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Forms and perceptions of domestic violence in Ulaanbaatar, Mongolia

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Forms and perceptions of domestic violence in Ulaanbaatar, Mongolia
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Sweeting, Jennifer
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English
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x, 171 leaves : ; 28 cm

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Family violence -- Mongolia -- Ulaanbaatar ( lcsh )
Family violence ( fast )
Mongolia -- Ulaanbaatar ( fast )
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bibliography ( marcgt )
theses ( marcgt )
non-fiction ( marcgt )

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Bibliography:
Includes bibliographical references (leaves 157-171).
General Note:
Department of Anthropology
Statement of Responsibility:
by Jennifer Sweeting.

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|University of Colorado Denver
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|Auraria Library
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ocn182519477
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Full Text
FORMS AND PERCEPTIONS OF DOMESTIC VIOLENCE
IN ULAANBAATAR, MONGOLIA
A thesis submitted to the
University of Colorado at Denver and Health Sciences Center
in partial fulfillment
of the requirements for the degree of
Master of Arts
Department of Anthropology
by
Jennifer Sweeting
B.S., University of Michigan, 1994
2007


This thesis for the Master of Arts
degree by
Jennifer Sweeting
has been approved
5- J
OUr-e.
o~^-
Date


Sweeting, Jennifer (M.A., Anthropology)
Forms and Perceptions of Domestic Violence in Ulaanbaatar, Mongolia
Thesis directed by Professor Craig R. Janes
ABSTRACT
Domestic violence in Mongolia represents a significant health and human
rights issue. Utilizing open-ended, qualitative questions, I explore the forms
and perceptions of domestic violence in Ulaanbaatar, Mongolia, as well as the
personal experiences of Mongolian women who have identified themselves as
victims of domestic violence. Social support networks, negative effects on
health and well-being and help-seeking behaviors are also examined, in
addition to the response to cases of domestic violence by health care providers
and civil society. Recognizing how domestic violence is perceived in
Mongolia, and how it affects Mongolian women, may contribute to the
development of effective prevention and intervention strategies, for victims
and perpetrators, and individual and community level social change.
This abstract accurately represents the conte ^
recommend its publication.
Signed


DEDICATION PAGE
I dedicate this thesis to the courageous survivors of domestic violence in
Mongolia. It is my hope that this work gives them continued strength in
knowing that their stories will be heard. I also dedicate this work to my
husband for all of his love and support throughout this endeavor.


ACKNOWLEDGMENT
My thanks to my advisor, Craig R. Janes, for the opportunity to work with
him in Mongolia and his assistance throughout the writing process. I would
also like to thank Dr. Scandlyn and Dr. Erzinger for their helpful suggestions
and insights. Support for this work was provided by the CAGSR Program,
The Graduate School, University of Colorado at Denver and Health Sciences
Center.


TABLE OF CONTENTS
CHAPTER
1. INTRODUCTION.................................................1
Defining Domestic Violence...............................1
Magnitude of Violence Against Women......................2
Potential Factors Contributing to Domestic Violence......5
Gender Roles, Cultural Norms and the Secrecy Surrounding
Domestic Violence........................................6
Negative Effects of Domestic Violence on Womens Health and
Well-being...............................................8
Non-governmental Organization Participation and Involvement.10
Anthropological Perspectives on Domestic Violence.......10
The Nature of Domestic Violence in Mongolia.............12
2. BACKGROUND..................................................15
Demographic and Historical Characteristics of Mongolia..15
The Transition to a Democratic Society and Market Economy...16
Mongolia in the New Millennium..........................18
Gender Roles and Traditional Values.....................20
Domestic Violence in Mongolia...........................22
Womens Organizations and the Role of Civil Society.....24
vi


Governmental Support for the Elimination of Violence Against
Women......................................................26
Summary....................................................29
3. METHODOLOGY...................................................30
Research Design............................................31
Data Collection Methods....................................32
Research Phases and Sample Populations.....................33
Data Analysis..............................................38
Applied Anthropology.......................................38
Researcher Bias and the Role of the Translator.............39
4. FORMS, PERCEPTIONS AND POTENTIAL FACTORS
CONTRIBUTING TO DOMESTIC VIOLENCE IN MONGOLIA..............41
Defining Domestic Violence.................................41
Forms of Domestic Violence.................................45
Potential Factors Contributing to Domestic Violence........53
Poverty and Socio-economic Conditions and Inequalities
Resulting from the Transition to a Democratic Society.55
Alcohol Use and Abuse.................................61
Unemployment, Lack of Male Education and Female
Empowerment...........................................63
The Influence of Traditional Values and Personal Attitudes ...67
Jealousy and Family Disputes..........................74
Being Exposed to Violence as a Child..................77
vii


5. NEGATIVE EFFECTS OF DOMESTIC VIOLENCE AND THE
ROLE OF HEALTH CARE PROVIDERS IN ADDRESSING AND
TREATING VICTIMS OF DOMESTIC VIOLENCE IN
MONGOLIA...................................................78
Negative Effects of Domestic Violence on Womens Health and
Well-being..............................................79
Negative Effects of Domestic Violence on Children.......86
Health Care Seeking Behaviors...........................89
Those Who Sought Care.................................89
Those Who Did Not Seek Care...........................91
Addressing Domestic Violence in the Health Care System..93
Disclosure and Inquiring About Domestic Violence......94
Domestic Violence Education and Training..............95
The National Trauma Hospital and the World Health
Organization..........................................99
6. SOCIAL SUPPORT, COPING STRATEGIES AND THE ROLE
OF CIVIL SOCIETY AND THE MONGOLIAN GOVERNMENT... 100
Social Support.........................................101
Coping Strategies......................................105
Police Involvement.....................................109
Survivors Reasons for Seeking Help.....................113
The National Center Against Violence...................116
Services Utilized by Survivors.......................120
viii
Shelter House
121


Counseling Services
122
Legal Services....................................122
Improving Services for Victims of Domestic Violence...124
The Role of Mongolian and International Non-govemmental
Organizations.........................................126
Governmental Responsibility for Addressing Domestic Violence.129
Strengthening the Fight Against Domestic Violence.....131
7. CONCLUSIONS..............................................134
Forms and Perceptions of Domestic Violence............134
Negative Effects of Domestic Violence and the Role of Health
Care Providers........................................138
Social Support, Coping Strategies and Social Services.142
The Role of Civil Society.............................144
The National Center Against Violence..................146
The Role of the Mongolian Government..................147
Final Comments........................................150
APPENDIX
A. HUMAN SUBJECTS RESEARCH COMMITTEE AT THE
UNIVERSITY OF COLORADO AT DENVER AND HEALTH
SCIENCES CENTER APPROVAL.................................153
B. KEY INFORMANT INTERVIEW..................................154
C. LIST OF KEY INFORMANT ORGANIZATIONS......................156
IX


D. SURVIVOR INTERVIEW..........................157
BIBLIOGRAPHY.......................................160
x


CHAPTER 1
INTRODUCTION
Defining Domestic Violence
Violence against women is a not only a violation of human rights, it is
increasingly recognized as a serious public health issue that negatively affects
womens physical health and well-being (Balci and Ayranci 2005; Bhatt 1998;
Ellsberg 2006; Faramarzi, Esmailzadeh and Mosavi 2005; Fikree and Bhatti
1999; Fischbach and Herbert 1997; Gage 2005; Hindin and Adair 2002; Hou,
Wang and Chung 2005; Jewkes, Levin and Penn-Kekana 2002; Krantz et al.
2005; Moore and Wesa 1997; Tinker 2000; Usdin et al. 2005; Walker 1999).
According to the 1993 United Nations (UN) General Assembly Declaration on
the Elimination of Violence Against Women, violence against women is
defined as ... any act of gender-based 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 deprivation of liberty,
whether occurring in public or private life (UN 1993:2). Such violence
against women includes physical, sexual, economic and psychological
violence and occurs in the family, within the general community and is often
perpetuated or ignored by the State (Bhatt 1998; Eisikovits, Winstok and
Fishman 2004; Moore and Wesa 1997; Xu et al. 2005).
While violence against women exists in many forms, there is also an
excess of terms that are utilized when studying such violence. A substantial
body of literature describes the variation in definition and measurement
issues. Often referred to as spouse abuse, gender-based violence,
1


battering, intimate partner violence and domestic violence, such abuses
typically take place in privacy and are perpetrated by spouses or intimate
partners. In addition to range of terminology utilized when studying such
violence, there is considerable disagreement as to what constitutes violent
behaviors other than extreme forms of physical violence. Narrow definitions
focus solely on physical aspects, while broader definitions include emotional,
psychological and sexual violence in addition to physical violence. Some view
psychological abuse as a warning sign rather than an exclusive type of abuse
in and of itself.
While men, children and the elderly are often victims of domestic
violence, numerous researchers have demonstrated that women are more
likely, in their lifetime, to be victims of spouse abuse and to sustain more
serious injuries than men who are attacked by their partner (Acosta 2002;
Bhatt 1998; Cascardi, Langhinrichsen and Vivian 1992; Diop-Sidibe,
Campbell and Becker 2006; Faramarzi, Esmailzadeh and Mosavi 2005; Glantz
and Halperin 1996; Johnson and Sigler 2000; Krantz et al. 2005). For the
purpose of this study, an investigation of violence against women in
Mongolia, domestic violence is defined according to the UN definition of
violence against women.
Magnitude of Violence Against Women
Domestic violence is pervasive and cuts across lines of culture,
education, religion and socioeconomic status (Balci and Ayranci 2005; Bhatt
1998; Krantz et al. 2005; Moore and Wesa 1997; McCoy 1995; Naved et al.
2006; Panda and Agarwal 2005; Radford and Tsutsumi 2004; United Nations
1993; Xu et al. 2005). According to the World Health Organization (WHO)
Multi-Country Study on Womens Health and Domestic Violence Against
Women (2005:1), a review of studies from 35 countries prior to 1999
2


indicated that between 10 and 52 percent of the worlds women have been
physically assaulted by an intimate partner in their lifetime and between 10
and 30 percent reported that they had experienced sexual violence by an
intimate partner. Manifested in unequal power relations between men and
women, domestic violence leads to discrimination and domination of women,
and is a social subordinating mechanism that creates a barrier to the
achievement of peace, development and equality.
A wide range of research on domestic violence reveals that it is
prevalent worldwide, in both developed and developing countries (WHO
2005). In 48 population-based surveys from around the world, 10 to 69
percent of women reported being physically assaulted by their intimate male
partners in their lifetime (Heise, Ellsberg and Gottemoeller 1999:37).
Population based surveys suggest that between 21 and 30 percent of American
women will be beaten by a partner at least once in their lifetime (Koss
1990:377) and up to 35 percent of women presenting in the emergency
department have experienced domestic violence (Abbott et al. 1995:1764).
One in four women in the UK report having experienced domestic violence
from a male partner at some time in their adult lives and as many as one in ten
will have experienced violence in the past 12 months (Radford and Tsutsumi
2004:1).
In a study of domestic violence among women in three provinces of
South Africa, Jewkes, Levin and Penn-Kekana (2002:1607) found that in the
past 12 months, the prevalence of domestic violence was 9.5 percent, while
the lifetime prevalence was 24.6 percent. In one province, 28.4 percent of
women reported ever being physically abused and over 50 percent of women
reported emotional abuse in the previous year (Jewkes, Levin and Penn-
Kekana 2002:1607). Diop-Sidibe, Campbell and Becker (2006:1263) reported
that 34 percent of women in their Egyptian sample had been victims of
3


