Episode 34: Gender-Based Violence & Human Trafficking
Author: Eoghan Colgan @eoghan_colgan
Special Guest: Kath Gallagher
12/06/19
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Guest Bios
Kath Gallagher
Kath Gallagher is the executive lead for Gender Based Violence at NHS Greater Glasgow and Clyde.
Show Notes
Eoghan and Kath discuss Gender-Based Violence - why it’s important, how it can present, how to tackle it, and a whole lot more.
Take Home Points
Why it is important
health services are the one place that they often present and can access support and safety
Do we miss it?
we are certainly missing cases
we may lack the confidence to ask
people often don’t want to disclose it because they are frightened or fearful of the consequence of telling
this might be harm to them or their families
Types of gender-based violence
examples include:
domestic abuse
rape and sexual assault
forced marriage
female genital mutilation
commercial sexual exploitation
Scottish Government has a strategy called ‘Equally Safe” - see the link at bottom of page
typically it is male power versus a female (but can also be man against man, or female against man)
Who is at risk?
anyone can be a victim
any age, background or ability
how to identify it
some indicators include:
BEHAVIOUR
they are accompanied by someone who appears controlling of their interaction
these people may be introduced as a friend, partner or family member
often observing their behaviour can give clues
they are evasive about the information they give
they appear nervous in the presence of the accompanying person
they may demonstrate distrust of services
HEALTH
injuries from an assault:
delayed presentation, or
they are inconsistent with how they received the injuries
repeated unwanted pregnancies
in human-trafficking cases, they may present with work-related injuries suggestive of poor health-and-safety practices
THINGS IN PLACE IN THE DEPARTMENT
staff would have access to training and awareness-raising
there should be private space for seeing patients confidentially if concerned
never use person accompanying them as an interpreter (may not give accurate history and requires their presence at all times)
address their communication needs properly
Trying to get space alone
ask person to step outside and explain it is routine to get some time alone with the patient
better than asking them to leave when you are in the room - they would have the chance to ask the patient if they want them to stay which can be harder to deal with (if they feel pressured to say yes)
If partner refuses to leave
if violent to staff or patient - call the police
if they refuse then remind them that it is an incomplete exam because you could not do parts of the examination with him present
it might be best to arrange a follow-up appointment
right time to ask about abuse
sensitively enquire when appropriate to do so
“this doesn’t quite fit with what you are telling me”
“is there anything you would like to tell me?”
if they are nervous - describe your concern and ask them if there is anything else going on
you can ask directly if they are resisting
you can state your concern regarding the injury or behaviour of those present
If they reveal abuse - how to respond:
don’t react - be calm and non-judgemental
listen, and see how you can work together to help them
believe what they tell you
your job is to help them feel safe and that they can trust you
let them know about the boundaries of confidentiality
if there is risk to children of vulnerable adults you may have to disclose the information in order to protect them
otherwise it would be entirely confidential and only shared if they agreed to it (with other medical staff who could help them)
assess the level of risk they feel they are under
then explore the choices moving forward
you will need some prior knowledge of locally-available services
What not to do
do not promise that you will keep them safe (you may not be able to)
do not promise to solve the problem for them because you can’t (but others will be able to help)
Links
click image to visit website