He is NOT a nice guy

Update: 30/8/2010 : It was brought to my notice that my view on the abuse-perpetrator is a bit misleading. Not all people who abuse their partners have a substance abuse problem or stressor, more over they do not abuse BECAUSE of these stressors. Men behave the way they do because that’s how they’re socialized and because society condones their behavior. While the above might contribute in their violence, the act of violence is a behavioral problem, not primarily an environmental

Some time ago a friend of mine told me about a friend of hers who was in an abusive relationship. This girl’s boyfriend would smack her around even in front of her friends and humiliate her in public but the girl “refused to see light” and stuck to the guy. It might have been the horrified look on my face, of her continued vilification of a friend which made her hastily add “but he is actually a nice guy”.

Abuse in relationships is an underplayed reality. This is because most of the time there is a certain criminal-victim exchange happening, people dont talk about it directly, but the defensive ejaculation by my friend is a small evidence for it. She knows that the guy beats her friend, she has seen her humiliation and tears, in spite of which she thinks he is “nice”. To her credit, among all the abused girls friends, she is the only one who has had the courage to stand up to the guy and ask him to back off in such situations. Yet, even she is unsure of what to do and what to believe.

What she means by “nice” is, when he is not beating up his girlfriend, he is pleasant, often doting towards her, works hard, is not beating up other people.

The had truth is, we believe that the girl deserved it. Else, why would a bunch of doctors who have witnessed a crime happening continue to hide behind the weak excuse of it being a “personal matter” and “she needs to help herself”.

I am willing to concede that ignorance about how to deal with the situation contributes to such beliefs and that most people have no idea how such relationships end or what harm they do to the people involved. Before I get into statistics, here is the basic thing to keep in mind :

The DEFINITION of a good person excludes someone who beats up his girlfriend/ wife. So think this, he is the enemy, the bad person, the criminal, He is NOT a nice g uy. Someone who runs a brothel and uses the profits to educate slum kids is TWICE a sinner, first for running the brothel and killing the souls within it and second for poisoning the children he feeds. He is NOT a nice guy.

Now, the Science and statistics.

Physical abuse has not just physical effects, it affects the woman’s mental emotional and social health also.

A significant portion of women who have been abused do not seek medical help for the injuries themselves, but those who do, present with non specific and chronic pain and bruises from having “bumped into something”. Women who suffer long term abuse, and are battered are found to have more injuries in the head, face, neck, thorax,  breasts, and abdomen when compared women injured in other ways. 1

Many women also have to put up with forced sex from intimate partners, which results in sexually-transmitted diseases, bleeding or infection, fibroids, genital irritation, pain on intercourse, and urinary-tract infection. Studies show that the odds of having gynecological problems is upto 3 times more in victims of physical abuse.

Mental effects of abuse are quiet profound too, some studies have shown that the risk of depression and post traumatic stress disorder was higher for abuse victims than even those who have had childhood sexual abuse.

• Fractures
• Miscarriage
• Depression
• Major Surgery
• lacerations requiring stitches
• Sexually transmitted infections including HIV
• Loss of vision/hearing

These are some of the prominent outcomes of intimate partner violence that most studies find. 2

In more than half of the cases of abuse, children are witnesses to it. And in upto 5% cases even the children are abused by the partners.

A study from rural south India showed that thirty-four percent of the women surveyed reported having ever been hit, forced to have sex by their husbands or both. Women belonging to lower caste, poorer households, having greater economic autonomy, and whose husbands consumed alcohol were more likely to report violence. Women’s economic autonomy and husbands’ alcohol consumption were significantly associated with violence,independent of caste and economic status. 3

Why does she not realize, react and seek help?

This is typical of a situation in abusive relationship. The reasons are a complex mixture. Many times health care workers who are the first to see the results of intimate partner violence fail to identify it or do nothing about it. This and the social approval for domestic abuse ensures that she “normalizes” the abuse. She is deluded, as people around her that she deserves it, or that he is otherwise nice, or that there is nothing that can be done to help her.

We need to realize that at this stage, it is no longer a personal matter, it is public. We need to step in. Perhaps there is a stressor, maybe the guy is mentally unstable, or there might be substance abuse, or maybe he is just a jerk, whatever be, if we stand by looking, we are accomplices to the slow murder of usr friend, soul first then her body.

Does she deserve it?
Is there any excuse for beating up ones spouse/girlfriend? Suppose she did provoke him, does that mean she should be beaten up?

Let me tackle the “its their personal matter” excuse again

If you see a robber getting into the house next door, do you go back to sleep because it’s a personal matter?

There is absolutely no difference, abusing ones mate is a crime and cases can be registered under Protection of Women from Domestic Violence Act 2005. Not just that, abuse, as you have seen above, has far reaching consequnces. If you know about it, you should react to it, you might be rejected or ridiculed or even shouted at but not doing anything is akin to abetting murder.

