/ 6 August 1999

GPs:First port of call for women

Marianne Merten

Just fewer than a quarter of women visiting their general practitioners (GPs) have experienced domestic abuse and are likely to suffer from post-traumatic stress disorder, according to a research study by clinical psychology intern Adele Marais of the University of Stellenbosch.

During two months in 1997, 16 GPs, representing private and state practitioners, were surprised when they questioned 1 050 women older than 18 on whether they had been physically hurt by, or forced to have sex with, someone with whom they had had an intimate relationship.

In the study – compiled with the help of the Cape Town-based Medical Research Council anxiety and stress disorder unit – more than 90% of women reported physical violence and fewer than a third sexual violence. More than 40% had been assaulted by their husbands, a quarter by their boyfriends and just fewer than 30% by their former partners. While 42,2% no longer had contact with their assailant, 38,7% still lived with the perpetrator.

Women who experienced domestic violence were more likely to be married, without high school education and working outside the home, but the study revealed that domestic violence crosses all racial and class boundaries. Post-traumatic stress disorder, depression and suicide attempts were higher among the women who reported domestic violence to the GPs. There was also a tendency towards increased substance abuse in women.

The GPs expressed surprise at the prevalence of domestic violence. Twelve of the 16 participating doctors said they believe GPs should routinely question women about domestic violence and should screen for a history of abuse.

Marais said doctors are usually the first port of call for abused women when they experience a range of physical problems, from back pain and headaches to vaginal bleeding, triggered by the abuse. That’s usually even before they have bruises or broken bones. Women’s shelters or support groups only see abused women when they decide to seek help, which only a minority do. “We miss them. We don’t get to them in the early stages when help is easier,” Marais said.

She has started holding lectures for GPs and other health care workers to try to help them spot abuse.