THERE have been reports from National Commission for Women as well as Childline about the voluminous numbers of women and children reporting abuse at home. We all know very well that those who call to report abuse are the only tip of the iceberg. Reports from China, the United Kingdom, the United States, Brazil, Germany amongst other countries indicate an increase in domestic violence cases since the COVID-19 outbreak. According to one report, the number of domestic violence cases reported to a police station in Jingzhou, a city in Hubei Province, tripled in February 2020, compared to the same period the previous year. The UN Women has declared Violence against Women and girls as a shadow pandemic, and rightly so..Violence against women tends to increase during every type of emergency, including epidemics. While lockdowns/quarantine are an effective measure of infection control, they can lead to significant social, economic and psychological consequences. In India, we are witnessing the huge impact on a large population that has been deprived of essential livelihoods. There is also increased risk of violence to women from marginalised communities such as sex workers, women with disabilities, members of sexual minorities, migrant workers, Muslim and Dalit women..The nature of the public health strategies to counter the pandemic poses specific challenges for VAW service provisioning as survivors of VAW may not be able to access these services due to restrictions on movement and closed centres/ clinics. Many international groups including the WHO have issued statements as well as guidelines for responding to VAW during these times. The response needs to be integrated into the public health response to COVID-19..Understanding the increased risk of violence within the home.The impact of lockdown, physical distancing, the closing of school/colleges, stay at home and other measures to address this pandemic has many consequences that affect women disproportionately especially those who are survivors of violence. Due to the rigid gendered roles, it increases the burden of domestic labour (cooking, cleaning and caring). With increased domestic work and children at home, it directly affects her paid work..The restrictions on movement affect access to services such as health, police, legal, social support. It also disrupts existing forms of social support that they may reach out such as friends, neighbours, natal family. Abusers have been reported to be using the restrictions due to COVID-19 to further exercise control over women that reduces their ability to access service, help from formal and informal networks..The disruption of livelihoods creates immense economic stress at the household level as resources become more scarce thus contributing to economic abuse. With limited access to basic sexual and reproductive health services, sexual violence within marriage can have severe health consequences..Current responses.The women's movement has raised the issue and many groups have already set up helplines so that survivors can call in any time. This is invaluable but much more is required considering the high numbers of women and girls reporting violence and the possible increase in this number. Children witnessing domestic violence is also on the rise..Hospital-based centres such as Dilaasa (Mumbai), Sukoon (Haryana), Bhoomika (Kerala), were quickly recognised as essential services by the state/Municipal Corporation and have continued to provide services even as they adhere to the COVID-19 prevention guidelines. The Sajha project that is a joint initiative of Care India and Government of Bihar has developed a protocol for its team to respond to survivors during this pandemic in one district and has been responding remotely..The MoHFW in its guidance note for enabling delivery of essential health services during this outbreak states that "Services to victims of sexual and physical violence should be ensured as per protocols. Information about support services under social welfare department, NGOs, One stop crisis centres and helplines should be provided to the victim.".But much more needs to be done to be able to respond effectively. The role of other state-run services such as OSCs, women's helplines, swadhar ghars, FCC, children's institutions, etc needs to be made operational through clear guidelines. The MWCD very recently has announced that its OSCs and helplines are open but there is no clear directive on how it will function. There is a need to educate staff running these services on how to take care of themselves during the pandemic and provide scientific information and orient them to the latest guidelines for responding to COVID-19..The staff themselves may harbour misconceptions about the spread and what to do and what not to do. It will be useful to follow universal precautions and not discriminate against survivors reaching them. Guidelines and protocols on how to respond to survivors during such times when face to face counselling may not be possible, what to do in severe abuse where their a threat to life, responding to mental health consequences ranging from mental fatigue, sadness, anxiety, depression, suicidal ideation..Essential elements of response.Declare Services for VAW as essential service.It is imperative that all services such as Women's helplines, Mahila thana, CWCs OSC, safe shelters for women and children, be declared as essential service. Fund allocation and training of staff in following preventive measures as prescribed by the MoHFW must be prioritised using existing online platforms of the Women's helplines across 32 state/union territory and OSCs across more than 400 districts. This will provide the necessary infrastructure and safe spaces for survivors..A strong message from the government that VAW will not be tolerated.The central and state governments need to send an unequivocal message about zero tolerance to violence within homes. The Kerala government has paved the way for this. In his daily address, the CM Pinarayi Vijayan talked about strict action against perpetrators of domestic violence and encouraged women to report mental, physical, sexual and social violence by dialling 181. Posters have been printed by Kerala's Women's Development Corporation, Govt of Kerala that provides information about whom to call, forms of domestic violence and the punishment under the DV law. These are captioned as "Should we go from Lockdown to Lock up? ".A similar novel response that must be emulated, is the announcement by the CEO of Zilla Parishad, Ayush Prasad that husbands who indulge in violence will be sent to institutional quarantine. Such an announcement can potentially act as a deterrent for men and at the same time encourage survivors to reach out for support..Services need to be oriented to the current context.From face to face counselling, telephonic counselling will have to be provided. In doing so concerns about the safety and privacy of the survivor as well as the counsellor need to be kept in mind. Specific safety plans that will work in the given situation will have to be planned together with the survivors. This may require mobilising SHGs, mukhiyas, gram pradhans and PRI members in rural areas and office bearers of housing colonies/buildings in urban areas..For this to be possible, the notices and awareness material on COVID-19 that the state and municipal bodies are issuing for these stakeholders must also include information about violence against women and children in their homes and services available. But in situations where there is a threat to life a clear message for her to step out of the house and contact neighbours, PRI members or police. Counsellors may have to also strategise with the police to respond in emergency situations..All currently registered women need to be contacted so that support to them is not broken. Specific training on how to orient services via telephone needs to be prioritised by the MWCD. Several guidelines from the provision of GBV services during humanitarian settings are available which can be adapted and protocol/s for OSCs and other services need to be issued at the earliest..Information about other essential services.It is important to enquire about the survivors overall wellbeing in the current circumstances, the impact that it has had on her household. This would help in assessing her needs for any social support due to loss of wages, access to essential goods. A list of govt agencies and NGOs providing free meals, essential goods can be shared with her..In a situation where abuser comes online.Counsellors may find themselves in a situation where they have to speak to the abuser. In such a situation, acknowledge the difficult times that everyone is living in, convey messages about stopping abusive behaviour and its impact on the woman and other family members..Care and support to service providers.Working in such circumstances where many service providers themselves may be operating from their own homes and struggling with the impact of lockdown themselves, being on-call can be stressful. Daily debriefing, supportive supervision and working with a team where the calls can be shared are necessary..Community Outreach.Increase public awareness and understanding of the increased risk of VAW during the lockdown and how to safely access support services. Mobile phones could be used for sending across information about available services..To conclude.In the absence of vaccine and cure, responding to COVID-19 is a huge challenge and public health measures that require restrictions on movement to curb the spread may continue for a longer period of time. We, therefore, cannot delay a coordinated response to the shadow pandemic of VAW that involve the ministries of health, WCD and social justice. With the Jammu and Kashmir High court taking suo motto notice of the consequences of lockdown on victims of domestic violence and issuing notice to the concerned authorities to submit an action taken report, there is hope..[Dr Padma is a senior advisor to CEHAT and Consultant with Care India].Photo Courtesy: Eileen Leeds
