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WFC PHC urges heightened awareness of domestic violence. April 9, 2020

April 9, 2020 

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WFC Public Health Committee urges heightened awareness of family and domestic violence amid COVID-19 pandemic.

With chiropractors increasingly engaged in telehealth and other consultations in the wake of the COVID-19 pandemic, the WFC’s Public Health Committee (PHC) is urging chiropractors to be on alert for signs of family and domestic violence experienced by patients seeking help for musculoskeletal concerns, such as back, neck and joint pains.

The call comes as United Nations Secretary-General António Guterres issued stark figures in his April 5, 2020 address [1]. He indicated that the rate of violence against women and girls had risen sharply following the imposition of lockdown measures during the pandemic. Dr Guterres pointed out that the threat of violence for many women and girls was largest in the very place where they should feel safest: in their own homes.

Family and domestic violence can be found everywhere and is not limited to low-income countries. Increased economic and social stresses, combined with people being contained within their own homes, are creating a toxic environment for domestic violence in all countries. Intimate partner violence is the most common form of domestic violence; one in three women have reported at least one event sometime in their lifetime. Of women who experience intimate partner violence, it is estimated that only 42% report an injury. Intimate partner violence during pregnancy raises the risk of miscarriage, pre-term deliveries, and low birth weight babies. Domestic violence can result in depression, anxiety disorders such as post-traumatic stress disorder, sleep difficulties, and suicide attempts [2].

The impact of domestic violence is profound and both male and female victims of domestic abuse suffer long term physical, sexual, reproductive and mental health consequences. The World Health Organization (WHO) reports [3] that the health effects from domestic violence include “headaches, back pain, abdominal pain, gastrointestinal disorders, limited mobility and poor overall health” many of which are patient complaints that present to chiropractors.

WFC PHC Chair Dr Claire Johnson commented, “We are raising awareness of the potential effects that the isolation and social distancing caused by the COVID-19 pandemic may have on increasing family and domestic violence. We are calling on all chiropractors who are conducting either in person or telehealth consultations to be acutely aware of non-accidental injuries or signs and symptoms of undue mental stress in their patients, which may be a result of abuse. Victims of physical, sexual, or emotional abuse may seek help for their injuries from their chiropractor. Patients may be evasive when reporting the cause of their injuries, therefore chiropractors should be cognizant of the rise in family and domestic violence and be prepared to assist their patients during their time of need.”

Since the COVID-19 outbreak, the United Nations has reported a surge in calls to domestic violence helplines around the world, most noticeably in China, where reports have tripled since the lockdown came into force. In Australia, Google reported that the number of online searches related
to domestic violence increased by 75 per cent. South Africa saw over 90,000 calls reporting incidents of domestic violence in the first week of the lockdown. Support groups have been overwhelmed by calls, with centers and refuges having quickly become full or recommissioned as additional COVID-19 wards. It is thought that the forced confinement has fostered tension and strain on relationships, which have been exacerbated by fears over security, loss of employment, health concerns and money worries.

Dr Johnson continued, “We strongly encourage all chiropractors to be mindful of issues around family and domestic violence when questioning patients about their signs and symptoms. Victims may be a spouse or partner, but may also be children or family members, keeping in mind that
those most vulnerable (e.g., women, children, elderly, and disabled) are those who are at the most risk. The WHO recommends that health care providers assist by being aware of the risks and consequences of domestic violence and that the provider should offer support to abuse survivors
by listening empathetically without judgment, inquiring about the patients’ needs and concerns, enhancing their safety, and connecting them with support services in their region.”

Women’s, children’s and adolescents’ health is one of the key focus areas of the WFC PHC and the impact of the COVID-19 outbreak has meant that many families are facing heightened challenges. As well as professional consultations, Dr Johnson also encouraged a heightened
awareness of those who may be trying to avoid their abusive environment by exhibiting unusual behavior such as by breaching lockdown rules to spend time in parks and other open spaces. “It is possible that some who are experiencing violence are seeking personal safety being avoiding their homes in order to avoid their abuser. We encourage everyone to show empathy and compassion during this extremely challenging time.”

For additional information, please download this WHO document: “COVID-19 and violence against women. What the health sector/system can do” available at
https://www.who.int/reproductivehealth/publications/vaw-covid-19/en/.

References
[1] United Nations news ‘UN chief calls for domestic violence ceasefire amid horrifying global
surge.’ 6 April 2020 https://news.un.org/en/story/2020/04/1061052
[2] UN Women: Fact and figures – ending violence against women
[3] World Health Organization fact sheet:
https://www.who.int/en/news-room/fact-sheets/detail/violence-against-women 

 
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