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DOW UNIVERSITY OF HEALTH SCIENCES
2
POST RN BScN Year 2 Semester 3
Presented by:
•GHULAM QADIR RAJPUT
•E.Mail: gqmcse@yahoo.com
•Cell#: 03013372448
SUBJECT: Ethical and Professional
Development in Health care
Presented to: Sir Amjad Ali
Date: 17th
February, 2017
OBJECTIVES
o Define the term violence
o Discuss the violence against women and its reasons.
o Understand common forms of violence against women.
Describe Domestic violence, its history and statistics.
Explore the effects of domestic violence.
Define sexual violence and its consequences.
Discuss the family violence (honor killing) and some
cases.
Recognize the physical violence (Acid attack), its reasons
and some cases.
3
CONT…
oExplain the challenges faced by nurse.
oUnderstand the role of nurses against violence.
oApply some recommendations for violence against women.
4
5
VIOLENCE
6
Violence is defined by the World Health Organization
(WHO) as
“The intentional use of physical force or power, threatened
or actual, against oneself, another person, or against a group
or community, which either results in or has a high likelihood
of resulting in injury, death, psychological harm, mal
development, or deprivation“.
VIOLENCE AGAINST WOMEN
• Violence against women also known as gender-based
violence and is collectively violent acts that are primarily
committed 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."
7
WHY VOILENCE AGAINST WOMEN IS SO
COMMON
• Physically weak.
• Gender inequality and discrimination.
• Low level of education.
• Limited economic opportunities.
• Low level of awareness about human
rights.
• male control over decision-making and
assets.
• Lack of safe spaces for women and girls.
8
TYPES OF GENDER BASED VIOLENCE
• Domestic Violence
• Sexual Violence
• Physical Violence
• Cultural Violence
• Religious Violence
• Socio – economic Violence
• Family Violence
9
MOST COMMON VIOLENCE AGAINST
WOMEN IN PAKISTAN
• DOMESTIC VIOLENCE
• SEXUAL VIOLENCE
• FAMILY/ COMMUNITY VIOLENCE (Honor Killing, Dowry
Death)
• PHYSICAL VIOLENCE (ACID ATTACK)
10
11
DOMESTIC VIOLENCE
12
• The term domestic violence refers to abusive behavior in
any personal relationship that allows one partner to
intimidate, or to gain power and control over the other.
This is often thought of to occur between married spouses
or in other intimate relationships, but actually refers to any
family relationship, or persons living in the same home.
HISTORY OF DOMESTIC VIOLENCEHISTORY OF DOMESTIC VIOLENCE
13
Historically, through the late 1800s, violence and abuse
committed against women within the confines of their
marriage was implicitly accepted as a husband’s right. It
wasn’t until the late 1970s that domestic violence started
gaining recognition as a crime of violence, and it took
another 20 years for federal and state legislation to catch
up, providing protection against, and serious punishment
for, such acts.
FORMS OF DOMESTIC VIOLENCE
• Verbal Abuse
• Physical Abuse
• Emotional or
Psychological Abuse
• Economic Abuse
• Sexual Abuse
• Isolation
14
STATISTICS OF DOMESTIC VIOLENCE
• 63% of the participants were identified as victims of
domestic violence on Karachi Domestic Violence
Screening Scale.
• 36% of the victims were males and 64% of the victims
were females.
15
Outpatient Departments Of Psychiatry, Liaqat National
Hospital, PNS Shifa and Sobraj Hospital Karachi.
CONT.….
• 35% of the victims reported facing physical abuse.
• 30% of the victims reported sexual abuse from their
partner.
• 60% of the victims had depression
• 90% of women in Pakistan face domestic violence (Tribune
Express).
• In 2011, Thomson Reuters survey ranked Pakistan as the
third most dangerous country for women in the world after
Afghanistan and Democratic Republic of Congo.
16
EFFECTS OF DOMESTIC VIOLENCE
• Anxiety
• Chronic depression
• Chronic pain
• Death
• Drug and alcohol dependence
• Health problems
• Malnutrition
• Panic attacks
• Repeated self-injury
• Self neglect
• Sexual dysfunction
• Sleep disorders
• Strained family relationships
• Suicide attempts
• Inability to adequately respond to the needs of their children
17
18
19
20
SEXUAL VIOLENCE
• Sexual violence is any sexual
act or attempt to obtain a sexual act
by violence and acts to traffic a
person or acts directed against a
person's sexuality, regardless of the
relationship to the victim.
• Sexual violence against women and
girls can take many forms and is
carried out in different situations
and contexts.
