When the parents of an injured five-year-old boy told Dr. Fai’zah A. Salim that he had fallen from a ladder, she was unconvinced and suspected otherwise.
Trained by UNFPA In Palu, the capital of Central Sulawesi, to identify physical and psychological signs of domestic violence, she referred the boy to a social counsellor. Shortly after, he explained what really happened and how his father beat him for mischief.
Recognition is the first step
“Recognition is the first step to being able to help,” said Dr. Salim. “We need to do more than treat symptomatic injuries. »
The Public Health Center, or Puskemas, where Dr. Salim works, is part of a pilot UNFPA program to address gender-based violence and other forms of domestic violence.
The program covers 11 districts in Indonesia, including Palu. Under this programme, UNFPA supports the government in policy development and trains health care providers. Local partners are encouraged to advocate for victims to come forward and seek help beyond the treatment of their physical injuries.
The results are significant. In the first three months of 2023, Puskemas Sangurara staff had already identified seven cases of domestic violence, compared to between one and two in an entire year in the past. “Is it because of advocacy or because we are better trained to recognize the symptoms of gender-based violence? Probably both,” Dr. Salim said.
Serious concerns about gender-based violence
Despite significant progress in gender equality, including increased access for women and girls to education, employment and health services, gender-based violence remains a serious public health and human rights issue. in Indonesia,” said Norcahyo Budi Waskito, program manager at UNFPA Indonesia. . National policies, strategies and legal documents have been put in place.
However, these measures have not always been implemented at the local level. The government has recognized the need for a systematic solution to ending gender-based violence and has partnered with UN agencies such as UNFPA and UN Women.
The number of reported cases has risen from about 216,000 in 2012 to almost 458,000 in 2022, according to the National Commission on Violence Against Women. This suggests that efforts to encourage more victims to come forward are paying off.
But those numbers probably don’t paint the full picture, as what happens behind closed doors in a family home is still considered by many to be taboo and reporting it is stigmatizing.
Shame is not the only reason that keeps victims from coming forward; there is also a financial disincentive.
Annisa Rahmah, an emergency physician at Anuta Pura Hospital in Palu, said some victims choose to opt out once they identify cases of domestic violence because treatment would then not be covered by government health insurance.
“It’s depressing to see them walk away,” she said. Those who remain benefit from a treatment program including psychological counselling.
Support for victims
In addition to training medical personnel, UNFPA also supports community groups and non-governmental organizations (NGOs). In Palu, the women’s organization Libu Perempuan, for example, has 30 volunteers – from lawyers to psychologists – to help victims. The association also runs a shelter, where two families currently live, and organizes training programs, including training for men on the prevention of gender-based and domestic violence.
“This is an important change of mentality in society that helping victims is as essential as bringing the perpetrators to justice,” explains Maya Safira, program coordinator. All his colleagues have participated in UNFPA courses.
In a country of 280 million people and more than 7,500 districts, UNFPA’s training in 11 districts can only go so far. But UNFPA program manager Budi Waskito said the pilot project offers a model that other donors or the government can replicate.
“We provide a recipe, but we can’t cook every meal,” he said.
UNFPA is working closely with the Ministry of Health so that the training it offers can be scaled up by the government. He helped the ministry develop a training manual for medical staff, intervention guidelines for hospitals and guidelines for local advocacy programs.
The Ministry of Health plans to replicate the success of this project, said Kartini Rustandi, Director of Reproductive Health, Age and Elderly.
“The Ministry of Health continues to make efforts to accelerate the equitable distribution of health facilities capable of managing violence against women and children and capacity building of health workers, either through regular budget funds , a specific budget allocation or in collaboration with donors,” she said.
For Dr. Faiza, the goal is clear.
“Until we prevent all cases of gender-based violence, we still have work to do,” she said. “And we do.”