Tuesday, February 5, 2013

Social Attitude on Gang Rape and Public Health Issues


Presented at the Meeting on “rape and violence against women” organized by PUCL and Radical Humanists India on 10th Jan 2013 at Gandhi Peace Foundation, New Delhi
Dr. Jugal Kishore
Professor Public Health Maulana Azad Medical College
Director (Hon) Center for Inquiry-India, 


The Delhi High Court on February 08, 2010 sentenced the prime convict in the 2002 Maulana Azad Medical College student rape case to life imprisonment. The Delhi police had in 2003 filed a charge sheet against four persons - Rahul, Amit, Mohan Lal and Ashok –except raul other were acquitted, two initially and Amit was released in 2010. It took eight years to settle the case.

Ms. Jyoti Singh 23 year old girl who was gang raped on December 16 on moving bus in Munirka Vasant Kunj road and had 13-day of agonizing struggle for life that ended in her death in Singapore. Her companion who was also beaten up by six culprits said that "My friend was grievously injured and bleeding profusely," he said. "Cars, autos and bikes slowed down and sped away. I kept waving for help. The ones who stopped stared at us, discussing what could have happened. Nobody did anything." This indicate our social and legal attitude to the cases of rape not to mention the attitude of police who always justified their inactions because of lack of staff, political pressure, religious and social pressure.

Statistics of violence against women
Every 3rd minute a case of violence against woman is registered in India. Every day 50 cases of dowry related violence are reported. Every 29th minute a woman is raped in 2011 and it was 54 minutes in 2002. The worst is this shameful list is Madhya Pradesh which has had Three thousand four hundred and six cases of rape reported in 2011 (3406) then West Bengal (2363) then Uttar Pradesh (2042) and so on. Fewer cases are reported from Sikkim and Nagaland, Manipur and Goa. The total number of RAPE case reported last year has been 23582.
Violence against women takes many forms – physical, sexual, psychological and economic. These forms of violence are interrelated and affect women from before birth to old age.
Up to 70 per cent of women experience violence in their lifetime.

Violence by an intimate partner
A World Health Organization (WHO) study in 11 countries found that the percentage of women who had been subjected to sexual violence by an intimate partner ranged from 6 per cent in Japan to 59 per cent in Ethiopia.

Women aged 15-44 are more at risk from rape and domestic violence than from cancer, car accidents, war and malaria, according to World Bank data. It is estimated that, worldwide, one in five women will become a victim of rape or attempted rape in her lifetime. The practice of early marriage – a form of sexual violence – is common worldwide, especially in Africa and South Asia. Over 60 million girls worldwide are child brides, married before the age of 18, primarily in South Asia (31.1 million and Sub-Saharan Africa (14.1 million).

Sexual violence in conflict or custody
It is frequently a conscious strategy employed on a large scale by armed groups to humiliate opponents, terrify individuals and destroy societies. Women and girls may also be subjected to sexual exploitation by those mandated to protect them. Violence against women in police custody is common and includes sexual violence, inappropriate surveillance, strip searches conducted by men and demands for sexual acts in exchange for privileges or basic necessities.

Violence and HIV/AIDS
Young women are particularly vulnerable to coerced sex and are increasingly being infected with HIV/AIDS. Over half of new HIV infections worldwide are occurring among young people between the ages of 15 and 24, and more than 60 per cent of HIV-positive youth in this age bracket are female. There is feminizing of AIDS.

Dowry murder
Dowry murder is a brutal practice where a woman is killed by her husband or in-laws because her family cannot meet their demands for dowry — a payment made to a woman’s in-laws upon her marriage as a gift to her new family. In India, 22 women were killed each day in dowry-related murders in 2007.

Honor killing
In many societies, rape victims, women suspected of engaging in premarital sex, and women accused of adultery have been murdered by their relatives because the violation of a woman’s chastity is viewed as an affront to the family’s honor

Trafficking in persons
Between 0.5 to 2 million people are trafficked annually into situations including prostitution, forced labor, slavery or servitude, according to estimates. Women and girls account for about 80 per cent of the detected victims

A 2004 study in the United Kingdom estimated the total direct and indirect costs of domestic violence, including pain and suffering, to be £23 billion per year or £440 per person (Rs.30800 per capita).

