In this first of a four-part series, psychiatrist Frank Gitau Njenga and lawyer Paul M. Mwangi discuss the salient features of the Battered wife Syndrome in relation to the Lorena Bobbitt trial in the United States.

As to those women on whose part ye fear disloyalty and ill-conduct, admonish them first, next refuse to share their beds, and last beat them lightly.” Sura- Tunisaa, The Holy Quran

The recent case in America in which a woman was charged with the assault of her husband when she cut off his penis has caused a great deal of interest the world over and has caused much debate in many countries regarding the circumstances under which the law and medicine influence one another. It is with this background that we decided to take a critical look at the relationship between legal issues and those in psychiatry. In preparing this series of articles, we recognise that at the end of the day more questions will arise than answers provided but we are nonetheless of the view that there is need to discuss these issues at this point.

In the Bobbitt case, the prosecution argued quite convincingly that under no circumstance may any member of society take the law into their own hands in judgement of a situation. It was argued in this case that in spite of the extreme provocation brought about by a drunk husband, who often assaulted and raped his wife, life in a civilised society does not allow the victim to retaliate other than through the established judicial system and that the only recourse available to the victim of battering is through the court of law.

The defence, on the other hand, argued quite convincingly (at least to the satisfaction of the jury) that the battered wife in this particular case was provoked in a way and degree that entitled her to take measures that are reasonable to maintain and retain some form of normal existence in society. In this case it was argued by the defence that a battered, wife is entitled to take reasonable steps for her own protection against a battering husband. It was argued specifically that in psychiatry there does exist the concept of the chronic stress syndrome of such a nature and severity as to cause the sufferer to experience a state of temporary insanity. It is in this state of temporary  insanity due to a severe hostile environment that a woman is said to take steps for her own protection.

We recognised the dangers that are immediately caused by the verdict particularly because it is now possible that battered wives may use the ruling to protect themselves even if not by cutting off the offending male organ, but certainly by using unreasonable force that may cause grievous bodily harm to the spouse. It is partly with this in mind that this series of articles became necessary to allow further discussion on the issues involved.

It must be stated at the very outset that the defences put forward in the American case – diminished responsibility and an irresistible impulse – are not available in Kenya. Therefore, until the law in this country changes, the battered wife does not legally have any defence available to her other than through the established judicial system. If Bobbitt had been tried in Kenya, she would possibly have befallen to the law in Deuteronomy 25:11 on women who dare hold a man’s private parts. It says: “If two men are fighting and the wife of one of them comes to rescue her husband from his assailant and she reaches out and seizes him by his private parts, you shall cut off her hand. Show her no pity.”

Who, however, is a battered wife? The UN definition of a battering is “Any act of gender-related violence that results in or is likely to result in physical, sexual or psychological harm or suffering to women including threats of such acts, coercion or arbitrary deprivations of liberty, whether occurring in public or private life.” This UN definition is appropriate and encompasses most conceivable instances of wife battering in as far as it includes domestic violence. One is no longer able to argue that violence against women is only in the context of matrimony and therefore not the province of greater society as far as the UN definition goes.

Violence against women is grossly under-reported and the health impact of abuse has not been fully realised. Relying on women to report abuse and violence by themselves grossly under-estimates its incidence the world over. The most common form of abuse is certainly by male partners of the age between 25 and 50 years and certain studies indicate that between 20 per cent and 25 per cent of women are subjected to violence by men  in one form or the other. In this context, harmful culture-bound practices are global and include such practices as genital mutilation, child marriage and in Western societies, cosmetic surgeries designed to make a woman more acceptable in the view of men. In this country we are much more familiar with instances of domestic violence in which women are “disciplined” by their husbands in the “traditional way”.

It must, however, be stated at the onset that the traditional methods of “disciplining” women were clearly defined both in terms of the circumstances under which the “discipline” could take place and also the area of the body that the husband could hit and by using what amount of force. For example, under no circumstances was a husband allowed to use any objects like sticks to hit the wife and under no circumstances was he allowed to hit her head or breasts. The kind of violence that we see these days is gross, severe and often causes bleeding, which was an eventuality clearly and completely prohibited under custom. No husband was allowed cause the shedding of blood by his wife under any circumstances. It is futile therefore for men in this day and age to argue that traditional men are allowed or entitled to exercise physical restraint on their wives.

The right of women to decide with whom and under what circumstances to participate in sexual intercourse has now been recognised as a right to be enjoyed by all women at all times. This fact has found legal backing in the finding in UK that men are now liable to be found guilty of the rape of their wives.

Women aged 14 to 44 suffer more damage to their health on account of rape and domestic violence than they do on account of breast cancer, cancer of the cervix, obstracted labour, heart disease, AIDS, respiratory diseases, motor accidents or war. The loss is great and cannot be ignored by the society. Many women experience many episodes of violence and studies have indicated a relationship between violence and alcohol abuse as well as other drug usage. The effects of sexual abuse in particular are long-term and may manifest themselves many years after the event.

Unwanted pregnancies, chronic pain to the pelvis, genital mutilation and other health hazards are often promoted by the women who are the subject of the violence. Many women suffer the post-traumatic stress disorder syndrome including depression, anxiety, sexual dysfunction, eating disorders etc, as a consequence of violence of the type described as the battered wife syndrome. Some women have committed suicide because of being battered. The marital difficulties that visit couples that have this kind of difficulties are many.

The impact of violence and abuse on health care system is great and those concerned cannot afford to be complacent in the face of a battered wife syndrome. It is clear therefore that the individual, the family, society at large and government has a vested interest in the examination of the health and social consequences of the battered wife syndrome.

Tomorrow, we will examine the common characteristics of the battered wife and circumstances under which she comes to the attention of medical practitioners. We will also look at the contribution, if any, that women make in attracting violent men.