Gender based Violence Photo (Image: AllAfrica)
Gender based Violence (GBV) is not particularly gender specific and can be defined as any act of violence that can result in physical, sexual, psychological harm and suffering. This includes coercion or a forced act, which leads to an arbitrary deprivation of liberty. Gender based Violence has been, and continues to be a social ill with far-reaching repercussions
A Global Perspective
According to the WHO report in 2021, there are an estimated 736 million women that suffer from Gender based Violence (GBV) globally. Almost one in every three women will suffer from acts of Gender based Violence (GBV) and/or have experienced violence starting from 15years and older. Unfortunately, most violence against women is perpetrated by either current/former husbands or intimate partners. Of which, one in four are adolescent girls aged 15 to 19.
Attributed to the COVID-19 pandemic, calls to helplines have increased five-fold in some countries as rates of reported intimate partner violence increase. UN women have stated that the restricted movement, social isolation, and economic insecurity during the pandemic have led to a global increase in women’s vulnerability to violence. To curb this, by September 2020, 52 countries had integrated prevention and response to violence against women and girls into COVID-19 response plans, and 121 countries had adopted measures to strengthen services for women survivors of violence during the global crisis. However, more efforts are urgently needed.
An African Perspective
The impact of GBV; the most prevalent human rights violation in the world, on individuals is typically glaring. However, there’s another complex impact that is often ignored – the socio-economic impact.
African countries with the highest rates of gender-based violence, such as South Africa, Nigeria, Kenya, Liberia and Zimbabwe cannot afford any further economic challenges. This makes it imperative for such countries to seek and implement policies and legislation to fight against gender-based violence.
A South African Perspective
In South Africa a report published by the South African Police Service (SAPS) and acknowledged by the Institute for Security Studies, which covers the period between 1 April 2018 and 31 March 2019, reveals an increase of reported GBV cases compared to previous years. The number of reported sexual offences increased to 52,420 in 2018/19 from 50,108 in 2017/18, most of which were cases of rape.
The reluctance of boys and men that suffer from GBV to speak out (in a bid to create awareness and highlight issues) further compounds the situation. GBV affects women, girls, men, boys and the LGBTQ+ communities. There needs to be more research, more empirical evidence to carry forward policies, advocacy and strategies to assist, prevent and intervene in GBV against boys and men, the LGBTQ+ community, women and girls.
A Zimbabwean Perspective On GBV
According to UNFPA in Zimbabwe, about 1 in 3 women aged 15 to 49 have experienced physical violence and about 1 in 4 women have experienced sexual violence since the age of 15. Reports of domestic violence, child marriage, violence by state officials and armed guards, online abuse and other forms of GBV have increased globally and regionally during the pandemic, and Zimbabwe is no exception to this trend (SAFE, 2020).
In response to GBV cases, Zimbabwe through a multi stakeholder approach has been able to help the survivors. The Victim Friendly Unit of the Zimbabwe Republic Police has been allowing both males and females to report mainly physical violence and they have been able to refer cases for further help. NGOs like the Institute of Women Social Workers have been providing psycho-social support to the survivors and are referring such survivors to other organizations like Women and Law in Southern Africa for legal help. Further to this, survivors are referred to Adult Rape Clinic and Musasa project for medical help and safe shelters respectively. Social workers in Zimbabwe have been able to provide counselling despite the shortage of resources and have also supported the survivors with economic empowerment activities.
Despite these efforts, men and boys are always left out because of the stigma and Attitude that the service providers have towards men in relation to GBV.
GBV In The Context Of Domestic Abuse In A Relationship
Abuse can be physical, sexual, emotional, economic, or psychological actions or threats of actions that influence another person. This includes any behaviours that frighten, intimidate, terrorise, manipulate, hurt, humiliate, blame, injure, or wound someone. Domestic abuse can happen to anyone of any race, age, sexual orientation, religion, or gender. It can occur within a range of relationships including couples who are married, living together, or dating. Domestic violence affects people of all socioeconomic backgrounds and education levels.
The Warning Signs In A Relationship Likely To Have Elements Of Domestic Abuse?
