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Professor Dr Gerard Hutchinson, psychiatrist and university lecturer

Even as gender-based violence (GBV) remains one of the most earnest threats facing women in T&T, there were still too many not admitting they were being abused which could be counter-productive in the fight to eliminate violence against women.

This was said by psychiatrist and university lecturer, Professor Dr Gerard Hutchinson while responding to Guardian Media’s question about the importance of clinical intervention in GBV.

In an email response, he wrote: “In many cases, the victims do not admit that their injuries or illnesses were occurring in the context of GBV, which presents the first hurdle.”

Speaking on whether there were clinical interventions in T&T set up to assist GBV clients, Hutchinson, who is also the head of the psychiatric unit at the Mt Hope Hospital, said currently there were no dedicated health interventions, though health staff was trained and sensitised to the possibilities of GBV.

He added, while not required to report without the patient’s consent, they do make referrals to the appropriate social services, which would then provide the requisite assistance.

Hutchinson’s colleague in the field, Dr Varma Deyalsingh confirmed this saying if a doctor suspected domestic violence and the patient does not want to admit this then a dilemma existed, as it would now present a case of confidentiality versus public duty.

“Sometimes an unwilling or suspected victim is provided all the community resources available for assisting or counselling. Once it is not grievous bodily harm, the concept of reporting any patient who is a competent adult to the police or other authorities without his or her consent remains a controversial topic,” Deyalsingh said.

The secretary of the Association of Psychiatrists of Trinidad and Tobago (APTT), explained in the instances where children were involved or present during acts of violence, reporting the incident without the victim’s permission might be easier as children were now placed in an at-risk situation.

“If someone admits to abuse, the doctor does inform the nurse or social worker who can inform the police. We need to be aware of that. Reporting against the wish of an adult competent patient may be interpreted as stripping power from an already weakened person,” Deyalsingh stressed.

He said hesitation by a victim to seek medical care or report the abuse stemmed from several reasons—fear of further angering the perpetrator usually topping the list.

Speaking on what the signs were for medical practitioners to spot a possible GBV victim, Deyalsingh said if one noticed a pattern of a person coming into casualty or clinic with suspect bruising this should raise a red flag. However, he explained some victims go to different hospitals so their patient file cannot be compared. He said some even give false names, which is why hospitals now ask for identification cards at the triage point.

Listing a few key signs, Deyalsingh shared, “Domestic violence should be suspected if the patient’s story does not match their injuries if they seem fearful of spouse if spouse belittles or controls the patient. One should also look for bruises or scratches on the inside of the upper arm area—that’s the grab spot. Check the patient’s face for smacks and punches. And bald spots caused by hair pulling. Also kick marks on the patient’s back and legs, mainly thighs and shins.”

He said doctors were trained to interpret signs and put a picture together.

Meanwhile, the president of the International Women’s Resource Network (IWRN), Adriana Sandrine Isaac-Rattan, stated she was unaware of any existing clinical interventions in T&T to assist battered women or victims of GBV. She said if any existed at all, they were not well known.

Isaac-Rattan revealed in the last two weeks, the network had been receiving an influx of victims requiring clinical intervention. And stated, clinical intervention was critically important for women who have experienced any type of violence particularly rape and intimate-partner violence.

She said because of this need the network was working on expanding its existing clinical intervention programmes offered to its clients. Isaac-Rattan said these programmes were headed by a licensed clinical social worker specialising with children, adolescents, adults, and seniors.

Asked to comment on the importance of women utilising such interventions, Isaac-Rattan said it was important to note, the time period for each case varied depending on the level of emotional and psychological turbulence involved.