Dealing domestic violence in small towns is a huge challenge. The lack of access to services and the difficulty in getting victims away from their abusers, which is difficult enough in big cities, are almost insurmountable problems in small enclosed communities. Paul Baker is a nurse practitioner in a tiny county town, he is the town’s first, and most times only, point of call for health issues. This is his story about domestic violence in rural Australia.
Dry, hot weather brings the high vis workers in to our air conditioned medical centre regularly, with an assault to the senses of the baking wind through the opened door and a flash of perspiration odour rising to my nostrils. Today, the “glow worm” (what we call the masses of workers dressed in their distinctive work clothes) is Jai*. Name emblazoned on the grimy shirt, stained by the hard labour of the day. Must be from one of the slasher crews from the well pads, with all the tiny grass shavings shaking off with every step.
This time, I don’t get the usual, “I’m in a great hurry and need to be seen immediately” line given by so many resource workers in this situation. Instead I receive a quietly spoken “I’m OK to wait. I have a few things going on, but nothing medically urgent.” But I can see that she is fidgety and nervous. The perspiration stains visible around the collar and armpits, hands shaking, eyes downcast while talking. Jai is a local resident, lucky enough to score a job in this industry and well known to me, as the town is very small. Her daughter is in the same year as mine at school and they are the only girls in the class.
I take her through to the consult room, and she quite simply states that she thinks her “happy pills” need to increase in dosage as she has been getting anxious and crying for no apparent reason. Practitioners come and go in this town, with the last one starting her medication regime. So, we move on to some assessment tools, which point to a very depressed individual, with a potential risk of self-harm/suicide, the only thing keeping her from the edge is her daughter, who is her reason to live and only purpose in life.
As we kept talking, Jai’s told me her main goal is to “protect her daughter from all the shit that happens in this town if you don’t get out when you can.” The determination that she has for her teenage daughter’s education and future is admirable, especially when the STI rate is above 50% amongst locals, and the alcoholism and normalisation of violence and abuse in the community is rarely talked about.
There had to be reasons for a woman with a permanent, full time job to stay in such a depressing situation, and, after a while, further difficult issues came to light.
Her partner is “only” ever physical when he’s been drinking. But drinking has progressed from sometimes, to every night of late.
“He is a good man apart from drinking too much”
“I only have access to the work car”
“My partner has the only keys to the car”
What about money? I say.
“We have a shared bank account that he has the only card to.”
“But this will all be fine when his work stops stressing him so much”
Eventually, she confessed the reason for the sweat stains: she wasn’t given access to any money to buy antiperspirant. Another small, petty humiliation designed to keep her demoralised and isolated.
This is an all too familiar situation. I knew these people as a good, stable family before today. But I’ve heard this story so many times in this tiny, dry town. Some women have stable jobs, some have very little employment prospects. But all experience a feeling of being trapped in the town by circumstances beyond their control. Some physically abused, some controlled by financial or emotional means. No option but to keep going, stay the course and try to make their children’s life at least bearable.
It seems to all go pear-shaped when daughters become teenagers though. Perhaps it is the recognition by the child that this situation should not be normal, and the child threatens to “go public” if mum doesn’t find help soon. Tragically, sometime the only help they find is at the bottom of a bottle. If they are fortunate enough to access health care providers, at least there is a chance they might be able to make a change. But it’s not easy to make big changes in a small town.
The rate of abuse in this town is massive. In my experience, up to 80% of adult females having experienced domestic violence and controlling situations. Some have grown to develop coping skills and the ability to change family situations, but many have little control and the abuse only stops when a health crisis occurs to the male partner. It is at this point that they must relinquish some control, which allows their female partners some freedom.
There are better solutions to this problem though. Here in Queensland, there have been great gains made recently in response to the highly public, horrific abuse that has been in all of mainstream media.
But the concerns in rural Queensland haven’t changed. Will the changes brought in by the Palaszczuk government change the rates of domestic violence in country areas? Or is it reserved to city dwellers? Will the next generation be better off? At least as teenagers through their school education programmes they see that their home situation is not meant to be how it should be, but will there be anything they can do to change things?
One thing is for certain. Doing nothing is no longer an option. I can only see one patient at a time. I can only refer one woman at a time to social services. But you can change how we see this. You can change the way you respond the next time you hear a “joke” about domestic violence. You can decide that enough is enough, and that your daughters will never have to deal with the insult to their bodies and psyches of abuse that is forced upon them in small country towns. My goal is to never have to refer a patient ever again to social services in abusive homes. Please make that a reality.
*names and details have been changed
If you are experiencing any issues to do with sexual assault or family violence, contact 1800 RESPECT, crisis line is open 24 hours a day, 7 days a week: 1800 737 732