) passed by MWIA since 1919)

MWIA works closely with the United Nations as a Non-Government Organization (NGO). It maintains official working relations with the WHO, and has category 2 status with the UN Economic and Social Council. MWIA provides its members with the opportunity to exchange ideas, medically and personally, with colleagues from other nations. Their international Congress is held every 3 years.  

1. Why is domestic violence and sexual assault happening in Australia?  

A. Cultural Attitudes and Behaviors and Structures:

i. Attitudes, behaviors and structures that perpetuate and condone gender inequity
ii. Attitudes, behaviors and structures that normalize violence and abuse

B. Associated Aggravating Factors:

 i. Drug and Alcohol issues 
ii. Lack of support services in many communities, particularly those that are oppressed and deprived.
iii. Racism (when violence is directed at women and children in part due to cultural or racial difference) 
iv. Homophobia (when violence is directed at women in part due to attitudes to lesbian, bisexual and transgender (LBT) women )  

C. Lack of Education and Awareness:

 i. Of the severity and extent of the problem, its medical, social and psychological effects, and hence the importance of all community members addressing the issue.
ii. On support services available for reporting, and dealing with VAW&C
iii. That specific support services are accessible to Aboriginal, LBT & NESB women, including services for perpetrators within these groups.
iv. Of how cultural attitudes inform and normalize behaviors that encourage and allow bullying and more significant abuses and violence to occur.   

2. What resources, programs or services are you aware of that are successful in preventing or reducing the effects of domestic and family violence or sexual assault?

 i. Refuge system for women and children
ii. Women’s Health Centres supply limited but valuable counselling and support services 
iii. Sexual Assault Centres for acute care and limited follow up counseling
iv. Rape Crisis Centres 
v. Mandatory training day for all public health personnel on reporting of child abuse
vi. DOCS 
vii. Small number of rehabilitation programs for offenders, eg anger management groups, effective perpetrator programmes 
viii. Education programs of Women’s International League for Peace and Freedom (WILPF)
ix. www.austdvclearinghouse.unsw.edu.au website as a central resource site for resources and services to reduce VAW&C   

3. What are the barriers to family safety for women and children in Australia?

Lack of education and training in specific support services in both public and private sectors: 

i. police services
ii. legal facilities 
iii. health facilities

Lack of education and review in services responsible for handling:

i. advertising and media complaints 
ii. reports of bullying and abuses in education services 
iii reports of bullying abuses in workplaces

Lack of funding to services that support women and children:

i. inadequate number of refuges with trained workers
ii. inadequate number of crisis services and workers
iii. inadequate strategies and services for offenders
iv inadequate support, services, resources and education for Aboriginal, LBT, Rural and Isolated women and women of NESB.

Lack of accessible, appropriate and mandatory education programs that are easily implemented in schools, colleges and universities on:

i. Cultural attitudes and behaviors encourage and allow bullying, significant abuses and violence to occur.
ii. How as a community of women and men we can work together to reduce violence and abuse.
iii. When behaviours and abuses should be reported
iv. How to report abuses and violations of women and children
v. Support services available eg counseling services,
vi. Awareness of bullying and intimidation as the first stages of VAW&C   

4. What suggestions do you have to reduce domestic and family violence and sexual assault against women and children?

  

We would like to acknowledge the enormous work that has been done so far, in setting up of services and resources, and creating increased awareness of the issues in support areas and the wider community.  

  

A. Ensure adequate services for timely response to VAW&C victims are available:

i. Refuges with expanded refuge worker training in associated skills ( eg drug and alcohol issues)
ii. adequate police training in responding to incidents and reports
iii. adequate training in health personnel ( basic education to all health personal and specific training programs for those who work in special services for victims of VAW&C) 
iv. Sexual Assault Centres
v. DOCS: ensure DOCS has capacity to respond to all notifications of VAW&C as needed, ensuring there are more trained workers and more funding, and more support to DOCS from outside services as needed ( eg psychiatrists, police, legal services)  

