Gender based violence

GENDER BASED
VIOLENCE
Dr. Kishor Adhikari
Assoc. Professor, SPH&AS, CMC

Myths surrounding gender-
based violence
 Myths and stereotypical attitudes about
GBV shape the way in which society perceives and
responds to violence perpetrated against women.
Such myths and attitudes are harmful as they tend
to blame the survivors for the violence, rather than
holding perpetrators responsible for their behaviour:
 Conflicts and discord are a normal part of any
relationship.
 Men and women are equally violent to each
other.
 Domestic violence happens only to a certain
type of person.
 GBV only includes physical abuse (hitting,
punching, biting, slapping, pushing, etc
Dr. Kishor Adhikari, Associate Professor, SOPH, Chitwan Medical
College

Myths …………….Contd.
 GBV is caused by substance abuse such as
alcohol and/or drugs.
 Women should tolerate violence to keep the
family together.
 Domestic violence is a private family matter, in
which the state has no right to intervene. How a
man treats his wife is a private matter.
 Sex workers cannot experience rape.
 A man cannot rape his wife.
 Most GBV is perpetrated by strangers.
 Victims of gender-based violence are helpless.
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Myths
 survivors of sexual assault are responsible for
their attack or are capable of preventing it.
 “boys will be boys”
 violent/ sexual aggravators represent a tiny
percentage of the population.
 domestic violence and sexual assault are the
only types of violence women experience.
 slavery doesn’t exist today
 Female Genital Mutilation (FGM) only happens
to women against their will.
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Some stories
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My husband slaps me, has sex with me
against my will and I have to conform. Before
being interviewed I didn't really think about this. I
thought this is only natural. This is the way a
husband behaves.
Woman interviewed in Bangladesh during the WHO Multi-country Study on Women’s
Health and Domestic Violence Against Women
”

So I take a blanket and I spend the night
with my children out in the cold because he is
hitting me too much. I have to take the kids to
stop him hitting them too. I would go out in the
fields and sleep there all night. I have done
that more than ten times…
Woman interviewed in Peru during the WHO Multi-country Study on Women’s
Health and Domestic Violence Against Women
“
”

If I protest I’ll be marked in the society and
then my daughter wouldn’t be able to get
married…
If I voice my protest the community will blame
me for not bearing it in silence. This
helplessness is a torture in itself.
Woman, 43 years old, interviewed in Bangladesh during the WHO Multi-country
Study on Women’s Health and Domestic Violence Against Women.
“
”

Statistics based on reported cases heavily underestimate the level of violence.
Only about one in three women assaulted by partners report an assault to police
* 2004 Canadian General Survey on Victimisation

Gender-based Violence
Definition
 The UN Declaration on the Elimination of
Violence Against Women (Article 1) defines
as:
 ‘Any act of gender-based violence that
results in, or is likely to result in,
physical, sexual or psychological harm
or suffering to women, including threats
of violence, coercion or arbitrary
deprivation of liberty, whether occurring
in public or private life.’
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 Article 2 of the Declaration further specifies that
violence against women should include, but not
be limited to:
 “Acts of physical, sexual and psychological violence
whether they be in the family or the community. The
acts of violence specified in this article include:
spousal battering, sexual abuse of female children,
dowry-related violence, rape including marital rape,
traditional practices harmful to women such as
female genital mutilation, non-spousal violence,
sexual harassment and intimidation, trafficking in
women, forced prostitution, and violence perpetrated
or condoned by the state such as rape in war.”Dr. Kishor Adhikari, Associate Professor, SOPH, Chitwan Medical
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Broader definition by USAID
 Women and girls are the most at risk and most
affected by gender-based violence.
Consequently, the terms “violence against
women” and “gender-based violence” are often
used interchangeably. However, boys and men
can also experience gender-based violence, as
can sexual and gender minorities.
 Regardless of the target, gender-based
violence is rooted in structural inequalities
between men and women and is characterized
by the use and abuse of physical, emotional, orDr. Kishor Adhikari, Associate Professor, SOPH, Chitwan Medical
College

