The man that loved me is not the same man that I Iive with now

The next patient that entered the consulting room was a light skinned, tall woman, well dressed but didn't look happy. She just managed to give me a smile as she sat down .
I had the following conversations with 3 patients;

PATIENT 1

Doctor ; Good day ma, how are you?
Patient 1; Am not fine doc
Doctor ; What happened?
Patient 1: Doctor what can be done about my face my husband hit my head on the wall after our discussion resulted into a fight.I want everything written in that folder. I will surely take up the matter. My whole body aches. I can't even lift this hand. He was just punching me like a sack of rice.
Doctor ; Sorry ma, I will prescribe some analgesics for you.
Patient; I am light skinned and I will need some thing to take away the black eye.

PATIENT  2

Nurse ; Doctor there is an emergency. A patient is bleeding from a laceration on the face.
Doctor ; Madame what happened?
Patient; Is it not my husband, he hit my head against the wall  in the bathroom.
Doctor; Where is he?
Patient; He didnt come,it was my neighbour that brought me here.
Doctor; Ok, just be calm while I suture the cut, is quite deep.
Patient;I feel much better now. The pain was so much . That man is very heartless. My daughter ran to him and told him that mum was bleeding from the face and lying on the floor. He never came to help me.
Doctor ; Really sorry for what happened. Take your drugs as prescribed. You will be fine.

PATIENT 3

Patient; Please I need help.
Doctor; What happened ma?
Patient ; My husband beat me. Look at my mouth is swollen , my back aches.
Doctor; What happened? Lie down on the couch so that I can examine you. I will give you some analgesics.
Patient; It all started during the last Christmas season.We were ...............

And the story goes on and on. All the above patients suffered from violence against women. I had to counsel all 3 patients and also show empathy. Surprisingly , all 3 women were well educated and I just couldn't figure out were they went wrong.

According to WHO;

• Violence against women - particularly intimate partner violence and sexual violence - are major public health problems and violations of women's human rights.
• Recent global prevalence figures indicate that about 1 in 3 (35%) of women worldwide have experienced either physical and/or sexual intimate partner violence or non-partner sexual violence in their lifetime.
• Most of this violence is intimate partner violence. Worldwide, almost one third (30%) of women who have been in a relationship report that they have experienced some form of physical and/or sexual violence by their intimate partner.
• Globally, as many as 38% of murders of women are committed by an intimate partner.
• Violence can negatively affect women’s physical, mental, sexual and reproductive health, and may increase vulnerability to HIV.

• Factors associated with increased risk of perpetration of violence include low education, child maltreatment or exposure to violence in the family, harmful use of alcohol, attitudes accepting of violence and gender inequality.
• Factors associated with increased risk of experiencing intimate partner and sexual violence include low education, exposure to violence between parents, abuse during childhood, attitudes accepting violence and gender inequality.
• There is evidence from high-income settings that school-based programmes may be effective in preventing relationship violence (or dating violence) among young people.
• In low-income settings, primary prevention strategies, such as microfinance combined with gender equality training and community-based initiatives that address gender inequality and relationship skills, hold promise.
• Situations of conflict, post conflict and displacement may exacerbate existing violence, such as by intimate partners, and present additional forms of violence against women.

The United Nations defines violence against women as "any act of gender-based violence that results in, or is likely to result in, physical, sexual or mental harm or suffering to women, including threats of such acts, coercion or arbitrary deprivation of liberty, whether occurring in public or in private life."

Factors specifically associated with intimate partner violence include:

• past history of violence;
• marital discord and dissatisfaction;
• difficulties in communicating between partners.

All these have health consequences like; Homicide or suicide, injuries, unintended pregnancies, depression, post traumatic stress disorder,emotional stress , negative impact on the children etc

Legislations that protect women , empowers women and promotes gender equality should be put in place.
If there is a crack or friction in your marriage always seek a marriage counsellor early before it deteriorates.

Remember that problem shared is problem half solved. Please do share your experiences with us.
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