She cannot help herself, people like us who compose the society further make it difficult for her to come out, also she is probably lead to believe that it is her fate or that its ok.

He is not a nice guy.

photo by eyesonmephotography

References

1 Health consequences of intimate partner violence Jacquelyn C Campbell Lancet 20012; 359; 1331-36
2 Berrios DC, Grady D: Domestic violence-Risk factors and outcomes. West J Med 1991 Aug; 155:133-135
3 Krishnan, Suneeta(2005)'Gender, Caste, and Economic Inequalities and Marital Violence in Rural South
India', Health Care for Women International,26:1,87 — 99


Are Rapists Victims?

There seem to be a serious confusion in the minds of our leaders and the common man alike about who is responsible for rape, the victim or the rapist. Things are so confusing that some even wonder if the poor rapist isn’t a victim of the crime of “incitement”.

“You can’t blame the locals; they have never seen such women. Foreign tourists must maintain a certain degree of modesty in their clothing. Walking on the beaches half-naked is bound to titillate the senses,”

This is a quote in response to the rape of a 6 year old Russian girl from no less than the deputy director of tourism of Goa, Pamela Mascarhenas.
So, should Ms Pamela release the rapist, who was apprehended the same day the quote was made, because after all he was titillated into the crime by an immodestly dressed six year old!

Unfortunately this is not an isolated sentiment of an ill-informed politician, a brief look at comments and discussions on eve-teasing would tell you that a majority still hold that more “obscenely” dressed dressed women get eve teased more, and that the onus is on women to avoid eve teasing. Why go on-line, even the deep philosophical discussions every Indian has at the tea shop echo the sentiments that women are somehow responsible for what happens to them, if not always, most of the time.

The reason why such an asinine logic has become so pervasive evades me, and if you dont think it is asinine, take a look at the root arguments:

if X does something “wrong” then Y is justified in doing anything wrong to X

(could be Hindi movies, bec the few Hindi movies I have seen have angry young men avenging the death/rape of their mothers/sisters by extreme violence. )

By this standard, if Ms. Pamela’s dog barks too much in the night, it is perfectly alright for her neighbor to poison it.

It is important that we separate the two actions from each other, and therefore the crime from the victim. Sure, a nocturnal canine opera is awful, but just because your sleep has been wronged and she is and idiot, you cannot poison her dog. You can picket, go on a hunger strike, or even talk things over with the owner, as impotent as these sound, but that’s the way, not murder.

If we all start killing irritating dogs, none of us would have any.

There is of course a bigger and more ignorant assumption underlying such statements. And that is that the human male, particularly in India is somehow a slave to his primal urges, never really having evolved his frontal cortex enough to be able to decide right from wrong. And so, like we would tip-toe around a sleeping giant, lest we wake him up, we should mollycoddle the male lest he be titillated and incited into doing something “unfortunate” and uncontrollable.

For those of you who didn’t catch the sarcasm of the previous paragraph, let me spell it out. Human beings, Indians, Pakistanis French or Greek, have the ability to resist their sexual urges, particularly in socially unacceptable situations.  If we did not, this world would have been one big orgy.

Why  a molester or a rapist commit the crime is a subject much studied and there is good evidence to show that it has nothing to do with the amount of flesh shown. Sexual assault of almost all kinds is related more to issues like power and control than sexual desire or urges. There is also a certain amount of risk-seeking or thrill seeking behavior involved. The rapist/molester gets his thrill by overpowering women and displaying his dominance. Almost all molesters started with less severe and easily overlooked forms of sexual assault and progress to more severe forms.

Dont belive me, read this paper [link]

The wonderful initiative by blank noise has made it very clear, not that we need evidence, that molesters don’t care about what you do or do not wear, people have been raped, whistled at, touched and pinched wearing burkas as well as saris. This adds to the clear evidence that victims of sexual crimes have absolutely no culpability.

This blatant criminal-victim-exchange not only increases the trauma to those affected, but it also makes the power hungry predator more confident of terrorizing women and getting away with it.

This post is a bit too late in joining the petition that blank noise has sent to the deputy director of tourism, but the fight doesnt end with a petition or a hundred, minds need to be enlightened, societies need to be changed, its a war out there, not a lover’s spat.

Having said that, I hope to write about the flip-side also, not about this particular case though, but about what the difference between personal responsibility and culpability is.

Salvageable?

Salvageable Adj: capable of being saved from ruin;

I was shocked the first time I heard my then boss asking a PG if the patient was “salvageable”. Comparing sick people to shipwrecks didn’t seem respectful or right but before long I found myself asking the same question when dealing with a sick patient, particularity one who was very sick and needed expensive and intensive care.