Types of GBV
 Intimate partner violence (physical, sexual,
psychological, economic)
 Sexual coercion
 Childhood sexual abuse
 Rape
 Trafficking
 Rape in conflict situations
 Acid throwing
 Female Genital Mutilation
 Honour killings
 Dowry deaths
--Source: WHO TEACH-VIP, 2005
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Gender-based Violence
 Violence against women and girls is one of the
most widespread, persistent and devastating
human rights violations in our world today
 It is a major obstacle to the fulfillment of
women’s and girls’ human rights and to the
achievement of the 2030 Agenda for
Sustainable Development. (G5)
 It occurs worldwide, cutting across all
generations, nationalities, communities and
spheres of our societies, irrespective of age,
ethnicity, disability or other background.
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Global Statistics
 Violence against women – particularly intimate
partner violence and sexual violence – is a major
public health problem and a violation of women's
human rights.
 Global estimates published by WHO indicate that
about 1 in 3 (35%) of women worldwide have
experienced either physical and/or sexual intimate
partner violence or non-partner sexual violence in
their lifetime.
 Most of this violence is intimate partner violence.
Worldwide, almost one third (30%) of women who
have been in a relationship report that they have
experienced some form of physical and/or sexualDr. Kishor Adhikari, Associate Professor, SOPH, Chitwan Medical
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Global
Statistics………….Contd.
 Globally, as many as 38% of murders of women
are committed by a male intimate partner.
 Violence can negatively affect women’s physical,
mental, sexual, and reproductive health, and may
increase the risk of acquiring HIV in some
settings.
 Men are more likely to perpetrate violence if they
have low education, a history of child
maltreatment, exposure to domestic violence
against their mothers, harmful use of alcohol,
unequal gender norms including attitudes
accepting of violence, and a sense of entitlement
over women.Dr. Kishor Adhikari, Associate Professor, SOPH, Chitwan Medical
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Global Statistics……Contd.
 Women are more likely to experience intimate partner
violence if they have low education, exposure to
mothers being abused by a partner, abuse during
childhood, and attitudes accepting violence, male
privilege, and women’s subordinate status.
 There is evidence that advocacy and empowerment
counselling interventions, as well as home visitation
are promising in preventing or reducing intimate
partner violence against women.
 Situations of conflict, post conflict and displacement
may exacerbate existing violence, such as by intimate
partners, as well as and non-partner sexual violence,
and may also lead to new forms of violence against
women.
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Regional rates of Intimate Partner
Violence around the World
Source: Preliminary analysis by WHO (World Health
Organization), presented in Klugman et al. 2014.
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National Scenario
 According to the 2011 Nepal Demographic Health
Survey, 22 per cent of women aged 15-49 have
experienced physical violence at least once since age
15, and 9 per cent experienced physical violence
within the 12 months prior to the survey.
 One in ten women reported having experienced
sexual violence.
 In Nepal close to half of women (48%) reported
experiencing violence in their lifetime, and over a
quarter had experienced violence in the past 12
months.
 Emotional violence (40%) was most commonly
reported, followed by physical violence (27%), sexual
violence (15%), and economic abuse (8%).
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 Women who had experienced violence
reported that almost three-quarters of the
perpetrators were husbands. A high
percentage of young women (74%) reported
having experienced sexual violence in Nepal.
 Domestic violence, marital rape, dowry-related
violence, child marriage, polygamy, female
infanticide and trafficking of women and girls
for sexual exploitation are particular problems
of GBV in Nepal.
UNFPA Nepal (2014) “Engaging Men and Boys, Communities and
Parents to End Violence against Women, Child Marriage and Other
Harmful Practices in Nepal”
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 About a third of married women suffer from spousal
violence, with higher rates of occurrence in Terai and
among those with no education and from poorer
households.
 According to a report published by Informal Sector
Service Centre, it recorded 2,202 cases of domestic
violence, 222 cases of polygamy, 242 rape cases, 94
cases of attempted rape, 37 cases of sexual abuse,
seven attempted trafficking in persons and 34
witchcraft accusations. INSEC said a total of 2,910
cases of violence against women were reported in
2016.
UN Statement for 16 Days of Activism
against Violence against Women 2013
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 A UNFPA 2013 perception study also revealed
that women from lower-caste or religious minority
groups, widowed, divorced, or separated women,
and women belonging to the hill regions, were
significantly more likely to report lifetime
experiences of violence.
 Dalit women face a high degree of exclusion and
traditional harmful practices such as Badi,
Chaupadi, Kamlari and Deuki, as well as child
marriage, which are still prevalent in many parts
of Nepal despite being formally prohibited.
Nepal MDG Progress Report p. 35; Amnesty
International, Nepal Submission to the
United Nations Human Rights Committee,
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 Women also face violence related to accusations of
witchcraft.
 There are also other traditional practices like son-
preference, stigmatisation of widows, seclusion of
women (purdah), family violence, and polygamy. Third-
gender face a separate and specific set of gender
based violence issues. Boys are more likely to be
educated in Nepal as they are seen as the future family
breadwinner while daughters live home to live with their