domestic violence in their lifetime and 16 percent were beaten in the last 12
months. In a study of domestic violence among Iranian women, Faramarzi,
Esmailzadeh and Mosavi (2005:227) found that the prevalence rates of
physical, psychological and sexual abusive experiences were 14.8 percent,
80.6 percent ad 43.6 percent respectively. According to the 2001-2002 Israeli
National Survey of Family Violence, 13 percent of women were exposed to
some form of lifetime physical violence, and 6 percent experienced physical
violence in the previous 12 months (Eisikovits, Winstok and Fishman
2004:739). The majority of the sample had also been exposed to emotional
abuse such as shouting, screaming, cursing, humiliation and threats, while
more than 56 percent reported experiencing controlling behaviors (Eisikovits,
Winstok and Fishman 2004:740).
In China, Xu and colleagues (2005:78) reported that of the 600 women
interviewed, the prevalence of lifetime intimate partner violence was 43
percent and violence within the last 12 months was 26 percent. Krantz and
colleagues (2005:1049) claimed that projects carried out by Vietnamese
womens organizations found that wife beating and other forms of intimate
partner violence are widespread, especially in rural areas, and estimated that
30-60 percent of divorce cases were the result of maltreatment of women. A
1997 study by the Tokyo Metropolitan Government found that among a
random sample of 1553 female adult Tokyo residents, approximately 33
percent of women had experienced some form of physical violence during
their lifetime (Yoshihama 2005:1238), while Kozus (1999:51) study of
domestic violence in Japan reported that 77 percent of respondents
experienced at least one type of physical, emotional or sexual abuse and more
than half experienced all three forms of violence. According to Doe (2000:
234), a 1997 national survey of married people provided empirical evidence
that the overall rate of domestic violence in Korea is 31.4 percent, with 3 out
4


of ten couples experiencing some form of domestic violence in the last 12
months.
In Uttar Pradesh and Tamil Nadu, 40 percent of women reported being
beaten by their husbands (Jejeebhoy and Cook 1997:S10). Naved and
colleagues (2006:2927) reports that the prevalence of lifetime physical
spousal violence among women in Bangladesh was approximately 40 percent
for lifetime experience and slightly less than 20 percent for the past 12
months. According to a study of intimate partner violence in the Philippines,
Hindin and Adair (2002:1387) state that more than one in ten married women
report physical abuse by their spouse.
Potential Factors Contributing to Domestic Violence
Numerous researchers claim that all societies have forms of violence
that are socially proscribed and/or socially tolerated through social customs
and norms (Bhatt 1998; Eisikovits, Winstok and Fishman 2004; Jewkes, Levin
and Penn-Kekana 2002; Johnson and Sigler 2000) and various studies have
been conducted to determine the widespread factors that contribute to
domestic violence. Poverty, unemployment, and educational status have been
associated with domestic violence in various countries (Chowdhury et al.
2006; Ellsberg et al. 1999; Faramarzi, Esmailzadeh and Mosavi 2005; Martin
et al. 1999; Xu et al. 2005), as well as infidelity, marital conflict and jealousy
(Bhatt 1998; Eisikovits, Winstok and Fishman 2004; Jewkes, Levin and Pee-
Kekana 2002; Xu et al. 2005). Eisikovits, Winstok and Fishman (2004)
showed that violence occurred more frequently among families with economic
hardships and violent men tend to be younger, with lower levels of education.
Faramarzi, Esmailzadeh and Mosavi (2005) showed that low levels of male
education, low income and unemployment were found to be predictors for
physical abuse among Iranian women. Unemployment and poverty are said to
5


reduce the ability of men to attain certain ideals of successful manhood,
particularly those based on ideas of men as providers for the family. These
variables are seen as indicators of stress in the family, with violence being
seen as a means of coping with stressful events (Gage 2005).
Numerous studies have found that domestic violence is associated with
alcohol abuse (Bhatt 1998; Chowdhury et al. 2006; Coker et al. 2000; Easton,
Swan and Sinha 2000; Fals-Stewart, Golden and Schumacher 2003; Gage
2005; Glantz and Halperin 1996; Hindin and Adair 2002; Jewkes, Levin and
Penn-Kekana 2002; Koenig et al. 2003; OFarrell and Murphy 1995; White
and Chen 2002; Xu et al. 2005). In their study of intimate partner violence in
China, Xu and colleagues (2005) found that domestic violence was associated
with perpetrator alcohol abuse, frequent quarreling, and either partner having
extramarital affairs. In India, incidences of domestic violence are notably
higher in the presence of substance abuse than others (Bhatt 1998; Chowdhury
et al. 2006). Such substance abuse aggravates domestic violence and is the
cause of physical and psychological morbidity, divorce, and even death (Bhatt
1998).
Gender Roles, Cultural Norms and the Secrecy
Surrounding Domestic Violence
Research suggests that the high prevalence of domestic violence in
some societies is related to inequalities between men and women, rigid gender
roles and specific cultural norms related to general ideologies of male
dominance or superiority. According to Faramarzi, Esmailzadeh and Mosavi
(2005), the strongest predictor for physical abuse among Iranian women was
womens attitudes of acceptance of male dominance, followed by low levels
of male education, low income and unemployment among men. Their study of
2000 Iranian subjects showed that 37.9 percent of women had a positive
6


attitude to male dominance and were more likely to tolerate any form of
violence from their intimate partner than did the women who had a negative
attitude to male dominance (Faramarzi, Esmailzadeh and Mosavi 2005:229).
Hindin and Adair (2002) found that in the Philippines, the more domains of
decision making men dominate, the more likely they are to dominate their
wives in terms of physical abuse; however, when women dominate decision-
making in the household, they are also more likely to experience intimate
partner violence. Gage (2005) also found that in Haiti, female-dominated
financial decision-making was associated with all forms of domestic violence.
Societies with strong ideologies of male dominance often endorse rigid
gender roles and cultural norms, limiting womens autonomy and access to
political systems, as well as affecting laws and criminal justice systems.
Studies in Iran (Faramarzi, Esmailzadeh and Mosavi 2005), Taiwan (Hou,
Wang and Chung 2005), Korea (Doe 2000), Japan (Yoshihama 2005),
Vietnam (Krantz et al. 2005), Bangladesh (Naved et al. 2006), Palestine (Haj-
Yahia 1998), India (Bhatt 1998) and China (Liu and Chan 1999; Xu et al.
2005) have demonstrated that domestic violence is one form of maintaining
hierarchical order in the family in patriarchal societies with strong traditional
values. Xu et al. (2005) found that in traditional Chinese families, family
structure is hierarchical and the husband is the final authority on numerous
family issues. Chinese women still adhere to the norms of male-dominated
cultures and have a relatively high approval and tolerance for violence as 36
percent of women agreed that if a woman was unfaithful, it was acceptable for
her to be beaten (Xu et al. 2005:82).
Because domestic violence occurs between intimate or familial
relations, it often takes place in secret or behind closed doors. For whatever
reason, it is often considered to be a part of normal life as men lash out at
women they can no longer economically support or control (Jewkes, Levin
7


and Penn-Kekana 2002). In many societies, such as Taiwan (Hou, Wang and
Chung 2005), Japan (Yoshihama 2005), Iran (Faramarzi, Esmailzadeh, and
Mosavi 2005); Bangladesh (Naved et al. 2006), China (Xu et al. 2005) and
Vietnam (Krantz et al. 2005), domestic violence continues to be viewed as a
private issue and is generally concealed, ignored or overlooked. Cases are
often not reported because women may fear further repercussions from
perpetrators, family shame or loss of reputation (Balci and Ayranci 2005;
Chowdhury et al. 2006; Eisikovits, Winstok and Fishman 2004; Ellsberg
2006; Faramarzi, Esmailzadeh and Mosavi 2005; Jewkes, Levin and Penn-
Kekana 2002; Johnson and Sigler 2000; Naved et al. 2006; Xu et al. 2005).
Negative Effects of Domestic Violence on Womens
Health and Well-being
Domestic violence is a significant cause of female morbidity and
mortality worldwide and represents an obstacle to economic and social
development (Diop-Sidibe, Campbell and Becker 2006; Heise 1998; Moore
and Wesa 1997; WHO 2005). Violence has direct consequences on womens
health and also increases womens risk of future ill health (Diop-Sidibe,
Campbell and Becker 2006; Ellsberg 2006). According to the United Nations
Fund for Women (UNIFEM 2004:16), women cannot lend their labor or
creative ideas fully if they are burdened with the physical and psychological
scars of abuse. Although the associations of intimate partner violence and
detrimental health outcomes have been well established in research from
industrialized countries, there are few studies from developing countries.
Domestic violence negatively affects womens physical, sexual and
psychological health and well-being in a variety of ways (Balci and Ayranci
2005; Faramarzi, Esmailzadeh and Mosavi 2005; Fischbach and Herbert 1997;
Glantz and Halperin 1996; Goodkind et al. 2003; Hou, Wang and Chung
8


2005; Jewkes, Levin and Penn-Kekana 2002; Martin et al. 1999; Panda and
Agarwal 2005; Usdin et al. 2005). Physical and mental suffering is associated
with a loss of basic human rights, humiliation and the loss of property items or
access to them (Schraiber and dOliveira 2002). Physical violence may result
in, but is not limited to, bodily injury, disability and complications in
pregnancy, chronic pelvic pain, sexually transmitted diseases, asthma and
headaches (Bhatt 1998; Diop-Sidibe, Campbell and Becker 2006; Ellsberg
2006; Faramarzi, Esmailzadeh and Mosavi 2005). Psychological violence may
also cause long-term consequences such as mental anguish, fear, nervousness,
anxiety, low self-esteem, depression, hopelessness and a sense of isolation
from family, friends and the community (Bhatt 1998; Coker et al. 2000; Diop-
Sidibe, Campbell and Becker 2006; Faramarzi, Esmailzadeh and Mosavi
2005; Glantz and Halperin 1996; Hou, Wang and Chung 2005; Krantz et al.
2005; Moore and Wesa 1997; Xu et al. 2005; Yoshihama 2005). Moreover,
women often lack the self-confidence and economic resources to achieve and
maintain independence.
Only ten years ago, the health needs of abused women were virtually
ignored outside of a few industrialized nations (Ellsberg 2006). Limited
understandings of the linkages between domestic violence and womens
physical and mental health problems have resulted in missed opportunities to
effectively and directly address the issue within existing health and
reproductive health programs. However, the last two decades have been
accompanied by significant progress, albeit not sufficient, in improving
womens access to support and services for violence within the health sector.
Interventions in industrialized countries have focused on health care provider
training and the development and implementation of protocols and tools to
identify and refer victims of domestic violence (Ellsberg 2006; WHO 2005).
Efforts in developing countries have concentrated their efforts on
9


strengthening the overall capacity of the health sector to address violence
against women.
Non-governmental Organization Participation and Involvement
Feminist activism and the development of womens organizations have
played a major role in bringing violence against women to the foreground of
debates about crime and human rights. In the United States (Johnson and
Sigler 2000), Japan (Radford and Tsutsumi 2004: Yoshihama 2005),
Kazakhstan (Snajdr 2005) and various other countries, womens groups have
been instrumental in developing and lobbying for policies and laws on gender
equality in the family and criminal coding of domestic violence. Additionally,
womens groups have raised public awareness of the issue of domestic
violence and, as a result, decreased public tolerance for acts of violence
(Hester 2004; Johnson and Sigler 2000). Furthermore, services such as shelter
houses, psychological counseling, legal aid and training of police and health
care workers on the issue of domestic violence have often been organized or
provided by womens organizations (Gage 2005).
Anthropological Perspectives on Domestic Violence
Historically, theories of domestic violence were based on the premise
that such abuse was a family or private matter that was a consequence of
mental illness, alcohol abuse, or poor impulse control (Amoakohene 2004).
Current theories, however, reflect the understanding that the purpose of
violence is the establishment of power and control over another through
different forms of abusive, coercive, and threatening behaviors (Gage 2005;
Home 1999; Moore 1994; Moore and Wesa 1997; Wood and Jewkes 1997;
Yoshihama 2005).
10