Self- care is a self-regulatory mechanism where one intentionally puts effort and measures towards their well-being. Well-being would affect and be affected by the different aspects of one’s life and the choices they make. GBV does not just happen, in most cases that are subtle or obvious signs that in more often people choose to ignore for many other reasons.
Violence against women happens across a spectrum, and at the end of that spectrum in most cases, is a man who snapped or a man who violates someone or their partner because they have inherent habits of violence. It should therefore be noted that we all have the power to remedy such behaviours in order to implement societal change.
Red Flags To Pick Up At The Pre-Relationship Stage
At the beginning of a relationship, there is such bliss, so much love and uncontrollable emotions that often cloud one’s clear judgement. Looking for early warning signs is not so easy, especially if there are underlying issues that could potentially hinder mental clarity and most people tend to not want to be realistic, but to rather get lost in the bliss of the long-awaited ‘force’ of love. During the early stages, where partners are still learning and exploring one another, there is a lot of uncertainty, which makes it a little bit difficult to do a proper due diligence due to influx of emotions, sexual and physical ‘forces’ at the start of relationship. In most cases, this is where some of the issues that later emerge are missed.
Some of the things that one can do, to have an idea of who a person is, especially if they are seeking a more stable relationship, include the following:
- Establishing the values of the other person and engaging beyond the surface,
- Asking questions to get to understand the person before committing,
- Things such as life goals, values, belief systems, their past experiences, family background, and their intentions,
- Listening with extra care what a person says, to establish how they view life and their approaches to making it work. e.g., biased views on the roles of women and men,
- Unpredictability, failing to fulfill set promises etc.
- Establishing underlying signs of traits such as jealousy, elements of possessiveness, a bad temper with others, impatience and a sense of entitlement. These are some of the ways of determining personalities, characters and habits that would likely lead to domestic abuse. For example, determining if a person has narcissist tendencies could be hard to pick up instantly, because there is a list of traits that come together to create this unpleasant personality.
Red Flags During The Relationship Can Be Explored Through The Use Of The Power – Control Wheel (DULUTH Model)
During the relationship one must explore the power and control wheel which in this phase/during the relationship is easier to determine whether there are signs of domestic abuse. The wheel has been used to describe and explain domestic situations of battered women. We have seen through numerous research that GBV is progressive and occurs over a spectrum. It all starts with mild gestures that most people deem as acceptable such as harmless remarks, condescending comments here and there, excuses towards responsibilities and the likes. It then escalates to plain verbal utterances, clear and precise control which then escalate to physical and in extreme cases, loss of mental perspective or life.
A personal reflection of a GBV survivor, highlights the importance of redefining focusing on better decision-making, learning from mistakes, and healing to ensure that one can better position themselves to build better and more meaningful connections in the future.
With this said it is important to empower women and to provide them with tools to get themselves out of disempowering situations. However, this should not equate to the disempowerment of men or boys, it should rather create a space to safeguard all rights and to also include men in the narrative to provide methods and means to reduce the dire effects of GBV. This should not leave the boy child bare and unattended, or the man left behind without creating mechanisms to navigate related issues or hidden suffering..
Conversations With Men In Respect Of GBV In Men And LGBTQ Community
GBV amongst men can begin at a very early age in childhood when a parent or caregiver was meant to display characteristics of love and nurture, instead the poor child was presented with maltreatment and abuse.
Let’s take a moment to imagine the scenario wherein;
“A young boy growing up in a household that is physically and emotionally abusive. His caregivers might hit, slap choke him and on other days he is being insulted, humiliated and sexually abused. These experiences end up being normal to him. He sees nothing wrong with such behaviour and has become desensitised to this life – that becomes the normal frame of his world view as a male adult.”
This is the hidden suffering of boys and men, wherein no one really talks about such experiences. These assaults are frequently not reported, thus creating a perception that GBV and SGBV only occurs to women. Furthermore, some people in the LGBTQ+ community fear being ostracised and humiliated by their microsystems, their communities and even their peers.
There are many cases where men don’t report being abused due to the lack of education, information and advocacy on such concerns. Men who do experience daily abuse often chose not to speak up because it may reduce perceived masculinity. These are the societal factors that influence the decision making to remain silent – Such are his family, education, beliefs and community.
