Violence against Women in Papua New Guinea through Socialisation and Impunity

Violence against women is a profound violation of human rights that exists in societies around the world. In Papua New Guinea, a small Pacific island country comprised of over 800 distinctive languages with a population of over 7 million that ranks towards the lowest of the Human Development Index, women face one of the highest rates of domestic and sexual violence in the world.

In February 2013, Kepari Leniata, a 20 year old mother, was accused of sorcery and subsequently stripped naked, tortured with a branding iron, tied up, soaked with fuel, and burnt alive in front of a crowd of over 200 people in Mount Hagen of the Western Highlands. This heinous incident is not unique in Papua New Guinea – there are daily and countless reports of women and girls being gang raped, murdered, tortured, beaten, and sexually abused.

It is important to note that gender-based violence requires a broad conceptualisation to accurately and meaningfully account for the realities faced by women. Gender-based violence can be sexual, financial, psychological, emotional, and physical and it exists across the spectrum of abuse, harassment, intimidation, neglect, threats, coercion, assault, murder, torture, and rape. Gender-based violence manifests in a range of private and public contexts – the family, the household, the workplace, the tribe, the marketplace, the community, and the street. It is perpetrated by men that are spouses, intimate partners, family members, acquaintances, and strangers. It occurs regardless of age, socioeconomic status, religious faith, and ethnic identity. Women, men, children, families, communities, and the economy all suffer from gender-based violence. Indeed violence against women in Papua New Guinea is an immense public health threat and a profound barrier to socioeconomic empowerment, wellbeing and dignity.

70 percent of women are survivors of violence in Papua New Guinea, and in the Chimbu and Western Highlands provinces almost 100 percent of women are survivors of violence. Although, it is impossible to provide a completely accurate estimate of the rate due to incomplete data and reporting asymmetries, the situation of violence against women in Papua New Guinea has been described as an ongoing humanitarian crisis and unique outside a war-zone.

The causes and factors that enable and perpetuate violence against women in Papua New Guinea are complex, deep-rooted, and multifaceted. Violence against women is seen as “em nomol ya” (that’s normal) in a country steeped in cultural epistemologies of conflict and masculinity coupled with an increasing socialisation of violence. Indeed, violence against women has not only become normalised but legitimised. Survivors are marginalised in the justice system, stigmatised in the community, and face multilayered barriers when seeking and accessing help particularly in the context of the feminisation of poverty.

From an early age girls and boys are exposed to violence and are socialised not only to expect but to accept violence against women by men – as “em pasin blo ol” (that’s their way). Violence that accompanies hierarchies of power, of men over women and of adults over children, is entrenched through generations of origin myths, informal institutions, and customary law.  Indeed, men are often seen to possess the “rait” (right) to express their aggression.

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'Crying Meri: Violence against women in Papua New Guinea'. Photography project by Vlad Sokhin

Fundamentally, a culture of impunity pervades Papua New Guinea where the justice system is disinterested in the safety and rights of women and, particularly, the survivors of gender-based violence. Access to justice in Papua New Guinea is incredibly limited and women are marginalised in a system that fails to offer legal recourse, closure for the victim, punishment of the perpetrator, and deterrence of future crimes.

Such failings stem from widespread corruption, stigma and apathy in the Royal Papua New Guinea Constabulary and in the various machinations of provincial and national government. Indeed, the police are under-staffed, under-trained, often corrupt, frequently violent, and largely disengaged from the safety and rights of women. Consequently, a widespread distrust in the community of the criminal justice system prevents any engagement and pretence of justice. The stark failing of the justice system for survivors of violence is demonstrated by comparing the rates of treatment of survivors with the rates of criminal convictions in Lea, Papua New Guinea. In 2010, the Family Support Centre in Lea treated 338 survivors whereas the Lea National Court only convicted 1 perpetrator in 2012. Thus the approximate probability of a sexual violence conviction is 1:338. The actual probability is even lower because not all survivors report or receive treatment for their violence. Threats of reprisals and prevailing stigmas of shame and guilt prevent survivors from receiving medical care or legal assistance. Thus the endemic and entrenched reality of violence against women is largely a silent crisis.