The feminist anthropologist Henrietta Moore (1994) argued that
experiences of male identity are bound up with experiences of power.
Challenges to the exercise of mens power are perceived as threat to
masculine identity. According to Moore, domestic violence occurs when male
self-representations and social evaluations are threatened by the behaviors of
others (their female partner), although the threat is often perceived and not
real. Despite this understanding, the characterization of domestic violence as a
private aberration together with other causes and complicating factors, such
as traditional gender roles, economic hardship and some religious practices -
continue to impede efforts to protect women and hold batterers accountable.
Generally viewed as evolving from the subordinate position of women
in society, domestic violence typically occurs in intimate situations, continues
to be handled internally within the family and is still kept largely private
(Faramarzi, Esmailzadeh and Mosavi 2005; Hou, Wang and Chung 2005;
Krantz et al. 2005; Naved et al. 2006; Pande 2002; Xu et al. 2005; Yoshihama
2005). Moreover, until recently, domestic abuse was seen as outside the
purview of state responsibility (Moore 1994; Soros 2006). Over time,
however, the notion of state responsibility under international law has been
expanded in a number of ways. Scholars, advocates and practitioners now
recognize that human rights law does, in fact, apply to private conduct such
as domestic violence.
In understanding the origins of physical and sexual intimate partner
violence, the ecological framework proposed by Heise (1998) has received
attention and been utilized by numerous researchers to examine factors
contributing to domestic violence. Heise proposes that abuse results from the
interplay of personal, situational and socio-cultural factors at various levels in
the social environment. At the individual level, factors include being abused
as a child or witnessing marital violence in the home or having an absent or
11


rejecting father. At the level of the family or marital relationship, factors
include alcohol use, male control of wealth and decision-making in the family
and marital conflict. At the community level, factors include poverty and
unemployment, social isolation of the woman and male participation in
delinquent peer associations. At the societal level, factors include male
ownership of women, ideas of masculinity linked to aggression and
dominance, rigid gender roles and acceptance of interpersonal violence.
Crowell and Burgess (1996) have also shown that domestic violence between
intimate partners is the result of multiple interacting contextual, social,
biological, psychological and personality factors that exert their influence at
different times and different situations.
The Nature of Domestic Violence in Mongolia
It is increasingly recognized that domestic violence in Mongolia
represents a significant health and human rights issue for women (CHRD et
al. 2002; Soros 2006; NCAV 2002). In a 2003 report on the Integration of the
Human Rights of Women and the Gender Perspective, the UN Special
Rapporteur on Violence Against Women stated that domestic violence is an
issue of particular concern in Mongolia. The 2003 U. S. State Department
Country Report on Human Rights Practices in Mongolia (U.S. State
Department 2002:18) stated that, approximately 98.5 percent of those who
committed violent crimes in the home were male, and women were
disproportionately the victims of these crimes. Further, in recent years,
domestic abuse appeared to be more violent; different statistical sources stated
that between 10 and 24 percent of murders occurred in the home (U.S. State
Department 2002:18). In 1998, murders of women were 8 percent of all
murder cases; in 2001, the number had doubled to 17 percent (U.S. State
Department 2002:18). Domestic violence is illegal in Mongolia, but a lack of
12


deterrence, inadequate victim protection and poor enforcement of legislation
that protect women from spousal rape remain obstacles and future challenges
for both the health care system and non-govemmental organizations
organizing treatment and interventions for victims of domestic violence.
Although cases of domestic violence have been reported in Mongolia,
the full scope of these abuses has not been well documented. Domestic
violence is often considered a family issue, goes unreported in many cases and
there is no unified method of gathering data on reported or unreported cases in
Mongolia (UNFPA 2003). Non-government organizations have provided
valuable insight into to the characteristics of victims and offenders, causes of
abuse and the extent of gender-based violence in Mongolia; however, much of
this research lacks quality theoretical and methodological tools and is mainly
quantitative in nature (Chuluunbaatar 2002). Studies investigating womens
individual perceptions of domestic violence, and their interaction with and
response to social services and health care providers, are lacking and have
received minimal systematic research attention. Furthermore, an investigation
of the literature on domestic violence in Mongolia showed a lack of
quantitative and qualitative scholarly literature on the subject. This relative
scarcity of research on domestic violence and interventions within Mongolia
has made it difficult to effectively explore strategies toward social change at
the individual and community level.
This thesis describes the current forms and perceptions of domestic
violence in Mongolia and elucidates the available social services for victims
of domestic violence, as well as the response of health care providers to cases
of domestic violence. Womens personal experiences with violence were
utilized to understand these subjects, as well as key informants, with
specialized knowledge of domestic violence in Mongolia, including
representatives from national and international non-govemmental
13


organizations (NGOs), doctors and a government representative. This
examination was motivated by several discussions with representatives from
NGOs working in Mongolia, in the summer of 2004, who believed that
domestic violence in Mongolia demanded systematic research. It is my hope
that this information provides a greater understanding of domestic violence in
Mongolia that will not only inform health care and social service intervention
strategies, but also increase public, parliamentary and international awareness
of the severity of the issue.
In the following chapters, I present the results of this research. In
Chapter 2,1 describe the social, economic and cultural factors that
characterize Mongolia and place domestic violence within that context. In
Chapter 3,1 describe the research methods employed, as well the sample
populations. In Chapter 4,1 present the research findings on the forms and
perceptions of domestic violence in Mongolia and also briefly discuss the
potential factors that contribute to it. The negative effect of domestic violence
on womens health and well-being are discussed in Chapter 5, as well as
womens experiences with the health care system and key informants
comments. Social support, coping mechanisms and available social services,
in addition to the role of civil society and the government, are discussed in
Chapter 6. In Chapter 7,1 state my conclusions, policy implications, as well as
challenges during this study and future research possibilities.
14


CHAPTER 2
BACKGROUND
Demographic and Historical Characteristics of Mongolia
Mongolia is a landlocked country in central Asia, situated south of
Russia and surrounded by the Peoples Republic of China to the east, west and
south. Mongolia is the fifth largest country in Asia, with a land area of 1.6
million square kilometers. The population is 2.4 million, with one of the
lowest population densities in the world. Mongolia is divided into 21 aimags,
or provinces, and the capital city, Ulaanbaatar. The capital city and these
aimags are further divided into soums (rural districts), khoroos (urban sub-
districts) and baghs (rural sub-districts). Over 50 percent of Mongolias
citizens live in urban areas, with approximately 32.5 percent of the population
living in Ulaanbaatar (UNIFEM 2004:4). With the exception of significant
population densities in urban centers such as Darhan and Erdenet, the
remainder of the population live in rural areas, which are remote and difficult
to access (Kohrt et al. 2004).
Mongolias people are ethnically homogeneous, with approximately
90 percent of the population speaking one of several dialects of the Mongol
language. The Khalka Mongols, renowned for being the most thoroughly
pastoral and nomadic of all the Mongol tribes, make up approximately 85
percent of the population. Mongolias largest minority (7 percent) are the
Kazah people of the Altai, a pastoral, Turkic-speaking and traditionally
Muslim people who live in far western Mongolia. Tungusic-speaking hunters
15


and reindeer herders in the northeast (4.6 percent), as well as a small number
of Chinese and Russians (3.4 percent), make up the rest of the population.
The Mongol empire, which was founded by Chinggis Khan, collapsed
in 1621 and until independence in 1921, Mongolia was a feudal theocracy
under the indirect rule of Chinas Qing (Manchu) dynasty (Nixson and
Walters 2006). Facing annexation by the Chinese Republican government,
Mongolia turned to the Russians for assistance in establishing an independent
state. However, true independence was short-lived; in 1924, the Soviets
exercised political hegemony over Mongolia, initiating political and economic
reforms that resulted in a Soviet-style, centrally planned economy and the
supplanting of feudal political forms and ideologies by a socialist form of
government.
From 1960 to 1990, life expectancy and literacy rates rose and women
entered the formal labor force. Health care and social services were
guaranteed; however, traditional and religious healers suffered extreme
persecution and death during this period (Janes and Chuluundoij 2004). By
the late 1980s, Mongolias strategy of heavy industrialization had been
realized and reform was inevitable. Popular demonstrations in Ulaanbaatar in
March of 1990 led to multi-party elections and the formation of a coalition
government that was committed to transforming Mongolia into a market
economy and a pluralistic society with new political and administrative
structures. A new constitution was signed in 1992, guaranteeing the economic,
social, cultural and political rights of all citizens.
The Transition to a Democratic Society and Market Economy
In 1990, Mongolia began a process of radical liberal economic reform
from a Socialist system of central planning to a democratic, free-market
economy (Janes and Chuluundoij 2004; Janes et al. 2006; Nixson and Walters
16


2006). The wholesale and rapid reduction of state ownership in Mongolia was
regarded as the essential condition for the transition to a market economy and
the shock therapy approach was favored in order to destroy old and
construct new institutions as quickly as possible (Griffin et al. 2001; Janes and
Chuluundoij 2004; Nixson and Walters 2006). State-owned enterprises were
privatized, prices liberalized and restrictions on international trade and foreign
investment were lifted, with the intention to create a pluralistic, capitalist
market economy.
Prior to the transition, although Mongolia was a relatively poor
country in terms of GDP, the State ensured a level of equality in living
standards through full and stable employment, the subsidizing of basic
necessities and an extensive system of social services including health and
education that were free at the point of delivery (Janes and Chuluundorj 2004;
Janes et al. 2006; Nixson and Walters 2006). Inequality was, by western
standards, low and poverty largely absent. These social and health institutions
in Mongolia were heavily dependent on financing from the Soviet Union.
With independence and the disintegration of the Soviet Union, Russian aid
and subsidies were halted. Under such conditions, the Mongolian central
government came under severe economic and political pressure to undertake
rapid macroeconomic reforms.
Initially, the economic reforms of the transition were applauded, with
expectations of an accelerated rate of growth of output and a substantial
improvement in the standard of living of the population (Griffin et al. 2001).
However, the transition to a market economy resulted in widespread social
chaos and economic collapse (Griffin et al. 2001; Janes and Chuluundorj
2004; Janes et al. 2006; Nixson and Walters 2006). The average Mongolian
experienced a decline in the average standard of living and a rise in inequality
in the distribution of income and productive assets. Social services, including
17


health care and education, diminished or disappeared as Mongolians were
deprived of the social security net that had been provided in the past.
Economic reforms resulted in multiple, interlocking forms of vulnerability and
insecurity for Mongolians (Janes and Chuluundorj 2004; Nixson and Walters
2006). High rates of inflation and price liberalization led to food shortages and
a rapid rise in the price of necessities, including basic utilities such as heating,
water and electricity. Arising from decreased employment opportunities,
economic insecurity was exacerbated by social insecurity, resulting from a
weakening of kinship networks and physical insecurities such as alcohol
abuse, domestic violence and marital breakdown (ADB and WB 2005; GOM
and WB 2001).
Another result of the transition to a market economy in Mongolia has
been the introduction of foreign aid and international NGOs and donor
agencies into the social and political context (Rossabi 2005). While some
international organizations have financially and technically contributed to
improving conditions in Mongolia, stabilization and structural adjustment
policies, which were not necessarily in the interest of the majority of
Mongolians, were mandated by the World Bank (WB) and the International
Monetary Fund (IMF). These structural adjustment programs appear to have
contributed to poor access by average Mongolians to essential institutions,
weak governance and increasing corruption. Moreover, a lack of transparency,
as well as other external factors, played a role in determining the nature and
characteristics of the post-1990 transition in Mongolia (Nixson and Walters
2006).
Mongolia in the New Millennium
In 2004, more than 10 years after the initiation of the transition, the
Mongolian economy was characterized by heavy concentration on the
18


production and export of a narrow range of commodities and aid dependence
(Nixson and Walters 2006). The transition has also been accompanied by
significant increases in unemployment and inequality in the distribution of
income (Griffin et al. 2001; Janes and Chuluundorj 2004; Janes et al. 2006;
Nixson and Walters 2006). Levels of poverty and inequality rose dramatically
in the early period of the transition and have remained high over the 15 years
of the transition, with over one third of all Mongolians officially living in
poverty and a considerable number living precariously close to it (Janes et al.
2006; Nixson and Walters 2006; UNFPA 2003).
In the past decade, population growth slowed down to an average 1.4
percent from 2.5 percent in the previous ten years (UNFPA 2003:6). The
crude birth rate has fallen sharply, which many women say is due to an
increasing reluctance to add motherhood to an already uncertain future (ADB
and WB 2005). Migration to urban areas has rapidly increased as rural people
abandon herding and seek employment and greater economic security. Zhuds,
or disastrous winter conditions have killed approximately 8.3 million domestic
animals in the 1999-2001 winters, decreasing herd size, a crucial determinant
of rural economic status (UNFPA 2003:6).
Government spending in the education and health sectors has
dramatically decreased over the past decade. Educational achievements
declined considerably during the transition with a narrowing but persistent
reverse gender gap and lower enrollment rates for boys have resulted in
lower educational achievement across all levels of education (ADB and WB
2005). Rates of sexually transmitted diseases have rapidly increased though
to-date, few cases of HIV/A1DS have been officially reported. Management of
health care is inadequate and poor infrastructure and communications, huge
distances and harsh climate remain major challenges to providing health and
human services throughout the vast Mongolian steppe.
19


