Violence against women is a serious health and social problem for women worldwide. Researchers have investigated the broad physical and mental health consequences of violence against women but few have focused on immigrant and refugee women. We assessed the history of violence and the impairment of physical and mental health among 60 women participants from the Iranian and Sri Lankan Tamil communities in Toronto, Canada. Our survey findings revealed that the participants had experienced various types of violence throughout their lifespan, with psychological abuse by a spouse/partner occurring most frequently in the past 12 months. Commonly reported types of abuse included insulting, criticizing, and intimidation by partner (psychological abuse); slapping, hitting, and shoving (physical abuse); and forced sexual intercourse and sexually degrading acts (sexual abuse) by a partner/spouse. We found that a substantial proportion of the participants also had experienced physical and mental health impairment, which could be a result of the various types of violence they had experienced throughout their lifespan. Research and practice implications are provided. 1. Introduction Violence against women is a global phenomenon and involves a spectrum of physical, sexual, and psychological acts of control, threat, aggression, abuse, and assault. Violence against women takes many forms, such as female infanticide, (girl) child abuse, incest, rape, sexual harassment, intimate partner violence (IPV), and abuse and neglect of older women. Although health science researchers are increasingly focusing on violence against women at local, national, and international levels, few have investigated violence against women across the lifespan (i.e., violence experienced prior to, during, and after migration) in various immigrant communities. Given the increase in international migration over the past few decades, there is a greater need to examine the experiences and effects of violence among immigrant and refugee women. To date, no published studies have focused on the experiences of violence throughout the lifespan and the physical and mental health consequences among immigrant and refugee women in Canada, even though more than 250,000 immigrants and refugees come to Canada annually, with a significant proportion arriving from the Middle East and Asia [1]. This paper presents the findings of a pilot study that examined women’s experience of violence throughout the lifespan and the presence of physical and mental health symptoms in a sample of Iranian and Sri Lankan Tamil
References
[1]
CIC—Citizenship and Immigration Canada (2010), Facts and Figures 2006. Immigration overview, 2010, http://www.cic.gc.ca/english/resources/statistics/facts2010/index.asp.
[2]
L. Heise, Violence Against Women: The Hidden Health Burden. World Bank Discussion Paper, The World Bank, Washington, DC, USA, 1994.
[3]
H. Crawley and T. Lester, Comparative Analysis of Gender-Related Persecution in National Asylum Legislation and Practice in Europe, United Nations High Commissioner for Refugees Evaluation and Policy Analysis Unit, Department of International Protection, and Regional Bureau for Europe, Geneva, Switzerland, 2004.
[4]
L. R. Bennett, L. Manderson, and J. Astbury, Mapping a Global Pandemic: Review of Current Literature on Rape, Sexual Assault and Sexual Harrassment of Women, Consultation on Sexual Violence Against Women, Global Forum for Health Research, Geneva, Switzerland, 2000.
[5]
K. Chantler, “Independence, dependency and interdependence: struggles and resistances of minoritized women within and on leaving violent relationships,” Feminist Review, no. 82, pp. 27–49, 2006.
[6]
C. Garcia-Moreno, H. A. Jansen, M. Ellsberg, L. Heise, and C. H. Watts, “Prevalence of intimate partner violence: findings from the WHO multi-country study on women's health and domestic violence,” The Lancet, vol. 368, no. 9543, pp. 1260–1269, 2006.
[7]
C. Garcia-Moreno, L. Heise, H. A. F. M. Jansen, M. Ellsberg, and C. Watts, “Violence against women,” Science, vol. 310, no. 5752, pp. 1282–1283, 2005.
[8]
WHO, Violence Against Women. Health Consequences, World Health Organization, Geneva, Switzerland, 1997.
[9]
T. H. Mahony, Women in Canada: A Gender-Based Statistical Report, Statistics Canada, Ottawa, Canada, 2011.
[10]
C. Watts and C. Zimmerman, “Violence against women: global scope and magnitude,” The Lancet, vol. 359, no. 9313, pp. 1232–1237, 2002.
[11]
I. Agger, “Abused refugee women: trauma and testimony,” Refuge, vol. 14, no. 7, pp. 19–22, 1994.
[12]
J. Briere and C. E. Jordan, “Violence against women: outcome complexity and implications for assessment and treatment,” Journal of Interpersonal Violence, vol. 19, no. 11, pp. 1252–1276, 2004.
[13]
M. Hossain, C. Zimmerman, M. Abas, M. Light, and C. Watts, “The relationship of trauma to mental disorders among trafficked and sexually exploited girls and women,” American Journal of Public Health, vol. 100, no. 12, pp. 2442–2449, 2010.
[14]
J. Campbell, A. S. Jones, J. Dienemann et al., “Intimate partner violence and physical health consequences,” Archives of Internal Medicine, vol. 162, no. 10, pp. 1157–1163, 2002.