On the contrary, men who have experienced rape, sexual abuse, violence and choose to speak out might not be taken seriously because the law enforcement does not escalate these issues because they don’t believe a male victim could go through such. Some communities find it shocking, taboo and unbelievable for men to be victims of GBV and SGBV.
The stereotypes of what it means to be a “hegemonic man” don’t give space for men to speak up about GBV and this remains a hidden issue which results in lack of research, advocacy and strategy. So far, the research done indicates that the GBV impacts men in various ways, such as using violence as a means to an end. The symptoms of GBV amongst men contributes to the overwhelming factor of GBV against women and girls. Concurrently Gender based Violence amongst men continues to be a topic that society doesn’t advocate enough.
We Need To “Stop Victim Blaming” And Rather Refer To Survivors-Reset The Narrative
“Victim-blaming” is a general term used to describe a situation where the victims are blamed for the events they experienced. In the paper written by Schwark & Bohner in 2019 defined “Victim-blaming” in discourses related to GBV tends to implicate victims and position them as responsible for their own safety, with little or nothing being said about the perpetrators’ actions. This myth, one of many “rape myths”, is reinforced by mainstream media reporting.
The meaning attached to the term “victim”, to label people who endured GBV and abuse, is increasingly considered problematic and replaced in activists’ and allies’ vocabulary with the term “survivor”, which reverses the power balance. While the term “victim” equates the existence of a person to their experience with trauma and places them in a position of vulnerability, the term “survivor” implies a future ahead. It is within this premise that we argue for the term “survivor” in such contexts instead of the term “victim” may have an impact on the misattributed judgement of blame and in turn improve reporting across the board for all those that are affected by GBV.
Help Mechanisms Include:
- Support programs – Family and Marriage Society of south Africa (FAMSA) for counselling.
- Tears Foundation for CRISIS interventions.
- The Trauma Centre for trauma counselling, and the Thuthuzela Care Centres, which are the anti-rape strategy centres to help victims from secondary victimisation.
- Helping victims and survivors with self-help programs – individual development, counselling and coaching to rebuild and restore hope in their lives- Changing Lanes Africa-: Self-awareness courses for women.
- This is normally through shelters, which in South Africa to a large extent, are much better resourced than in other African countries which may have many challenges with providing adequate support.
- Talk about your experiences to help others- Simanye Clinic Podcasts and Conversations with my brothers.
KEY TAKE HOME MESSAGE
- To have boundaries and enforce them from the on-set.
- Be realistic and don’t ignore red flags.
- Reposition yourself for better life.
- Use protection orders and maintenance orders to safeguard your rights.
- Remember you are a survivor.
- Every one of us should educate the youth about such issues and how they can be avoided or at the least alleviate the burden of GBV.
- Men should be included in the solution to reduce violence against women and children
- Men and members of the LGBTQ+ community also suffer from GBV but there are few to no statistics as they remain silent- the hidden suffering.
- GBV should not be seen as something that happens to specific people, rather should be addressed across the spectrum within which it occurs.
We acknowledge Dr Maribanyana Lebeko who is part of the advisory for Simanye Clinic for his assistance with respect to compilation, editing and proofreading of this article.
Article By: Thandiwe Maretlane, Lindo Radebe, Linah Ruparanganda and Chiedza Jowa and Dr Kim Lamont-Mbawuli. In collaboration with the National Association of Social workers, Zimbabwe and Simanye Clinic, South Africa.
The Role Of Medical Legal Opinion In Potential Medical Negligence Matters
Written By: Dr Kim Lamont-Mbawuli & Adv Dennis Chamisa
There is a reluctance of doctors to testify against each other, compromising the necessary checks and balances within the medical profession. As such, obtaining a comprehensive expert opinion is important to safeguard the rights of all parties involved in legal matters.
Medical negligence is a complex and sensitive area of law that involves cases where healthcare providers are alleged to have breached their duty of care, resulting in harm to patients. In such cases, legal practitioners often require the assistance of medical experts to establish whether negligence occurred. This is where the crucial role of medico-legal experts in providing a necessary service to society in the form of a medico legal opinion is indispensable
In this article, we will explore why legal practitioners need a medical legal opinion in potential medical negligence matters.