If the patient was not “salvageable” and there was a “salvageable” patient waiting for that bed, then by unsaid rules, less time, effort and money would be spent on him/her, particularly if the patients relatives could not afford the treatment.

The truth about the god-like (read: Inhuman) choices that doctors working in resource-limited circumstances is rarely spoken about outside medical ethics seminars. On the rare occasion a news paper, a novel or even a sit-com decides to take up the topic, it receives nothing more than a few over the shoulder cliché’s about how real life is different from the books.

Chances are, no senior doc will sit a house surgeon down and explain tenderly that while all human life is sacred and deserves equal effort in saving, the ground realities force us to give preference to the young, the “salvageable” over the old or “un-salvageable” patients. That this does not make the old, terminally ill patient any less important or deserving of ones time and effort.

Yet day after day, thousands of “cases” are categorized and differentially treated. It is foolish to think that our actions do not affect us, the rare some learn to love humanity and do their best to bridge this unfair and gap while others learn to value life in terms of productivity and “salvagability” and are forever condemned to be less than human, for that is what you turn into, if you cannot see sanctity of life.

Someday, I hope there is reckoning and justice for the young lives scarred by the inhuman task they were given though we are not mere victims of our circumstances.

Compulsory HIV testing; Violating or protecting Human rights?

On October 9th the Parliamentarians’ Forum on HIV/AIDS (PFA) declared that HIV testing will be made mandatory for all pregnant women. They said that passing HIV from mother to child was a human rights violation and that for a generation that is free from HIV, this needs to be done.

Making the test compulsory raises hopes as well as questions. On the positive side is the fact that if the HIV status of the mother is known, the delivery can be made safer for the mother, the child and the health worker. Up to 40% mothers with HIV transmit the disease to their children without being aware of having HIV. A child has a 25-45% risk of contracting HIV during delivery from its mother, which can be brought down to under 2% if adequate precautions are taken and the mother is treated.

The most important question it raises is that of a woman’s right to autonomy. This is closely linked to the fact that in spite of the male partner being the source of HIV in majority of the cases, women are the ones who have to bear the brunt of the social stigma and abuse. Even though as per guidelines, the person getting tested for HIV has absolute rights about who gets to know about the result, in practice this rarely happens. Privacy and autonomy are alien to our culture, as a result of which chances are that if you are diagnosed with HIV in a typical Indian hospital, everyone from the ward-boy to the sweeper knows the results. There is no doubt that making this test compulsory breeches the fundamental dignity of women, and makes them vulnerable to the anger of their families.

It must be kept in mind that in many states in the south, all pregnancies followed up in government hospitals are already screened for HIV and Hepatitis B under the RCH scheme. But there is a big lacuna in this scheme and that is the home deliveries. Depending on the state and region of the state anywhere from 25-50 percent of children are born in homes, with no access to a doctor. The PFA has suggested that leaders at village level be involved in ensuring they are screened. This might be a good way of reaching health care to the most interior places, but it is obvious that this is going to expose women even more to hostile forces. Unless the forum comes up with a unique way of ensuring privacy while maximizing health care cover, such a drastic move is going to adversely affect lakhs of women.

While the intentions of the PFA are good, and their science is accurate, they fall short in keeping the ground realities in mind. One of the ways they can do better is by involving grass-route level organizations that work in the HIV/AIDS field. Also, there needs to be public debate about medical issues in the country. It is sad that the media and other sources are mostly silent, and even when this is a decision that will affect millions of our countrymen, there is a pitiable lack of public interest.

In the end the decisive question is whether protecting the unborn from a preventable disease outweighs the risk of ostracism and the moral duty of respecting women’s autonomy.

From the Archives: The New East India Company

Published on The Blog Of Dysfunction on September 18 2008

Indians of any background should have reason enough to celebrate their historical or cultural association with Nagarjuna’s penetrating philosophical arguments…Maitreya’s searching questions, Carvaka’s reasoned skeptisism, Aryabhattas astronomical and mathematical departures, Kalidasa’s dazzling poetry, Sudraka’s subversive drama, Abdul fazal’s astounding scholarship.. or Ravi Shankar’s and Ali Akbar Khan’s music, without first having to check the religious background of each

Sen, Amartya,The Argumentative Indian (Penguin Books 2005), p75

Among the many good habit I am nurturing in me of late is reading books about India. This stemmed from the realization that for someone who claims to be a patriot I know pathetically little about my nation.I began with “In Spite of the Gods by Edward Luce” and now am reading this delightful book.

Dr.Sen is a genius and a scholar sans comparison, yet his language is engaging and easy arguments to understand. One of the essays, from which the above quote comes from, examines the Hindutva movement very closely, and in the wake of the renewed violence against minorities in the country, this passage is particularly relevant.