in-laws. Almost half of the population gets married
between the age of 14 to 19 years and dowry is the
major driver of child marriage as well as a cause of
violence against girls and women. The recent desk
review by UN Women (2015)
“A Desk Review: Conflict Related Sexual
Violence in Nepal” (March 2015), UN
Women Nepal
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Scope
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Factors that Perpetuate
Violence
1. Socio-cultural factors: Socio-cultural factors
like unequal power relations, low status of
women in society
2. Legal factors: inadequate legal provisions,
inaccessibility of legal services, and
ignorance of rights and responsibilities.
3. Policies and practices: There are factors
like negative policy environment, gender
insensitive policies .
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Factors that Perpetuate
Violence
4. Economic factors: Economic factors include
economic dependence, poverty, limited
opportunities and income sources, lack of
control of own resources .
5. Education: Illiteracy and limited educational
opportunity
6. Institutional factors: lack of or inadequate
victim support services and distances from
courts, health facilities, police services, etc.
which does not provide enabling atmosphere.
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Forms of gender-based
violence
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Economic and Social Council. “Report of the Working
Group on Violence against Women,” Vienna, United
Nations, 1992 has defined the forms of Gender-
based violence as follows:
1. Physical violence:
 Physical violence is defined as the intentional
use of physical force with the potential to
cause death, disability, injury or harm. Physical
violence includes, but is not limited to: scratching,
pushing, shoving, throwing, grabbing, biting,
choking, shaking, poking, hair-pulling, slapping,
punching, hitting, burning, use of a weapon (gun,
knife or other object), and use of restraints or one's
body, size, or strength against another person.
Physical violence also includes coercing other
people to commit any of the above acts.
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2. Sexual violence:
 Sexual violence: is divided into three
categories:
a. Use of physical force to compel a person to
engage in a sexual act against his or her will,
whether or not the act is completed
b. An attempted or completed sex act involving a
person who is unable to understand the nature
or condition of the act, to decline participation,
or to communicate unwillingness to engage in
the sexual act (e.g. because of illness,
disability, or the influence of alcohol or other
drugs, or due to intimidation or pressure).Dr. Kishor Adhikari, Associate Professor, SOPH, Chitwan Medical
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c. Abusive sexual contact, including intentionally
touching directly or through the clothing, of the
genitalia, anus, groin, breast, inner thigh, or
buttocks of any person against his or her will, or
of any person who is unable to understand the
nature or condition of the act, to decline
participation, or to communicate unwillingness to
engage in the sexual act (e.g. because of illness,
disability, or the influence of alcohol or other
drugs, or due to intimidation or pressure).
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3. Threat of physical or sexual
violence:
 The use of words, gestures, or weapons to
communicate the intent to cause death,
disability, injury, or physical harm.
 Also the use of words gestures or weapons to
communicate the intent to compel a person to
engage in sex acts or abusive sexual contact
when the person is either unwilling or unable to
consent.
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4. Psychological/emotional
violence:
 Psychological/emotional violence: Trauma to the
victim caused by acts, threats of acts, coercive
tactics when there has also been prior physical or
sexual violence, or prior threat of physical or sexual
violence.
 Psychological/emotional abuse can include but is not
limited to: humiliating a person; controlling what the
person can and cannot do; withholding information from
the person; getting annoyed if the person disagrees;
deliberately doing something to make the person feel
diminished (e.g. less smart, less attractive); deliberately
doing something to make the person feel embarrassed;
isolating the person from friends and family; prohibiting
access to transportation or telephone; denying access to
money and other resources; threatening loss of custody
of children; and, smashing objects or destroying
property.
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Contd.
 Psychological/emotional abuse as described
above may be considered as acts of violence
only when there has also been prior physical
or sexual violence, or the prior threat of
physical or sexual violence.
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“GBV is Public Health Issue”
Justify
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Types of Violence Against
Women
being practiced in Nepal
 Sex Selective Abortion
 Attempt to Trafficking
 Domestic Violence
 Witchcraft Allegation
 Jari
 Polygamy
 Lack of Pre and Post Partum Service
 Rape
 Rape attempt
 Sexual Abuse
 Women Trafficking
 Dowry System
 CHHAUPADI System
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Gender-based violence through the
lifecycle
Source: Heise L, Pitanguy J and Germain A. Violence against women: The
hidden health burden. World Bank Discussion Paper no. 255, Washington, The
World Bank, 1994, p.5.PHASE TYPES OF VIOLENCE
Pre-birth Sex-selective abortion (as prevalent, for example, in
China, India, Republic of Korea);
Battering during pregnancy (which can have serious
emotional and physical effects on the woman; and
effects on birth outcomes); coerced pregnancy (for
example, mass rape in war)
Infancy Female infanticide; emotional and physical abuse;
differential access to food and medical care for girl
infants
Girlhood Child marriage; genital mutilation; sexual abuse by
family members and strangers; differential access to