Interpretation of Medical Records
One of the primary reasons why legal practitioners require a medical legal opinion in medical negligence cases is the interpretation of medical records. Medical records are crucial evidence that can determine whether a healthcare provider deviated from the standard of care. However, these records are often filled with complex medical jargon and abbreviations that may be difficult for lawyers to understand fully.
A medical legal opinion from a qualified expert can bridge this gap. Medical experts can review and interpret medical records, ensuring that all relevant information is considered. They can identify discrepancies, omissions, or irregularities that may indicate negligence, providing invaluable assistance in building a strong legal case.
Establishing Standard of Care
Medical negligence cases hinge on whether a healthcare provider breached the standard of care expected in a particular situation. Determining the standard of care requires specialized medical knowledge and experience. Legal practitioners often rely on medical experts to establish what a competent healthcare provider would have done under similar circumstances.
A medical legal opinion helps in defining and explaining the standard of care to the court and the jury. It allows legal practitioners to present a well-substantiated argument, demonstrating how the defendant’s actions or inactions deviated from accepted medical norms.
The Role of Expert Opinion in Courts
In medical negligence cases, expert witness testimony is often crucial. Legal practitioners need medical experts to testify about the standard of care, causation, and the extent of the patient’s injuries. These experts can provide objective, professional opinions that carry significant weight in court.
A medical legal opinion serves as the foundation for expert witness testimony. It allows the expert witness to provide a well-informed and credible account of the case, helping the judge and jury understand the medical complexities involved.
The test applied by South African courts to evaluate expert evidence in medical negligence cases.
South African courts employ a test akin to that utilized in numerous other common law jurisdictions to gauge the significance of expert testimony in medical negligence cases.
This test, as articulated by the Supreme Court of Appeal (SCA) in the case of Michael and Another v Linksfield Park Clinic (Pty) Ltd and Another 2001 (3) SA 1188 (SCA) at paragraph 34, emphasizes the role of the court in evaluating expert opinions. The court held:
“In the course of the evidence, counsel often inquired of the experts whether certain conduct was reasonable, unreasonable, or negligent. The presiding judge was not swayed by this into relinquishing his decision-making responsibility. Nor, we believe, did counsel intend for that to happen. However, it is worth reiterating that the determination of reasonableness and negligence is the purview of the court itself, based on the array of sometimes conflicting expert opinions presented. Typically, this determination does not hinge on matters of credibility but rather necessitates scrutinizing the opinions and their underlying reasoning to facilitate the court’s formation of its own conclusions on the raised issues.”
In this specific case, experts were not solicited, nor did they endeavor, to express a collective or representative perspective regarding what constituted reasonable conduct for a South African specialist anesthetist in 1994. The court expressed its frustration at the experts called, asserting that they did not offer a ‘collective or representative opinion’ on how a reasonable anesthetist would have responded under identical circumstances. Furthermore, it raised concerns that the primary function of the experts summoned was more akin to ‘teaching.’
The court pointed out the ‘absence of evidence’ pertaining to customary practices within the specific field and underscored that the assessment of such evidence should revolve around the extent to which the opinions put forth are grounded in logical reasoning. The court also referenced the House of Lords ruling in Bolitho v City and Hackney Health Authority  AC 232, stating that the court is not obligated to absolve a defendant doctor of liability for negligent treatment or diagnosis solely on the basis of the concurrence of multiple medical experts. Instead, the court must ensure that such opinions have a ‘logical basis,’ implying that the expert considered the relative risks and benefits and reached a ‘defensible conclusion’ (at 241G-242B).
The court went on to emphasize that even in instances where the professional opinion asserts that overlooking an apparent risk is not negligent, the defendant can still be held accountable (at 242H). Furthermore, the court contended that courts must rely on expert opinions to assess medical risks and benefits and that the court would be incapable of making clinical judgments without the guidance of medical experts. “It is only when a judge is convinced that the body of expert opinion lacks any logical support that such opinion will not serve as the benchmark against which the defendant’s conduct is to be assessed” (at 243A – E).