Indeed the vast majority of claims of domestic, family and sexual violence never escape the informal and customary mechanisms exercised by village courts and in families, tribes and communities. Traditional Melanesian 'Big Man' politics and cultural norms create an environment where survivors of gender-based violence face a backlash from their own community when seeking justice and struggle with the stigmatisation of being a victim. Ultimately, the justice system of Papua New Guinea is failing survivors of gender-based violence.

The way forward in challenging and preventing the entrenched reality of violence against women in Papua New Guinea is not simple or straightforward. At the fore of this must be the empowerment of women, advocacy of gender equality and removal of discriminatory laws, systematic reform of the criminal justice system, and the wholesale improvement of support and emergency services. In the context of the feminisation of poverty, the economic and political enfranchisement of women and better access to educational opportunities and quality healthcare are also vital. Efforts made to hold the Papua New Guinean Government accountable to meet its obligations under the Convention on the Elimination of Discrimination against Women are paramount. Particularly, since the Papua New Guinea Parliament passed the Family Protection Act in September 2013 that criminalises domestic violence.

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Tasman Bain is the Co-Founder of Meri Toksave (an anti-violence against women initiative in Papua New Guinea), a White Ribbon Ambassador, and a former UNICEF Australia Young Ambassador. He studies anthropology and development at the University of Queensland.

Meri Toksave (a non-profit initiative co-founded by Ayesha Lutschini, Courtney Price and myself) is working to provide youth-led solutions to gender-based violence in Papua New Guinea. Our first project was centered on rectifying the information asymmetries that are profound barriers for survivors of gender-based violence seeking and accessing support services. Our next project is a grassroots campaign to raise awareness of the rights of women and to challenge the prevailing norm and legitimacy of violence. For more information on Meri Toksave please visit www.meritoksave.org and www.facebook.com/meritoksave.

[1] Chandler, J. (2014) Violence against women in PNG: How men are getting away with murder. The Lowy Institute. Accessed at: http://www.lowyinterpreter.org/post/2014/08/29/Violence-against-women-in-PNG.aspx.

[2] Papua New Guinea Law Reform Commission (1992) Final Report on Domestic Violence. Papua New Guinea Law Reform Commission. Accessed at: http://www.paclii.org/pg/LRC/REP_14.htm.

[4] Pollak, S. (2013) Woman Burned Alive for Witchcraft in Papua New Guinea. Time Magazine. Accessed at: http://newsfeed.time.com/2013/02/07/woman-burned-alive-for-witchcraft-in-papua-new-guinea/.

[5] Agence France-Presse (2012) MSF chief urges PNG to act on sexual violence. Australian Broadcasting Corporation Australia Plus. Accessed at: http://australiaplus.com/pacific/2012-11-15/msf-chief-urges-png-to-act-on-sexual-violence/1046910.

[6] Médecins Sans Frontières (2011) Hidden and Neglected: the Medical and Emotional Needs of Survivors of Family and Sexual Violence in Papua New Guinea. Médecins Sans Frontières. Accessed at: http://www.doctorswithoutborders.org/publications/article.cfm?id=5390&cat=special-report.

[7] Jolly, M., Stewart, C. and Brewer, C. (ed.) (2012) Engendering Violence in Papua New Guinea. Australian National University Electronic Press. Accessed at: http://press.anu.edu.au/apps/bookworm/view/Engendering+Violence+in+Papua+New+Guinea/9211/cover.html.

[8] Howes, S. and Lokuge, K. (2013) Sexual violence in Lae: Impunity and Resistance. Australian National University Development Policy Centre. Accessed at: http://devpolicy.org/sexual-abuse-in-lae-impunity-and-resistance-20130319/.

[9] Amnesty International (2006) Papua New Guinea: Violence against women - Not inevitable, never acceptable. Amnesty International. Accessed at: http://www.amnesty.org/en/library/asset/ASA34/002/2006/en/416c8345-d422-11dd-8743-d305bea2b2c7/asa340022006en.html.

