Healthcare responses to gender-based violence in Timor-Leste

Research shows that Timorese women want their health providers to show empathy, and provide information and safety after experiencing violence or abuse.

Story by Drish Lokee. Photo by Alexandrino de Carvalho, used with permission.

Timor-Leste has recorded high rates of intimate partner violence. According to the Demographic and Health Survey conducted in 2016, 35 percent of Timorese women have experienced physical or sexual violence from their partner in the previous 12 months. However, only 20 percent of them sought help to stop the violence while 75 percent never sought help and never told anyone.

Dr Kayli Wild, a Senior Research Fellow with Judith Lumley Centre and the Institute for Human Security and Social Change at La Trobe University, conducted a study with women about their experiences of trauma and help-seeking. A recent article published in the Journal of Interpersonal Violence looked at the reasons why women were reluctant to disclose abuse, and their points of resilience and safety.

Dr Wild collaborated with Timorese researchers Guilhermina de Araujo and Angelina Fernandes, and a number of local NGOs to safely talk with women about their experiences. . The study was supported by Professor Angela Taft and Dr Linda Kelly from La Trobe University and Lidia Gomes from the National University in Timor-Leste.

The research used a mixed-methods study design consisting of qualitative interviews with 28 Timorese women who had experienced different forms of physical or sexual violence, and a quantitative sorting activity where the participants were asked to what degree they wanted certain interventions from their health providers.

“The main aim was to support the work of government ministries, NGOs and the UN system in Timor-Leste in strengthening the health system’s response to violence against women and children,” says Dr Wild. “By listening to women’s stories, we can bring their voices into that policy and improve practices based on women’s needs.”

The study showed highest-ranked interventions centered around emotional support, information and safety, the middle-ranked interventions centered around empowering women and playing an advocacy role, and the lowest ranked interventions were around intervening at the relationship level and mandatory reporting to the police.

Dr Wild says that speaking about violence can be very difficult for women and many experienced victim-blaming and stigma, which contributed to further trauma. It is therefore critical that survivors of violence are treated with compassion and kindness, and are empowered by advocacy services, health professionals, the police and the justice sector.

“International literature shows that when a woman reports domestic violence this is the one of the most dangerous times, as her partner can become more threatening and more violent knowing he might be losing control,” Dr Wild says.

Dr Wild believes healthcare providers in Timor-Leste have an important role to play in increasing safety and support for women, and documenting the injuries and health impacts of violence which can improve medical care and access to justice for survivors.

Dr Wild and her colleagues are about to release a book on Gender-based Violence and Healthcare in Timor-Leste, published in both English and Tetum, that will help health providers improve their services and better support people who have experienced domestic violence or sexual assault.

“There are many sectors in Timor-Leste that are working to address violence against women. We need to work together to strengthen support for service providers, so they are able to do this complex work well,” says Dr Wild. “We also need to support systems-level change so that the laws, policies and guidelines that are in place are able to be implemented on the ground to improve outcomes for women.”