Violence against women: a look from the Cuban health system

EDUMECENTRO 2022;14:e2418

LETTER TO THE EDITOR

 

Violence against women: a look from the Cuban health system

Violencia contra la mujer: una mirada desde el sistema cubano de salud

 

Grace Sarduy Pérez1* http://orcid.org/0000-0001-5169-7774
Benita Mavel Beltrán González2 http://orcid.org/0000-0001-8773-6384
Guillermo José López Espinosa3 http://orcid.org/0000-0001-8699-8366

 

1 Villa Clara University of Medical Sciences. "Juan B. Contreras" University Polyclinic. Ranchuelo Municipality. Clear Villa. Cuba.
2 Villa Clara University of Medical Sciences. School of Medicine. Cuba.
3 Villa Clara University of Medical Sciences. Academic Vice President. Cuba.

 

*Autor for correspondence. Email: gracesp@infomed.sld.cu

 

 

Submitted: 30/05/2022
Accepted: 06/07/2022

 

 

Dear editor:

Recently, your journal has published an article that caught our attention: Cuban families: importance of a new legislative project in the practice of Family Medicine,(1) in which its authors analyzed the family variety in the Family Code Project in Cuba. ,it´s based on equality and non-discrimination. We thought it pertinent to give continuity to the topic, and focus this debate on an almost invisible aspect that occurs in all societies, including the Cuban one: violence against women. In the current project, its treatment is considered necessary for adequate social development, which is addressed with the title: discrimination and violence in the family environment.(2)

The objective of this letter is to reflect on whether health professionals in different areas, particularly General Practitioners and nurses, should also have academic training in this subject, especially when dealing with an injured woman, in a way that allows them to have a different perspective on the comprehensive care needed in such circumstances.

To explain the relationship between aggression and gender, it should be noted that the main risk condition for violence is not sex as a biological state, but identification with the domination of others, associated with the traditional masculine stereotype. Violence against women is a very complex phenomenon, because it is not correctly identified by the population, and its recognition would be the first difficulty to overcome in order to face it with the necessary energy and emergency. It is recognized as a current social and health problem due to the fatal effects it causes, and because it nullifies fundamental human rights, which has turned it into a "silent and invisible pandemic".(3)

Violence against women, especially domestic violence, has negative health consequences: injuries ranging from cuts and bruises to permanent disability, sexually transmitted diseases, unwanted pregnancy, chronic pelvic pain, high blood pressure, depression, anxiety disorders, headache, irritable bowel syndrome and psychosomatic manifestations. It can also lead to death, and in women who are chronically beaten or sexually abused, the emotional and physical stress can lead to suicide.(3,4)

The assumption, according to which intimate partner violence is difficult to accept, but "normal", it is shared by the majority of people in charge of providing care. It turns out to be a vicious circle of concealment-normalization and reproduction of the culture that sustains violence. Due to its magnitude, health providers are key actors in the process of prevention, detection, care and monitoring of the difficulties caused by domestic violence.

The absence of statistical records in most countries has meant that the problem did not have solid foundations. In Cuba, the first figures were published in 2018 and served as the basis for public policies with the aim of continuing to advance in fairer and more equitable relations.

Violence against women affects well-being and quality of life, requires knowledge through information and data management, and a perception of family risks and consequences.

It is necessary to signify the role played by health professionals in primary health care, specifically the Basic Health Teams (BHT), and the preparation required on the subject to teach, assume and share bioethical principles through prevention and promotion actions , so that the incidence and prevalence of this phenomenon continues to be explored and recorded.(5)

Deficient training and professional improvement, ignorance of protocols and stereotyped views on gender violence in the BHT themselves are verified. Identification and response should be taught to women victims, bearing in mind that training cannot be an isolated intervention, without follow-up: it must have technical content and encompass attitudes and values present in society. Sometimes professionals lack basic knowledge, time or empathy or simply do not know what to do, or where to refer the victim; they may even experience violence themselves or make wrong value judgments, so you have to listen and treat the woman with expertise, providing support, guidance and concern for the woman's safety. A welcoming health service should be sought in which women are treated with respect.(6)

Each health professional must face the problem with the acquisition of knowledge, skills and values; Recognizing the person as a bio-psycho-social being implies assuming that the life experience of each patient can have unsuspected ways of manifesting itself in the health-disease continuum complex, and the expression of gender violence is not excluded from this.

 

BIBLIOGRAPHIC REFERENCES

1. Hernández-Fernández L, Rodríguez-Corría R, Sánchez-Fernández M. Familias cubanas: importancia de nuevo proyecto legislativo en el ejercicio de la Medicina Familiar. EDUMECENTRO [Internet]. 2022 [citado 20/05/2022];14:[aprox. 2 p.]. Disponible en: http://www.revedumecentro.sld.cu/index.php/edumc/article/view/e2359/html

2. República de Cuba. De la discriminación y la violencia en el ámbito familiar. Proyecto del Código de las Familias. La Habana: Ates gráfica "Federico Engels". 2022.p.6.

3. Ferrer Lozano DM, Guevara Díaz EL, Martínez de Ring ME. La violencia como problema de salud. Miradas desde la realidad cubana. Gac Med Espirit [Internet]. 2020 [citado 23/03/2022];22(1):[aprox. 14 p.]. Disponible en: https://scielo.sld.cu/scielo.php?script=sci-artt&pid=S1608-89212020000100049&Ing.=es

4. Llosa Martínez S, Canetti Wasser A. Depresión e ideación suicida en mujeres víctimas de violencia de pareja. Psicología, Conocimiento y Sociedad. [Internet]. 2019 [citado 28/05/2022];9(1):[aprox. 22 p.]. Disponible en: http://www.scielo.edu.uy/pdf/pcs/v9n1/1688-7026-pcs-9-01-138.pdf

5. González Sánchez L. Conocimientos, barreras y actitudes de los profesionales de atención primaria de salud frente a la violencia de género [tesis] España: Universidad Autónoma de Madrid; 2020.

6. Hernández García Y. Violencia de género, feminismo y representación en Cuba. Rev Estud Fem [Internet]. 2019 [citado 11/02/2022];27(1):[aprox. 15 p.]. Disponible en: https://www.scielo.br/pdf/ref/v27n1/1806-9584-ref-27-01-e53719.pdf

 

 

Declaration of interests

The authors declare no conflict of interest.

 

 

Authors contribution

Grace Sarduy Pérez: conceptualization, methodology and preparation of the draft.
Grace Sarduy Pérez, Benita Mavel Beltrán González and Guillermo José López Espinosa: review of the draft, editing and approval of the final version of the article.

Copyright (c) 2022 EDUMECENTRO

Licencia de Creative Commons
Esta obra está bajo una licencia de Creative Commons Reconocimiento-NoComercial-CompartirIgual 4.0 Internacional.