[10] Papua New Guinea National Council of Women (2010) The CEDAW Shadow Report: On the Status of Women in Papua New Guinea. Papua New Guinea National Council of Women. Accessed at: http://www.iwraw-ap.org/resources/pdf/46_shadow_reports/G2L/Papua_New_Guinea/CEDAW_SHADOW_REPORT.pdf.

[11] United Nations Development Programme (2013) The Future We Want: Voices from the People of Papua New Guinea.  United Nations Development Programme. Accessed at: http://www.pg.undp.org/content/dam/papua_new_guinea/docs/MDG/UNDP_PG_The%20future%20We%20Want%202015.pdf.

[12] Fulu, E., Warner, X., Miedema, S., Jewkes, R., Roselli, T. and Lang, J. (2013) Why Do Some Men Use Violence Against Women and How Can We Prevent It? Quantitative findings from the United Nations Multi-country study on man and violence in Asia and the Pacific. United Nations. Accessed at: http://unwomen-asiapacific.org/docs/WhyDoSomeMenUseViolenceAgainstWomen_P4P_Report.pdf.

[13] Wiseman, H. (2013) Stop Violence against Women and Children in Papua New Guinea. ChildFund Australia. Accessed at: http://www.childfund.org.au/sites/default/files/publications/Stop%20Violence%20Against%20Women%20and%20Children%20in%20PNG%202013.pdf.

[14] Betteridge, A. and Kamalini, L. (2014) Combatting the family and sexual violence epidemic in Papua New Guinea. Australian National University Development Policy Centre. Accessed at: http://devpolicy.org/pdf/Submission%20to%20Women%20and%20Girls%20Inquiry%20FINAL.pdf.

[15] Hayward-Jones, J. (2013) Violence: PNG’s women face a crisis. The Lowy Institute. Accessed at: http://www.lowyinterpreter.org/post/2013/03/08/Sorcery-killing-draws-attention-to-treatment-of-women-in-PNG.aspx

[16] Manjoo, R. (2013) Report of the Special Rapporteur on violence against women, its causes and consequences, on her mission to Papua New Guinea. United Nations Office of the High Commissioner for Human Rights. Accessed at: http://www.ohchr.org/Documents/Issues/Women/A-HRC-23-49-Add-2_en.pdf.

Special Taskforce on Domestic and Family Violence

Speech at the Launch of the Special Taskforce on Domestic and Family Violence in Queensland      10 September 2014

Heather Douglas, h.douglas@law.uq.edu.au

Domestic and family violence touches us all. As employers, work colleagues, teachers, friends and family members, we all know someone who is living with, or has tried to leave behind, a relationship where there is family violence. It is an issue that crosses political, socio-economic, racial and age  boundaries.

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University of Queensland law              lecturer Professor Heather Douglas

The kind of violence we are talking about is coercive and controlling. Such behaviour manifests itself in a wide variety of ways. In the worst cases it results in death. In 2013, 18 people died in Queensland as a result of domestic and family violence related homicides. The national Homicide Monitoring Project classified 36% of all homicides as domestic in its most recent report.[1]

The victims in domestic homicide cases, and indeed of domestic violence generally, are overwhelmingly women. While homicide is a very terrible thing, these figures don’t encapsulate the extraordinary numbers of women and children who are alive but live daily with terrible disabilities as a result of domestic violence.

In hearing a sentencing case involving assaults and threats perpetrated by a violent abuser, President McMurdo of the Court of Appeal addressed the sadly, not atypical experience of a victim of domestic violence. She said:

She was taking pain killing medication for neck, back and shoulder injuries and regularly visited a chiropractor for back and nerve damage, all resulting from the respondent's assaults. She had lost a great deal of hair and required hair extensions because her hair was damaged and uneven from his assaults. She suffered from ringing in her ears because he had hit her in the head so many times. She had a permanent black eye from the last assault. She had continuing pain from the cut to her finger and had lost feeling in the finger tip. She was suffering from depression and anxiety, was on medication for stress and anxiety and took sleeping tablets. During the course of the respondent's abuse, she was afraid he might kill her and the children. She and the children were receiving counselling. The respondent's behaviour had alienated her from her friends. The children were frightened, scared and anxious and were demonstrating behavioural problems. She was in a difficult financial position because she was unable to work due to a post-traumatic stress disorder resulting from the abuse.[2]