The impact of the economic transition affected men and women
differently. There is a persistent wage gap across all sectors, inefficiencies in
investments in education and the loss of potential contributions from women
to economic growth. During the transition, the government reduced
employment in the public sector and drove a disproportionate number of
women from the labor force. In contrast to the socialist governments
promotion of full employment for women, current business practices were
discouraged from hiring women because of the legal requirement that
businesses provide maternity benefits (Nixson and Walters 2006). Moreover,
when property was privatized, titles were given to male household members,
further exacerbating gender disparities (Kohrt et al. 2004).
Like employment, womens health has suffered disproportionately as a
result of the economic transition. While child and infant mortality rates have
improved, maternal mortality ratios have remained high (ADB and WB 2005).
Womens overall health has decreased, from high levels of anemia to poor
quality emergency obstetric services, especially in remote rural areas.
Additionally, there have been increases in newly emerging forms of gender
violence in Mongolia, including domestic violence, sexual harassment in the
workplace and trafficking of women.
Gender Roles and Traditional Values
Leading Western scholars agree that Mongolian women traditionally
have had relatively higher social positions and greater autonomy than women
in the Islamic societies of Inner Asia, China or Korea where women are
generally considered subordinate to men and restricted to the domestic sphere
(GOM and the WB 2001). Womens access to education and careers outside
of the home have been compromised over the past decade due to rising levels
of poverty and unemployment; however, in comparison with other nations in
20


central Asia, indicators of education and employment rates of women are
high, especially in comparison with Mongolian men (ADB and WB 2005).
Among the younger generations, girls and women are better educated than
boys and men. Nevertheless, while women have gained prestige in the public
and non-profit sphere, they remain underrepresented in more influential
positions such as management and government (UNFPA 2003). For example,
the proportion of women elected to the national parliament fell from 23
percent in 1990 to 10 percent in 2000 to only 7 percent in 2004, a trend
reflected at all levels of political decision making (UNFPA 2003:4).
In pastoral societies, there is a defined division of labor between men
and women. While much of the Mongolian population has migrated to urban
areas, traditional pastoral customs and values are evident in the expression of
gender roles and traditional values. From a young age, children are trained in
specific skills according to their age and gender. Girls begin to help their
mothers in the household or ger (felt tent or yurt) and are responsible for
preparing dairy products, cooking, making tea, making and repairing clothes,
caring for elderly, children and small animals, washing and cleaning,
undertaking all milking activities, collecting dried dung for fuel and fetching
water (Janes and Chuluundoij 2004; Chuluunbaatar and Urtnasan 2002). Boys
are taught to pasture animals, clean animal shelters and collect firewood, in
addition to carpentry and metal crafting skills. Men also care for the familys
horses, which are a sign of prestige, linked to war and sport.
According to the United Nations Population Fund (UNFPA 2003),
gender inequalities exist in Mongolia, albeit in a different context than other
Asian countries, and these inequalities are not fully acknowledged or
understood. Social values and attitudes from the pre-socialist period persist
and influence the roles of men and women in the new Mongolian society.
Cultural beliefs still support the view that the man is the head of the
21


household, that he makes all family decisions and has the right to govern the
family, by whatever means (Enhjargal 2002). Moreover, research by UNIFEM
Mongolia (2004) has shown that Mongolian traditional proverbs strengthen
gender stereotypes and abuse womens rights. Phrases such as If a husband
does not beat his wife once a month, he is not a man or Womens hair is
long, but their minds are short reinforce discriminative views of women and
endorse the traditional Mongolian view that women are slaves for men and
servants for the home. However, it is unclear, in the modem and rapidly
globalizing context of urban Mongolia, whether these traditions hold much
sway. In this way, family culture, traditions and behaviors have a negative
impact on the relations among family members, especially husband and wife.
At a time of increasing globalization, gender issues are receiving greater
attention in Mongolia; however, in a newly democratic Mongolian society,
there has been little discussion and integration of these issues at a state and
policy level.
Domestic Violence in Mongolia
After many years of social and government denial, there is increasing
public discussion of domestic violence in Mongolia (UNFPA 2003). UNIFEM
(2004) states that gender-based violence is evident in all spheres of social
relations in Mongolia and that it is intensifying. According to studies
conducted in 1996 and 1998 by the National Center Against Violence
(NCAV) and the Population Training and Research Center of the National
University of Mongolia, among 3000-5000 people surveyed from all 21
aimags, one out of every five families in Mongolia reported abusive relations;
one out of every three women reported suffering from at least one type of
violence or pressure and one out of every ten women is regularly beaten by
their spouses (UNFPA and NCAV 2003:4). In 2004, 45.3 percent of surveyed
22


Mongolian women said that their husband was the perpetrator while 15.3
percent said that their in-laws inflicted domestic violence against them (UN
Human Rights and Gender Team 2004:11). Moreover, a study on violence and
its health consequences by the Directorate of Medical Services in 2004
reported that 36 percent of respondents had experienced violence in their
lifetime (UN Human Rights and Gender Team 2004:11).
In Mongolia, domestic violence is increasingly being recognized as a
societal rather than private issue; however, the majority of Mongolians
consider domestic violence to be a part of normal life and relationships and it
is often hidden or considered a family matter (UNIFEM 2004). The police,
courts and hospitals lack standardized reporting systems for domestic violence
and there is a low level of enforcement among police officers to combat
violence against women. Victims of domestic violence are often hesitant to
report cases because of the likely long-term detention of spouses in detention
centers and the resulting loss of household income (U.S. Department of State
2002). This reluctance is exacerbated by the lack of state policy and
institutions to provide shelter for victims; the lack of a strong legal framework
for prosecution; the length of time required to process cases; lenient
sentencing of perpetrators; and the tendency for victims to withdraw claims.
Moreover, it has been said that decision makers, political leaders, state
officials and members of the private sector lack sensitivity, knowledge and
awareness regarding issues of violence against women.
The consequences of domestic violence extend beyond the physical
effects on women and children who are predominantly victims (UNIFEM
2004). While bruises and broken bones are the most visible consequences of
domestic violence, surveys in Mongolia have shown that the emotional or
psychological effects of violence have long-term consequences on health and
well-being including high blood pressure, dizziness, headaches, depression,
23


low self-esteem, fear and anxiety. Economic costs, for women and society,
include lost workdays, health care system resources and lost educational and
professional opportunities. While domestic violence tends to be perceived as
physical and not psychological abuse, sexual abuse within families is severely
underreported and poorly understood in Mongolia.
The increase in domestic violence in Mongolia in the last ten years has
been attributed to social and economic changes resulting in poverty,
unemployment and low wages (UNIFEM 2004). An Analytic Report on
Domestic Violence in Mongolia (Chuluunbaatar 2002) stated that low levels
of education were also associated with domestic violence. However, to date,
there have been no analytical studies to determine the factors associated with
domestic violence. Descriptive data have provided numerous hypotheses on
causal factors, including family history of violence, domestic conflicts,
financial issues and jealousy (CHRD et al. 2002). Alcohol is most frequently
cited as both causing and exacerbating domestic violence in Mongolia and a
study by the NCAV showed that 87 percent of people questioned said that
family disputes most frequently occurred when alcohol was consumed
(CHRD et al. 2002:26). However, there is a need for more scientifically sound
and well-planned studies on causal, or contributory, factors related to
domestic violence in Mongolia.
Womens Organizations and the Role of Civil Society
Since the 1990s, womens NGOs in Mongolia have pioneered the
promotion and awareness of democratic values and human rights through
government advocacy activities, legal reform and other forms of civic
engagement (ADB and WB 2005). Despite limited government support,
womens movements have increasingly brought attention to the nature,
severity and magnitude of violence against women and have played an
24


instrumental role in bringing it to the attention of both the public and the State
(UN 1993). In Mongolia, womens NGOs are the driving force promoting
gender equality and the improvement of the status of women, particularly
gender-based violence, and advocating for change. While some NGOs provide
solely financial and technical support, many play a vital role in formulating,
implementing and providing social services related to domestic violence.
Founded in 1995, the National Center Against Violence (NCAV) is a
national womens NGO that has taken the lead on the issue of domestic
violence in Mongolia. They were the first organization to conduct nationwide
surveys and studies of domestic violence in Mongolia to determine the
magnitude of the problem and define public perceptions and attitudes. It is the
only organization that provides a variety of direct services for victims and
perpetrators of domestic violence in Mongolia, which are available in nine
provinces and two districts of the capital city, Ulaanbaatar. They offer the
only shelter homes for women and children who are victims of domestic
violence, as well as a victim hotline, psychological and legal counseling,
training for male perpetrators and child protection. Additionally, the NCAV
trains police personnel and health care providers and advocates for increased
domestic violence knowledge, education and awareness among the public,
parliamentarians and state officials.
Womens NGOs have also played a crucial role in drafting laws,
which support womens rights and creating political will among politicians,
state officials and civil society. Drawing on the framework established by the
Convention on the Elimination of all Forms and Discrimination Against
Women (CEDAW), to which Mongolia is a party, in 1996 numerous
organizations supported international experts and womens NGOs in drafting
a law on domestic violence. This new law would allow for restraining orders
and compensation for victims, as well as defining the roles and responsibilities
25


of law enforcement and health professionals in addressing the issue. The
NCAV updated a survey on domestic violence in 1999 that was used to
support the legal justification for the legislation and in 2002, numerous
organizations supported the NCAV and Mongolian Women Lawyers
Association (MWLA) to advocate for, and finalize, the draft of the domestic
violence bill in coordination with the parliamentary domestic violence
legislative task force.
Governmental Support for the Elimination
of Violence Against Women
The government of Mongolia has increasingly recognized the
importance of addressing gender issues and inequalities. In 2003, the
government approved the National Program on Gender Equality, which
focuses on five areas including family welfare and development (Open
Society Institute 2006). The National Committee on Gender Equality,
assigned with the task of facilitating the implementation of the Gender
Equality program, as well as the Millennium Development Goals, was not
established until 2005. One of the main goals of this committee is to monitor
and provide guidance to the National Program on the Implementation of the
Domestic Violence Law. Additionally, a UN Gender Team, consisting of
members from international organizations, NGOs and government
representatives, was established in 2003 and is charged with meeting on a
regular basis to discuss the progress and challenges of implementing the new
law.
With support and pressure from civil society organizations, the
Mongolian Parliament unanimously passed the Law on Domestic Violence on
May 13, 2004. The law was to be effective as of January 1, 2005 and
articulates important principles including security for victims in government
26


