American biomedicine has many aspects but overall our health system looks at populations as a whole in a medicalized way, the advent of ‘modern’ Western medicine, instead of one that could be considered more personal or uses natural remedies (Gabriel). By reframing gender violence as a health issue we perpetuate a large scale focus on the population picture instead of an individual or particular approach. For instance, looking at the statistics in Haiti, it is reported that 21% of women will experience physical and/or sexual intimate partner violence in their lifetime (UN Women). This does not give an accurate look at how survivors in Haiti are impacted but gives a general overview of the population. 

When we look at symptoms of trauma and assault from gender violence, we look at in a way that needs to be cured. Trauma is loosely defined, typically something that is life-threatening but can encompass many other things and is culturally determined (Gabriel & Sperlich). Typically, post-traumatic stress disorder (PTSD) is treated with medication such as selective serotonin reuptake inhibitors (SSRIs) when diagnosed by a doctor in American medicine (Seng & Sperlich). Medicinal cures reinforce drug/pharmaceutical cures instead of altering the environment or stressors one may face and another form of medicine may prescribe outside of biomedicine. These drugs often have adverse side effects. For pregnant women, the risk of birth defects could be slightly higher for those taking SSRIs (Seng & Sperlich). As someone who personally takes SSRIs this is something I was unaware of that scares me a little bit. Beyond that, there are far more side effects to these medications such as drowsiness, nausea, dry mouth, lack of sexual drive, digestive issues among many others. Sometimes I wonder, are we fixing or creating more problems through our medicalization of trauma? 

According to UN Women, about 15% of Haitian women experienced intimate partner violence within the last 12 months (UN Women). Another aspect of these statistics to consider is how often are people reporting them? When we make gender violence a health issue we often ignore the barriers that come with reporting. By looking that this from a population and statistical standpoint, we lose the stories of why a woman chooses not to report her instance(s) of violence. The WHO article did a good job of breaking down many aspects of gender violence but not touch on this aspect of reporting violence and how numbers are likely to be far higher than they actually are. Women often do not report their instance(s) of gender violence out of fear of retaliation, fear of not being believed, fear of getting a loved one in trouble among a host of other things. These voices are not heard when we look at this issue from a biomedical, population-based survey. 

Another aspect of medicalizing trauma is class-based. By making biomedicine the answer to fixing our trauma we often leave the most vulnerable behind due to expenses. About 70% Haitians live in poverty (as defined by the UN) lacking access to safe drinking water, bathrooms, food and other essentials (Malow et. al, 2010). Additionally, only about 40% of Haitians had access to medical care in 1998 (Hemptsone et. al, 2004), and recent natural disasters such as the hurricane in 2010 have exacerbated the lack of medical infrastructure in the country (USAID, 2017). On top of that, poverty exacerbates the changes of sexual violence in the country especially among women who decide to go into sex work to make ends meet (Malow et. al, 2010). These people barely have money to put food on the table and sometimes don’t this often means going without medical care because of the cost and the time it may take to get to a clinic. Mental health being monetized and medicalized keeps it from populations such as this. Intergenerational trauma feeds off of this. Many impoverished people live in situations that enable gender violence, kids grow up seeing this as it is normalized and these are factors that allow for men to be violent and women to stay within violent relationships (World Health Organization). Instead of solving the systemic issues of why trauma exists, especially among the impoverished, our idea of PTSD enables us to push pills onto patients and continue living life without making mass societal changes. This way we often get generations of people who are either neglecting their issues or are taking SSRIs to combat their past traumatic experiences. 

Trauma often goes unnoticed for the most vulnerable because of how we see it as a medical problem that someone needs to seek help for because otherwise they are just another statistic. Biomedicine depersonalizes medicine and allows us to keep distance from it as we have seen with how pregnancy and death are seen in American medicine and trauma is no different. I truly believe the way we look at trauma as only a medical issue societal issue to stem it from happening instead of putting band-aids over issues. I see framing trauma as a health issue in the way Americans see medicine as a solution to a problem not an act to stop the systematic issues that cause the problem from happening in the first place. 

Gabriel, C. Deconstructing Biomedicine. [Powerpoint Slides]. Retrieved from http://anthropology.msu.edu/anp270-us19/lecture-videos/deconstructing-biomedicine/. 

Gabriel, C. & Sperlich, M. Violence Against Women, Trauma, and Resilience As Health Issues. [Powerpoint Slides]. Retrieved from http://anthropology.msu.edu/anp270-us19/lecture-videos/violence-against-women/. 

Hempstone, H., Diop-Sidibe, N., Ahanda, K. S., Lauredent, E., Heery, M., (2004). HIV/AIDS in Haiti: A Literature Review. USAID and Health Commission Partnership.

Malow, R., Rosenberg, R., Lichtenstein, B., Devieux, J.G. (2010). The Impact of Disaster on HIV in Haiti and Priority Areas Related to the Haitian Crisis. J Association Nurses AIDS Care, 21(3), 283-288. doi:10.1016/j.jana.2010.02.002.

Seng, J. & Sperlich, M. (2008). Survivor Moms: Women’s Stories of Birthing, Mothering, and Healing After Sexual Abuse. Motherbaby Press.

UN Women. (2016). Prevelance Data on Different Forms of Violence Against Women. Retrieved from http://evaw-global-database.unwomen.org/fr/countries/americas/haiti. 

USAID. (2017). Health Fact Sheet. Retrieved from https://www.usaid.gov/haiti/global-health.

World Health Organization. (2012). Understand and Addressing Violence Against women: Intimate Partner Violence. Retrieved from https://drive.google.com/open?id=1v3A9iFgtYMr27iQxastE2blCwzr72AUe.