Children are also traumatised by domestic violence when they see and hear it; sometimes they are forced to spy on a parent, used as a hostage, blamed for the violence or feel compelled to intervene.  Children may receive their own injuries or be called on to tend to the injuries of a parent,  it may be a child who calls the police and children are often made homeless as a result of domestic violence.[3]

Workplaces are impacted by domestic violence. Studies show that  productivity losses cost Australian businesses alone $1.5 billion per year in direct, indirect and lost opportunity costs through absenteeism, errors, stress, performance management, search and hiring costs, retraining costs, and permanent loss of labour capacity.[4]

Too many women and children across Queensland are currently living with serious physical and psychological injuries that have resulted from domestic violence. Too many are homeless and can not find safe refuge.   

We must ensure women and children can live safely and we must hold violent perpetrators to account and assist them to break out of their own cycles of intergenerational violence. Criminal prosecution may be one way to do this. Yet prosecutions of non-fatal offences remain low, in part women do not feel they are supported in the prosecution of offenders.

Women need much better access to court support to help them feel more confident when they appear in court for protection applications or as witnesses in criminal matters. Too often women are unrepresented next to a legally represented perpetrator. One woman I spoke to said:

I was confused. I was terrified to go into the court. I’d never been in a court room in my life.... It was all so new to me and humiliating. I was open, baring everything out there about what I’d hidden and lied about for years. And he was there with his solicitor. I didn’t have a solicitor ‘cause I didn’t have any money. I felt like I was going to throw up. I was absolutely intimidated, completely intimidated.[5]

Generally justice system responses need better support. Perpetrator programs should be mandated through the conditions of protection orders and through sentencing. Research shows that where programs are available magistrates tend to use them.[6]  Some perpetrators may also need drug and alcohol rehabilitation. This can also be one of the conditions of a protection order or sentence. 

Currently our criminal justice system may be ill equipped to respond to some of the injuries reported by women. For example consideration should be given to the abolition the defence of provocation to assault. Queensland is the only state that retains this defence.[7]

Consideration should also be given to the development of an offence of non-fatal strangulation. Such behaviours should be clearly identified on the police record, either through prosecution or through clear case histories. We know that a woman who has been strangled is 800 times more likely to be murdered by her partner or suffer really serious injury in the following weeks.[8]

Certain groups in our community are particularly vulnerable to domestic and family violence. Indigenous women and women from culturally and linguistically diverse communities are disproportionately represented. In Australia, Indigenous women and girls are 35 times more likely to be hospitalised for domestic violence related assaults than other Australian women.[9] An understanding of the needs of women from diverse backgrounds is imperative in the consideration of policy development and law reform.

In response to the Australian Law Reform Commission’s 2010 report on domestic and family violence, the Queensland   Department of Justice and Attorney General is already starting to link up all the separate aspects of the justice process so that cases can be more easily tracked. But law is but one aspect, although an important one, in an integrated response to domestic violence. 

It’s great to see the Government committing to a real expansion of support for victims and crisis accommodation.

I look forward to hearing the results of the taskforce.

For more information on the Special Taskforce on Domestic and Family Violence in Queensland visit: https://www.qld.gov.au/community/getting-support-health-social-issue/dfv-taskforce/

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[1] Australian Institute of Criminology, Homicide in Australia: 2008–09 to 2009–10 National Homicide Monitoring Program annual report http://www.aic.gov.au/publications/current%20series/mr/21-40/mr21.html

[2] R v Major; ex parte Attorney-General (Qld) [2011] QCA 210 (30 August 2011).

[3] Cathy Humphreys C  Domestic violence and child protection: Challenging directions for practice. Issues paper 13. Sydney: Australian Domestic & Family Violence Clearinghouse 2007.