shelters, programs for prevention behavior change for offenders and
strengthening the stability of family relationships. The law also states that the
State shall provide shelter to victims and promote NGO activities aimed at
preventing and combating domestic violence. According to this law, domestic
violence is defined as any intentional act or failure to act by a person
mentioned in the provision 3 of this Law with respect to another person that
infringes upon the latters human rights and freedom, or any act that causes or
contains a threat to cause harm (Law Against Domestic Violence 2004; 1 -2).
Article 4 of the new law states:
Activities aimed at combating domestic violence shall be based
on the principle of providing security to victims, prevention from
possible violence, taking complete and timely measures against
violence, influencing behavior of offenders and strengthening
stable family relationships.
While the Mongolian Law Against Domestic Violence includes
positive changes in legislation regarding violence and abuse, a number of
weaknesses have been identified. There are concerns that the law does not
clearly ensure the safety of victims and the accountability of offenders.
Restraining orders, as envisaged by this law, must be issued by the decision of
a three-member board of judges, which makes the procedure difficult and time
consuming for victims. The law also places an undue burden on NGOs, as
they are responsible for protecting victims during meetings with their
perpetrators. As a result, the NCAV is working to amend parts of the law to
eliminate such inadequacies and ensure effective protection of the victims,
placing the responsibility of victim protection on the police and other
government agencies.
The new law also proposes that social workers and police can apply
for protection orders for victims, independent of their wishes or requests and
27


without the involvement of advocates who represent victims interests.
Moreover, teachers, medical personnel and social welfare staff are obligated
to inform police of violence or potential violence. Such provisions that
authorize government representatives, medical personnel and others to make
decisions about orders of protection, without the involvement of the victims,
undermines the victims autonomy and decision-making ability. Excluding
women from decisions about how to handle an incident of violence in the
home may also present more danger and retaliation from the victims spouse
or partner.
Mongolia does not have a system of public defenders and the burden
to provide necessary free legal services to the victims of domestic violence
lies entirely on a few NGOs, including the National Center against Violence
(NCAV) and the Mongolian Women Lawyers Association (MWLA).
Members of these organizations advocate for lawyers to provide mandatory
free legal assistance to the poor at least twice a year and the Lawyers Center
for Legal Reform has initiated strategic human rights litigation and advocacy
cases. The Womens Leadership Foundation also represents victims of
domestic violence as a violation of human rights and seeks justice for victims
of domestic violence, sexual harassment and perpetuation of derogatory
images of women in the press.
NGOs are working closely with the government to ensure that the new
legislation is implemented and enforced effectively. The Working Committee
on National Action Plan for the Implementation of the Law Against Domestic
Violence was established in the spring of 2005 to develop a national plan to
prevent and combat domestic violence. Implementation activities and
responsibilities were being developed at the time of this study; however,
despite the official adoption of the new law, it has yet to be implemented
within the government and supported by the state budget. Only time will tell if
28


there is sufficient political will to commit the necessary government funding
and program development for the implementation of the domestic violence
law. However, increased incidence of reporting indicates that more women are
willing to risk public humiliation, loss of reputation and possible further abuse
from their partner and the legal system to acquire protection and redress.
Summary
As public discussion of domestic violence in Mongolia increases,
Mongolia continues to struggle to restore a basic level of social and health
services to its population. Hampering this effort is a lack of community-level
information on health needs, particularly from vulnerable populations such as
women who are, or have been, victims of domestic violence. Investigating
womens individual perceptions of domestic violence in Mongolia, and their
interactions with and response to social services and health care providers will
not only give these women a voice, it will contribute to our understanding of
domestic violence in Mongolia and the need to prevent it. The knowledge and
experiences of NGO representatives, doctors and other Mongolian
professional will also elucidate the issue. The information provided by the
study will thus be of benefit to NGOs targeting domestic violence
interventions and health care providers as they attempt to design an accessible
response to domestic violence.
29


CHAPTER 3
METHODOLOGY
An eight-week study was conducted in Ulaanbaatar, Mongolia during
June and July 2005.1 developed the research questions, data collection
instruments and conducted all interviews, though at times I required the
assistance of a translator. While some quantitative methods were employed, I
utilized predominantly qualitative methods in this study, which was grounded
in ethnographic fieldwork. In this way, structured interviews were
complimented with observations and material documents in order to
systematically describe domestic violence in a Mongolian context.
The data collected consists of interviews with survivors of domestic
violence, as well as key informants such as Mongolian and international NGO
representatives, doctors and government representatives who possess
specialized knowledge of gender issues, and more specifically, domestic
violence in Mongolia. The data were supplemented with documents on gender
issues and domestic violence in Mongolia, provided by key informants and
other sources in Ulaanbaatar, Mongolia. These resources provided prior
statistics on domestic violence in Mongolia and information on relevant
programs addressing gender issues and domestic violence. The research
protocol was reviewed and approved by the Human Subjects Research
Committee at the University of Colorado at Denver and Health Sciences
Center (Appendix A) and funding support for the project was provided by the
Council Awards for Graduate Student Research (CAGSR Program), The
30


Graduate School, University of Colorado at Denver and Health Sciences
Center.
Research Design
While in Mongolia during the summer of 2004,1 had the opportunity
to intern at the United Nations Population Fund (UNFPA), which not only
provided me with an in-depth understanding of high priority health concerns
in Mongolia and the political economy in which those concerns are manifest,
but also afforded me the opportunity to familiarize myself with various NGOs
working in Mongolia. During this time, I began to inquire about topics of
research that were lacking in Mongolia. Domestic violence was a recurring
theme that many people thought needed attention and systematic research.
During the fall of 2004 and spring of 2005,1 conducted a literature
review and the research protocol was developed. The data collection
instruments were also formulated, which consisted of open-ended questions to
be administered to key informants from NGOs and other knowledgeable
individuals, as well as women who self-identified as victims of domestic
violence. Additional semi-structured questions were formulated for women
concerning their personal experiences with domestic violence. Pilot testing of
the basic instrument, to test the translatability and context of questions, as well
as language barriers and possible misunderstandings, was conducted in
October of 2004 with two female Mongolian students at University of
Colorado at Denver. It was also helpful to discuss domestic violence in
Mongolia with these women in order to develop appropriate means of
approaching such sensitive issues with women I would encounter in the field.
Necessary changes were made to the data collection instruments after these
initial pilot interviews.
31


Upon returning to Mongolia in the summer of 2005, contacts that were
established during the summer of 2004 were then utilized to select key
informants and, subsequently, subjects to participate in the second phase of
research. A purposive, snowball sampling technique was utilized to recruit
information rich subjects for both phases of research, which involved
identifying subjects through talking with knowledgeable informants who
recommended other knowledgeable informants until sources converge;
nominations snowballed as inquiry broadened and converged into a small
number of core subjects recommended by a number of different expert
informants (Patton 2002).
Data Collection Methods
Data collection was composed of two overlapping phases, each
employing methods that involved in-depth, semi-structured, ethnographic
interviews in order to understand respondents perceptions, feelings and
knowledge of domestic violence in Mongolia. Rather than a self-administered
survey, qualitative open-ended questions allowed me to probe different issues
and clarify misunderstandings concerning certain questions. It also afforded
women the opportunity to tell their personal experiences with domestic
violence and the investigation to move beyond a view of domestic violence
framed by institutions and international organizations. Interviews were
approximately one hour in length and were conducted in a place chosen by the
participant. With informed consent, interviews in both English and Mongolian
were audio recorded and later transcribed, as well as recorded through note
taking during the interviews. No names were used to ensure anonymity.
The collection and analysis of various documents regarding gender
issues and domestic violence in Mongolia, from national and international
NGOs, provided an excellent background on the issue. The collection of these
32


resources also offered an opportunity to compare interview findings with
national research and documentation of domestic violence in Mongolia. These
resources provided statistics on domestic violence, public perceptions and
relevant programs addressing gender issues and domestic violence in
Mongolia and were utilized in order to triangulate overlapping areas of
investigation, test for consistency and explore different and deeper facets of
the same phenomena (Patton 2002).
Research Phases and Sample Populations
There were two overlapping phases of research in this study, including
key informant interviews and interviews with women who are self-identified
victims of domestic violence. All research took place in the city of
Ulaanbaatar, although many of the organizations represented in the sample
conduct research and advocacy activities on domestic violence in other areas
of Mongolia. Additionally, a portion of the women interviewed lived in urban
and rural areas outside of Ulaanbaatar and were visiting for short- or long-
term assistance. With each phase of research, sample populations varied and
are described below.
The first phase of research involved interviewing key informants who
were considered to have specialized knowledge of, and/or experience with,
gender issues and domestic violence in Mongolia. The semi-structured,
ethnographic interviews followed a general format/outline (Appendix B), with
some variation depending on the particular field of those being interviewed.
This allowed for individual focus and comparability. Interviews were
conducted, for the most part, in private and in a place chosen by the
interviewee. Subject selection was based on a review of national and
international NGOs working on gender issues and domestic violence in
33


Mongolia, as well as referrals by contacts made in the summer of 2004 and
those made by interviewed subjects.
Many of the questions asked of key informants were framed as a query
regarding opinion of norms without reference to personal experience. This
allowed participants to answer without feeling as if they were representing
their organization and avoid the feeling that there were right and wrong
answers. Participants were first asked to describe, in their opinion, the forms
of domestic violence in Mongolia, contributing factors, the role of traditional
beliefs and gender roles and negative effects on health and well-being. Social
services and the role of NGOs, the health care system and the government
were then discussed. Lastly, participants were asked their opinion of the
publics perception and awareness of domestic violence and any
recommendations they had to increase awareness of the issue.
Nineteen key informant interviews were conducted. Of the 19 key
informants that were interviewed, the majority were representatives from
NGOs (14 or 74 percent). While a number of the key informants were doctors,
three of the nineteen key informants (16 percent) were currently employed as
doctors, one involved in public health, one in maternal and child health and
one clinical psychologist. One key informant was a government representative
and one was a representative from the Mongolian National University. Of
these 19 key informants, the majority were women (15 or 79 percent). All of
these women were Mongolian. Of the four men (11 percent), three of them
were Mongolian and one was an American. Twelve interviews (63 percent)
were conducted in English, while seven interviews (37 percent) were
conducted in Mongolian with the aid or assistance of a translator. Appendix C
lists the organization with which each key informant is affiliated.
The second phase of research involved interviewing women who
identified themselves as victims of domestic violence and were actively
34


seeking assistance in Ulaanbaatar through treatment, counseling and/or care.
Semi-structured, ethnographic interviews followed the same general
format/outline as key informants. Additionally, women were asked to talk
about their personal experiences with domestic violence and the
assistance/support they received from organizations, family and friends (See
Appendix D). The interview was designed to probe womens individual
perceptions of domestic violence in Mongolia, and their interaction with and
response to social services and health care providers. More importantly,
women were able to voice their personal experiences with domestic violence
and situations related to domestic violence in order to provide an
understanding of Mongolian-specific cases.
For this second phase of research, representatives from the National
Center Against Violence (NCAV) and Gender Equity Center (GEC)
facilitated contact with women who identified themselves as victims of
domestic violence and are voluntarily seeking treatment, counseling and/or
care. This was an important factor in subject selection as I did not want to
jeopardize the safety of women who had not already come forward seeking
assistance. Representatives from these organizations contacted women and
generally informed them of the study. The NCAV called numerous women
and, if they were willing to participate, they were told to come to the NCAV
on one of two days at which time they were further informed of study, their
eligibility was assessed, and informed consent was received. Eleven such
interviews were completed, all with the assistance of a translator. Interviews
were conducted in a private counseling room at the NCAV. A representative
from the GEC organized one interview and after the woman expressed
interest, she then called my translator and set up an appointment in a meeting
place of her choice. This interview was conducted at a marketplace where the
woman worked.
35