food and medical care; child prostitutionDr. Kishor Adhikari, Associate Professor, SOPH, Chitwan Medical
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PHASE TYPES OF VIOLENCE
Adolescenc
e
Dating and courtship violence (for example, acid
throwing in Bangladesh, date rape in the USA);
economically coerced sex (for example, African
secondary school girls having to date “sugar
daddies” to afford school fees); sexual abuse in the
workplace; rape; sexual harassment; forced
prostitution; trafficking in women
Reproductiv
e Age
Abuse of women by intimate male partners; marital
rape; dowry abuse and murders; partner homicide;
psychological abuse; sexual abuse in the workplace;
rape; sexual harassment; abuse of women with
disabilities
Elderly Abuse of widows; elder abuse
Gender-based violence through the
lifecycle
Source: Heise L, Pitanguy J and Germain A. Violence against women: The
hidden health burden. World Bank Discussion Paper no. 255, Washington, The
World Bank, 1994, p.5.
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Risk Factors
 Factors associated with intimate partner and sexual
violence occur at individual, family, community and
wider society levels. Some are associated with being
a perpetrator of violence, some are associated with
experiencing violence and some are associated with
both.
 Risk factors for both intimate partner and sexual
violence include:
 lower levels of education (perpetration of sexual
violence and experience of sexual violence);
 a history of exposure to child maltreatment
(perpetration and experience);
 witnessing family violence (perpetration and
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 antisocial personality disorder (perpetration);
 harmful use of alcohol (perpetration and
experience);
 having multiple partners or suspected by their
partners of faithlessness (perpetration);
 attitudes that condone violence (perpetration);
 community norms that privilege or ascribe
higher status to men and lower status to
women; and low levels of women’s access to
paid employment.Dr. Kishor Adhikari, Associate Professor, SOPH, Chitwan Medical
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 Factors specifically associated with
intimate partner violence include:
 beliefs in family honour and sexual purity
 ideologies of male sexual entitlement
 weak legal sanctions for sexual violence.
 Gender inequality and norms on the
acceptability of violence against women are a
root cause of violence against women.
Source: WHO, 2017Dr. Kishor Adhikari, Associate Professor, SOPH, Chitwan Medical
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Consequences of GBV
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Group work
 Discuss on social and health effects of
violence on age groups:
a. Children (Group A: Roll 1 to 5)
b. Adolescents (Group B: Roll 6 to 10)
c. Youths (Group C: Roll 11 to 15)
d. Adults (Group D: Roll 16 to 20)
e. Elderly (Group E: Roll 21 to all)
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Health Consequences
 Intimate partner (physical, sexual and emotional)
and sexual violence cause serious short- and
long-term physical, mental, sexual and
reproductive health problems for women. They
also affect their children, and lead to high social
and economic costs for women, their families and
societies.
Such violence can:
 Have fatal outcomes like homicide or suicide.
 Lead to injuries, with 42% of women who
experience intimate partner violence reporting an
injury as a consequence of this violence.Dr. Kishor Adhikari, Associate Professor, SOPH, Chitwan Medical
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 Lead to unintended pregnancies, induced
abortions, gynaecological problems, and
sexually transmitted infections, including HIV.
 The 2013 analysis found that women who
had been physically or sexually abused were
1.5 times more likely to have a sexually
transmitted infection and, in some regions,
HIV, compared to women who had not
experienced partner violence. They are also
twice as likely to have an abortion.
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 Intimate partner violence in pregnancy also
increases the likelihood of miscarriage, stillbirth,
pre-term delivery and low birth weight babies. The
same 2013 study showed that women who
experienced intimate partner violence were 16%
more likely to suffer a miscarriage and 41% more
likely to have a pre-term birth.
 These forms of violence can lead to depression,
post-traumatic stress and other anxiety disorders,
sleep difficulties, eating disorders, and suicide
attempts. The 2013 analysis found that women
who have experienced intimate partner violence
were almost twice as likely to experience
depression and problem drinking.Dr. Kishor Adhikari, Associate Professor, SOPH, Chitwan Medical
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 Health effects can also include headaches, back
pain, abdominal pain, gastrointestinal disorders,
limited mobility and poor overall health.
 Sexual violence, particularly during childhood,
can lead to increased smoking, drug and alcohol
misuse, and risky sexual behaviours in later life.
It is also associated with perpetration of violence
(for males) and being a victim of violence (for
females).
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Impact of GBV on children
 Children who grow up in families where there is
violence may suffer a range of behavioural and
emotional disturbances. These can also be
associated with perpetrating or experiencing
violence later in life.
 Intimate partner violence has also been
associated with higher rates of infant and child
mortality and morbidity (through, for example
diarrhoeal disease or malnutrition).
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Social and economic costs
 The social and economic costs of intimate
partner and sexual violence are enormous and
have ripple effects throughout society.
 Women may suffer isolation, inability to work,
loss of wages, lack of participation in regular
activities and limited ability to care for
themselves and their children.
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Dr. Kishor Adhikari
Assoc. Professor, SOPH,
CMC
HUMAN TRAFFICKING

