Professionals from the Institut Català de la Salut have started a training program, consisting of a game, to detect cases of sexist violence that reach health centers. The staff of the hospital emergency services will begin – which is where most of the episodes are identified –, followed by the traumatology, gynecology, obstetrics and psychiatry services, defined as “hot spots of sexist violence” by Vanessa García. , responsible for equality and social policies at the ICS. In a second phase, the experience will be transferred to primary care, a level that recognizes a pending issue: only 5% of cases emerge in outpatient clinics.
The boss, Pierre Malchair, and a group of professionals from the Bellvitge hospital emergency service sat around a table yesterday to play A Close Look, an activity that tries to discover an abused woman among a group of six, who They are real cases treated in the health system.
After a first reading of the patients' files, the participants discuss the cases and, after deliberation, they discard two, which in their opinion are not victims. Angène is beyond suspicion: “Woman, 28 years old, Senegalese origin. She has been in Catalonia for 6 years, she speaks little of the language, she arrives at the emergency room accompanied by her sister, who speaks the language better. The sister comments that the woman has fallen down the stairs.”
On the other hand, Cristina remains in the game: “A 45-year-old woman arrives at the emergency room with her 11-year-old son because he suffered a sprain in a basketball game. When they have the consultation, the woman makes pessimistic comments, she constantly distorts the speech about how her son has been injured and she is quite upset. When they ask her about her son's medical history, she does not remember some important information such as the year of birth.
Four left. A second round of information is read to rule out another two non-victims through analysis of the facts and debate. In the end, two suspects remain and a third batch of information is analyzed to identify the victim of sexist violence. Once chosen, a QR code is deciphered to understand the entire case and discover that the other five women, although their symptoms were not so alarming, were victims of violence.
“This training helps emergency services, primary care and specialists to discover that the reason for a certain consultation may have a background of sexist violence that we must take into account and sometimes we overlook it because we go directly to the reason for the consultation. ”, explains Antoni Haro, Bellvitge emergency doctor. Trauma and fractures are the most obvious signs, but there are many other reasons that can go unnoticed.
In Catalonia, 9,000 cases of sexist violence were registered in 2022, and the vast majority passed the filter of the first level of care. The family physicians, gathered in Valencia at the annual congress of the Spanish Society of Primary Care Physicians (Semergen), sing the mea culpa. Although 93% of women who suffer gender violence go to the family doctor for various reasons and very frequently, "only 5% of reported cases are identified in health centers." The rest (not all) is detected in the emergency room when the consequences are already dire.
This is indicated by María del Rosario Blasco Martínez, a doctor at the Nueva Andalucía health center (Almería), who recognizes that doctors do not know how to detect what she calls "battered woman syndrome", a "pathology" that presents numerous physical problems. , such as intestinal disorders, headache, insomnia, hair loss, multiple non-specific pains, depression, anxiety, low self-esteem...
A set of pathologies that goes unnoticed by the family doctor, among other reasons, due to "the lack of awareness about gender violence as a health problem, both due to its magnitude and severity and the impact on the health system." “We think that family medicine consultations are privileged settings for identifying the signs of abuse and being able to offer victims the necessary tools to address them,” says Blasco.
“We must learn to recognize the symptoms that gender violence entails in order to be able to act early from this level of care and thus contribute to reducing the numbers of gender violence effectively,” argues Ana Rosa Jurado, member of the working groups. of sexology and care for women in Semergen.