With the use of a translator, I completed 12 such interviews 11 with
victims or survivors of domestic violence and one with a survivors mother,
who discussed her daughters experiences with domestic violence. Interviews
were completely confidential with no indication of identity and, as mentioned
above, interviews were conducted in a private counseling room or in a place
chosen by the woman. If sensitive issues were addressed or the respondent
appeared to be uncomfortable at any time, the interview was paused until the
respondent regained composure. Women were told they could end the
interview at any time. While precautions were taken, such as pauses and
prompts, most women appeared open in their discussions of domestic
violence, both on a societal and personal level.
The ages of the 12 women survivors ranged from 26 to 42 years old.
The mean age of the sample was 33.25, including the age of the daughter, and
not the mother interviewed. Of the 12 women survivors, 66.7 percent (eight)
were currently living in a ger (felt tent or yurt), while the other 33.3 percent
(four) were living in an apartment. Eleven (91.7 percent) women had been
married to their partner at the time described in the interview. The number of
years of marriage ranged from three to eighteen years, with the mean number
of years being 11.67. Although the unmarried woman had been with her
partner for 21 years, they were never officially married. Seven (58.3 percent)
women were currently married of which two (16.7 percent) said that they
were living apart from their husband and two (16.7 percent) stated that they
were currently seeking a divorce. Three (25.0 percent) women were currently
divorced and one (8.3 percent) womans husband was deceased. The number
of children per woman ranged from one to three, with the mean number of
children being 2.08. This did not include miscarriages or deceased children.
The distribution of educational status among women included five
(41.7 percent) women who had completed secondary school, two (16.7
36


percent) who had completed University, two (16.7 percent) who completed a
specialized technical or management program, and one (8.3 percent) who was
completing her Masters degree. One (8.3 percent) woman did not state her
educational background. Self-reported employment status is as follows: four
women are unemployed, two work at the market (informal sector of the
economy), one is a housekeeper, two are tailors, one is a social worker, one is
a cashmere producer, and one is a teacher. Of the 12 women, two reported no
income and said that they relied on the help of their families. Reported
monthly incomes ranged from 21,000 Tg (USS 21) to 175, 000 Tg (US$ 175),
with the mean monthly income being 63,200 Tg. (US$ 63).
To supplement the data collected in key informant and survivor
interviews, documents produced in Mongolia and related to domestic violence
were also collected and analyzed. These documents were collected from
organizations from which representatives were interviewed, as well as
additional organizations reporting on gender issues and domestic violence.
These documents include definitions and forms of domestic violence in
Mongolia, legislation related to domestic violence, prevention and
intervention strategies and a range of statistics on victims and perpetrators of
domestic violence. Not only do these documents provide insight into NGO
and governmental roles in addressing domestic violence in Mongolia, they
also provide background and information that may be compared, supplement
or expand on the concerns and priorities of survivors of domestic violence and
NGO representatives actively working to decrease domestic violence in
Mongolia.
During this investigation, I drew from two sample populations. These
samples include 1) a key informant interview sample population of 19
individuals, who reflected on the forms and perceptions of domestic violence,
the response of the health care system and social support systems available to
37


survivors; and 2) a survivor sample of 12 women, including 11 victims of
domestic violence and one mother who discussed her daughters situation.
These samples are heretofore referred to as the key informant sample and the
survivor sample, respectively.
Data Analysis
All field notes and taped interviews were transcribed into a computer
file and continuously reviewed to assess for themes and patterns in
perceptions of domestic violence, responses to and experiences with social
services and the health care system. Content analysis was utilized to identify
core consistencies and meanings from the data (Patton 2002). Using thematic
analysis techniques, interviews were read and reread to identify the variety of
different issues or themes that occur and develop a comprehensive picture of
domestic violence in Mongolia. As patterns arose and themes developed, the
data were coded openly, leaving room for further interpretation. This process
of immersion and crystallization involved repeated engagements with the data
leading to insights, interpretations and the identification of general themes
(Borkan 1999). This process was followed by repeated transcript reviews and
quotations that best expressed the various themes were selected.
Applied Anthropology
Medical anthropologists study human health problems and healing
systems in their broad cultural and social contexts (Barfield 1997). Applied
anthropology, a sub-discipline of medical anthropology, emerged from
applied work in international health and aims to illuminate a societal concern
and offer solutions to practical problems by providing information, creating
policy or taking direct action. The process has many forms and is shaped by
the actual problem at hand, the availability of disciplinary knowledge on the
38


topic and the role the anthropologist is expected to play (policy researcher,
advocate, analyst).
Applied research requires a familiarity with the domain of application,
such as active community organizations, relevant legislation and multi-
disciplinary knowledge. In this way, I place domestic violence in a larger
context in order to elucidate the phenomenon of domestic violence in
Mongolia, as perceived by both professional Mongolians and survivors who
have sought help. My aim is not to understand and explain the basic nature of
the phenomenon, but to contribute to the understanding of domestic violence
in Mongolia, conveying the perspective of Mongolian women who have
survived such abuse, in hope that their voices will be heard and their
experiences will shape and contribute to the improvement of social and health
services in such cases. The results of this study are not generalizable; rather
the relevance, clarity, utility and applicability of these findings are most
important.
Researcher Bias and the Role of the Translator
The training, attributes and personal biases of the researcher cannot be
disregarded in understanding how research is conducted, analyzed and
interpreted. The researcher not only frames what questions to ask, but
ultimately determines what information is deemed relevant or important.
Therefore the research does not exist outside of, or remain unaffected by, their
personal knowledge base. New information collected throughout the research
process enhances, alters and/or redirects a researcher.
Cross-cultural interviews allow the researcher to present an individual
perspective on an issue, from an indigenous context and within a specific
worldview; however, there are also a number of challenges associated with
this type of interviewing. Cross-cultural interviews have a greater risk of
39


misunderstanding, misinterpretation and miscommunication (Patton 2002).
Language differences may affect the understanding of and response to
questions. Varied understandings and interpretations of the questions being
asked, or social and cultural constraints, may affect answers.
A Mongolian student at the University of Colorado at Denver
recommended the Mongolian translator that I utilized. The translator was a
woman whom, at the time of this study, was attending University in the
United States and exhibited excellent English skills. She was informed of the
study and, most importantly, the sensitivity of the issues being discussed.
After a thorough discussion, an agreement was signed to ensure the
confidentiality of the identity of all respondents and the content of interviews.
This translator was utilized with 7 (37 percent) key informants and all 12 of
the women, and may have affected how subjects responded to questions.
Some words and ideas'cannot be directly translated. The questions asked or
the given responses may have been affected by cultural differences in
meanings, by the translator, the respondent or both.
Both key informants and women who had been victims of domestic
violence appeared comfortable and open in discussing sensitive issues and
personal experiences with domestic violence. Nevertheless, I approached
these issues with empathetic neutrality, a heightened sensitivity and respect
for individual values, norms and worldviews. Questions were asked in a non-
judgmental way and responses were neutral, although at times probing issues.
40


CHAPTER 4
FORMS, PERCEPTIONS AND POTENTIAL FACTORS
CONTRIBUTING TO DOMESTIC VIOLENCE
IN MONGOLIA
The ways in which victims of domestic violence perceive what is
occurring offers an understanding of domestic violence from a unique
perspective. Womens experiences with domestic violence, and the factors
that they feel contribute domestic violence, may inform prevention and
intervention strategies that are culturally appropriate and addressing issues
that survivors recognize as important. Understanding the social and cultural
context in which violence against women occurs is also essential to
developing the social responses to tackle this problem. If prevention and
intervention strategies are to work, they need to be based on an understanding
of domestic violence in a Mongolian context from the perspective of those
who have experienced it. Because services related to domestic violence are
NGO-driven, it was also important to hear how people who work at those
organizations talk about violence, as well as their attitudes and perceptions of
domestic violence. Because they are designing and implementing prevention
and intervention strategies, the input of key informants was invaluable.
Defining Domestic Violence
Domestic violence is a somewhat new issue in Mongolia and key
informants stressed that womens NGOs in Mongolia have been responsible
for focusing public, and political, attention to the issue. While there is greater
acceptance and knowledge of the term than in the past, a small portion of key
41


informants noted that some Mongolians do not believe that domestic violence
exists in Mongolia. A number of key informants discussed spending time
studying and working abroad; when they returned home, people said that they
had a foreign mentality and that domestic violence is an imported idea or
issue. However, survivors and key informants both believed that domestic
violence in Mongolia is widespread and that incidents are increasing.
All of the respondents believed that domestic violence generally
occurs between spouses or intimate partners. Some respondents also
acknowledged that in-laws sometimes inflict domestic violence on women, as
well as brothers and sisters-in-law. While some respondents stated that
women sometimes inflict psychological forms of domestic violence on their
spouse, an overwhelming majority recognized that domestic violence is
committed by men against women, children and the elderly. Few survivors
and key informants said that women provoked situations of violence; the
majority of respondents blamed husbands for resorting to domestic violence.
No matter what term is used to describe the phenomenon of domestic
violence, it is clear that it encompasses a complex web of forms, causes and
consequences. When asked how they define domestic violence, survivors
responded with various answers. While some survivors listed forms or types
of violence in response to this question, others listed consequences or causes
of domestic violence. Key informants were not asked to define the term
domestic violence. This question was omitted from the questionnaire after
pilot and initial interview subjects expressed that the term domestic violence
should be defined according to international human rights standards and that
they were uncomfortable answering this question with their own opinion.
However, key informants discussed domestic violence as a tool for limiting
womens autonomy, controlling them and making them submissive to their
perpetrators desires or plans.
42


The majority of survivors associated domestic violence with issues of
power, control and limiting of womens rights. Survivors said that domestic
violence is related to family conflict, which is influenced by economic
situations, living conditions or family environment.
Domestic violence is someone more powerful abusing someone
who is less powerful, including husband abusing wife, brothers
abusing younger children and parents abusing children.
(Survivor, 2005)
Domestic violence depends on three things economic situation,
living condition, and individual power. (Survivor, 2005)
Economic freedom being limited and beating, putting down or
under control... (Survivor, 2005)
In addition to issues of control, mens attitudes and behaviors were also
discussed, as well as levels of male education, family values and personal
appearance.
In my opinion, domestic violence is caused by someones
behavior, family tradition and personal appearance. It is about
putting someone under control and in these cases, if they cant
make them do what they want. (Survivor, 2005)
It really depends on someones husbands education level and
the way he thinks. If you have healthy thinking and a good mind,
you dont need to commit domestic violence. (Survivor, 2005)
Findings from other studies have indicated that power and control are
widely believed to underlie intimate partner violence (Gage 2005; Home
1999; Moore and Wesa 1997; Wood and Jewkes 1997; Yoshihama 2005).
However, few of these studies have investigated whether victims themselves
define domestic violence in such a way. According to Yoshihama (2005),
Japanese women recognized domestic violence as having strong roots in
43


gender discrimination; victims said that domestic violence was used by their
spouse to control women, using verbal threats and threatening acts to make
them scared and submissive. According to Home (1999), Russian women also
define domestic violence as a consequence of misunderstandings and conflicts
or a way to control and dominate women.
Overall, survivors most often defined and discussed domestic violence
as a tool for limiting womens autonomy, controlling them, violating their
rights and making them submissive to their partners desires or plans. These
results are also consistent with other studies in which victims of domestic
violence define, and associate, domestic violence with issues of power and
control (Home 1999; Yoshihama 2005). Survivors associated domestic
violence with conflict in the family, which they claimed is influenced by
economic situations, living conditions and family values/environment, as well
as mens attitudes and education level.
While these findings cannot be generalized, they are consistent with a
public opinion survey on the general publics understanding of and attitude
toward domestic violence in Mongolia. Among 1944 male and female
respondents from eight aimags (provinces) and eight districts of Ulaanbaatar
city, 47.9 percent of respondents defined domestic violence as inequality in
family relations such as lack of respect or understanding, violating rights,
forcing to live under pressure and hindering rights to education and
employment (GCSD 2002:12). Inequality in the family, violating rights,
pressuring women and restricting access to education and employment were
all discussed by survivors when defining domestic violence and describing the
various forms.
44