21
SEXUAL VIOLENCE AGAINST WOMEN
The WHO’s World Report on Violence and Healthlists the following
ways in which sexual violence against females can be committed:
•Rape within marriage or dating relationships.
•Rape by strangers. (Gang Rape)
•Unwanted sexual advances or sexual harassment, including demanding
sex in return for favors
•Sexual abuse of mentally or physically disabled women
•Denial of the right to use contraception or to adopt other measures to
protect against sexually transmitted diseases
•Forced prostitution and trafficking of people for the purpose of sexual
exploitation.
22
CONSEQUNECES OF SEXUAL
VIOLENCE
• Depression and anxiety
• Loss of self-esteem
• Emotional distress
• Nightmare
• Self blame
• Mistrust
• Chronic mental disorder
• Committing suicide
AND MANY MORE…….
23
24
25
HONOR KILLING
Honor killings in Pakistan are known
locally as karo-kari. An honor killing
is the homicide of a member of a
family or social group by other
members, due to the belief the
victim has brought dishonor upon
the family or community. The death
of the victim is viewed as a way to
restore the reputation and honour
of the family.
26
STATISTICS
27
• According to the findings of Human Rights and Legal Aid
Centre in Karachi, in the first three months of 2013, 120
Pakistani women were murdered in the name of Honor
Killing.
• According to the Human Rights Commission of Pakistan,
“Over 1000 honor killings take place every year in
Pakistan and, in the Punjab alone, at least 700 women are
raped each year,” and then subsequent honor killing
SOME CASES OF HONOR KILLING IN
PAKISTAN
• On 27 April 2010, Ayman Udas, a Pashtun singer from Peshawar, was
shot to death by her two brothers who "viewed her divorce,
remarriage and artistic career as damaging to family honor.“
• On 27 May 2014, a pregnant woman named Farzana Iqbal was stoned
to death by her family in front of a Pakistani High Court for marrying
the man she loved.
• In July 2016, popular Pakistani social media celebrity Qandeel Baloch
was strangled by her brother in an act of honor killing in Multan. She
had reportedly raised controversy by posting controversial pictures
of herself on social media.
28
29
30
ACID VIOLENCE
• Acid violence is the deliberate
use of acid to attack another
human being.
• The victims of acid violence are
mostly women and children,
and attackers often target the
head and face in order to
disfigure and blind.
31
REASONS OF ACID ATTACK
• Revenge for refusal of a marriage proposal or other romantic
or sexual advances.
• The person throw acid with the intention of injuring or
disfiguring the bodies, and to burn the faces.
• Land or family disputes.
• Demands for dowry.
• For attending schools, for not wearing Hijaab and abaya, for
not behaving well, for speaking too much or for laughing
loudly. 32
STATISTICS
• Acid attacks are most prevalent in Pakistan, Bangladesh, India, Nepal and
Cambodia, they have also been reported in Afghanistan and in parts of
Africa and Europe.
• Between 150 and 400 cases of acid attacks are reported in Pakistan every
year. As many as 80 per cent of the victims are women, and almost 70
per cent are below 18. Such attacks are not used to kill the victim but to
cause disfigurement, and can often cause blindness, hearing loss and
physical and mental pain.
Published in Dawn, October 18th, 2015
33
ACID ATTACK VICTIMS AND THEIR STORIES
Irum Saeed, 30 years old. Irum was burned
on her face, back and shoulders twelve years
ago when a boy whom she rejected for
marriage threw acid on her in the middle of
the street. 
34
Memuna Khan, 21years old.
Menuna was burned by a group of boys
who threw acid on her to settle a dispute
between their family.
35
Najaf Sultana, 16 years old. At the age
of five Najaf was burned by her father
while she was sleeping, apparently
because he didn't want to have another girl
in the family. As a result of the burning
Najaf became blind after this incident.
Shahnaz Bibi, 35 years old.
Ten years ago Shahnaz was burned with acid by
a relative due to a familial dispute. 
36
37
WOMEN RIGHTS LAW OF PAKISTAN
o DOMESTIC VIOLENCE (PREVENTION & PROTECTION
BILL, 2013.
According to the bill those who found guilty of beating women or
children will face a minimum six months behind bars and a fine of at
least 100,000.
o Acid control and Acid Prevention Bill 2010. According to the
bill, the culprit would face fourteen years imprisonment and a
minimum fine of 1 Million rupees.
o In 1997 the National Assembly passed a law that provided for theIn 1997 the National Assembly passed a law that provided for the
death penalty for persons convicted of gang rape.death penalty for persons convicted of gang rape.
38
SOME FACTS
39
• It is estimated that about one third of
children who are abused or exposed to
violence as children become violent
themselves in later life.