Definition of Human
Trafficking/Trafficking in Persons
(TIP)
 “Trafficking in Persons as the recruitment,
transportation, transfer, harbouring or receipt of
persons, by means of the threat or use of force or
other forms of coercion, of abduction, of fraud, of
deception, of the abuse of power or of a position of
vulnerability or of the giving or receiving of payments
or benefits to achieve the consent of a person
having control over another person, for the purpose
of exploitation. Exploitation shall include, at a
minimum, the exploitation of the prostitution of
others or other forms of sexual exploitation, forced
labour or services, slavery or practices similar to
slavery, servitude or the removal of organs.”
- United Nations’ Office on Drugs and Crime
Dr. Kishor Adhikari, Assoc. Professor, SOPH, Chitwan Medical
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Human trafficking
 The action or practice of illegally transporting
people from one country or area to another,
typically for the purposes of forced labour or
commercial sexual exploitation.
 Human trafficking is the fastest growing
criminal industry in the world, second to drug
dealing and tied with arms dealing.
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Elements of Human
Trafficking
Dr. Kishor Adhikari, Assoc. Professor, SOPH, Chitwan Medical College

Human trafficking in Nepal
 It is a growing criminal industry affecting
multiple other countries beyond Nepal,
primarily across Asia and the Middle East.[1]
 Nepal is mainly a source country for men,
women and children subjected to forced
labor and sex trafficking.[2]
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Destinations
1. Within Nepal
 Trafficking victims often are taken to
locations within Nepal, often from rural
areas to the urban centers.
 Mainly young girls and women are
trafficked for sexual exploitation in places
such as cabin/dance
restaurants, massage parlors, and other
places within tourism sectorDr. Kishor Adhikari, Assoc. Professor, SOPH, Chitwan Medical
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2. Cross-border to India
 The trafficking of girls from Nepal into India for forced
prostitution is perhaps one of the busiest slave
trafficking routes anywhere in the world, with
estimated 5,000-10,000 Nepali women and girls
trafficked to India each year.[3][4]
 An estimated 100,000-200,000 Nepali trafficked
persons are in India.[5]
 Nepali girls are especially desirable as prostitutes in
India because they are considered more attractive
due to their lighter skin color, and because Nepali
virgins are believed to be able to cure AIDS.[6]
 The 1850 kilometers of open, porous border between
Nepal and India make trafficking simple and difficult to
catch.Dr. Kishor Adhikari, Assoc. Professor, SOPH, Chitwan Medical
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Contd.
 In addition, there is no immigration control for
Nepalese migrating to India or Indians coming
in Nepal under the 1950 Peace and Friendship
Treaty between India and Nepal.
 In addition to being a destination, India is also
a transit country for Nepalese and
Bangladeshi women trafficked to Pakistan,
Western Asia, and the Middle East and for
women trafficked from the Russian Federation
to Thailand.[7]
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3. Cross-border (excluding
India)
 Victims, especially girls and women, are trafficked to Saudi
Arabia, Malaysia, Hong Kong, Russia, Pakistan, the
United Arab Emirates and other Gulf states.[2][7]
 Experts believe China is also becoming an emerging hub
for Nepali victims.[2]
 Many victims who end up overseas are passed through
India first before their final destinations.[7]
 For non-India foreign destinations, the victims are most
commonly subjected to sex trafficking, especially to non-
brothels.
 Also widespread is labor exploitation of victims in
unorganized, informal sectors in Gulf states, such as
domestic servitude.Dr. Kishor Adhikari, Assoc. Professor, SOPH, Chitwan Medical
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Types of Trafficking
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1. Sex Trafficking/Girl
Trafficking
 Sex trafficking is human trafficking for the purpose of sexual
exploitation, including sexual slavery.
 Sex trafficking has two aspects of supply and demand.
 The sex exploitation is based on the interaction between the
trafficker selling a victim (the individual being trafficked and
sexually exploited) to customers to perform sexual services.
 Sex trafficking crimes are defined in three ways: acquisition,
movement, and exploitation, and includes child sex tourism
(CST), domestic minor sex trafficking (DMST) or commercial
sexual exploitation of children, and prostitution.
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Sex trafficking……….Contd.
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 Sex trafficking is one of the biggest criminal
businesses and is "the fastest growing criminal
industry in the world."
 The trafficking of women for sexual
exploitation is an international, organized,
criminal phenomenon that has grave
consequences for the safety, welfare and
human rights of its victims.
 Trafficking of women is a criminal
phenomenon that violates basic human rights,
and totally destroying victims' lives.

