Violence Prevention in Low- and Middle-Income Countries Finding a Place on the Global Agenda: Workshop Summary (2008) / Chapter Skim
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2 Setting the Stage
2 Setting the Stage
Pages 14-21
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. He noted that using public health science to help understand the variance in these rates can lead to risk identification and prevention in 14
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THE PUBLIC HEALTH APPROACH TO VIOLENCE PREVENTION Dr. Mark Rosenberg, the chair of the workshop planning committee, focused his opening remarks on differentiating the public health approach from that of health care; providing a brief, selective history of violence and public health; explaining the tenets of a public health approach; and lastly, exploring the relationships among different types of violence to help lay the foundation for the ensuing discussions.
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Subsequently, in Dr. Rosenberg's historical review, an advocate named Fran Henry, working to prevent child sexual abuse, approached the CDC and asked whether the newly developed public health approach could be used to prevent such abuse.
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He arrived at the CDC to study the public health approach for several years and later went on to apply it on an international level by spearheading the violence and injury prevention work at the World Health Organization (WHO)
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Violence as a result of conflict, he observed, is palpable and insistent in the modern world and leads to horrendous, but often repetitive, consequences that are captured by the media. His initial experience in the 1990s with armed conflict involved the coordination of a two-year global study led by Graça Machel for the United Nations, to examine the impact of armed conflict on children, which he found "desperately upsetting because of the extraordinary violations of children on every front -- physical, sexual, emotional, and physiological -- unbearable violations of their tiny and vulnerable personae." Everywhere there were armed conflicts -- from Burundi to Cambodia to Colombia -- the study recommended the appointment of a special representative of the Secretary-General for the United Nations to deal precisely, and in an ongoing fashion, with the prevention of these destructive instincts of others toward children.
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Manifestation of this pervasive violence against women in every country partially defines the "madness that grips the world," as it surely "destroys the soul and certainly the women." Mr. Lewis emphasized that the direct relationships between sexual violence and HIV/AIDS and our inability to address violence prevention -- the desperation "to find a microbicide or vaccine as a preventive technology that can do what behavior change has not been able to do" -- is underscored. The cascading effects of this relationship play a role in redefining the human family in parts of the world, as elderly grandmothers struggle in their attempts to parent their orphaned grandchildren; as pregnant mothers in Africa are unable to access drugs to prevent mother-to-child transmission of HIV; and as children infected with HIV have little access to lifesaving drugs and treatment.
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He also reviewed how international financial aid policies of the last 20-30 years, including conditions that reduce access to health care and education, may have contributed to the disintegration of the fabric of many different societal sectors and directly or indirectly induced individual and broader society violence. In conclusion, he enumerated a number of items that he felt are significant for elevating the issue on the global agenda.
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Betrayal of these promises, he stated, "compels much of the world to live in a constant environment of violence." Attention must be given to addressing the relationships between poverty, violence, and disease -- as much, in his opinion, as the amount of attention and resources that go to supporting wars in the Middle East. The second item is support of the recommendation for a full, international agency as part of the United Nations, with an Under-Secretary-General and reasonable fiscal resources, that would give women activists the capacity to have an impact and would diminish the violence against women.
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