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Cristina Flores

Cristina Flores, a nurse in Tegucigalpa, Honduras, has learned how to help patients who are victims of gender-based violence.

In Honduras, a training is helping health workers understand gender-based violence and provide support for women

Nurse Cristina Flores sees it every day: the fear in a woman’s eyes, the bruises on her body, the hesitancy to say how it happened. At the public health clinic in Tegucigalpa, Honduras, where Flores has worked for 15 years, she can recount numerous cases where women have endured violence.

One woman came to the clinic pregnant, afraid to go home to her husband who beat her. He was a member of a local gang, and she didn’t know what he might do next. Another woman lied and said she had been hit by a bus to cover up the injuries she sustained from her husband. When she eventually reported the abuse to police at a nurse’s urging, her husband was taken to jail, but later he escaped and stabbed her to death.

“Every day, we attend women who have signs of violence, both physically and emotionally,” says Ruth Medina, who coordinates a regional advisory group against violence at the main health center in Tegucigalpa. These women face numerous barriers to getting help, from a fear of reporting their partner to the trepidation that they might be judged by authorities or health staff.

Understanding a woman’s experience

The health sector—often a victim’s first point of contact—can play a key role in treating gender-based violence and helping women find solutions. That’s why PATH and the InterCambios Alliance in Latin America developed a powerful training tool called Caminando en sus Zapatos (“In Her Shoes”).

“Every day, we attend women who have signs of violence, both physically and emotionally.”
—Ruth Medina

Now being used in Honduras and several other countries in Central and South America, the curriculum offers eight stories of violence against women, based on real-life events, that show the role the community and institutions can play in breaking the cycle of violence. Health workers and community members role-play a woman facing abuse and have to decide what to do, experiencing for a short time the day-to-day realities of victims of gender-based violence. PATH and InterCambios adapted In Her Shoes from the original English version created by the Washington State Coalition Against Domestic Violence.

Responding with compassion

In Honduras, In Her Shoes has aided health workers in providing support to women who have experienced abuse. Often they will come to a clinic complaining of a headache or stomachache, caused by the stress of their situations. Others may have sexually transmitted infections or unwanted pregnancies as a result of violence, or they may want to use contraception but fear their partner will get angry. Many women say their husbands or partners withhold money and food from them and their children, inflicting mental abuse. Now, trained health staff can ask questions to determine their situations, offer guidance, and work with the women to find solutions.

“I counsel them to learn to love themselves, because that’s the most important thing,” says Francesca Laínez, a nurse and counselor in a Tegucigalpa neighborhood clinic. Before receiving the training, she didn’t view a man’s neglect of his partner as abuse, but now she realizes that violence isn’t just about bruises and battering.

Laínez and other health staff trained with In Her Shoes have learned to respond with compassion to victims of violence. They refer women to other medical services, help them find shelters, or support them in reporting their abusers to police.

Shining a light on violence

In addition to training health staff to better handle cases of violence, public health centers in Tegucigalpa are now tracking cases to show the prevalence of gender-based violence as a huge public health issue. Advocates hope to draw increased resources and awareness to address the violence so that effective action continues in the justice system and in communities.

For so long, violence has been a private matter, something that’s kept behind closed doors, never discussed. Now, In Her Shoes is helping health workers like Cristina and Francesca understand and shine a light on the experience of abuse—and combat this very real health issue.

Photo: Miguel Alvarez.