Raising the medical staff’s knowledge in responding to gender-based violence in the Republic of Moldova

Abstract

Introduction: Domestic and gender-based violence ranks among the most frequent crimes committed in any society and country in the world, reaching epidemic proportions. Furthermore, this social phenomenon is a public health challenge and medical doctors need specific knowledge and skills to ensure an appropriate response. But, to achieve this goal, they should understand what domestic and gender-based violence means, know the causes and consequences of this phenomenon for victims, their descendants and society, their important role in identifying victims and potential victims, recognition and documenting injuries, reporting and referring the victim to other professionals, specialized services for the subjects of domestic violence and authorities. The extent of domestic and gender-based violence in the Republic of Moldova is regrettably high, certain stereotypes regarding the role of men and women persist within the society, but physicians do not have the appropriate knowledge and practical skills in identifying and managing cases of domestic and gender-based violence. As a result, victims do not seek medical help, or even if they do, cannot receive information and appropriate treatment, being unable to fulfil their constitutional rights to health, bodily integrity, life and fair justice. Purpose of the research: To show actions aimed at enhancing the awareness and knowledge of medical staff regarding domestic and gender-based violence in the Republic of Moldova. Discussion: In recent years, the Republic of Moldova has carried out several actions focused on reducing the incidence of domestic violence and violence against women. One of the most important is the adoption of Law No 45/2007 on preventing and combating domestic violence and ratification (14 October 2021) of the Council of Europe Convention on preventing and combating violence against women and domestic violence (2011), known as the Istanbul Convention. It is the first instrument in Europe to set legally binding standards specifically to prevent gender-based violence, protect victims of violence and punish perpetrators. Article 15 urges parties to provide or strengthen appropriate training for the relevant professionals dealing with victims or perpetrators of all acts of violence covered by the scope of the Convention, on the prevention and detection of such violence, equality between women and men, the needs and rights of victims, as well as on how to prevent secondary victimisation. In 2018, the Moldovan Government approved the 2018-2023 National Strategy followed by the 2023-2027 National Programme on preventing and combating violence against women and domestic violence. According to the National Programme’s specific objective 1.3, institutions responsible for the training of professionals ensure systemically the development of knowledge and skills to appropriately prevent and respond to violence against women and domestic violence. Based on these regulatory acts, the Ministry of Health, Labour and Social Protection and the Nicolae Testemițanu State University of Medicine and Pharmacy have been entrusted to mainstream the topics of violence against women and domestic violence in the curriculum of the initial and continuous training for physicians and medical practitioners. In order to achieve this goal, the training curriculum entitled Domestic and Gender-based Violence was approved in 2018 and updated in 2023. The course designed for students is an optional one and comprises 30 academic hours, 10 hours for each – lectures, seminars and self-training. The following topics are discussed during the course: Gender-based and domestic violence; National and international laws regarding gender-based and domestic violence; Gender norms, masculinity and violence; Sexual violence and consensual intercourse, Prevention and combating gender-based and domestic violence; Healthcare system response to gender-based and domestic violence. Interactive methods such as discussions with audio-visual support, didactic films, role-playing games, small and large group exercises are used with the audience to increase the training impact. For the first time, both the national training manual and methodical guidelines for the course were developed and published in three languages (Romanian, English and Russian). By 2024, 759 national and international medical students were trained in addressing domestic and gender-based violence. Moreover, within the project Strengthening the physicians’ ability to a better response to domestic violence implemented by the Nicolae Testemițanu SUMPh with the support of the Embassy of Finland in Bucharest, in spring 2024 more than 300 medical students and physicians were additionally trained in responding to this phenomenon. Conclusions: The Republic of Moldova has committed to ensuring the development of knowledge and skills in preventing and appropriately responding to violence against women and domestic violence in all professionals involved in addressing this social phenomenon, including medical staff. Nicolae Testemițanu State University of Medicine and Pharmacy developed a course for medical students and doctors aiming at increasing their awareness, professional knowledge and skills in identifying victims of domestic and genderbased violence and addressing such cases.