[15]
B. E. Carlson, L. A. McNutt, D. Y. Choi, and I. M. Rose, “Intimate partner abuse and mental health,” Violence Against Women, vol. 8, no. 6, pp. 720–745, 2002.
[16]
G. S. Feder, M. Hutson, J. Ramsay, and A. R. Taket, “Women exposed to intimate partner violence: expectations and experiences when they encounter health care professionals: a meta-analysis of qualitative studies,” Archives of Internal Medicine, vol. 166, no. 1, pp. 22–37, 2006.
[17]
J. Johnson and V. P. Bunge, “Prevalence and consequences of spousal assault in Canada,” Canadian Journal of Criminology, vol. 43, no. 1, pp. 27–45, 2001.
[18]
A. Kramer, D. Lorenzon, and G. Mueller, “Prevalence of intimate partner violence and health implications for women using emergency departments and primary care clinics,” Women's Health Issues, vol. 14, no. 1, pp. 19–29, 2004.
[19]
J. Leserman, D. A. Drossman, L. Zhiming, T. C. Toomey, G. Nachman, and L. Glogau, “Sexual and physical abuse history in gastroenterology practice: how types of abuse impact health status,” Psychosomatic Medicine, vol. 58, no. 1, pp. 5–15, 1996.
[20]
M. B. Mechanic, “Beyond PTSD: mental health consequences of violence against women: a response to Briere and Jordan,” Journal of Interpersonal Violence, vol. 19, no. 11, pp. 1283–1289, 2004.
[21]
S. B. Plichta, “Intimate partner violence and physical health consequences: policy and practice implications,” Journal of Interpersonal Violence, vol. 19, no. 11, pp. 1296–1323, 2004.
[22]
D. L. DeLaet, “Introduction: the invisibility of women in scholarship on international migration,” in Gender and Immigration, G. A. Kelson and D. L. DeLaet, Eds., Macmillian Press, London, UK, 1999.
[23]
D. Woodhead, The Health and Well-Being of Asylum Seekers and Refugees, The King’s Fund, London, UK, 2000.
[24]
A. Burnett and M. Peel, “Asylum seekers and refugees in Britain: health needs of asylum seekers and refugees,” British Medical Journal, vol. 322, no. 7285, pp. 544–547, 2001.
[25]
D. Ingleby and C. Watters, “Mental health and social care for asylum seekers and refugees. A comparative study,” in Forced Migration and Mental Health: Rethinking the Care of Migrants and Displaced Persons, D. Ingleby, Ed., pp. 193–212, Springer, New York, NY, USA, 2004.
[26]
L. J. Kirmayer, L. Narasiah, M. Munoz et al., “Common mental health problems in immigrants and refugees: general approach in primary care,” Canadian Medical Association Journal, vol. 183, no. 12, pp. E959–E967, 2011.
[27]
B. D. Gushulak and D. W. MacPherson, “Health aspects of the pre-departure phase of migration,” PLoS Medicine, vol. 8, no. 5, Article ID e1001035, 2011.
[28]
S. Guruge, A. Tiwari, and M. B. Lucea, “International perspectives on family violence,” in Family Violence and Nursing Practice, J. Humphreys and J. Campbell, Eds., Springer, New York, NY, USA, 2nd edition, 2010.
[29]
C. Menjívar and O. Salcido, “Immigrant women and domestic violence: common experiences in different countries,” Gender and Society, vol. 16, no. 6, pp. 898–920, 2002.
[30]
S. Guruge, K. Refaie-Shirpak, D. Gastaldo, I. Hyman, M. Zanchetta, and S. Sidani, “A meta-synthesis of post-migration changes in marital relationships in Canada,” Canadian Journal of Public Health, vol. 101, no. 4, pp. 327–331, 2010.
[31]
S. Guruge and E. Collins, Eds., Working with Women: Issues and Strategies for Mental Health Professionals, Centre for Addiction and Mental Health (CAMH), Toronto, Canada, 2008.
[32]
S. Guruge and N. Khanlou, “Intersectionalities of influence: researching health of immigrant and refugee women,” Canadian Journal of Nursing Research, vol. 36, no. 3, pp. 32–47, 2004.
[33]
M. Vahabi, “Iranian women's perception and beliefs about breast cancer,” Health Care for Women International, vol. 31, no. 9, pp. 817–830, 2010.
[34]
Government of Canada, A History of Iranian Immigration to Canada, from the series: The creation of Canada, 2004, http://collections.ic.gc.ca/seeds/seeds/iii/38/history2.html.
[35]
V. Garousi, (2005) Iranians in Canada: A statistical analysis, 2011, http://www.iranian.com/News/2005/June/IraniansCanada.pdf.
[36]
A. Molavi, “Iranian youths seeking to escape. Bleak prospects lead some toward border, others to drugs,” Special to The Washington Post, p. A-25, 2003.
[37]
R. Cheran, Changing formations: tamil nationalism and national liberation in Sri Lanka and the diaspora, Unpublished Ph.D. thesis dissertation, York University, Centre for Refugee Studies, Toronto, Canada, 2000.
