BEIRUT: Christelle Khadra remembers well the woman who was abused by her blind husband. The victim told her that when she sat down to have coffee with friends and would glance at the wall, she would have a flashback of her husband beating her against the wall.
“He was totally dependent on her, and yet I was struck at how much he was beating her,” Khadra said.
“I asked her: How are you still with him? She said my brothers will kill me if I leave my husband,” Khadra added.
Two new papers by Lebanese researchers are shedding light on different facets of domestic abuse in Lebanon and the complex interplay of factors that must be addressed to deal with the phenomenon here, even beyond legislation aimed at curbing the practice.
The first paper, co-authored by Khadra, a doctoral student at the University of Montreal, and supervised by Antonine University faculty, found a high prevalence of symptoms of Post-Traumatic Stress Disorder among affected women, a malady common among soldiers and individuals who spend extended periods of time in combat zones.
The second paper, published in the British Journal of General Practice and co-authored by Jinan Usta, associate professor of clinical medicine at the American University of Beirut, found that most physicians in Lebanon tend to blame victims of domestic violence for the abuse and tend to justify the resort to violence.
Together, they add to the growing body of research into domestic violence in the country, and to solutions to combat a phenomenon that has come to the fore with numerous high-profile cases of violence and legislation to combat the practice.
For Khadra’s research, 85 women filled a questionnaire prepared by researchers. Khadra personally interviewed some of the women, too.
PTSD symptoms were found among 97 percent of the women who had suffered from physical abuse, with women who had a lower education level suffering greater severity of symptoms.
On average, the women experienced a high level of PTSD symptoms that increased with the level of domestic violence they experienced.
Women who had not completed high school experienced more PTSD symptoms, as were those who remained in abusive relationships.
Women who were in abusive relationships for over seven years showed fewer PTSD symptoms than those who were in a similar relationship for less than a year, perhaps because they developed coping mechanisms or were desensitized eventually to the abuse.
The symptoms were also worse among women whose partners used alcohol or gambled.
Khadra and her team enlisted the help of KAFA, an organization that campaigns against domestic abuse, to identify suitable women. She also used “snowball sampling,” a technique where members of society and even abused women help identify potential candidates who meet the criteria for physical abuse.
KAFA estimates that at least three quarters of all Lebanese women have suffered from physical abuse at some point in their life.
Khadra blames the “normalization” of violence in Lebanon, a country troubled since the Civil War, with abetting domestic abuse, as well as the traditional patriarchy that imposes specific roles that women must adhere to at home. Women often experienced violence as a result of failing to do what was perceived as their duty at home, like cooking and cleaning.
She also said the cultural constraints that oblige women to stay in an abusive relationship “for the children’s sake” often compelled them to stay in violent marriages.
PTSD is particularly troublesome because the consequences persist, and its symptoms include distress, intense fear, flashbacks to the violent event – often prompted by triggers – as well as nightmares, among other symptoms.
“That’s the thing with PTSD, it stays with you,” Khadra said.
Khadra and her team said health-care professionals should be increasingly involved in identifying women at risk and referring them to “appropriate resources,” such as counseling and shelters
But the research by Usta, from AUB, highlighted the challenges women face in seeking the help of physicians, many of whom subscribe to the same cultural beliefs that abet violence against women.
Usta and her team interviewed 92 physicians, all of whom had at least five years of experience and met with patients for at least 100 consultations a week. Fifteen of them were women.
Usta’s study revealed that doctors were reluctant to involve themselves in issues of domestic violence due to cultural and religious beliefs that condone the practice, worries over losing patients and personal safety.
Doctors were worried that they would be stigmatized for opposing what they perceive as religious values.
Those who did mediate between women who experience domestic violence and those who assaulted them leaned toward blaming the victim and justifying the violence perpetrated against them.
Usta said the majority of physicians justified the violence, for instance by questioning what the woman would have done to provoke her partner, a result she attributed to cultural biases.
The researchers concluded that physicians in Lebanon do not consider domestic violence as a matter for them to address beyond treating obvious, physical injuries.
Usta’s research is particularly alarming as doctors are among the most educated segments of society.
“They are the most educated, and the ones who talk about social justice and work against violence, and yet they are justifying it,” Usta said. “It is upsetting.”
Usta said doctors should find out if the women are victims of domestic violence and help them address the root causes of the violence, rather than simply treating the effects. She likened it to smoking, where it makes more sense to treat the behavior instead of its adverse health effects.
Doctors can advise the women to seek additional help or report the violence, she said, in addition to recommending anger management for the abusive spouses, and to assessing whether the women may be at risk of escalating violence and referring them to shelters.
Educational and awareness efforts about domestic violence should occur early on in schools, in addition to empowering women to assert themselves.
Doctors should act as role models and denounce violence, she said.
Usta is working on a training package with KAFA and the U.N. for healthcare workers to raise their awareness of domestic violence and the harm of blaming the victim of such abuse.