• The sons of the most violent parents had
a rate of wife abuse 100 times higher than
the sons of the nonviolent parents.
DIFFICULTIES FACED BY VICTIMS
• Lack of Awareness
• Lack of Health Services
• Access to Legal Remedies
• No Job, No Income
• Social Stigma
AND MANY MORE ……
40
CHALLENGES AS A
NURSE
• If a women comes to you with bruises or injuries on her
body how would you deal with her ?
• As a nurse what are our limitations to deal any violence
case?
• Can we play a significant role in changing the life of the
women?
41
ROLE OF NURSES
• Nurses should educate them, and confront their fears, values
and beliefs.
• Acknowledge what the patient said.
• Assess the patient's safety needs.
• Refer the patient to social and mental health workers as well
as community and State domestic violence agencies and
hotlines.
• Document their findings in the patient's chart.
• Arrange to have the patient follow up with them.
42
RECOMMENDATIONS
• To improve the status of woman within society.
• Changing perceptions.
• Education.
• Easy access to law and order.
• Stigma related to violence.
• Moral support to the victim.
• Emergency management.
43
44
REFRENCES
• http://www.jpma.org.pk/full_article_text.php?article_id=1372
• http://www.webmd.com/mental-health/tc/domestic-violence-topic-
overview#3
• http://www.who.int/mediacentre/factsheets/fs239/en/
• http://www.unwomen.org/en/news/stories/2013/6/it-is-time-for-
action-to-end-violence-against-women-a-speech-by-lakshmi-puri
• https://www.hrw.org/reports/1999/pakistan/index.htm
• http://www.endvawnow.org/en/articles/300-causes-protective-and-
risk-factors-.html
45
46

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Violence against women or Domestic violence

  • 1. 1
  • 2. DOW UNIVERSITY OF HEALTH SCIENCES 2 POST RN BScN Year 2 Semester 3 Presented by: •GHULAM QADIR RAJPUT •E.Mail: gqmcse@yahoo.com •Cell#: 03013372448 SUBJECT: Ethical and Professional Development in Health care Presented to: Sir Amjad Ali Date: 17th February, 2017
  • 3. OBJECTIVES o Define the term violence o Discuss the violence against women and its reasons. o Understand common forms of violence against women. Describe Domestic violence, its history and statistics. Explore the effects of domestic violence. Define sexual violence and its consequences. Discuss the family violence (honor killing) and some cases. Recognize the physical violence (Acid attack), its reasons and some cases. 3
  • 4. CONT… oExplain the challenges faced by nurse. oUnderstand the role of nurses against violence. oApply some recommendations for violence against women. 4
  • 5. 5
  • 6. VIOLENCE 6 Violence is defined by the World Health Organization (WHO) as “The intentional use of physical force or power, threatened or actual, against oneself, another person, or against a group or community, which either results in or has a high likelihood of resulting in injury, death, psychological harm, mal development, or deprivation“.
  • 7. VIOLENCE AGAINST WOMEN • Violence against women also known as gender-based violence and is collectively violent acts that are primarily committed 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." 7
  • 8. WHY VOILENCE AGAINST WOMEN IS SO COMMON • Physically weak. • Gender inequality and discrimination. • Low level of education. • Limited economic opportunities. • Low level of awareness about human rights. • male control over decision-making and assets. • Lack of safe spaces for women and girls. 8
  • 9. TYPES OF GENDER BASED VIOLENCE • Domestic Violence • Sexual Violence • Physical Violence • Cultural Violence • Religious Violence • Socio – economic Violence • Family Violence 9
  • 10. MOST COMMON VIOLENCE AGAINST WOMEN IN PAKISTAN • DOMESTIC VIOLENCE • SEXUAL VIOLENCE • FAMILY/ COMMUNITY VIOLENCE (Honor Killing, Dowry Death) • PHYSICAL VIOLENCE (ACID ATTACK) 10
  • 11. 11
  • 12. DOMESTIC VIOLENCE 12 • The term domestic violence refers to abusive behavior in any personal relationship that allows one partner to intimidate, or to gain power and control over the other. This is often thought of to occur between married spouses or in other intimate relationships, but actually refers to any family relationship, or persons living in the same home.
  • 13. HISTORY OF DOMESTIC VIOLENCEHISTORY OF DOMESTIC VIOLENCE 13 Historically, through the late 1800s, violence and abuse committed against women within the confines of their marriage was implicitly accepted as a husband’s right. It wasn’t until the late 1970s that domestic violence started gaining recognition as a crime of violence, and it took another 20 years for federal and state legislation to catch up, providing protection against, and serious punishment for, such acts.