[38]
J. La, “Forced remittances in Canada’s Tamil enclaves,” Peace Review, vol. 16, no. 3, pp. 379–385, 2004.
[39]
R. Philips, “Multiculturalism and integration in Canadian society,” in SACEM (The Society for the Aid of Ceylon [Sri Lanka] Minorities). A Vision for the Third Decade, SACEM, Ontario, Canada, 2003.
[40]
SACEM (The Society for the Aid of Ceylon [Sri Lanka] Minorities), Tamils: Ten Years that Made a Difference: 10th Anniversary Publication, SACEM, Ontario, Canada, 1993.
[41]
C. Zimmerman, M. Hossain, L. Kiss, J. Hoey, K. Weneden, and C. Watts, Asylum-Seeking Women, Violence & Health: Results from a Pilot Study in Scotland and Belgium, Scottish Refugee Council, Fedasil, Belgium, Belgian Red Cross, Gender, Violence and Health Centre, London School of Hygiene & Tropical Medicine, London, UK, 2009.
[42]
C. Zimmerman, M. Hossain, K. Yun, B. Roche, L. Morison, and C. Watts, Stolen Smiles: The Physical and Psychological Health Consequences of Women and Adolescents Trafficked in Europe, The London School of Hygiene and Tropical Medicine, London, UK, 2006.
[43]
L. R. Derogatis, BSI Brief Symptom Inventory. Administration, Scoring, and Procedures Manual, National Computer Systems, Minneapolis, Minn, USA, 4th edition, 1993.
[44]
D. D. Heckathorn, “Respondent-driven sampling: a new approach to the study of hidden populations,” Social Problems, vol. 44, no. 2, pp. 174–199, 1997.
[45]
N. Burns and S. K. Groves, The Practice of Nursing Research: Appraisal, Synthesis, and Generation of Evidence, Saunders Elsevier, St Louis, MO, USA, 2009.
[46]
A. Geddes, “Chronicle of a crisis foretold: the politics of irregular migration, human trafficking and people smuggling in the UK,” British Journal of Politics and International Relations, vol. 7, no. 3, pp. 324–339, 2005.
[47]
C. Lindsey, “Women and war,” International Review of The Red Cross, vol. 839, pp. 561–579, 2000.
[48]
S. Swiss and J. E. Giller, “Rape as a crime of war. A medical perspective,” Journal of the American Medical Association, vol. 270, no. 5, pp. 612–615, 1993.
[49]
S. Guruge, “Perceptions of and responses to intimate partner violence: findings from a study in the Sri Lankan Tamil community in Toronto,” in Out of the Shadows: Woman Abuse in Ethnic, Immigrant, and Aboriginal Communities, J. S. F. Fong, Ed., pp. 264–283, Canadian Scholars Press, 2010.
[50]
M. Faramarzi, S. Esmailzadeh, and S. Mosavi, “Prevalence and determinants of intimate partner violence in Babol city, Islamic Republic of Iran,” Eastern Mediterranean Health Journal, vol. 11, no. 5-6, pp. 870–878, 2005.
[51]
R. Mason, I. Hyman, H. Berman, et al., “Violence is an international language,” Violence Against Women, vol. 14, no. 12, pp. 1397–1412, 2008.
[52]
T. O. Afifi, H. MacMillan, B. J. Cox, G. J. G. Asmundson, M. B. Stein, and J. Sareen, “Mental health correlates of intimate partner violence in marital relationships in a nationally representative sample of males and females,” Journal of Interpersonal Violence, vol. 24, no. 8, pp. 1398–1417, 2009.
[53]
J. C. Campbell, “Health consequences of intimate partner violence,” The Lancet, vol. 359, no. 9314, pp. 1331–1336, 2002.
[54]
A. L. Coker, K. E. Davis, I. Arias et al., “Physical and mental health effects of intimate partner violence for men and women,” American Journal of Preventive Medicine, vol. 23, no. 4, pp. 260–268, 2002.
[55]
C. N. Wathen, E. Jamieson, M. Wilson, M. Daly, A. Worster, and H. L. MacMillan, “Risk indicators to identify intimate partner violence in the emergency department,” Open Medicine, vol. 1, no. 2, pp. E113–E122, 2007.
[56]
S. Guruge, N. Khanlou, and D. Gastaldo, “Intimate male partner violence in the migration process: intersections of gender, race and class,” Journal of Advanced Nursing, vol. 66, no. 1, pp. 103–113, 2010.
[57]
M. Smyth and M.T. Fay, Personal Accounts from Northern Ireland’s Troubles: Public Conflict, Private Loss, Hampshire, Pluto Press, 2000.
[58]
L. J. Kirmayer and A. Young, “Culture and somatization: clinical, epidemiological, and ethnographic perspectives,” Psychosomatic Medicine, vol. 60, no. 4, pp. 420–430, 1998.