Forms of Domestic Violence
When asked to describe the forms of domestic violence in Mongolia,
there was complete overlap in the responses of survivors and key informants.
All of the survivors and key informants recognized physical forms of
domestic violence. Ten survivors (83.3 percent) suffered from physical forms
of domestic violence from their spouse and of those ten, two survivors (20
percent) were also physically abused by their mother and father-in-law and
another (10 percent) by her brother-in-law.
Physical forms of abuse were recognized as most often being
associated with domestic violence and included hitting, kicking, beating,
slapping, punching, throwing things and torturing women. Driving a woman
to suicide and murder were described as the most detrimental forms of
physical violence and were only discussed by a few key informants. In the
most serious of cases, one woman described how her daughter was beaten by
her in-laws and husband and then put in the bathtub in her coat until she was
soaking wet and chained to a heater, under an open window, all night long in
the winter:
My daughters husband always gets drunk and then beats my
daughter and our family is under stress because of this. Not only
my son-in-law, but also his parents are beating my daughter. My
daughter met her husband in 1998 and they were living with his
parents. One of the brothers had told her that his parents fought and
when they were fighting, she should stay in her room. Once, a fight
was going on and my daughter went out to help her mother-in-law
and she pushed her father-in-law to the floor. He kept beating his
wife and my daughter and so she pushed him again. Then the mother
asked her who she thought she was, beating her husband, and both
her in-law parents started to beat her together. Then her husband
came home and he started to beat her, too, all three of them. Then
they put her in her winter coat and put her in the bathtub and tied her
to an old broken heater overnight in a freezing cold apartment.
(Mother of Survivor, 2005)
45


All of the survivors and key informants recognized psychological
forms of domestic violence. Psychological or mental forms of domestic
violence included pressuring, stress, cursing, verbal abuse or yelling,
threatening, insulting and humiliating women. Pressuring involved
manipulating women, as well as attempting to control their behaviors by
restricting womens ability to go out alone or closely monitoring them and/or
having them followed. All of the survivors said that they suffered from
psychological forms of domestic violence. Two of those survivors (16.7
percent) said that they also experienced such violence from their mothers and
fathers-in-law and their brothers-in-law, as well as their spouse. Both
survivors and key informants acknowledged that psychological or mental
forms were less obvious and often unrecognized and/or accepted as domestic
violence; however, both groups agreed that effects from this type of violence
had a greater impact on womens health and well-being than physical forms.
Economic forms of domestic violence were described by eight
survivors (66.7 percent) and ten key informants (52.6 percent). Five survivors
(41.7 percent) suffered from economic forms of domestic violence. This form
of abuse included husbands restricting a womans right to education,
employment and income, as well as causing the loss of employment. One
survivor described how she cut clients hair and her husband was jealous that
she touched other men, so he came to her job and caused a scandal, forcing
her to quit. Refusing or restricting access to money for food or childcare items
was also discussed. Survivors were often given a small allowance or no
money at all to provide for themselves and their children and said that men
often spent money poorly, on alcohol and things for themselves.
We have been interviewing unemployed women in rural
Mongolia, most of them from so-called vulnerable groups. In
my discussion, I found out that not only do men not work, but
46


they also oppose very much if the wife works. They oppose the
woman being even a nurse, working part time; they want to be
cared for and ask women to stay at home and beat them up if
they want to go and work, so I think that feeling very powerless
in the modem society, men try to reinforce it with some kind of
power demonstration at home. (Key Informant, 2005)
Since we have been married, my husband has never bought any
clothes for me or for my one child. When he gets paid, he gives
half of his salary to his mother and he keeps the other half for
himself vodka and only his favorite groceries. I buy clothing
for our daughter and for him. My husband used to work at the
state department store, but two years ago, he decided to go to
Korea and he said he would send his salary, mostly, home to me
and I could care for our daughter and the house and pay debt...
So I made a list of daily expenses and sent it to my husband in
Korea and I talked to his sister that all of the money he sent was
gone and that he needed to send money for food for his daughter.
I begged her to tell him that please we needed money to live, but
his sister said nothing about it. She made fun and laughed. On
June 7,1 told my husband to send money or else I would go to his
company and tell them to bring him back here, but he said that he
will run away from his job and escape. (Survivor, 2005)
Survivors and key informants also discussed property issues related to
economic forms of domestic violence. Many said that during socialist times,
private property was non-existent. However, in the new market economy,
there are new ideas of ownership. Men often put property in their own name,
or someone from their family, so that if women were to leave or divorce, they
would have nothing and nowhere to go. Additionally, some survivors said that
men sometimes took out loans in their name or in the name of the womans
family, binding her to him and holding her, or her family, responsible for
repayment.
Before the market economy, we did not have property, everything
was shared and now it is different. This is a new idea here. Most
husbands take special accommodation with property, so if they
47


ever want to divorce, the woman will lose everything that is in his
name and she will have nowhere to go with the children. Women
do not have their own property. Women can go to the shelter house,
but they cannot stay there. (Key Informant, 2005)
... I have no place to live. I cant just divorce and leave him. I need
somewhere to go. The apartment should be family property but since
he works in a tax organization and has a lot of friends, he eliminated
my name from the lease and put it in his brothers name. Now I am
trying to settle the property issue. (Survivor, 2005)
Sexual violence was recognized less often, by only two survivors (16.7
percent) and eight key informants (42.1 percent), and was discussed in terms
of rape, fathers abusing daughters and stepfather/stepdaughter abuse. Two key
informants (10.5 percent) also discussed sexual harassment in the workplace
as a form of domestic violence. None of the survivors claimed to personally
suffer from sexual forms of domestic violence. This type of abuse, when
recognized, was said to occur less frequently in Mongolia compared to other
forms of domestic violence, though key informants claimed that this may be
due to underreporting by families. However, key informants believed that the
number of sexual violence cases in Mongolia is said to be rising.
Victims of domestic violence often experience and identify multiple
forms of abuse, including physical, psychological, economic and sexual abuse
(Gage 2005; Glantz and Halperin 1996; Fikree and Bhatti 1999; Liu and Chan
1999; Panda and Agarwal 2005; Yoshihama 2005). While the literature on
economic forms of abuse is limited (Yoshihama 2005), sexual forms of
violence have been found to be quite common in a number of studies (Gage
2005; Jewkes, Levin and Penn-Kekana 2002). Other researchers have shown
that while sexual violence may be prevalent in a society, it is less often
recognized or revealed (Bhatt 1998).
48


Emotional abuse often co-occurs with physical abuse (Eisikovits,
Winstok and Fishman 2004; Ellsberg et al. 2000; Gage 2005; Glantz and
Halperin 1996; Hou, Wang and Chung 2005; Jewkes, Levin and Penn-Kekana
2002; Panda and Agarwal 2005; Yoshihama 2005). In many studies, victims
of domestic violence often claim that psychological forms of domestic
violence occur more frequently and that the effects from this type of violence
have a greater impact on womens health and well-being than physical forms
(Heise, Pitanguy and Germain 1994; Krantz et al. 2005; Panda and Agarwal
2005). Other researchers have found that perceptions of marital violence
generally vary according to social class and education level and that poorer
uneducated women associate violence with physical force while wealthier
more educated women consider psychological consequences (Amoakohene
2004; Casimiro 2002; Krantz et al. 2005).
In Chiapas, victims of domestic violence described the nature of
violent events, which often included physical, psychological and sexual forms
of abuse (Glantz and Halperin 1996). Women associated physical violence
with kicking, punching, pulling hair and shouting, as well violent episodes
during pregnancy, delivery or postpartum. They also discussed forced sexual
relations and mens threatening behavior. Pakistani women most often
associated physical violence with slapping and pushing, as well as pulling
hair, choking, injuries resulting in sore muscles, head injuries, bruises and
black eyes (Fikree and Bhatti 1999). According to a qualitative study by Liu
and Chan (1999), rural Chinese women said that they suffered from physical,
psychological and sexual violence. Physical forms included pushing,
punching, hitting, kicking, dragging and slapping.
In a study by Yoshihama (2005), Japanese women described the
various types of violence they endured from partners, such as physical,
psychological, economic and sexual forms of violence, including name-
49


calling, degrading behavior, verbal abuse and forced sex. Japanese women felt
that physical and psychological violence occur together and interact.
Additionally, in Japan men attempted to control womens behaviors, often
restricting womens ability to act independently or closely monitoring them
and imposing curfews. Some men limited womens financial spending or
forced them to live on a small allowance or no money at all. They also
prohibited women from working outside of the home and forced them to quit
or lose jobs in order to take care of them, the household and their children.
One womans partner changed the deed to the house without consulting her.
The results of this study indicate that survivors and key informants
recognize multiple forms of domestic violence, including physical,
psychological, economic and sexual forms of abuse. Survivors suffered from
physical, psychological and economic forms of abuse, from spouses or
intimate partners, as well as from their partners family. With the exception of
sexual forms of abuse, these results are consistent with findings from other
countries such as Haiti (Gage 2002), India (Panda and Agarwal 2005), Mexico
(Glantz and Halperin 1996), China (Liu and Chan 1999), Pakistan (Fikree and
Bhatti 1999) and Japan (Yoshihama 2005) where women suffer from more
than one type of abuse. All of the survivors and key informants recognized
physical and psychological forms of violence. Moreover, almost all of the
survivors experienced both physical and psychological forms of domestic
violence, from their spouses as well as their in-laws and husbands family.
This is consistent with other findings in which emotional abuse co-occurs with
physical abuse (Eisikovits, Winstok and Fishman 2004; Ellsberg et al. 2000;
Gage 2005; Glantz and Halperin 1996; Hou, Wang and Chung 2005; Jewkes,
Levin and Penn-Kekana 2002; Panda and Agarwal 2005; Yoshihama 2005).
Physical forms of abuse were recognized as most often being
associated with domestic violence and included hitting, kicking, beating,
50


slapping, punching, throwing things and torturing women. Driving a woman
to suicide and murder were described as the most detrimental forms of
physical violence and were only discussed by a few key informants. Many of
the types of violence that survivors reported were classified as less severe
(Jewkes, Levin and Penn-Kekana 2002; Schafer, Caetano and Clark 1998);
however, numerous survivors appeared to suffer serious physical and
psychological abuse from their spouse or partner.
In this study, psychological forms of domestic violence included
pressuring, stress, cursing, verbal abuse or yelling, threatening, insulting and
humiliating women. Pressuring involved manipulating women, as well as
attempting to control their behaviors, by restricting womens ability to go out
alone or closely monitoring them and having them followed. Both survivors
and key informants acknowledged that psychological forms of domestic
violence were less obvious and often unrecognized and/or accepted as
domestic violence; however, as with other research (Heise, Pitanguy and
Germain 1994; Krantz et al. 2005; Panda and Agarwal 2005), the majority of
respondents agreed that psychological forms of domestic violence occur more
frequently and that the effects from this type of violence have a greater impact
on womens health and well-being than physical forms.
The results of this study do not lend support to the view that
perceptions of marital violence generally vary according to social class and
education level and that poorer uneducated women associate violence with
physical force while wealthier more educated women consider psychological
consequences (Amoakohene 2004; Casimiro 2002; Krantz et al. 2001). All of
the respondents recognized both physical and psychological forms of abuse
and the majority of survivors, as well as key informants, recognized that
psychological abuse had a greater impact and a longer lasting effect on
womens health and well-being. While this is an interesting finding, it may be
51