Sex trafficking……….Contd.
 Sex trafficking is when someone uses coercion, force, or
fraud to cause a commercial sex act with an adult or
causes a minor to commit a commercial sex act.[5]
 A commercial sex act includes
prostitution, pornography or sexual performance done in
exchange for an item of value, such as money, shelter,
food, drugs, or clothes.[5]
 There are an estimated 150,000 to 200,000 Nepali
women and girls who are trafficked to Indian brothels
each year.[21] Girls are sold to brothels at prices ranging
from 50,000 to 70,000 Indian rupees.[5]
 The younger the girl, the higher the price she will be sold
for.[9]
 Once sold, the girls are property of the brothel owner
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Types of
trafficking………Contd.
2. Forced labor
 Forced labor refers to "situations in which persons
are coerced to work through the use of violence or
intimidation, or by more subtle means such as
accumulated debt, retention of identity papers, or
threats of denunciation to immigrant authorities.“
 Elements of forced labor include deception,
exploitation and abuse, violating the International
Labour Organization Declaration on Fundamental
Principles and Rights at Work, adopted in 1998.
 In Nepal, slavery was one of the oldest forms of
forced labor.
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Human trafficking risk factors
 Economic factors
 Cultural factors
 Humanitarian crises
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Challenges after trafficking
1. Health consequences
 The psychological effects of trafficking are often
more neglected than the social and physical
consequences, despite its extremely large
influence on personal quality of life and on society.
 Because of the prolonged abuse, victims often
suffer from physical and emotional trauma such
as Post-Traumatic Stress Disorder(PTSD),
depression, anxiety, and drug addiction.
 Female survivors of human trafficking are
significantly more vulnerable to depression and
anxiety compared to victims of other varieties of
traumatic events.Dr. Kishor Adhikari, Assoc. Professor, SOPH, Chitwan Medical
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Challenges …….Contd.
 Victims are also at a high risk for sexually
transmitted infections (STIs) including tuberculosis
and HIV/AIDS.
 According to the 2002 United Nationsdocument
"Nepal's National HIV/AIDS Strategy," Nepal has
a low HIV prevalence in its general adult
population, however, it has a "concentrated
epidemic" of HIV with much higher prevalence
rates in sex workers.
 Over 50% of the HIV positive women in Nepal are
women who were deported after working in the
sex industry in India.[10]
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2. Reintegrating into society
 In addition, since many survivors do not have the
citizenship status, they have very limited options for
legal recourse, and are ineligible for most government
poverty reduction programs.
 Even after being aided by NGOs, many women report
continued stigma in the community and lack of
opportunities for livelihood.
 Many have extreme difficulty reintegrating into society
due to the strong stigma they face of being previous sex
workers regardless of the fact they were forced into it.
 When survivors return to home villages, they are often
throw out by family members and home communities.
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Situations of Trafficking in Person in Nepal
(TIP National Report, Nepal;2015-16)
 Evidences of human smuggling have been reported
widely in the FY 2015/16 to several countries including