  • 14. FORMS OF DOMESTIC VIOLENCE • Verbal Abuse • Physical Abuse • Emotional or Psychological Abuse • Economic Abuse • Sexual Abuse • Isolation 14
  • 15. STATISTICS OF DOMESTIC VIOLENCE • 63% of the participants were identified as victims of domestic violence on Karachi Domestic Violence Screening Scale. • 36% of the victims were males and 64% of the victims were females. 15 Outpatient Departments Of Psychiatry, Liaqat National Hospital, PNS Shifa and Sobraj Hospital Karachi.
  • 16. CONT.…. • 35% of the victims reported facing physical abuse. • 30% of the victims reported sexual abuse from their partner. • 60% of the victims had depression • 90% of women in Pakistan face domestic violence (Tribune Express). • In 2011, Thomson Reuters survey ranked Pakistan as the third most dangerous country for women in the world after Afghanistan and Democratic Republic of Congo. 16
  • 17. EFFECTS OF DOMESTIC VIOLENCE • Anxiety • Chronic depression • Chronic pain • Death • Drug and alcohol dependence • Health problems • Malnutrition • Panic attacks • Repeated self-injury • Self neglect • Sexual dysfunction • Sleep disorders • Strained family relationships • Suicide attempts • Inability to adequately respond to the needs of their children 17
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  • 21. SEXUAL VIOLENCE • Sexual violence is any sexual act or attempt to obtain a sexual act by violence and acts to traffic a person or acts directed against a person's sexuality, regardless of the relationship to the victim. • Sexual violence against women and girls can take many forms and is carried out in different situations and contexts. 21
  • 22. SEXUAL VIOLENCE AGAINST WOMEN The WHO’s World Report on Violence and Healthlists the following ways in which sexual violence against females can be committed: •Rape within marriage or dating relationships. •Rape by strangers. (Gang Rape) •Unwanted sexual advances or sexual harassment, including demanding sex in return for favors •Sexual abuse of mentally or physically disabled women •Denial of the right to use contraception or to adopt other measures to protect against sexually transmitted diseases •Forced prostitution and trafficking of people for the purpose of sexual exploitation. 22
  • 23. CONSEQUNECES OF SEXUAL VIOLENCE • Depression and anxiety • Loss of self-esteem • Emotional distress • Nightmare • Self blame • Mistrust • Chronic mental disorder • Committing suicide AND MANY MORE……. 23
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  • 26. HONOR KILLING Honor killings in Pakistan are known locally as karo-kari. An honor killing is the homicide of a member of a family or social group by other members, due to the belief the victim has brought dishonor upon the family or community. The death of the victim is viewed as a way to restore the reputation and honour of the family. 26
  • 27. STATISTICS 27 • According to the findings of Human Rights and Legal Aid Centre in Karachi, in the first three months of 2013, 120 Pakistani women were murdered in the name of Honor Killing. • According to the Human Rights Commission of Pakistan, “Over 1000 honor killings take place every year in Pakistan and, in the Punjab alone, at least 700 women are raped each year,” and then subsequent honor killing
  • 28. SOME CASES OF HONOR KILLING IN PAKISTAN • On 27 April 2010, Ayman Udas, a Pashtun singer from Peshawar, was shot to death by her two brothers who "viewed her divorce, remarriage and artistic career as damaging to family honor.“ • On 27 May 2014, a pregnant woman named Farzana Iqbal was stoned to death by her family in front of a Pakistani High Court for marrying the man she loved. • In July 2016, popular Pakistani social media celebrity Qandeel Baloch was strangled by her brother in an act of honor killing in Multan. She had reportedly raised controversy by posting controversial pictures of herself on social media. 28
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  • 31. ACID VIOLENCE • Acid violence is the deliberate use of acid to attack another human being. • The victims of acid violence are mostly women and children, and attackers often target the head and face in order to disfigure and blind. 31
  • 32. REASONS OF ACID ATTACK • Revenge for refusal of a marriage proposal or other romantic or sexual advances. • The person throw acid with the intention of injuring or disfiguring the bodies, and to burn the faces. • Land or family disputes. • Demands for dowry. • For attending schools, for not wearing Hijaab and abaya, for not behaving well, for speaking too much or for laughing loudly. 32
  • 33. STATISTICS • Acid attacks are most prevalent in Pakistan, Bangladesh, India, Nepal and Cambodia, they have also been reported in Afghanistan and in parts of Africa and Europe. • Between 150 and 400 cases of acid attacks are reported in Pakistan every year. As many as 80 per cent of the victims are women, and almost 70 per cent are below 18. Such attacks are not used to kill the victim but to cause disfigurement, and can often cause blindness, hearing loss and physical and mental pain. Published in Dawn, October 18th, 2015 33
  • 34. ACID ATTACK VICTIMS AND THEIR STORIES Irum Saeed, 30 years old. Irum was burned on her face, back and shoulders twelve years ago when a boy whom she rejected for marriage threw acid on her in the middle of the street.  34 Memuna Khan, 21years old. Menuna was burned by a group of boys who threw acid on her to settle a dispute between their family.
