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Reports of domestic violence burn injury cases likely 'tip of the iceberg', researcher says

Reports of domestic violence burn injury cases likely 'tip of the iceberg', researcher says

Roia Atmar will never forget that night — her scars are a quiet reminder.
WARNING: This story contains images that are graphic.
In 1997, as a 21-year-old, her then-husband doused her in turpentine and set her alight while she held their baby.
The mother-of-four suffered second and third-degree burns across 35 per cent of her body.
"Burns are something permanent. I mean, this happened to me 30 years ago, and now, even today, I'm still going through surgeries."
For Ms Atmar, the abuse began after she moved to Australia as a child bride and had her first baby.
If you need help immediately call emergency services on triple-0
Isolated from her Afghan family in Pakistan, she said she did not fully comprehend her husband's "controlling" behaviour.
"He didn't let me go to school. He did not let me have any friends," Ms Atmar said.
"He did not let me go anywhere or speak to anybody unless he was there, present with me.
Her husband's constant surveillance made it nearly impossible for Ms Atmar to seek help, even after being set alight.
At the burns unit, he rarely left her side. Ms Atmar said her husband spoke on her behalf, and told the doctors that her scarf had "caught on fire".
"He told me that even if I tell anybody the truth, nobody was going to believe me, because he had rinsed the turpentine bottle clean," she said.
"But my biggest fear during that time was that he would somehow take my kids away from me."
Ms Atmar's former husband was later convicted of a charge of unlawful grievous bodily harm with intent to maim, disfigure or disable over the incident and sentenced to 12 years' jail.
Injuries like Ms Atmar's have now been the subject of a national study led by Monash University.
It found suspected violence accounted for 2.5 per cent of the 6,262 cases of women admitted to eight Australian burn centres between 2009 and 2022.
Lead researcher Yvonne Singer, who analysed the clinical details of women aged 18 years and older in the Burns Registry of Australia and New Zealand (BRANZ), said that number was likely to be an underestimation because women often do not report the violence.
"The reasons why they don't disclose it are fear of retaliation, fear of consequences to family, finances or to housing and children, shame, and also negative responses from clinicians," she said.
"Or, they might not know what services and what rights they might have."
Reports of women being set on fire have made headlines in recent years.
Rowan Baxter murdered Brisbane mum Hannah Clarke and their three children in 2020, and earlier this year cases of fire in domestic violence-related incidents made the news in Brisbane and Adelaide.
Ms Singer said the Clarke family's tragedy was "one of the impetuses" behind the research.
Of the cases linked to suspected violence in Ms Singer's study, almost half involved perpetrators who were current or former intimate partners.
Her report also found women with burns from suspected violence were more socio-economically disadvantaged, lived in remote areas and had more mental health and substance issues than women with accidental burns.
"A greater proportion of them died, which most likely reflects the greater severity of injury they had," Ms Singer said.
University of Melbourne law professor Heather Douglas has studied the use of fire in domestic violence.
Dr Douglas said while there was limited data available on the issue, she suspected these incidents were "reasonably common".
"Things like lighters and accelerants like petrol — they're things we find around the house, or they're very easy to get access to," Dr Douglas said.
Dr Douglas, who was a co-author of the BRANZ research, said fire was "a lot easier to claim as an accident" compared to other forms of domestic violence, particularly when perpetrators accompany victims to hospitals.
"It's the abusive partner that actually gives the story of what happened behind the injury. And that could be claimed as an accident in that context," she said.
Help arrived for Ms Atmar after a social worker told her husband to leave the hospital room.
"I had been living in Australia for nearly six years, and that was the first time that somebody had asked me if I was OK and if I needed help," Ms Atmar said.
Ms Atmar believes cultural and religious ignorance may have stopped others from reaching out sooner.
"It was the way that I appeared to them. Like, a Muslim woman coming from a different country, because I used to wear the long dresses and the scarf, and my English wasn't really well," she said.
"Everybody was too scared to ask the question.
"And I think maybe it was out of fear that they didn't want to offend my culture, they didn't want to offend my religion, they didn't want to come across as racist.
"But if somebody had asked me about what was happening to me and explained there was help available, me and my children probably wouldn't have had to go through what we went through."
Dr Douglas said women from culturally diverse backgrounds often faced additional barriers to getting help, such as language barriers, insecure visa concerns and financial dependence on their abuser.
"In some cases, [they] may not be aware of the legal rights or may feel ashamed about speaking up," Dr Douglas said.
Ms Singer said burn centres should "build capacity" to recognise and respond to domestic violence in "culturally appropriate and trauma informed ways".
"Part of that is also developing screening tools, and data like this study can help us build evidence about the types of characteristics of [women at risk]," she said.
All Australian public hospitals stated they have processes in place to screen and respond to domestic violence patients.
But the health departments in Queensland, Western Australia and Tasmania responded that their burns clinicians are trained to identify non-accidental burns.
"All burns clinicians are trained in how to identify patterns of burn, and any other factors such as delayed presentation and changes to description of the circumstances as to how the injury was sustained," a Tasmanian health department spokesperson said.
The South Australian health department said it was "mandatory" for staff to respond to patients they suspected were experiencing violence, while a Victorian health spokesperson said "evidence-based risk factors and screening tools" were used to assess risk.
In the Northern Territory, a spokesperson said staff who care for patients with burns provide "trauma informed care", while a New South Wales spokesperson said its staff were trained to "identify possible indicators" of family and domestic violence and "take action to intervene early."
To Ms Atmar, identifying domestic violence is everyone's responsibility.
She said cultural or religious differences should not stop anyone from reaching out.
Mr Atmar wants victims of family and domestic violence to know "there is light at the end of the tunnel".
"Me and my children — we went through what we went through, and I am sitting here today talking about our experience because of the help and the support we got," she said.
"And you can be in the same place."

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