/ 6 August 1999

The high cost of abuse

Marianne Merten

Abuse of women is not simply a matter between the woman and her partner, as commonly perceived. The cost of violence extends beyond the proverbial four walls of the home. According to a new study, three of South Africa’s predominately rural provinces spent more than R29-million last year alone to treat injuries women sustained during beatings.

The study by the Medical Research Council women’s health sections reveals that in Mpumalanga, Eastern Cape and the Northern Province some 289 162 women sought medical help following domestic abuse at the cost of tens of millions of rand to the often cash-strapped health sector.

Yet the number of women turning up at hospitals or primary health facilities does not completely reflect the predominance of violence against women, according to researcher Dr Rachel Jewkes. Many may fail to seek medical help for emotional distress or injuries like a black eye, especially as access to medical centres is often difficult in rural areas. Conversely, many others repeatedly go to hospitals or clinics for what Jewkes terms psychosomatic illnesses related to abuse, such as backaches and headaches.

Jewkes says one of the surprising discoveries is the level to which women have accepted abuse as part of their lives. “Women did not recognise they have been abused. They see what happened to them as normal.”

The Eastern Cape Department of Health spent more than R12-million last year to treat about a third of women injured as a result of domestic violence. In Mpumalanga, half the abused women sought medical attention at a cost of R7,5-million. The Northern Province spent R9,5-million treating battered women.

Jewkes says the council has initiated a training programme for health workers at hospitals and clinics in conjunction with NGOs and health education TVprogramme Soul City to help them spot abuse. Pilot projects will be launched by the end of the year in the Eastern and Western Cape.

Research shows one of every four women in the Eastern Cape and Mpumalanga and one in every five women in the Northern Province has been abused by her partner. Rape statistics are 7% of women in Mpumalanga and 5% of women in the Eastern Cape and Northern Province. Jewkes says women generally did not report rape by partners.

Violence during pregnancy also seems widespread. Moreover, the partners of a quarter of the abused women in the Eastern Cape refused to buy clothing, food or medicine for their babies. One in 10 women in the Eastern Cape was prevented by her partner from using antenatal care.

Women told of emotional abuse and threats of violence. The partners of one in 10 women in Mpumalanga boasted about other girlfriends or have even brought the other woman home. One in 10 women in Mpumalanga was evicted from home by a partner in the past year. The figures in the Eastern Cape and Northern Province are slightly lower. Women are also prevented from going to work and one in 10 women in the Eastern Cape and Northern Province was not provided with money for sustenance even though it was available.

Jewkes says her findings show relations between men and women are skewed and need to be addressed even as early as in school.

A third of the women in the Northern Province told researchers being beaten by a partner is an expression of love. Almost a quarter of women in Mpumalanga and 15% of those in the Eastern Cape held the same view. A substantially higher figure – almost 60% in the Northern Province, 40% in Mpumalanga and just fewer than a quarter in the Eastern Cape – believe their culture allows beatings as a sign of love.

In response to a question whether women believe they have to obey their partners, nine in 10 women in the Eastern Cape, more than eight in 10 in Mpumalanga and more than three-quarters of women in the Northern Province agreed.

In Mpumalanga and the Northern Province, just fewer than 60% of women said they believed they could not refuse sex with their partners, while in the Eastern Cape 43% of women held the same view.

The level of awareness of abuse even among women remains a problem and, Jewkes says, it is simply not enough to provide services for abused women. “It [the study] reflects the attitude that it’s okay to beat women and that women have internalised this,” Jewkes says. “We need to make a point that violence against women is a big problem. But we need to understand it more to change this.”

A study of working-class men in the Cape Peninsula underscores this point. The majority of men who claimed they do not abuse their partners believed hitting a woman and shouting or humiliating her is acceptable and does not constitute violence.

Forty per cent of the men, predominately coloured, said they had abused their partners over the past 10 years. These men were generally younger, less educated and poorer. Alcohol and substance abuse emerged as important factors, as did violence during childhood and their residence in gang-infested neighbourhoods.

Jewkes said that although men abuse, there are few projects to help change their attitudes and awareness around gender relations and non-violent conflict resolution – and that this needs to change.

“Any improvement in women’s position requires a change among men,” Jewkes says. “And since they are the primary instigators, they should bear the primary responsibility to reverse their behaviour.”