International Day For The Elimination of Violence Against Women

The United Nations General Assembly has made 25th November the designated ‘International Day for the elimination of violence against women.’

Here I describe an example of why we need action to prevent violence against women.

Having been a Doctor in England for twenty years, I have seen many thousands of patients and faced multiple challenges. I feel I have a battle hardened, robust personality. However recently I had to deal with a situation which touched me emotionally.

My patient was a married, childless, friendless Pakistani lady in her thirties. She had arrived in England ten years previously after falling in love and marrying her husband, against the will of her parents. This didn’t conform to the norms of the conservative society she originated from. She was unable to speak much English. I had known her for about two years. She mostly used to consult myself as I could speak her language. Over time we developed a bond of trust and she confided in me.

She would tell me of the worsening domestic abuse and violence she was suffering from her husband and in laws. She became tearful and depressed and couldn’t see a way out of her difficulties.

Her estranged parents and siblings were far away in Pakistan and anyway she couldn’t afford to go and see them. She had chosen her own partner and felt obliged to stay with him. She lived with her husband and his parents.

She wasn’t allowed out of the house, but could see her Doctor alone when ill.

On many occasions I said I would report the abuse and help her, but she declined. She had no one to run away too. I was close to blowing the whistle anyway. I was uncomfortable with the delay in reporting her circumstances as it increased the duration of the abuse. She was regularly subjected to verbal, psychological and physical abuse. She was too frightened to ever call the police, worried that her domestic stress would worsen.

However we came to an agreement that when she was ready she would come straight to the practice for help. I took a calculated risk, the ‘wait and see’ option made me feel uncomfortable.

Honoured based violence is now a more recognised phenomena in England and many lives are lost as a result of the family simply losing ‘face’ or respect.

A few weeks ago one lunchtime the patient made the decision to escape, she managed to pack a small case and run away from home. In that single moment she left ten abusive years of marriage. She only had one chance at this plan. If she was caught there may have been terrible consequences for her.

She arrived at my practice crying in a very distressed state, she had nobody to help her apart from us. She trusted her safety and life with us. We were worried that her family would notice she had left and try to follow and find her.

We put her into a side room far from the main entrance of the practice and she had a cup of tea.

As I had rehearsed this very scenario in my mind a few times already, I was fairly well prepared and had the relevant numbers scribbled down.

I quickly liaised with the domestic violence crisis team and the police. The response and support from the agencies was excellent. The patient was lodged in a hotel overnight and the next day she was transferred to a safe refuge one hundred miles away.

I didn’t hear anything from her family. For the patient the formulated plan worked well.

As she walked out of the practice accompanied by a policeman, I had tears in my eyes. This vulnerable patient’s journey had upset me but at the same time felt relieved that her torture was over and that she would be safe.

I have immense respect for this very brave lady who felt empowered enough to make the decision to leave her home.

It brought back to me the reasons why I wanted to be a Doctor, to help and assist patients in need. I was in a unique position of responsibility for this vulnerable patient.

I don’t think I can ever forget the stormy journey I traveled with this patient, our bond was strengthened with mutual understanding, respect and trust.

I hope she has a happier, less traumatic life now.

[ Contributed by Dr I Malik ]