This fundamental distinction between the scientific and judicial standards of proof was eloquently underscored by the House of Lords in the Scottish case of Dingley v The Chief Constable of Strathclyde Police 2000 SC (HL) 77, which issued a caution:
“One cannot completely dismiss the risk that by immersing oneself in the minutiae and attempting to comprehend the thought processes of the experts, a judge may be drawn into a situation where he employs the standards the expert would use to determine whether a particular thesis has been proved or disproved – instead of conducting an assessment, as a judge must, of where the preponderance of evidence lies after considering the entire body of evidence.”
The Western Cape High Court judgment in Kosana v MEC for Health (WCC) (unreported case no 9230/2005, 23-1-08) (Erasmus J) further expanded on this concept. The court invoked a passage from the Appellate Division judgment in Van Wyk v Lewis 1924 AD 438 at 444 and expounded in paragraph 36:
“When appraising the level of skill and diligence possessed and exercised by members of a specialized profession (the responsible group of medical practitioners skilled in the particular field), ‘the evidence of qualified surgeons or physicians is of the greatest assistance.'”
The court then drew from the judgment in Maynard v West Midlands Regional Health Authority  1 WLR 634 at 639:
“I must emphasize that a judge’s ‘preference’ for one body of distinguished professional opinion over another, also professionally distinguished, does not suffice to establish negligence in a practitioner whose actions have garnered approval from those whose opinions, honestly expressed and genuinely held, were not favored. In the realm of diagnosis and treatment, negligence can only be established if there has been a failure to exercise the ordinary skill of a doctor (within the relevant specialty if they are a specialist).”
The court also cited the Bolitho case, in which it was declared:
“The evaluation of medical risks and benefits is a matter of clinical judgment that a judge typically cannot undertake without expert evidence. As Lord Scarman’s quote makes clear, it would be erroneous to allow such an evaluation to degrade into an attempt to persuade the judge to favor one of two views, both of which can be logically supported. Only when a judge is convinced that the body of expert opinion lacks any logical support will such opinion not serve as the benchmark against which the defendant’s conduct is to be assessed.”
In Honisz v Lothian Health Board  CSOH 24, paragraph 39, the Scottish court, relying on the Bolitho case, elucidated:
“As a general rule, when there are two conflicting schools of thought within the relevant group of responsible medical practitioners regarding the appropriateness of a particular practice, it is not the role of the court to favor one school over the other (Maynard v West Midlands Regional Health Authority, Lord Scarman, p 639F-G). Nevertheless, the court does not unconditionally defer to the opinions of the relevant professionals to the extent that, if a defendant presents evidence that other responsible professionals within the relevant group of medical practitioners would have taken the same actions as the impugned medical practitioner, the judge must invariably conclude that there was no negligence. This is because, thirdly, in extraordinary cases, the court may conclude that a practice endorsed by responsible medical practitioners does not withstand rational scrutiny (Bolitho v City and Hackney Health Authority, Lord Browne-Wilkinson, pp 241G-242F, 243A-E). When the judge is satisfied that the body of professional opinion on which a defendant relies is unreasonable or irresponsible, he may find the medical practitioner guilty of negligence, despite the endorsement of his conduct by that body of opinion.”
The evaluation of evidence based on expert-based knowledge is a catalyst for justice vis-a-vis the standard integrity, logic and comprehensive knowledge and experience in the area concerned. In the realm of medical negligence, legal practitioners rely on medical legal opinions to navigate the complex and intricate intersection of law and medicine. These opinions are invaluable for interpreting medical records, establishing the standard of care, assessing causation, and providing expert witness testimony. Whether the case goes to trial or is settled outside of court, a medical legal opinion is often the linchpin that determines the outcome. It ensures that justice is served by holding healthcare providers accountable for their actions and ensuring that patients receive fair compensation for their injuries.
