Primary Care centers, against sexist violence

2023-11-24 09:47:31

On the eve of 25N, International Day for the Elimination of Violence against WomenEFEsalud speaks with the coordinator of the women’s care working group of the Spanish Society of Primary Care Physicians (Semergen), Mary R.Blascoabout the crucial role that these professionals play in the battle against sexist violence.

The battered woman syndrome

Gender violence has multiple and devastating consequences for women’s health. In fact, explains Blasco, there is a specific syndrome, which is that of the abused woman and health professionals must know how to recognize it in the consultation.

It is a syndrome, he explains, described by the psychologist and activist Leonor Walker in 1979.

“They present multiple physical symptoms, such as headache, abdominal pain, poor digestion, muscle pain or multiple joint pain. They come to the consultation multiple times for different symptoms and also, of course, psychological symptoms,” the Primary Care specialist points out about victims of sexist violence.

They are women who also have very low self-esteem. With symptoms of anxiety that of depressioneven with suicide attempts in the most serious cases of abuse.

“All this should make us doctors and Primary Care professionals suspect that, underneath all these symptoms, there is sexist violence,” insists the member of Semergen.

But also the health of children of the victims is beaten. They present varied physical symptoms, with anxious-depressive symptomseven posttraumatic stress if they have witnessed the violence that the mother has suffered.

The role of the health professional is key

The importance of the role of health personnel in the prevention and detection of sexist violence “is maximum.” And it is because the woman goes to the health center to see her Primary Care doctor as a result of her abuse, often without recognizing that she is a victim of it.

EFE/ Bienvenido Velasco

“The first door of entry and the first doctor you contact on a regular basis is the family doctor. The professional has to be trained and be able to recognize the situation, even before the attacks occur,” says Blasco.

Early detection

In fact, according to the expert, this medical specialty is emphasizing early detection.

It was in 2021 when the Government approved the catalog of urgent measures of the Improvement and Modernization Plan against Gender Violence. A document that has 15 urgent measures.

To reinforce early detection, the document focuses its objective on consolidating proximity public services as “fundamental gateways” to achieve this. And it pays special attention to health centers, social services, specialized services and the educational field.

Thus, there are two measures directly related to health services.

One of them deals with the development of “a standardized validated instrument to facilitate the detection of gender violence in Primary Care services” of the National Health System. The implementation will be progressive throughout the territory.

three questions

It consists of a questionnaire developed by the World Health Organization (WHO) and adapted to the approximately ten minutes of consultation that professionals have with each patient. It is aimed at all women over 14 years of age, who come alone for consultation.

In Andalusia, for example, which is where Blasco works as a primary doctor, a pilot project is being carried out in three different districts. “It is a screening for early detection,” summarizes the expert.

“We tell you that if you agree to answer the questions, they are aimed at seeing the tension in the couple’s relationship,” he says.

The first question is general: “How would you describe the relationship you have with your partner, is there little, some or a lot of tension?”. The second would be: “When you and your partner have problems, do you solve your difficulties with great difficulty, some difficulty, or no difficulty?”explains Blasco.

The answers carry a certain score that if reached, a third, more direct question is asked about whether she has suffered emotional, physical or sexual abuse by her partner or someone important to her in the last twelve months.

Training need

The other measure approved by the Executive related to health is intended for the specific training of health personnel.

For early detection but also for the management of indicators of suspicion, risk assessment and development of skills for interviewing the professional teams involved in the comprehensive care and recovery of victims of gender violence in Primary and hospital Care.

EFE/Miguel Gutiérrez.

In this regard, Blasco emphasizes that “We are living a social and health reality in which it is necessary for medical and, in general, health personnel to be trained”.

“With this plan we are going to detect many more cases of sexist violence in Primary that we did not even suspect and we have to be prepared to face those situations and those new cases that are going to come to us,” he points out.

It must be taken into account that, according to Blasco, 95% of the complaints of physical attacks that have been made from the healthcare field due to sexist violence come from victims treated in hospital emergencies, while 5% have been from the Primary School..

Furthermore, at the university, during the degree, there is no specific training on this topic. It is during the residency stage of the specialty when they begin to have it.

When the professional detects the case, he has to inform the Prosecutor’s Office so that it can follow up but, also, and this is why training is crucial, he must inform the woman of the resources available to her, and refer her to the services of attention to the victims, who will accompany them throughout the process.

Message for 25N

Looking ahead to 25N, Primary doctors want to send a message to the victims to tell them that they are not alone, that they are accompanied and not to be afraid to go to the health center.

“Our goal is for each health center to be a violet point, for the woman victim of gender violence to have complete confidence that by going there, she and her children will be cared for and accompanied in the process,” says Blasco.

The Primary doctor emphasizes that sexist violence is “a national problem.”

There is still a lot to do “and a long way to go” and doctors, says Blasco, do everything they can and are aware of what lies ahead and what can be improved: “We always have to work on improvement of assistance to victims,” he concludes.

52 women have been murdered so far this year in Spain by their partners or ex-partners

016 assists all victims of sexist violence 24 hours a day and in 53 different languages, as does the email [email protected]; Assistance is also provided through WhatsApp through the number 600000016, and minors can contact the ANAR Foundation telephone number 900 20 20 10.

In an emergency situation, you can call 112 or the numbers of the National Police (091) and the Civil Guard (062) and if you cannot call you can use the ALERTCOPS application, from which a message is sent. Police alert signal with geolocation.