Violence leading cause of death,WHO

Violence is one of the leading causes of death worldwide with every sector of society feeling its effects in some way, the World Health Organisation (WHO) World Report on Violence and Health said.

Released this week, the report said that in 2000, an estimated 1.6 million people worldwide died as a result of self-inflicted, interpersonal or collective violence and most of these deaths occurred in low to middle income countries, with less than 10 percent in high-income countries.

Nearly half were suicides, one third were homicides and about one fifth were war-related, the report said.

The highest rate of homicide in the world was found among males aged 15-29 years and over 60 percent of the suicides occurred among males.

There were also regional differences. In Africa and North America the homicide rate was three times higher than the suicide rate, whereas in Europe and South-East Asia the rate of suicide higher.

Violence imposed a major burden on the health and well-being of populations and exacted a human and economic toll on nations, costing economies billions of US dollars each year in health care, legal costs, absenteeism from work and lost productivity, the report said.

Youth violence was the most visible form of violence and could be caused by witnessing violence in the home, economic crises, poverty, being physically or sexually abused, prolonged exposure to armed conflict, poor supervision at home and peer pressure.

Because of the importance of parental supervision, family structure and economic status in determining the prevalence of youth violence, an increase in violence by young people was likely where families had disintegrated through wars or epidemics or because of rapid social change, researchers found.

This affected about 13 million children worldwide who had lost one or both parents to HIV/AIDS.

The extent of the epidemic meant that many communites could not rely on traditional structures to care for the children, having serious implications for violence among young people.

The report found that in both developing and industrialised countries, physically abusive parents were more likely to be young, single, poor and unemployed and to have less education than their non-abusing counterparts. I

In addition, stress resulting from job changes, loss of income, or health problems could exacerbate the situation.

Partner violence accounted for a significant number of murders of women, the study showed.

Studies from countries including Canada, Israel and South Africa found that 40-70 percent of female murder victims were killed by their husbands and boyfriends. An American study showed that by contrast, only 4 percent of men murdered between 1976 and 1996 were killed by their wives, ex-wives or girlfriends.

Partner violence had many links with HIV/AIDS and in six countries in Africa, fear of ostracism and consequent violence in the home was an important reason for pregnant women refusing to take an HIV/AIDS test, or not returning for their results.

The study also found that women who lived with violent partners had difficulty protecting themselves from pregnancy and sexually transmitted infections through coerced sex which interfered with a woman's ability to use contraceptives.

Violence against the elderly was often considered a private matter, the report said. The most serious forms were rape, assault and, in some cases, being killed after being accused of being a witch by heirs wanting land.

Rape of women and men was often used as a weapon of war, as a form of attack on the enemy, the report said. Forms of sexual violence included forced marriage or cohabitation, which was used to legitimise rape, and the marriage of children, female genital mutilation and forced virginity testing.

A study in South Africa found that one third of rapes had been gang rapes.

For many women, the most common place where sexual coercion took place was at school and research in Africa has highlighted the role of teachers in facilitating or perpetuating sexual coercion in return for good grades.

In some places like Zimbabwe, the custom of "ngozi" meant a girl could be given to a family as compensation for the death of a man caused by a member of the girl's family.

On reaching puberty the girl was expected to have sexual intercourse with the brother or father of the person who died to produce a son to replace the one who died. "Chimutsa Mapfiwa" - wife inheritance, meant when a married woman died, her sister was obliged to replace her in the matrimonial home.

Collective violence such as armed conflict, left millions of people either dead, tortured or raped, the report said.

This type of violence could also lead to famine which could kill millions of people, and the spread of deadly diseases through bombed water sources. It halted immunisation programmes, forcibly closed clinics and drove medical workers out, leaving the population unable to heal injuries or cure illnesses, the report found.

In addition, it could set of a sudden mass movement of people trying to escape the conflict and this would place them in further danger of violence, rape, torture and diseases, the report concluded.