Feel free to contact Dr Kim Lamont-Mbawuli at Kim@klmattorneys.co.za for your medical legal opinions
Deborah Bless, African storyteller and cook partners with Chat GPT 3 to launch “Love Envoy”
Deborah Bless, all known as Deborah Ogwuche, has made history today as one of the world’s first AI romance co-authors. The partnership between Deborah Bless and Chat GPT 3 to Co-author the book “Love Envoy” is among the first creative collaboration between an artificial intelligence and a human. The collaboration is unique because it explores boundless opportunities and how AI will shape innovation in the writing profession.
According to Deborah Bless, the incorporation of AI in the writing of “Love Envoy” was like having a mentor to keep her focused and build a captivating piece that surpasses readers’ standards. In addition, she mentioned that the lucidity provided by AI in word selection and developing excitement was extraordinary and beyond her expectations.
Titled “Love Envoy,” the book tells the story of an immigrant Nigerian single mother on a journey of self-discovery and budding romance with an unlikely character. This book is expected to be the first of many AI co-authored works that will take the literary world by storm.
“Love Envoy” is launched today, April 1st, 2023 and will be made available to the public through Deborah Bless’s website, as well as notable book platforms.
Deborah Bless expressed her excitement about the launch of “Love Envoy,” saying, “I am thrilled to have worked with OpenAI’s Chat GPT 3 on this groundbreaking project. I believe that this collaboration will inspire other writers to explore the possibilities that AI presents in co-authoring works of literature. I also cannot wait for readers to experience this captivating love story.”
For more information on “Love Envoy” and Deborah Bless’s works, visit her website and other leading book and social media platforms.
Marius Botha: Insurtech booms on back of fintech’s success story
Marius Botha, Group CEO of aYo Holdings
The past couple of years have been brutal for the African continent. We’ve been through Covid-19, and now we’re living through turbulent socio-economic times, with high inflation and rising prices causing untold consumer hardship in most countries. But despite this, the fintech industry is booming, thanks largely to exponential growth in mobile network coverage and smartphone use.
Indeed, Briter Bridges’ Africa Investment Report 2022 paints a picture of Africa as an increasingly viable investment destination, with growing numbers of major deals over the past 12 months alone. Needless to say, fintechs continue to dominate the market, grabbing up to 60% of all deals over the past half decade, including the highest value and highest profile deals.
As a result, African consumers are rapidly becoming more used to using digital financial products like Mobile Money (MoMo) and payments from the palm of their hand. And this is good for related industries like insurtech, which is surging as consumers transition to a world where financial services are easily accessible via mobile phone and transacted via apps and other channels.
What’s particularly encouraging is the growth in early-stage support networks, which involve angel networks, seed funds and accelerator cohorts. Many promising start-ups, especially those in less glamorous parts of the fintech market, fail in their early stages precisely because of a lack of funding, and a greater appetite by funders to take on these risks can only benefit the continent’s fintech sector.
One of the major success stories for us has been the appetite for microinsurance in Africa, which has traditionally been the world’s most uninsured, and underinsured, continent. As its name suggests, microinsurance is small, rapidly underwritten financial protection that offers consumers financial protection against specific risks – like hospital cover for accidents, for example – for tiny premiums. Typically, policyholders can buy cover and claim directly from their mobile phones.
According to the IMARC Group’s latest report on global microinsurance trends, the market will grow to more than US$111 billion worldwide by 2027. A sizeable chunk of this growth will take place in Africa, where we’re only just scratching the surface of the demand for financial services products that make people’s lives easier and bring them into the financial mainstream.
What’s important about the growth of microinsurance is its impact not only on individuals and communities, but on entire economies. The impact of being insured is transformative: it not only drives greater financial inclusion, but it shields people with lower incomes from the economic shocks that would otherwise keep them locked into an endless cycle of poverty.
The kicker is that in spite of massive growth in investment into the continent in the past few years, all of Africa’s venture capital still only makes up around 1% of the world’s VC money. We’re still in our baby shoes. The phenomenal growth we’ve seen in fintech and start-ups in Africa in the past decade is only the beginning. We are still just exploring the potential of fintech and microinsurance to transform the lives of our people.
Our continent is hungry for financial inclusion. We’re increasingly ready to take our place at the world’s top economic tables. In spite of the uncertain economic times we’re dealing with, the only way is up. It’s a great time to be in Africa.
By-lined by Marius Botha