What makes the women vulnerable?
  1. Customs
  2. Attitude of society towards girl child
  3. Polygamy and polyandry
  4. Child Marriage
  5. Sati pratha
  6. Casteism
  7. Honor Killing
  8. Female Genital Mutilation
  9. Gender based violence
  10. Poor health conditions such as HIV, STDs, TB, Leprosy
  11. Sexual harassment
  12. Prostitution
  13. Poor educational status
  14. Poor Law and order
  15. Women’s occupations
  16. Women’s insecurity
  17. Misuse of advancement of Technology such as ultrasound machine, emergency pills,
  18. Infanticide and feticides

Prevention and control
These all conditions of women enumerated above are the symptoms of disease which lying in physico-psycho-social environment and has multi-dimensional causation. Causes of women sufferings are more related to her social, cultural, religious, legal, political and mental status. According to my understanding sacred scriptures are responsible for her poor status. As science and humanism are improving the conditions of human being on the other hand the orthodox and rotten scriptures continue to pollute the society’s mind to behavior barbarically. So prevention and control should focus on core of the problem. It has to be multidimensional and integrated in nature. One must understand that woman suffering is not her own problem rather whole family and society gets affected.  Following corrective measures need to be   
  1. Corrections of sacred books
  2. Promoting science based humanism
  3. Annihilation of harmful practices against any gender  
  4. Women’s empowerment and equalizing gender power
  5. Protecting the rights of girl child and reproductive rights
  6. Protecting and promoting health of the women
  7. Educating children and adolescents for life skills
  8. Protecting environment and decreasing consumerism
  9. Strict implementation of laws and making appropriate laws
Most of the preventive and measures are self explanatory, however, here last two need little more elaboration. Life skill education trained the person to learn skills required for day to day life and dealing with stress and strain in life without damaging health.
-Communication
-Assertiveness
-Negotiation
-Critical thinking
-Coping skills

Life skill education is advocated at school level but very few places it is started. School authorities in both public and private should take this responsibility to inculcate in them these skills. We are not telling our children to develop life skills rather exposing them to consumerism and violence. Society plays a paradoxical role confusing the developing mind. On one side violence is accepted through movies, literature, sacred scriptures, role model based mythological tales and on other side it preaches Ahimsa, peace and love. Both concepts can’t stay together. Young people should be exposed to truth so that they can use their critical thinking for exploring further truth. We have to provide opportunities to learn communication and negotiating skills with your other colleague, friends, family, neighbor and opponents.

What coping mechanism we have if some young girl is rapped. How society react to this is important. For her it is the end of life. Or it is end for rapist also. One does not have other choice. How a young person will cope to this situation need to be told. There should be scope of improvement, tolerance, let go feeling and forgiveness. Society moves on and develops strong flexibility.

References
1.      Jugal Kishore. Female Feticide: An Instigation of female status. Saarbr├╝cken: LAP LAMBERT Academic Publishing GmbH & Co. Germany 2012.

Saturday, February 2, 2013

Effect of Community-Based Behavior Change Communication on Delivery and Newborn health care practices in a resettlement colony of Delhi


Background: Neonatal morbidity and mortaliy in India continues to be high. Among other reasons, newborn care practices are major contributors for such high rates.
Objective: To assess the effect of behavior change communication (BCC) package among pregnant women regarding neonatal care. 
Material and methods: Semi-structured and pre-tested schedule was used to interview 200 multigravidas on various aspects of neonatal care. Based on the preliminary data BCC package was designed and implemented in intervention block in the community. Follow up was done to find out change in their behaviour.
Statistical Analysis: Data was analyzed using Epi – info and Fischer exact test and chi-square test were applied in the baseline data. A p value of less than 0.05 was considered significant.  Effect of the BCC package is given in terms of relative risk.
Results: BCC package increased 1.76 times higher number of deliveries conducted by trained dais in intervention group. There was significant improvement in using sterile cord tie (p=0.01), applied nothing to the cord and giving bath to their baby within 6 hour of birth (p=0.02) in intervention group as compared to non-intervention group. Significant difference was found between the two groups with regard to breast-feeding practices of baby. Harmful practices were reduced in intervention group. Significant improvement was found in intervention group as compared to non-intervention group with regards to knowledge of danger signals, physiological variants, management of breastfeeding related problems, and awareness of skin-to-skin technique for the management of hypothermic baby. 
Conclusion: Inadequate knowledge and adverse practices regarding neonatal care among mothers in study areas were found. BCC package had favorable impact on behavior of mothers for neonatal care in intervention group. 



Keyword: Neonatal Health Care, Behavior Change Communication, Community Intervention, Breastfeeding, Hypothermia. http://www.ijcm.org.in/text.asp?2013/38/1/42/106627