An Under-Recognized Public Health Hazard: Male Victims Of Intimate Partner or Domestic Violence

On the same day (March 14, 2018) the great physicist Stephen Hawking died, I received a phone call from a dear friend in India. It was morning at work and was getting ready to round when the call came through WhatsApp - a popular private social media platform among Indias. I couldn't ignore the caller when I saw the caller ID even though I had a long day ahead. WhatsApp has made it possible to keep connection with old friends and classmates through private groups. My medical school classmate group has 87 members. Some are entrepreneurs, some professors in major Indian medical schools, few solo practitioners and some providing vital health care in remote villages through India’s public health service. Everyone has a busy life with their significant other, children, extended families and work. Nevertheless, every day my friends get together on this virtual room to chat. They exchange prevalent Bollywood jokes, old Bollywood songs, current politics, viral videos from the internet and gastronomical experiences. They hold gala get togethers once every few years and mini get togethers several times a year in the real world.

The phone call bore bad news. Another dear friend Dr. Babu Hundekar from medical school days was no more. The people he loved and trusted most, had taken his life in the most violent way. Shocking is the mildest word to describe my feelings. Babu was missing for two days. He did not answer his phone call from his hospital which was unusual. His elderly parents had registered a police complaint a day after his missing. A charred body was discovered on the outskirts of the city which later turned out to be that of Babu. The police have subsequently arrested his wife and brother-in-law who reportedly have confessed to have hired contract killers. Under duress, reportedly Babu had transferred all of his assets to his wife and brother in law but they did not spare his life. They had an elaborate plan to destroy evidence and mislead the ensuing investigation. But somehow, it backfired. There never will be a perfect murder, the truth will eventually prevail. The killers had impersonated Babu and had sent messages to our WhatsApp group. The message said that Babu would be out of town for a few days, the message purportedly be coming from Babu when he was long gone. It appears that the killers wanted it to become an unsolved missing person case or a “hit and run” robbery case. They had placed his body in his car, doused with petroleum and set it on fire.

More story: here

Babu was a classmate in medical school. Coming from a modest background, he worked hard and became a successful entrepreneur. With many of our common friends from medical school, in 2006 he built a beautiful multispecialty hospital, in a medium size city in India. Babu had invited me to be an investing partner or even relocate. Had I listened to him then, I would have seen several fold returns on my investment. The hospital was named after the famous ancient Indian surgeon Sushruta who lived around 1000 BC and wrote the first medical treatise in Sanskrit.

When I last visited the Sushruta hospital in 2016, they were in an expansion mode adding a new tower. The hospital & its team of physicians had earned people’s respect for hundreds of miles away. Short of cardiac surgery and transplant, they have been providing high quality, affordable care in every arena to thousands of patients every day. Private sector which dominates in India, can be divided in to three types: a) Corporate owned b) Multi physician owned multi-specialty and c) Mom & pop type small hospitals. The b & c type together constitute vast majority and they typically have deep community connections. Sushruta is a b type hospital. Babu’s loss leaves a deep void not only among his friends & hospital staff but also among the patients and families he served. Babu was an orthopedic surgeon by training. He had a good name as a surgeon & specialized in Ilizarov technique of bone lengthening. Despite his stature, he was quiet, always smiling and available to his friends at all times. In October 2017, he took a major role in organizing a reunion of my classmates which I sadly could not attend. He along with other friends, invited all of our medical school teachers and honored them.

A friend shared the above picture that Babu had recently shared, on his Facebook page. Did he have an intuition? Why did he not share his sorrow with his friends? Well this is a problem in India & perhaps in every society. There is stigma attached to mental health. You want to be seen as perfect and hide your personal stress even though you are merely another gullible human. They cannot share their personal details with friends and they do not want to seek professional counseling either. If you are a physician, you are worse.

Babu is a male victim of intimate partner violence, a counter-intuitive phenomenon especially in India. However, it is surprisingly common. A perspective article by Mr. Kumar gives an insight. It’s a global phenomenon. According to US national domestic violence hotline, the statistics are striking. Even though majority of victims are women, men are common victims too. Nearly 29% women and 10% men in the US have experienced rape, violence or stalking by an intimate partner in the US. According to this dailymail article, about 37% of domestic abuse victims in England and Wales were men. This article in the influential British newspaper Independent, there is an unacknowledged crisis with the need for a national dialogue. “Men who find themselves as victims of domestic violence are often viewed by and made to feel emasculated and weak”.

“Men who find themselves as victims of domestic violence are often viewed by and made to feel emasculated and weak”.

In India until recently, the domestic abuse law provided exclusive protection to women. However on July 27 2017, the Supreme Court of India changed the language of the domestic abuse law providing equal protection to men under the law. Per this article in PRI website, the supreme court went a step ahead and stated that Indian women were filing inaccurate claims of domestic violence. Please don’t get me wrong. Violence against women is more common but there are male victims too.

Why should pediatricians care about intimate partner abuse? Well, irrespective of the perpetrators or adult victims, the ultimate sufferers of intimate partner abuse are children. Intimate partner abuse also affects rest of the society. According to Centers for Disease Control, in 2003 intimate partner abuse cost at least $8.3 billion to the society. Corporate Alliance to End Partner Violence (CAEP) has some interesting work place statistics on intimate partner violence.

“Although nearly 2 in 3 corporate executives (63%) say that domestic violence is a major problem in our society and 55% cite its harmful impact on productivity in their companies, a majority of top executives have blinders on when it comes to seeing the reality of domestic violence victims working in their own companies.” CAEP Survey 2007.

According to the statistics compiled by hotline, 96% of victims of domestic abuse also experience problems at work due to abuse. “Sixty four percent of the respondents in a 2005 survey who identified themselves as victims of domestic violence indicated that their ability to work was affected by the violence. More than half of domestic violence victims (57%) said they were distracted, almost half (45%) feared getting discovered, and two in five were afraid of their intimate partner’s unexpected visit (either by phone or in person)”

"Ninety six percent of domestic abuse victims also experience abuse at work"

Domestic violence against women or men is bad. Children are the ultimate victims. Let us reconcile that it is a public health problem.