  • 35. 35 Najaf Sultana, 16 years old. At the age of five Najaf was burned by her father while she was sleeping, apparently because he didn't want to have another girl in the family. As a result of the burning Najaf became blind after this incident. Shahnaz Bibi, 35 years old. Ten years ago Shahnaz was burned with acid by a relative due to a familial dispute. 
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  • 38. WOMEN RIGHTS LAW OF PAKISTAN o DOMESTIC VIOLENCE (PREVENTION & PROTECTION BILL, 2013. According to the bill those who found guilty of beating women or children will face a minimum six months behind bars and a fine of at least 100,000. o Acid control and Acid Prevention Bill 2010. According to the bill, the culprit would face fourteen years imprisonment and a minimum fine of 1 Million rupees. o In 1997 the National Assembly passed a law that provided for theIn 1997 the National Assembly passed a law that provided for the death penalty for persons convicted of gang rape.death penalty for persons convicted of gang rape. 38
  • 39. SOME FACTS 39 • It is estimated that about one third of children who are abused or exposed to violence as children become violent themselves in later life. • The sons of the most violent parents had a rate of wife abuse 100 times higher than the sons of the nonviolent parents.
  • 40. DIFFICULTIES FACED BY VICTIMS • Lack of Awareness • Lack of Health Services • Access to Legal Remedies • No Job, No Income • Social Stigma AND MANY MORE …… 40
  • 41. CHALLENGES AS A NURSE • If a women comes to you with bruises or injuries on her body how would you deal with her ? • As a nurse what are our limitations to deal any violence case? • Can we play a significant role in changing the life of the women? 41
  • 42. ROLE OF NURSES • Nurses should educate them, and confront their fears, values and beliefs. • Acknowledge what the patient said. • Assess the patient's safety needs. • Refer the patient to social and mental health workers as well as community and State domestic violence agencies and hotlines. • Document their findings in the patient's chart. • Arrange to have the patient follow up with them. 42
  • 43. RECOMMENDATIONS • To improve the status of woman within society. • Changing perceptions. • Education. • Easy access to law and order. • Stigma related to violence. • Moral support to the victim. • Emergency management. 43
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  • 45. REFRENCES • http://www.jpma.org.pk/full_article_text.php?article_id=1372 • http://www.webmd.com/mental-health/tc/domestic-violence-topic- overview#3 • http://www.who.int/mediacentre/factsheets/fs239/en/ • http://www.unwomen.org/en/news/stories/2013/6/it-is-time-for- action-to-end-violence-against-women-a-speech-by-lakshmi-puri • https://www.hrw.org/reports/1999/pakistan/index.htm • http://www.endvawnow.org/en/articles/300-causes-protective-and- risk-factors-.html 45
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Editor's Notes

  1. low levels of education (for boys associated with perpetrating violence in the future and for girls, experiencing violence); limited economic opportunities (an aggravating factor for unemployed or underemployed men associated with perpetrating violence; and as a risk factor for women and girls, including of domestic abuse, child and forced marriage, and sexual exploitation and trafficking); the presence of economic, educational and employment disparities between men and women in an intimate relationship; conflict and tension within an intimate partner relationship or marriage; women’s insecure access to and control over property and land rights; male control over decision-making and assets; attitudes and practices that reinforce female subordination and tolerate male violence (e.g. dowry, bride price, child marriage); lack of safe spaces for women and girls, which can be physical or virtual meeting spaces that allow free expression and communication; a place to develop friendships and social networks, engage with mentors and seek advice from a supportive environment. normalized use of violence within the family or society to address conflict; a limited legislative and policy framework for preventing and responding to violence; lack of punishment (impunity) for perpetrators of violence; and, low levels of awareness among service providers, law enforcement and judicial actors. (Bott, et al., 2005;
  2. Physical: pushing, grabbing, slapping, kicking, hitting with an object, use of knife or gun, acid throwing, burning. Verbal: shouting, making threats, calling names, humiliating remarks (gestures). Sexual: forcing intercourse, making her to do sexual things against her will. Physical violence that can lead to injuries such as bruises or broken bones Sexual Abuse Threats of physical or sexual violence Emotional abuse that may lead to depression, anxiety, or social isolation