[4] Estimates vary, generally see:  Rosa Campbell, ‘The financial cost of domestic violence’ Australian Domestic and Family Violence Clearinghouse, 2011.

[5] Heather Douglas and Tanja Stark, Stories from Survivors: Domestic Violence and Criminal Justice Interventions, 2010, University of Queensland, at 70.

[6] Heather Douglas, 'Not a Crime Like Any Other: Sentencing Breaches of Domestic Violence Protection Orders' (2007) 31 (4) Criminal Law Journal 200-233

[7] Heather Douglas, 'The Criminal Law's Response to Domestic Violence: What's Going On?' (2008) 30 (3) Sydney Law Review* 439-469

[8] Heather Douglas, Robin Fitzgerald, 'Strangulation, Domestic Violence and the Legal Response' (2014) 36 (2) The Sydney Law Review 231

[9] Australian Law Reform Commission and New South Wales Law Reform Commission, Family Violence — A National Legal Response Final Report, Report No 114 (2010) <http://www.alrc.gov. au/publications/family-violence-national-legal-response-alrc-report-114> 

Land acquisition in an era of climate change

It is beyond scientific doubt that increased heat in the ocean and melting ice caps and sheets will cause a rise in global sea levels. It is hard to predict the exact amount of this rise, as so much depends on what action is taken across the globe to reduce carbon dioxide emissions. Even if emissions are immediately reduced, a global sea-level rise of 0.28-0.60m by 2100 is still possible. However, if we retain the status quo and emissions continue to rise, global sea-level rise in the range of 0.53-0.97m by 2100 is likely. Furthermore, sea-level rise will exacerbate the impact of extreme weather events, with the potential for more frequent and more damaging storm surge and erosion events.

 University of Queensland law lecturer Dr Justine Bell

This poses a serious threat to Australian communities. Australia has approximately 35,000kms of coastline, with the majority of the nation’s population settled close to the coast. It is estimated that 85% of Australians live within 50 kilometres of the coast, and in 2009, there were over 711,000 residential addresses located within 3km of the shore, and less than 6 metres above sea level. Consequently, there are billions of dollars worth of private property and infrastructure threatened by sea-level rise and extreme weather.

Given this level of risk, it seems logical to introduce strong regulation for developments in coastal areas. The reality though is far more complicated. Governments have to weigh up the sanctity of private property rights with competing environmental objectives. Strong presumptions against retrospectivity make it difficult to regulate existing developments along the coast, and compulsorily acquiring land may be only way for governments to completely alleviate risks to private property. This all occurs in a context where the timescales are long, and scientific uncertainty is high.

On the flipside though, these long timescales provide a unique opportunity for governments to spread costs and implement a strategic approach to acquiring property. Governments can, in effect, ‘time-limit’ communities, as the impacts of sea-level rise may not be experienced for several decades. Governments may prefer to implement measures that allow homeowners to reside in their properties for the remainder of their lifetime, or until the risk materialises, rather than acquiring properties immediately. This would achieve a compromise, by allowing landholders to remain in their homes and communities for the short- to medium-term, whilst still ensuring that homes vulnerable to sea-level rise are eventually moved into public ownership.

Theoretically, a land acquisition policy can be implemented gradually, even over several decades, with priority given to those properties most at risk in the short-term. However, this approach would require a significant re-imagination of the role of land acquisition laws in Australia. These laws differ considerably across the States, and most Acts would require some amendment. In particular, laws could be amended to allow for acquisition and lease-back land, for long-term notices of intention to acquire, and for scaled compensation schemes.

These are difficult policy questions to resolve, particularly given the high prominence of privately-held property in Australia. That said, deferring action is not a sound approach, as extreme events and associated calls for disaster relief will result in huge financial shocks for government. It is crucial that these issues are considered now, to allow for the cost burden to be spread over time.

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Dr Justine Bell is a Lecturer in the TC Beirne School of Law at the University of Queensland. Her book, Coastal Development and Climate Change Law in Australia, was recently published by the Federation Press.