Macau, UAE, Oman, Kuwait, Saudi Arabia, Portugal,
Dubai, Qatar, Malaysia, Sri Lanka and India.
 The numbers of trafficking cases registered in Nepal
Police, however, is still low against the believed number
of trafficking victims.
 In the FY 2015/16, a total of 212 cases of human
trafficking were registered in which there were 352
numbers of victims. Four in 10 victims are children; more
than 95 percent victims are females and 3 in four victims
do not have education at all. Majority of victims are from
Janajati (48%), followed by 29 percent for
Brahman/Chhetri and 15 percent for Dalit and 8 percent
for Madeshi groups.Dr. Kishor Adhikari, Assoc. Professor, SOPH, Chitwan Medical
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Contd.
 Drawing on the NGOs interventions including the rescue
efforts of metropolice Crime Investigation Division of
Kathmandu, Nepal Police and Foreign Embassies to
Nepal, the estimated number of trafficking victims comes
out to be about 23,200 in the FY 2015/16 in Nepal. It
provides an estimate of 6,100 persons as trafficked;
13,600 persons as victims of attempt trafficking; and
3,900 persons remained missing.
 The number of children reported missing in Balbalika
Khoj Talash Kendra was 1,502 in the FY 2015/16.
 Among them, girls outpaced the boys (60% vs. 40%)
and more than one-thirds were in the age range of 14-
16 years. Overall, untraced rate was estimated to be
73.5 percent (78% for girls and 66 percent for boys).
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On Entertainment Sector and
Nexus of Trafficking
 This study estimated that there are currently
around 600 entertainment establishments in
Kathmandu valley where more than 2,000
girls/women are working as dancers, waiters,
massage parlors, and in others.
 Majority of entertainment establishments in
Kathmandu valley located in Thamel area,
Gongabu bus park area, Kalanki area,
Koteshowar-Sinamangal-Gausala-Chabahil
area and Sundhara and Durbar Marg area.
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References
1. Human Trafficking: a Global Perspective.
2. ^ Jump up to:a b c d e f g h i US State Department (2011). Trafficking in Persons Report 2011
Country Narratives -- Countries N Through Z. Retrieved March 5, 2012,
from http://www.state.gov/j/tip/rls/tiprpt/2011/164233.htm
3. Koirala A, Banskota HK, Khadka BR: Cross border interception – A strategy of prevention of
trafficking women from Nepal. Int Conf AIDS :15. 2004, Jul 11–16
4. Thapa, G (1997). "Women trafficking: better policing measures needed, the Rising Nepal, 15
July, Gorkhapatra Corporation Publication, Nepal. In Girl-trafficking, HIV/AIDS, and the position
of women in Nepal, 2000". Gender and Development. 8 (2): 74–79
5. Mukherji KK, Muherjee S. (2007): Girls and women in prostitution in India Department of
Women and Child Development, New Delhi, India.
6. Jones, C (2010). "Nepal's "Cabin Restaurants"". Ms. 20 (4): 23.
7. Joffres, C.; Mills, E.; Joffres, M.; Khanna, T.; Walia, H.; Grund, D. (2008). "Sexual slavery
without borders: trafficking for commercial sexual exploitation in India". International Journal for
Equity in Health. 7: 1–11. doi:10.1186/1475-9276-7-22.
8. "What is Sex Trafficking? - Shared Hope International". Shared Hope International.
Retrieved 2016-03-24.
9. "Human Trafficking | 3 Angels Nepal". 3angelsnepal.com. Retrieved 2016-03-24.
10. Sanzero Eller, Lucille (April 23, 2004). "Psychological Factors in Nepali Former Commercial
Sex Workers with HIV". Journal of Nursing Scholarship. 35: 53–60.
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LEVELS OF GENDER
BASED VIOLENCE

