Violence against women is a common phenomenon in India. Most of the abuse and violence takes place within the family. Violence affects women and girls in different ways causing major health problems. The World Health Organization (WHO) accepts that violence against women and girls is a significant public health concern. Evidence points to a major impact on the health of the survivors of gender-based violence (GBV).
Research has shown that even when women do not seek legal services to deal with the domestic violence they are experiencing, they may still avail of the benefits of the health systems. This implies that healthcare providers can play an important role in the detection of violence, and provide immediate and long-term medical support, emotional support, and even referrals for legal aid services. They can also undertake valuable case documentation.
According to a multi-site study conducted in seven cities in India by the Delhi-based INCLEN Trust International in 2000, almost half (45.3%) of the women who faced violence reported injuries requiring treatment. Another study, which examined cases of women recorded in the emergency police register of the casualty department in an urban, government-run hospital in Mumbai, found that two-thirds of the women over 15 years of age (66.7% or 497 women out of 745) were definitely or possibly cases of domestic violence (Domestic Violence against Women: An Investigation of Hospital Casualty Records Mumbai published in the Journal of Family Welfare in 1999).
Health professionals are therefore in a strategic position to reach women facing domestic violence – they are one of the most certain and earliest contacts for a survivor of violence. Early identification of women facing violence and appropriate intervention by healthcare providers can prevent more severe health consequences.
Keeping this in mind, India’s first hospital-based crisis intervention centre was established in 2001 by the Center for Enquiry into Health and Allied Themes (CEHAT) at the K. B. Bhabha Hospital, Bandra, Mumbai. It was named Dilaasa, which means ‘reassurance’, and its working process is broadly accepted as the Dilaasa Model. The success of the Dilaasa Model laid the foundation for the development of one stop crisis centres (OSCCs) by the Ministry of Women & Child Development, Government of India in 2013-14. The central government allocates funds from the Nirbhaya Fund for the OSCCs. However, the implementation of the centres is in the hands of the state governments.
Survey of one stop crisis centres in four states of India
Women Gaining Ground (WGG) is a global consortium which aims to address sexual violence and GBV, and encourage political participation of young women and women with disabilities. India is one of the participants of the consortium and the programme is run in four states of India – Uttar Pradesh, Bihar, Jharkhand, and West Bengal. CREA, Delhi functions as India’s implementing global partner of the consortium. The strategic partners working in India include Gramonnati Sansthan in Uttar Pradesh, Aakanksha Seva Sadan in Bihar, YUVA in Jharkhand, and Sruti Disability Rights Centre in West Bengal. The WGG (India) team decided to conduct a survey of the functioning of the OSCCs in the four states where the consortium works.
According to the website of the National Commission for Women, there are 38 OSCCs in Bihar. Some of them started operations as long back as February 2017. There are 24 such centres in Jharkhand; the earliest one started working in March 2017. There are 75 centres in Uttar Pradesh, and the first one started in March 2017. In West Bengal, there are 22 such centres, with the first one starting operations in July 2022.
Survey findings
According to the survey field reports, not all the OSCCs are located within a hospital, the primary premise for these centres. For example, the centre at Mahoba in Uttar Pradesh is not within a hospital, but located close to a prominent political party’s office. The location itself can deter women facing violence from visiting the centre. Then again, the timings as well as the services offered at the centres differ from each other. While some have shelter facilities, others offer services only during ‘office hours’, thus defying the 24-hour services required in cases of GBV. None of the centres have properly trained and enough human resources.
There are two major concerns that came forth from the survey. First, not a single OSCC addresses the concerns of women with disabilities. The buildings are not barrier-free, and no support persons like sign language interpreters or trauma-informed psychologists have been recruited. The staff of the centres seem completely unaware of the needs of women with disabilities. None of the centres is connected to the National Tele Mental Health Programme of India.
Second, the staff of the OSCCs lack a feminist perspective. In the cases where adolescent women are brought to the centres (often after running away from the parental home with a male friend has proved abortive), the women are counselled to go back to their parents instead of trying to understand their sexual needs or if the parental home is abusive.
The Bengal scenario
The overall picture of the four states shows that some centres are functioning quite well, but some are not able to provide proper support to the survivors of violence. However, barring West Bengal, there are at least some efforts afoot to make the centres run better. The scenario in West Bengal is pathetic. The state started these facilities much later than the other states. Even so, though the first centre in the state was inaugurated in 2022, there is a general lack of awareness about the centres. The state government has not advertised the availability of the OSCCs through public messaging. As a result, not just the survivors, even senior journalists and members of the West Bengal State Legal Aid Services Authority are unaware that such centres exist.
A visit to the OSCC at the Bijoygarh State General Hospital in South 24 Parganas was revealing. The hospital was empty barring some workmen. The security guard tried to stop the researchers from entering the hospital. After the researchers insisted that they had urgent work at the OSCC, he let them walk in. Inside the centre, there was only one employee who said she was the data entry operator. How she would be able to provide necessary support to any survivor in distress was a mystery.
Unfortunately, the centre in the North 24 Parganas district was worse. When the researchers visited the Barasat State General Hospital, they were shown a locked cubicle and told that this used to be the centre. Hospital staff informed that there used to be a few banners inside the hospital about the centre, but these had been taken down.
The OSCCs can play an important role in providing restorative justice to the survivors of violence. Yet, the West Bengal government has not even notified a centre for Kolkata, the state capital! It is a shame on the part of the state government to overlook such an important scheme to address GBV.
The city of Kolkata has seen unprecedented roars of protests post a terrible rape and murder of a young woman doctor inside a government hospital. The bare minimum that the state government can do is to start operating the OSCCs in right earnest so that some faith in the government systems is restored as far as addressing GBV is concerned.
In a separate note, the author points out that today, December 16, is observed as Nirbhaya Day. Moreover, on December 16, 2016, the Rights of Persons with Disabilities Act, 2016 became a reality after a protracted struggle. Read article Rights of Persons with Disabilities Act, 2016 Is a Reality! published in the December 2016 issue of Varta – Editor.
About the main photo: Media conference held at the Press Club Kolkata on December 3, 2024 to disseminate the findings of the Women Gaining Ground survey of the OSCCs in four states. From left to right in the photograph are Chitrita Bandapadhyay, Trustee, Sruti Disability Rights Centre; the author; and advocate Jhuma Sen. Photograph courtesy Sruti Disability Rights Centre