REPRODUCTIVE HEALTH AND DOMESTIC VIOLENCE (CbyC)

UQ Pro Bono Centre

Semester 1, 2014 

Pui-Chi Cheung, Hannah Baldry, Harry Maxwell and Phuong Nguyen

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“No woman can call herself free who does not control her own body.” - Margaret Sanger

Children by Choice (CbyC) is a small not-for-profit feminist organisation that offers pro-choice, all options pregnancy counselling, information and referrals for women experiencing unplanned pregnancy in Queensland. CbyC’s vision is that all women have the knowledge and power to take control of their sexual health and reproductive choices.

The project, coordinated by the UQ Pro Bono Centre and supervised by Professor Heather Douglas, involved preliminary research in relation to the role and impact of domestic violence as a barrier accessing reproductive health choices. The aim was for CbyC to ultimately utilise this research in order to develop tools (such as a briefing paper and factsheets) that could be implemented to increase support from key stakeholders for victims of domestic violence to access an abortion. The first stage of research involved a literature review of international and Australian research, with a particular focus on current scholarship from the United States and Scandinavia. The second stage involved researching four main areas:

1. How key terms such as “domestic violence” and “reproductive coercion” are defined and understood in research;
2. Australian data on “forced pregnancy” as a form of domestic violence;
3. Barriers to reproductive health in circumstances of domestic violence; and
4. Whether abortion is a form of safety planning in the circumstances of domestic violence.

A number of key findings were made during the course of the research and are outlined below. 

There were variations of the term “domestic violence” (such as “intimate partner violence” and “family violence) as well as a variety of definitions. However, it was found that there was a central element of ongoing power and control and behaviour that included both physical and non-physical conduct in all of these definitions.[1]

During the initial stages, it became apparent that there was a somewhat lack of Australian literature on the links between domestic violence and unplanned pregnancy. Nevertheless, literature from other jurisdictions, particularly from USA, confirmed that not only are there strong links between domestic violence, reproductive coercion and unplanned pregnancy, but that unplanned pregnancy is more common among women who identify as being in a relationship marked by domestic violence.[2]

Further research confirmed that this correlation is often because of ‘reproductive coercion’ within an abusive relationship.[3] Reproductive coercion may manifest as emotional and physical conduct, which can include:

• The male partner convincing the woman that he will leave her if she does not become pregnant;
• The male partner engaging in birth control sabotage (such as destroying birth control pills, pulling out vaginal rings etc);
• The male partner exercising financial control, so as to limit access to birth control and;
• The male partner insisting on unprotected sex or rape.[4]

These forms of behaviour to coerce a woman to become pregnant could be seen as a deliberate strategy to entrench power and control by a male partner, which strongly resonates with definitions of domestic violence more broadly.[5]

The effective use of medical contraception as a strategy to retain reproductive integrity and to prevent pregnancy is not straightforward in a domestic violence context.[6] In particular, a woman in a domestic violence relationship may be under heavy financial scrutiny which may impact upon her ability to purchase contraception and especially longer-lasting, more expensive options that may not be on the Pharmaceutical Benefits Scheme.[7] Long-acting reversible contraception (LARC), such as the Implanon, intrauterine devices (IUD) or Depo Provera injection, reduces the risk of partner interference with a woman’s contraceptive method. Yet, the reported prescription of such methods is low in Australia due, in part, to insufficient knowledge and training on the part of health care professionals, as well as the high costs of such methods.[8] 

There is an increased likelihood of violence towards a woman during pregnancy which poses significant health risks.[9] As such, it was suggested that abortion could be categorised as a safety mechanism for women in domestic violence relationships. Termination may be appropriate to prevent the woman from being further entangled with the perpetrator in a co-parenting situation or to prevent further harm to herself or her child.[10]

There remains limited access to abortion in Queensland, largely due to its standing criminalisation.[11] Nevertheless, while the laws may be complex, it is generally accepted that a medical practitioner can still lawfully provide termination of pregnancy in Queensland when he/she has formed an honest and reasonable belief that the woman’s physical and/or mental health is at risk of serious harm if the pregnancy continues. However, as a result, abortion in Queensland is predominantly provided through private termination clinics, the majority of which are based in the South East corner of the state. This is particularly problematic for women in rural or isolated areas, whose physical distance may be further hindered by controlling behaviour characteristic of any domestic violence relationship.  Moreover, the substantial out of pocket cost associated with an abortion at a private clinic (the procedure itself and potential travel expenses), like contraception, also presents a major barrier to women, particularly to those who may be under financial control by an abusive partner.[12] 

