Health Workers Learn to Help Violence Survivorsby Tatiana Zabelina, Yevgenia Issraylian and Nadezhda Mitrofanovna Fall 1996Although violence against women is at the center of international discussion on women's issues, the subject was taboo in Russia until recently. Official Soviet history and sociology texts examined violence only in the context of class, race and international relations, rarely mentioning violence against individuals at all. There were almost no studies, public opinion surveys or statistics on the issue, and the mass media often kept facts quiet. Only in the age of glasnost was it publicly acknowledged that Russian women, just like women of other countries, are subjected to violence in the home, on the job and increasingly, as victims of ethnic conflicts. Nongovernmental organizations were the first to address this issue. Women's movement activists have begun to create support hotlines and crisis centers for women and children who have suffered from violence. In 1993, the Center for Women, Family and Gender Studies at the Moscow Youth Institute hosted a training seminar for crisis center consultants called "Women, Youth and Violence," and in 1995, the Center published its first Russian booklet, How to Start and Manage a Women's Crisis Center, now widely used by social workers and NGOs in the former Soviet Union. [See Surviving Together, Winter 1995.] Government leaders have slowly begun to take action. In 1995, the State Duma Committee for the Affairs of Women, Youth, and Children has begun to develop laws against violence in the family. The Russian National Report to the 4th UN Women's conference, entitled "Actions in the Interests of Equality, Development and Peace," acknowledged the acuteness of the problem and cited statistics of such crimes. It is time for violence against women to be addressed in Russia's medical institutions. While these issues are being studied in medical schools and secondary schools of other countries, educational plans and programs in Russian nursing schools do not require courses on the problems of medical and psychological help for survivors of sexual and other types of violence. It is important to include this training in the process of educating nurses, midwives and medical assistants. Training could be implemented as an optional course offering, similar to that sponsored by the Center in a recent seminar on the roles of nurses and other health workers in helping victims of violence. The week-long seminar attracted over 150 nursing and psychology students as well as instructors from 25 nursing schools, doctors, psychologists, lawyers and NGO representatives from Moscow and the surrounding areas. Dr. Lee Ann Hoff, an American expert on crisis intervention, violence prevention and women's health, led the participants through an interdisciplinary way to study and teach about problems associated with violence. Participants were very enthusiastic about Dr. Hoff's explanation of how teachers of nursing, gynecology, social medicine and psychology can include domestic and sexual violence issues in their courses and educational programs. The key to her approach was instruction based on partnership between the teacher and student. Partnership entails a necessary respect for the students' experiences, their willingness to share in an atmosphere of openness, and a recognition of the important role they play in the process of helping victims of assault. In Dr. Hoff's opinion, this approach yields excellent results when seminar participants are prepared for discussions of examples or situations which are familiar to them from professional or personal experience. Many years of teaching subjects related to the issue of violence have convinced her that this is one of the most effective means for the students to assimilate key concepts and implement appropriate strategies of help and medical care. "I don't like long lectures, since they imply a hierarchical relationship between the teacher and the student, instead of a reciprocal one," she emphasized. Dr. Hoff is the founder and director of the Life Crisis Institute, an adjunct professor at the University of Ottawa and a professor at the University of Massachusetts in Lowell. She shared her extensive experience as a practical public health worker, teacher and author of numerous publications, including Family Violence: Clinical Guidelines for Nurses. Excerpts from this book and other publications, translated by the Canadian Nurses Association, were reproduced especially for participants of the seminar. Each presentation from Dr. Hoff was accompanied by visual materials and supplemented by a display of translated videos, enabling viewers to see Canadian nurses, doctors and psychotherapists interacting with violence survivors. The Canadian experience in preparing health care workers to provide help and healing to women who have suffered sexual or family violence was demonstrated, especially the roles of psychologists and psychotherapists as consultants for public health care workers who lack special training in the dynamics of psychological trauma. For the majority of students, this was the first they had participated in such a seminar, and all of them noted in the evaluation that they had received useful information for their professional development. They wrote that issues concerning medical and psychological help for victims of sexual and domestic violence must be included in the process of training medical students. The experience of holding this seminar showed that violence knows no boundaries. To overcome it requires uniting efforts, studying and adapting what has worked elsewhere, analyzing our own circumstances and applying new academic materials based on an interdisciplinary approach. Nurses and instructors at medical institutes must play an important part in the fight against violence. Tatiana Zabelina and Yevgenia Issraylian are co-directors of the Center for Women, Family and Gender Studies at the Moscow Youth Institute. Nadezhda Mitrofanovna is the director of Moscow Nursing School No. 7. Lee Ann Hoff contributed to this report. Translated by Lydia Bryans. Center for Women, Family and Gender Studies: 3-1-46 Moldagulova St., Moscow 111538, Russia; ph: 7-095-374-8295; fax: 7-095-177-7331; <julia@tokoex.msk.su> |
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