We read with interest the article by Kumar et al (Reference Kumar, Jeyaseelan and Suresh2005). In developing countries, where families are closely knit and cohesive, domestic violence was thought to be uncommon. However, studies of domestic violence in developing countries show a similar prevalence to that in developed countries. In Sri Lanka a survey at the out-patient department of the North Colombo Teaching Hospital in Ragama, a semi-urban area in the suburbs of Colombo, found that 40.7% of women had been abused by their partners (further information available from the authors on request). The abuse was physical as well as verbal, emotional and sexual and most women reacted in a submissive manner: 79% of those abused have stayed in their marriages for more than 10 years. This submissive behaviour could be because Sri Lankan women usually lack the means to leave their husbands and live independently and the fact that society looks down upon such women.
In a study in eastern Sri Lanka, Subramaniam & Sivayogan (Reference Subramaniam and Sivayogan2001) reported that most women, regardless of their level of education and their employment status, cited the welfare of their children as a prime reason for staying in an abusive relationship.
Parental separation is considered a risk factor for poor mental health in the offspring. Therefore parents staying together in marriage may protect their children from mental health problems. However, in our study children of 31% of the victims had witnessed the abuse. It has been demonstrated that emotional abuse in childhood has a major impact on adult mental health (Reference Edwards, Holden and FelittiEdwards et al, 2003). Kumar et al found that 56% of women who had been abused had poor mental health. Since parental mental disorder has been shown to be associated with psychological problems in the offspring (Reference RuttelRutter, 1966), it is doubtful whether staying in an abusive marriage is beneficial for the children.
Studies in developing countries repeatedly confirm that domestic violence is a problem that cannot be ignored and will significantly affect the mental health of future generations. We appreciate the efforts of Kumar et al in highlighting this issue and we consider the time has come to prevent this form of abuse in developing countries.
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