The unfortunate truth is that in the name of “true Indianness” the proponents of the militant Hindutva movement (and those of other religions) are just peddling fascism, and are using the tactic the British East India company is famed to have used to rule India; “divide and rule”. Our colonial overlords were driven out amidst united slogans of “quit India”, I think it is time the same happens to intolerant and militant religious fundamentalism, be it of any religious conviction.

mażhab nahīñ sikhātā āpas meñ bair rakhnā
hindī haiñ ham, vat̤an hai hindostāñ hamārā

Religion does not teach us to bear ill-will among ourselves
We are of Hind, our homeland is Hindustan.

Jai Hind

Schizo

Unnatural Affections?

The unknown and the different have always evoked strong reactions from people. Perhaps there is an evolutionary imperative in being wary of all that is alien. Of all the “strange” socio-cultural phenomenons to create waves in the past 30-40 years, nothing matches the gay rights movement in its perseverance and success. Yet, inspite of all the success of the movement across the world, there is perhaps no group so hated and misunderstood. Part of the reason is that in most cultures sex is taboo, and talking about “unnatural”sex is further taboo. Lies mis-conceptions and false information passed on from mouth to mouth end in a grossly misrepresented image or reality.This series will look at the most common  objections and misunderstandings about homosexuality.

That homosexuality is “unnatural” and against the “order of nature” is perhaps the most commonly used argument, heard the loudest and so pervasive as to be even in our constitution till this year.
What is Natural?

Any discussion about the unnatural must begin with understanding what natural is. Explanations and definitions abound and for this discussion I choose to define natural as that which adheres to natural laws.Natural laws are laws that govern what we observe in nature; eg. gravity, electromagnetism etc. but as far as we know, there is no universal law of sexuality and even if there was one, the very fact that homoxesulaity defied the law would mean it was not really a law. It’s not that I have chosen a definition to suit my views, taking any other definition, save those that have a religious origin, there is no scientific reason to call homosexuality unnatural.
Take for example the belief that only human beings have homosexual behaviour, and therefore it is a deviation from the natural norms. Contrary to this belief, there are hundreds of species of animals that exhibit homosexual behaviour. Following is a quote from a popular magazine. The science of the article is accurate, if a bit dramatic.

Giraffes have all-male orgies. So do bottlenose dolphins, killer whales, gray whales, and West Indian manatees. Japanese macaques, on the other hand, are ardent lesbians; the females enthusiastically mount each other. Bonobos, one of our closest primate relatives, are similar, except that their lesbian sexual encounters occur every two hours. Male bonobos engage in “penis fencing,” which leads, surprisingly enough, to ejaculation. They also give each other genital massages.

The Moralistic Argument

However, often statements about the unnaturalness of homosexuality stem from religious or moralistic beliefs. Of the world’s dominant religions, all monotheistic religions have clear cut objections to homosexuality and one can find a wide range of personal beliefs about it, from believing homosexuals to be “lost souls” to “perverts going to hell”.

Most religions believe that there is a clear and fixed natural order, a guideline of how nature and people are supposed to behave. The problem with this outlook is that this presumes that religions know all there is to know about nature and its working. But if religions indeed are right about such an order why do their moralistic and natural standards change with time? Natural and unnatural vary across religions and sometimes even across sects within religions, it is unnatural for a man to be clean shaven if he is Amish and unnatural for him to sport a beard if he is a Quaker. Oral sex was deemed unnatural by all Christian sects till just a hundred years ago, yet now many an evangelical preacher is heard supporting it from posh progressive pulpits. So the natural-unnatural divide as proposed by religions is like writing in sand, with no sound and timeless principles behind them about the natural world and therefore cannot be accepted as a valid one.

Reproduction or Evolution Argument

There are many pseudo-scientific arguments hovering around the theory of evolution, usually propounded by religious groups to lend credibility to their moralistic arguments. The typical argument is that sex was evolved for reproduction and since homosexuality does not lead to reproduction, it is unnatural/wrong/evil. To begin with, it is quiet a big assumption to say that the only purpose of sex is reproduction, and if it were true, any sexual behavior that does not directly or indirectly lead to conception should also be deemed unnatural.

Such reductionist thinking does not keep in mind that the evolutionalry scientists themselves are at times not sure about the evolutionary significance of many human traits. One such example is the female orgasm, if the only purpose of sex is reproduction, then (sorry ladies) the female orgasm is rather useless. In fact for a long time it was not even accepted as normal for a woman to have an orgasm.

In conclusion, there is no good scieintific reason to think homosexuality is an abnormal deviation, or unnatural form of sexual preference. Hopefully with advances in science we will know better about the physiology, psychology and genetics involved.

The next part of this series will talk about the medical aspects of homosexuality, adressing questions like “Arent all gay people HIV positive?” And isnt homosexuality a disease?