B. Ensure support services are available.

i. Counseling services (Rape Crisis Centres, Counseling at Women’s Health Centres) 
ii. Legal services
iii. Rehabilitation programs for offenders with mandatory attendance being a condition of ongoing contact 
iv. Specific counselling services for perpetrators who are female
v. Availability of Family Therapy for offenders and family where appropriate  

C. Ensure that existing associated support services receive mandatory education: training for all personnel in the following areas in both public and private sectors:

i. police ( with acknowledgement of what has already been implemented)
ii. education facilities 
iii. health facilities
iv. human resources departments  

D. Review of Legal system to ensure: 

i. adequate penalties for abuse and violations, especially with repeat offenders
ii. incorporation of additional penalty systems to increase awareness between VAW&C and its consequences. Eg Sweden requires all offenders to pay into funds that support refuge and assault services. 
iii. implementation of mandatory rehab and education for offenders.

E. Ensure education programs to raise awareness of issues are implemented and made mandatory in: 

i. Schools
ii. University Colleges in relevant occupations: Law, Medicine, Education 
iii. Larger workplaces where other training programs exist, and for all employees in Human Resources Departments.

F. These mandatory education programs (some excellent ones have already been designed eg the work of WILPF) in schools, colleges and universities need to include education on: 

i. The cultural attitudes and behaviors that inform and normalize behaviors that encourage and allow bullying, more significant abuses and violence to occur.
ii. When behaviours and abuses should be reported 
iii. How to report abuses and violations of women and children 
iv. Support services available for follow up care eg counseling services
v. How as a community of women and men we can work together to reduce violence and abuse. 
vi. Mandatory training courses in all health care training programs, including medical and dental schools, and post grad training programmes, all nursing colleges and all affiliated care and health professions eg physiotherapy, naturopathic etc
vii. Ensure all services ( support services, drug and alcohol services and mandatory offender services) available for families of mainstream, Aboriginal, LBT, NESB and for isolated families.  

G. Continued evaluation of the severity of the issues of VAW&C with evaluation of effectiveness of services and their responses.

H. Further development of a Central Agency such as www.austdvclearinghouse.unsw.edu.au which all services are encouraged to link into and which:

i. Holds inventory of all co-ordinated services, training and education programmes, legal systems and is a constant resource of information and services available.
ii. Continues to evaluate the severity of the issues of VAW&C with evaluation of effectiveness of services and their responses. 
iii. Reviews international methodology and current strategies. 
iv. Promotes research into causes of VAW&C and effective strategies for reducing VAW&C.

APPENDIX

MWIA: Relevant Resolutions passed since 1919:

R.26 Domestic violence (intimate partner abuse) is a major public issue worldwide, with significant long-term impact on morbidity and mortality for the whole community, especially for women and children. To effect change, societal attitudes towards partner abuse must be considered unacceptable. MWIA urges governments in all countries to legislate that Domestic Violence (as defined by the UN, Beijing 1995) is a criminal offence, equivalent to other forms of violence. MWIA urges governments to form social structures (through effective legislation) to provide protection, information, education and support to all victims of domestic violence, including children. MWIA urges that legislation addressing domestic violence considers the direct and indirect impact on all members of the family, being aware that the consequences of intervention may further victimise these members. MWIA urges research in order to develop effective therapeutic and rehabilitative programs for perpetrators to prevent occurrence now and in future generations. MWIA urges that every effort should be made to discourage the dowry system, as it is a major cause of domestic violence and death of women in some countries. R.15 Medical Women’s International Association regards marriage as a partnership between equally empowered and freely consenting adults. MWIA condemns all inequality, discrimination and exploitation relevant to the marital status of girls and women. Women in marriage can be exposed to physical, sexual, and psychological abuse and also financial and legal exploitation. MWIA completely condemns ‘temporary’, forced, and pseudo marriages as disguises for deliberate exploitation of girls and women and calls for legislation and enforcement as required to eradicate physical, sexual, financial and legal exploitation. MWIA calls on governments to enact and enforce laws that set the legal age of marriage at 18 years of age, as marriage earlier than age 18 can cause reproductive health problems arising from early intercourse and childbirth. R.19 MWIA resolves that female medical caregivers should be equally accessible throughout urban, rural and remote areas MWIA resolves that strategies to improve recruitment and retention of doctors in rural and remote areas should specifically address barriers experienced by female practitioners. These include financial disincentives, the need for flexible hours, access to maternity leave and childcare, and provisions for employment of their partners and education of their children. MWIA resolves that rural female practitioners have appropriate representation in the decision-making processes of government bodies and medical organisations. R24 Culture, as a way of life, is dynamic. When a ‘cultural practice’ becomes a threat to human well being, it is a crime MWIA believes that vigorous advocacy must be carried out against all harmful practices that demean individuals and violate their human rights MWIA condemns that use of “culture and tradition” by perpetrators as an excuse or a ruse to carry out criminal acts such as rape, harmful widowhood rites, and other harmful practices MWIA urges that legal reforms in inheritance and ownership be implemented and enforced, taking precedence over discriminatory customary laws against women. 1976.3 Whereas children are the world’s greatest asset, Whereas it has always been the reponsibility of PARENTS to protect the health, safety and well-being of children, Whereas there is much suffering among the world’s children from abuse, neglect and deprivation, Whereas children are powerless to speak for themselves and have no access to legal redress of wrongs, be it resolved that MWIA through its members representing National Associations and Individual Members urge each national government to be concerned with the interests and protection of children and coordinate efforts on behalf of children. 1978.1 1. Mass media should encourage the reporting of child abuse to police or to social agencies etc. by anyone who suspects it, especially neighbours. 2. Those reporting suspected child abuse must be immune from liability and their names must not be disclosed to the public. Whereas sexual behaviour between adults and children has far-reaching medical and psychological consequences for its victims, the MWIA 1. deplores such behaviour, 2. supports the introduction of education on this subject into medical school curricula, 3. and calls for the development of social and legal resources to protect children against sexual exploitation. 1987.4 The MWIA stresses upon the UN to take all possible measures to prevent that children and adolescents: 1. are imprisoned on open or hidden political grounds; 2. participate involuntary in military actions. 1995.19 MWIA strongly condemns traffic in children, child prostitution and the exploitation of children by sex tourists. MWIA urges every effort to prevent it Whereas sexual behaviour between adults and children has far-reaching medical and psychological consequences for its victims, the MWIA 1. deplores such behaviour, 2. supports the introduction of education on this subject into medical school curricula, 3. and calls for the development of social and legal resources to protect children against sexual exploitation. 1987.4 The MWIA stresses upon the UN to take all possible measures to prevent that children and adolescents: 1. are imprisoned on open or hidden political grounds; 2. participate involuntary in military actions. 1992.2 The MWIA opposes commercial live donor transplant across international borders on the following grounds: It is: 1. against medical ethics; 2. a procedure for which there is no medical indication; 3. the exploitation of the poor by the wealthy; often it is women who sell their organs to secure food and medical care for their children. 4. produces two standards of humanity. The wealthy who purchase health at the expense of the loss of health of the under-privileged. 5. The concept of children as live donors of organs for transplantation is unacceptable. 1998.15 Violence against women MWIA reaffirms its stand that violence against women in all its forms (physical, psychological, social, cultural and sexual) is a violation of women’s fundamental human rights. Violence against women is a public health issue and has become a global problem affecting every society. MWIA further states that although there are many long term consequences of the effects of this violence on women’s health, the full extent of the problem is not known in many countries. MWIA recognizes the efforts made by a number of countries towards increasing awareness of the problem of violence against women and through the UN Commission for the Elimination of Discrimination Against Women (CEDAW). MWIA states its concern about the long-term psychological effects on children of witnessing such episodes of violence. MWIA expresses concern about the sometimes insensitive manner in which abused women are subsequently treated. MWIA therefore urges Governments and NGOs to allocate resources for extensive research into the extent and causes of this violence as well as for prevention and treatment programmes.

MWIA urges the effective training and educating of the abused women, health, social welfare and law enforcement personnel, as well as the members of the criminal justice system on the various aspects of violence against women.