The research team favoured the term “coerced pregnancy” over terms such as unplanned or unwanted pregnancy as it highlighted reproductive coercion as its cause. It was also suggested that coerced pregnancy or reproductive coercion should be specifically included as an example of domestic violence in Section 8(2) of the Domestic and Family Violence Protection Act 2012 (Qld). Finally, it was noted that the continuing criminalisation of abortion creates significant barriers for women in general and that such barriers are intensified for women in domestic violence relationships. 

Whilst the link between domestic violence and a woman’s ability to exercise reproductive health choices appears to be an obvious one, this research project clarified and allowed for a more nuanced consideration of these issues. The research is just a stepping stone for more awareness, appreciation and conversation.

[1] See, for eg, Australian Law Reform Commission, ‘Family Violence and Commonwealth Laws – Improving Legal Frameworks’ (ALRC Report 117, November 2011).

[2] Elizabeth Miller et al, ‘Reproductive Coercion: Connecting the Dots between Partner Violence and Unintended Pregnancy’ (2010) 81 Contraception 457.

[3] Elizabeth Miller et al, ‘Recent Reproductive Coercion and Unintended Pregnancy Among Female Planning Clients’ (2014) 89 Contraception 122.

[4] Elizabeth Miller et al, ‘Pregnancy Coercion, Intimate Partner Violence and Unintended Pregnancy’ (2010) 81 Contraception 316.

[5] See, for eg, Elizabeth Smith (2008) ‘Domestic Violence in Pregnancy’ 3 International Journal of Childbirth Education 23, 23-25; Krug, E., Dahlberg, L., Mercy, J., Zwi, A. and Lozano, R. (2002). World report on violence and health. Geneva: World Health Organisation. retrieved 1 June 2014, from <http://whqlibdoc.who.int/hq/2002/9241545615.pdf>

[6] Corrine Williams, Larsen, Ulla and McCloskey, Laura, ‘Intimate Partner Violence and Women’s Contraceptive Use’ (2008) 14 Violence Against Women 1382.

[7] Amanda Dennis and Grossman, Daniel, ‘Barriers to Contraception and Interest in Over-the-Counter Access Among Low-Income Women: A Qualitative Study’ (2012) 44(2) Perspectives on Sexual and Reproductive Health 84; Lucke, Jayne, et al, ‘Unintended pregnancies: Reducing rates by improving access to contraception’ (2011) 40(11) Australian Family Physician 849.

[8] Kirsten Black, Bateson, Deborah and Harvey, Caroline, ‘Australian women need increased access to long-acting reversible contraception’ (2013) 19(5) MJA 317; Heidi Fantasia et al, ‘Chronicity of partner violence, contraceptive patterns and pregnancy risk’ (2012) 86.

[9] Karuna Chibber et al, ‘The Role of Intimate Partners in Women’s Reasons for Seeking Abortion’ (2014) 24(1) Women’s Health Issues e131; Lynn Meuleners et al, ‘Maternal and foetal outcomes among pregnant women hospitalised due to interpersonal violence: A population based study in Western Australia, 2002-2008’ (2011) 11(70) BMC Pregnancy and Childbirth 1.

[10] Karuna Chibber et al, ‘The Role of Intimate Partners in Women’s Reasons for Seeking Abortion’ (2014) 24(1) Women’s Health Issues e131, e133-e134.

[11] Caroline de Costa, Russell, Darren and Carrette, Michael, ‘Abortion in Australia: still to emerge from the 19th century’ (2010) 375 The Lancet 804.

[12] Rose Durey, ‘Women and Abortion’ (Issues Paper No 6, Women’s Health Victoria, May 2010).

