Lillian Agbeyegbe, DrPH, MPH,CHES, CPHWednesday, July 12, 2017
Silver Spring, MD


ecent reports in the news have alleged that the death of Mrs. Ranti Abosede Dauda, lawyer and former member of the Governing Council of the National Human Rights Commission was caused by domestic violence. She was married to former President of the Nigerian Bar Association, Mr. Joseph Daudu (SAN).

As is common with victims of domestic violence, the victim has been blamed for remaining with her abuser for so long. And in what some consider not to be a surprising move, the children of the deceased recently issued a press release stating that their mother was not a victim of domestic violence.

First of all, domestic violence is not a "disease." What qualifies as domestic violence are any of a set of four behaviors that occur among people in an intimate relationship whether they be current or former partners.

Domestic violence is also not exclusively about physical violence. The four types of behavior included in intimate partner violence (IPV) are physical violence, sexual violence, stalking and psychological aggression. The invisible scars of non-physical violence can be as, and even more, devastating as visible scars.

Experiencing domestic violence can result in the death of a victim directly or indirectly. Yes, a victim may be killed by an abuser. But a victim may also die away from the abuser as a result of poor health outcomes from experiencing abuse. A victim may also commit suicide as a result of experiencing abuse.

Domestic violence is not the same as marital conflict. Marital conflict may arise for issues that can cause conflict even among non-intimate partners. Domestic violence is about power and control such that whereas an abuser is able to respect others and treat people with respect, the victim is singled out for demoralizing and debasing experiences. This is why drugs or alcohols are not accepted as reasons for being abusive. If you drink and go to work without beating up your colleagues, alcohol is not responsible for you being violent to your partner at home.

How does an abuser remain abusive for 28 years? No friends of the abuser found it necessary to advice the abuser about behavior? We bother to tell overweight people about exercising. We bother to tell people with diabetics about waiting their sugar intake. We tell the hypertensive person, "no salt." We promote cancer screening and advocate for participation in vaccination programs. But an abuser can be left alone to figure whether they do or don't want to modify their behavior!

Domestic violence is a public health problem that is best addressed with public health interventions, and the Centers of Disease Control and Prevention (CDC) promotes the goal of stopping intimate partner violence before it begins.

I would like to draw a parallel between lung cancer prevention strategies and domestic violence prevention strategies. Since studies established the link between smoking and lung cancer, we have not left it exclusively to the individual to stop smoking. Interventions have been at multiple levels.

Despite putting up a strong fight, the tobacco industry was made to not only acknowledge the dangers of tobacco but to state it on their products.

Tobacco products cannot be advertised within certain distance from schools, and have restrictions on time of adverts on television.

There is an age restriction on who can buy cigarettes.

There is a ban on smoking in many public places. Currently, some cities have expanded the ban on smoking to public housing. That is, if you live in a public housing complex, you cannot smoke on those grounds, whether you are inside your own house or not.

Taxes on tobacco continue to make them expensive.

Recently, a major pharmacy store, CVS, discontinued the sale of tobacco products.

Organizations and health departments promote and implement smoking cessation programs.

All these efforts have not seen the elimination of smoking in the United States, but for the most part, cigarette smoking among adults has continued to decline.

The solution to ending domestic violence is not to tell a victim, "Leave your abusive relationship because you may end up dead". The factors influencing a person in a relationship do not support an individual behavioral change intervention only. Besides, leaving an abuser has its own challenges. According to one report, about 75% of women killed by their abusers were killed while trying to leave or after leaving their abuser.

The issue of leaving an abusive relationship will be non-existence when there are no abusers. Why do we have abusers?

Our educational systems should incorporate social-emotional learning.

People need to be taught from a young age how to handle disappointments and manage their anger.

People need to be educated on what a healthy relationship is and what a healthy relationship is not. Having a few people here and there advocating for healthy relationships is not the same as having societies that embrace healthy relationships.

Faith communities that prioritize staying married over the safety of individuals will neither promote abuser accountability nor encourage victims to flee for safety.

Societies that look down on female divorces are less likely to encourage women to flee abusive marriages.

The availability of domestic violence services is not a necessary and sufficient condition for a victim to flee an abusive relationship.

Why doesn't she leave? How vested are we as a society to make sure there is a large scale favorable response when she leaves? Not a few friendly circles here and there "" a large scale favorable response.

And the really important question we should ask is, why does an abuser remain abusive?