Visions for the future, vocational training and special aspects esp. family violence

Family violence is a global public health problem, which constitutes a violation of human rights and is considered a hidden epidemic. Family violence (also named domestic violence, domestic abuse or battering) includes intimate partner violence, child abuse/neglect and elder abuse, among others and can take many forms: physicial, emotional, verbal, sexual, physchological, etc. Its consequences involve serious damage to the physical, mental and social well-being of individuals and families.

Primary health care professionals may be the first or only point of contact for victims who may be hesitant or unable to seek other sources of assistance. These professionals are in the unique position to offer a safe and confidential environment to facilitate disclosure of violence, and provide appropriate support and referral to other resources and services.

Evidence shows that abused women use health care services more than non-abused women, and identify health care professionals as those who they would trust the most with disclosing an abuse. Yet, they tend not to disclose abuse unless specifically asked. Therein lies a problem: most of the practicing physicians have received either no or insufficient education or training in any aspect of family or gender violence.

The scope of the problem is alarming: WHO indicates that about 1 in 3 (35%) of women worldwide have experienced either physical and/or sexual violence by intimate partner or non-partner violence in their lifetime. However, experts know that rates of all forms of family violence are underestimated.

Why are we not prepared to face an epidemic like this? What are the reasons behind this lack of knowledge and barriers to take action? How can we, health care professionals in the frontline, assume our roles and responsibilities to provide the best care possible to victims, families and perpetrators?