Kah Hey Loh - Manning St Project

I participated in the ‘Manning Street’ Project in 2011 and 2012. Both projects were conducted at Caxton Legal Centre. We worked in small research groups working at an average of 4 hours a week over a period of one semester at the centre to research and write our research projects.

First Project: Oral Health & Human Rights

The first project I participated in focused on the lack of access to oral healthcare among the disadvantaged communities in Australia, with a particular emphasis on the right to dental healthcare. The project was supervised by Dr Tamara Walsh in groups of two. Dr Tamara Walsh made our research topic very interesting and was eager to discuss anything we were unclear about.

My task centred largely on providing legal arguments for which oral health issues ought to be focused upon in the country. I focused my research on various legal aspects, one of which was in the context of human rights’ entitlement to healthcare as enunciated in various international conventions, such as, Article 25 of the Universal Declaration of Human Rights and Article 12 of the International Covenant on Economic, Social and Cultural Rights. We researched whether the right to healthcare articulated in the international conventions included the right to dental healthcare, and we concluded in the affirmative. We concluded that such recognition of the right to healthcare provides strong legal arguments for the government to invest in dental care. The second aspect we focused upon was in the context of bioethical principles, in particular, the principle of justice. This principle means that all patients ought to be treated without prejudice regardless of race, status or gender. However, we found that the low standard of dental health in Australia is largely associated with the lack of accessibility to dental care among the disadvantaged communities, thus, provides an argument which supports the improvement of public dental health services.

Second Project: Doctors & Drugs

The second project required a team of four to investigate the prevalence of ‘doctor-shopping’ in Australia, a practice of patients visiting multiple doctors in a short time frame to deceive them and obtain restricted prescription drugs. The research focused on the conduct of medical practitioners, as opposed to patient liability or criminal misconduct regarding the misuse of prescription drugs. Our research paper discusses the reasons for doctor-shopping, strengths and weaknesses of the current regulatory regime and bodies (e.g. Australian Medical Association and Australian Health Practitioner Regulation Agency) in identifying doctor-shoppers, as well as prosecuting medical practitioners who have allowed patients to misuse medications. The paper also provides some recommendations on  how the current regulatory framework could be improved to minimise doctor-shopping. Ms Monica Taylor, our supervisor, was very helpful and supportive. She gave us incredible insights into the content and scope of our research topic, as well as suggestions on the structure and content of our research paper.

My area of research in the project centred on the medio-legal and regulatory frameworks which attempted to address the prevalance of doctor-shopping. In particular, I researched the standards of care owed by medical practitioners to patients imposed by common law and equity,  focusing on contractual, fiduciary and tortious duties. The current standards require doctors to exercise ‘reasonable skill and care,’ in the treatment and provision of drugs prescriptions. As a team, we considered the possibility and effectiveness of the law to increase the standard of care imposed on medical practitioners (from a duty to exercise ‘reasonable skill and care’ to a duty to act in the patient’s best interest) as a mechanism to minimise  doctor-shopping. However, we concluded that imposing a duty on medical practitioners to act in the best interest of patients may not be plausible as such standard is inconsistent with the existing contractual and/or tortious duty upon doctors to exercise ‘reasonable skill and care’ in the prescription of medications and the content of ‘best interest’ has been criticised for its inherent uncertainties. 

Our Reward

There was no strict separation of workload while working on both projects. We  helped each other out while working on the projects. Most of the time,  the discussion among ourselves and  our supervisor helped clear our doubts and improve our understanding on the subject. The staff at Caxton Legal Centre were extremely helpful and were always willing to assist us with our projects.

Throughout my involvement in the projects, I enjoyed wide-ranging opportunities, including interviewing doctor-shoppers, medical experts and legal academics. These experiences have taught me to question the effectiveness of laws in achieving their initial objectives and to think about how the law/government policies could be improved within the current regulatory scheme. Personally, both of these projects piqued and reinforced my interest in pursuing a career in healthcare law and enabled me to gain legal experience about social justice and law reform issues.

If you are interested in the Manning St Project find more information at:

http://www.law.uq.edu.au/manning-st-project