Domestic Abuse Victims Face Cultural Barriers: A Role for Physicians

Study points to a role for family physicians to help South Asian victims of domestic abuse - photo by Martin Dee
Study points to a role for family physicians to help South Asian victims of domestic abuse – photo by Martin Dee

UBC Reports | Vol. 55 | No. 3 | Mar.
5, 2009

By Catherine Loiacono

Illuminating the barriers surrounding domestic abuse among South Asian women is part of Dr. Amritpal Arora’s goal to help women in his community.

“Domestic abuse is an ever-present issue that casts a dark shadow over all communities and cultures,” says Arora. “Over the past two years the issue of domestic abuse among South Asian women of the Lower Mainland has received a significant amount of attention. I wanted to delve deeper into the issue.”

Freshly graduated from UBC’s Faculty of Medicine and working as a family physician, Arora’s recent study, published in the journal The Canadian Family Physician, explores the impact of domestic abuse on South Asian women in the Lower Mainland to develop a better understanding of their experiences, coping strategies and barriers to seeking support to help family physicians provide better care.

“Although the impact of domestic abuse on a woman’s health has been well documented, the impact on South Asian women has not been thoroughly investigated,” says Arora.  “Existing studies have found that domestic violence is one of the leading causes of suicide attempts by South Asian women. They are also more likely to suffer from depression and anxiety and report sexual health concerns more frequently.”

Arora approached various women’s agencies and gained the cooperation of 11 South Asian women between the ages of 24-54 who were either still in an abusive relationship or who had left. Participants were interviewed on the barriers preventing access to social services as well as the role family physicians could play in helping them obtain necessary support.

“The question South Asian victims of domestic abuse undoubtedly face is why they choose to stay in an abusive relationship,” says Arora. “A perceived lack of understanding by the broader community is what deters participants from seeking help.”

According to the study, cultural expectations, family honour, isolation and the stigma of divorce are some of the major barriers South Asian women face.

Cultural expectations emphasize the importance of a patriarchal family and the submissiveness and dependence of a woman on her husband.

“When women face difficulties in their marriage, tradition dictates that these problems are kept within the family,” says Arora. “The ideals for a good wife often begin in childhood and can include the sacrifice of personal autonomy.”

Along with fulfilling the cultural ideals of being a good wife, maintaining family honour was found to be a major barrier for woman. 

“A woman is expected to uphold the honour of her husband’s family and that of her parents,” says Arora. “A woman who is experiencing abuse is often extremely reluctant to reach out for fear of the consequences on her family’s honour.”
Divorce also carries a large stigma.

“Separation or divorce may give a woman’s parents the reputation of raising unstable or unruly girls and affect the marriage prospects of younger siblings,” says Arora. “Women themselves are often concerned about their own daughters’ eligibility for marriage should they decide to leave.”

“New immigrant women are also often financially, socially and psychologically dependent on their husbands,” says Arora. “Many are discouraged from working and if they do work their finances are controlled solely by their husbands. Consequently, when these women are faced with abuse, fear of not being able to survive independently serves as a significant barrier.”

According to the study, the family physician can play an integral role in identifying victims of abuse and helping them obtain support that is both culturally sensitive and congruent with the desires of both the patient and the physician. 

“Family physicians were seen as potentially important allies by participants,” says Arora. “However, participants felt that physicians failed to recognize or ask about their abusive situations. Participants in the study were frustrated by the tendency of their physicians to swiftly prescribe medications without discussing their chronic complaints. When the participants did confide in their family physicians, the women were frustrated at divorce being presented as the only option.”

Arora plans to become an advocate for change in his community and within his practice. He hopes the results of his study will help family physicians better identify, care for and support at-risk South Asian women.

“In the past, the community denied the issue, but now the community is trying to take steps to address the issue,” says Arora. “My key message is that domestic abuse exists and is not acceptable and that there are support systems and resources available to women.”

“My generation can help break the cultural cycle,” says Arora. “We can educate and raise our children differently as well as promote change in our generation and the one prior to us.”