Dr. Kishor Adhikari
Assoc. Professor, SOPH, CMC
LIFE CYCLE OF
VIOLENCE

 Lenore E. Walker interviewed 1,500 women
who had been subject to domestic
violence and found that there was a similar
pattern of abuse, called the "cycle of abuse“.
 The cycle of abuse concept is widely used
in domestic violence programs, particularly in
the United States.
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 The cycle usually goes in the following order,
and will repeat until the conflict is stopped,
usually by the survivor entirely abandoning
the relationship or some form of intervention.
 The cycle can occur hundreds of times in an
abusive relationship, the total cycle taking
anywhere from a few hours, to a year or more
to complete.
 However, the length of the cycle usually
diminishes over time so that the
"reconciliation" and "calm" stages mayDr. Kishor Adhikari, Assoc. Professor, SOPH, Chitwan Medical
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Life Cycle of Violence
By Lenore Walker
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1. Tension building phage
 Stress builds from the pressures of daily life, like
conflict over children, marital issues,
misunderstandings, or other family conflicts.
 It also builds as the result of illness, legal or
financial problems, unemployment, or
catastrophic events, like floods, rape or war.
 During this period, the abuser feels ignored,
threatened, annoyed or wronged. The feeling
lasts on average several minutes to hours, it
may last as much as several months.
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Contd.
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 To prevent violence, the victim may try to
reduce the tension by becoming compliant and
nurturing. Or, to get the abuse over with,
prepare for the violence or lessen the degree
of injury, the victim may provoke the batterer.
 "However, at no time is the batterer justified in
engaging in violent or abusive behavior," said
Scott Allen Johnson, author of Physical
Abusers and Sexual Offenders.

2. Acute violence (Incident)
 Characterized by outbursts of violent,
abusive incidents which may be preceded
by verbal abuse and include psychological
abuse.
 During this stage the abuser attempts to
dominate their partner (survivor) with the
use of domestic violence.
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Contd.
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 In intimate partner violence, children are
negatively affected by having witnessed
the violence and the partner's relationship
degrades as well.
 The release of energy reduces the
tension, and the abuser may feel or
express that the victim "had it coming" to
them.

3. Reconciliation/honeymoon
 The perpetrator may begin to feel remorse, guilty
feelings, or fear that their partner will leave or call the
police. The victim feels pain, fear, humiliation,
disrespect, confusion, and may mistakenly feel
responsible.
 Characterized by affection, apology, or, alternatively,
ignoring the incident, this phase marks an apparent
end of violence, with assurances that it will never
happen again, or that the abuser will do their best to
change.
 During this stage the abuser may feel or claim to feel
overwhelming regret and sadness.Dr. Kishor Adhikari, Assoc. Professor, SOPH, Chitwan Medical
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3. Reconciliation……..Contd.
 Some abusers walk away from the situation
with little comment, but most will
eventually shower the survivor with love and
affection.
 The abuser may use self-harm or threats of
suicide to gain sympathy and/or prevent the
survivor from leaving the relationship.
 Abusers are frequently so convincing, and
survivors so eager for the relationship to
improve, that survivors (who are often worn
down and confused by longstanding abuse)
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4. Calm
 During this phase (which is often
considered an element of the
honeymoon/reconciliation phase), the
relationship is relatively calm and
peaceable.
 During this period the abuser may agree to
engage in counseling, ask for forgiveness,
and create a normal atmosphere. In
intimate partner relationships, the
perpetrator may buy presents or the couple
may engage in passionate sex.
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4. Calm ……..Contd.
 Over time, the batterer's apologies and requests
for forgiveness become less sincere and are
generally stated to prevent separation or
intervention.
 However, interpersonal difficulties will inevitably
arise, leading again to the tension building phase.
 The effect of the continual cycle may include loss
of love, contempt, distress, and/or physical
disability. Intimate partners may separate, divorce
or, at the extreme, someone may be killed.
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Critiques
 Walker's cycle of abuse theory was regarded
as a revolutionary and important concept in the
study of abuse and interpersonal violence,
which is a useful model, but may be simplistic.
 Critics have also argued the theory is flawed as
it does not apply as universally as Walker
suggested, does not accurately or completely
describe all abusive relationships, and may
emphasize ideological presumptions rather
than empirical data.
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THANK YOU
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PUBLIC HEALTH
RESPONSIBILITY FOR
PREVENTING VIOLENCE
PLEASE KEEP THE KEY NOTES
DERIVED FROM THE CLASS
DISCUSSION UNDER THIS TOPIC
(NOTED BY MS. SAMITA)
Dr. Kishor Adhikari, Assoc. Professor, SOPH, CMC

Gender based violence

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