Behind the screens: Domestic violence and health care practices

Abstract

abstract Domestic violence (DV) is one of the most pervasive forms of violence in South Africa with numerous physical and psychological consequences that have severe and enduring impacts on health. This takes a significant toll on women, their families and the health care system. Local and international literature suggests that DV is one of the most common reasons for women to present at health care facilities, placing health care practitioners in a unique position to identify abuse and intervene. As widespread as it is, DV is not a specifically prioritised public health concern and thus suffers from vastly inadequate resource allocation. The Domestic Violence Act, No 116 of 1998, was the first and only South African legislative attempt to recognise DV victims’ rights to seek immediate medical assistance. It did not, however, impose any positive legal duties on health care practitioners to inquire about, screen for or holistically treat DV-related injuries and other health-related consequences of DV or make referrals. The Act only implies that health care practitioners have a duty to attend to DV cases. International codes delineate duties for health care practitioners in providing care for women in abusive relationships, and South Africa has detailed medico-legal protocols for the examination and treatment of survivors of sexual offences. It is therefore curious that a similar treatment protocol does not exist for DV. This Article reviews the literature on the health consequences of DV and the need for screening, and recounts the historical attempts of civil society in South Africa to impose legal duties on the state to assist DV victims who present to health care facilities. We argue that it is time that Parliament review the provisions of the Domestic Violence Act to include legal duties on health care practitioners to properly address the health consequences of DV.