due to the fact that all of these women had accessed the National Center
Against Violence for assistance and they may be better informed than other
women of varying classes and education levels.
Economic forms of domestic violence were described by over half of the
respondents; nearly half of the survivor population suffered from this type of
abuse. Restricting a womans right to education, employment and income, as
well as causing the loss of employment were associated with economic abuse,
as well as refusing or restricting access to money for food or childcare items.
Survivors and key informants also discussed property issues related to
economic forms of domestic violence. These forms of economic abuse are
consistent with results from Japan (Yoshihama 2005), in which men took
liberties with property, as well as limiting womens financial spending and
forcing them to live on a small allowance or no money at all. Japanese men
also prohibited women from working outside of the home and forced them to
quit or lose jobs in order to take care of them, the household and their
children, which was also the case with Mongolian women.
While sexual forms of violence have been found to be common in a
number of studies (Gage 2005; Jewkes, Levin and Penn-Kekana 2002), the
findings from this study are consistent with studies in which sexual violence is
less often recognized or revealed (Bhatt 1998). Sexual forms of abuse were
recognized as existing in Mongolia, by a small portion of survivors and almost
half of the key informant population, and were discussed in terms of rape,
fathers abusing daughters and stepfather/stepdaughter abuse. This type of
abuse, when recognized, was said to occur less frequently in Mongolia
compared to other forms of domestic violence, though key informants claimed
that this may be due to underreporting by families. None of the survivors
claimed to suffer from sexual forms of domestic violence. However, key
52


informants believed that the number of sexual violence cases in Mongolia is
said to be rising.
Statistics from studies within Mongolia show that 57 percent of
women respondents, from the general public, have suffered from some form
of physical, psychological and/or sexual forms of violence in their lifetime
(UN Human Rights and Gender Team 2004:13). Results from this study
suggest that Mongolian women suffer from multiple forms of abuse including
physical and psychological forms of domestic violence. However, survivors
more frequently suffered from, and were more likely to recognize, economic
rather than sexual forms of abuse.
While these results are not generalizable, they are consistent with
results from a Mongolian public opinion survey in which 81.1 percent of
respondents most often associated physical assault and beating with domestic
violence including hitting and causing injuries (GCSD 2002:14). Only 1.7
percent of respondents recognized murder as an act of violence (GCSD
2002:15) and one fifth of respondents (21.1 percent) defined domestic
violence as physical and psychological pressure resulting from beating, verbal
abuse, insults, arguments and scandals (GCSD 2002:12). In this survey,
psychological forms of domestic violence included stress or pressure,
repression, jealousy and suspicion, coercion, domination, threats and insults;
when added together, these forms were recognized more often than physical
abuse. Sexual abuse was only recognized by 10.2 percent of respondents
(GCSD 20002:15).
Potential Factors Contributing to Domestic
Violence in Mongolia
According to the Report on Domestic Violence Needs Assessment by
the UN Human Rights and Gender Group Team (2004), no analytical studies
53


to determine the cause of domestic violence have been conducted in
Mongolia; only descriptive studies have discussed public opinions and views
of causal factors. While the aim of this study was not to establish or
hypothesize about causal factors associated with domestic violence in
Mongolia, I did expose many of the factors and conditions that are associated
with domestic violence. Understanding these potential factors that survivors
and key informants feel contribute to domestic violence, as well as survivors
actual experiences, places domestic violence within a larger context of how it
is perceived.
Respondents most often associated domestic violence with alcohol
use, unemployment, poverty and social and economic conditions resulting
from the socio-economic transition to a democratic society. Because of the
social stresses in society, key informants believed that men use domestic
violence as a tool to vent anxiousness, anger, frustration or dissatisfaction
with society. The ways in which these factors interact is briefly discussed and
then examined in greater detail below, as well as less recognized factors
contributing to domestic violence.
Many key informants directly stated that poverty, unemployment and
alcoholism are linked or interrelated (21.1 percent), while both survivors and
key informants discussed domestic violence in the context of all three factors.
Depression, anxiety and losing hope in the future were also discussed by a
small percentage of key informants (15.8 percent), which may be a result of
these social stresses.
Causes are poor living conditions, poverty, unemployment and
alcohol. These are the basic causes of domestic violence today
and when you have some kind of shortage, or feel uncomfortable
and express feeling in bad ways in these situations.
(Survivor, 2005)
54


While these findings cannot be generalized, they are consistent with a
Mongolian public opinion survey in which a small percentage of respondents
(14.2 percent) believed that domestic violence is an abnormal way of releasing
stress and anxiety caused by alcoholism, unemployment, decline in living
standards and other social issues such as the inability to provide for families
(GCSD 2002:13). In the survey, an overwhelming majority of respondents
(90.4 percent) believed that incidents of domestic violence were increasing
and they attributed this increase to alcoholism (62.7 percent) and
unemployment (55.9 percent) (GCSD 2002:27).
Poverty and Socio-economic Conditions and Inequalities
Resulting from the Transition to a
Democratic Society
Survivors (24.9 percent) and key informants (57.9 percent) recognized
social stresses such as poverty and poor living conditions as contributing to
domestic violence. Respondents said that poverty often leads to social
depression as people cannot earn money or improve their own lives; men feel
inadequate, as they cannot provide for their families. None of the survivors
directly stated that poverty contributed to personal situations of domestic
violence; however, when asked directly, five survivors (41.7 percent) and all
of the key informants stated that poverty contributes to domestic violence.
Almost one third of key informants stated that poverty was the underlying
cause of domestic violence and that alcoholism and unemployment are both
consequences of poverty (31.6 percent). One key informant described poverty
as an umbrella:
Poverty is like the umbrella. People do not make enough money
and they cannot improve their condition and this leads to, sort of,
stresses and depression, because they cannot do anything to
55


improve their lives. Men have no work and they cannot help
themselves. Alcoholism, also, but poverty is the sort of underlying
cause. (Key Informant, 2005)
I think that there is almost a direct relation with poverty. From
what I observe, I think that not being able to earn money
contributes to even more insecure positions of men and when
women earn more than men that will definitely lessen their ego.
But, on the other hand, I think that it is difficult for them to accept
that you can be a family provider... Poverty, unemployment,
alcoholism... I think both alcoholism and unemployment, of course,
very much, are both consequences of the poverty. Unemployment
is, again, putting men in the position when they are not able to
provide for the family. Therefore, unemployment kind of takes out
the major part of the man being the pillar of the household. (Key
Informant, 2005)
Surveys show that poverty is the main factor of domestic violence
because men dont work and they stay home and drink and there is
stress. When men have lots of time, hanging around and nothing
too do, they use their power over their families. Unemployment,
poverty, nothing to do and free time instead of being busy... These
are the social reasons. (Key Informant, 2005)
While survivors and key informants agreed that poverty contributes to
domestic violence, respondents also recognized that domestic violence occurs
among both rich and poor, employed and unemployed families.
Domestic violence is not only happening with poor people. It is
affecting rich people too, but they dont discuss it because they care
about their reputation.... My husband is a really well educated man.
He graduated from the lawyer university. Living condition doesnt
always have to do with it [domestic violence], but it is family
environment and the person. (Survivor, 2005)
Key informants (36.8 percent) and, to a lesser extent, survivors (8.3
percent) described socio-economic conditions and inequalities resulting from
the transition to a democratic society as resulting in, and contributing to,
56


domestic violence. Social and economic stresses, resulting from the transition,
such as poverty and unemployment, were said to be changing many issues
within the family and putting pressure on families. Domestic violence was
discussed as a way to release tension, anger and frustration with society.
These stresses were said to not only influence domestic violence, but also
psychological problems, drinking behaviors and alcoholism. Depression,
anxiety and losing hope in the future were also discussed by a small
percentage of key informants (15.8 percent), which may be a result of these
social stresses. Additionally, key informants discussed how in the new
democratic society, every social protection is gone and there is no social
safety net. Family life is private and there is no social support system from the
government.
When we were a Socialist system, there was also domestic
violence, but not like this time. Now we have a democratic system
and every social protection is gone. In some families there is no
basic livelihood, job or anything and this mostly affects men. So
men dont have confidence. Women work and even do small things
for the protection of their family, looking for other money for family.
And the men are drinking and women doing any small thing and still
there is stress. (Key Informant, 2005)
I think one, definitely, is associated with socio-economic changes
that the country has been experiencing during the last 10 or 12 years.
During the transition period, change from one system to another and
the transition to the market economy has put a lot of pressure for
individual families to transform the way they view their income and
business. All of this, I think, has had a tremendous effect on family
structures. Many people, who have been for the last 50, 60, 70 years,
believing in an idea, but losing that, almost overnight, and that drove
many men, including young men, into the streets, so that, definitely,
alcoholism has really been increasing rapidly and almost becoming a
chronic problem for the society. I think that is the obvious reason that
can be contributing to domestic violence... On the other hand, society
itself does not really provide a kind of social protection or social safety
57


net. That is missing, so people do not have means to get assistance
from outside or to go somewhere where they can express their
frustrations and share problems and try to find solutions. None of this
is available really. That probably also is a factor when a family partner
comes home and vents all the pressure and stress to one another. (Key
Informant, 2005)
The post-transitional economy from a socialist system, pressure and
maybe depression lead to domestic violence to release anger or tension
and the wife and children are weaker. Social depression among men
and women, kids. People are not angry; they are nervous or anxious.
(Key Informant, 2005)
Before the 1990s, in Socialist society, everyone thought that we
had to all be equal and society controlled peoples lives family,
living condition jobs and family life was discussed openly. Now
individual life is a private thing and no one discusses this in front
of others. (Key Informant, 2005)
Numerous studies have associated domestic violence with poverty
(Chowdhury et al. 2006; Ellsberg et al. 1999; Martin et al. 1999; Xu et al.
2005). However, violence against women has never been limited to the poor
or underprivileged; women from all socio-economic groups, educational
status, religions and cultures suffer domestic violence. Nevertheless, abuse is
often prolonged if a woman is isolated or lacks the resources needed to get
away.
As previously socialist or communist and so-called developing
economies have become more market-oriented, some forms of violence
against women appear to have increased or reemerged (Hester 2004). In both
China and Vietnam, violence against women is perceived as a consequence of
the recent rapid socio-economic transition (Rydstrom 2003; Tang, Wong and
Cheung 2002). The introduction of market forces, combined with associated
foreign evils from the late 1970s and backward Confucian traditions
have been said to contribute to the use of domestic violence against women. In
58


India (Chowdhury et al. 2006) and South Africa (Gilbert 1996), domestic
violence and family discord were associated with poverty, alcohol and
unemployment and were considered to be consequences of rapid urbanization,
erosion in the family and social decay in a society in transition. In Russia,
economic and political destabilization have been proposed as a primary cause
of domestic violence and many believe that solutions addressing this issue
will decrease social stresses, such as poverty, unemployment and alcoholism,
which are said to influence domestic violence (Home 1999).
Various researchers have argued that the transition to a market economy,
and the resulting process of privatization, have contributed to increases in
poverty and social inequality in Mongolia (Griffin et al. 2001; Janes and
Chuluundoij 2004; Janes et al. 2006; Nixson and Walters 2006). In this study,
survivors and key informants recognized that social stresses, such as poverty
and socio-economic conditions and inequalities resulting from the transition to
a democratic society, contribute to domestic violence. While survivors and
key informants agreed that poverty contributes to domestic violence,
respondents also recognized that domestic violence occurs among both rich
and poor, employed and unemployed families.
While the results of this study cannot be generalized, they are
consistent with the results of a Mongolian public opinion survey in which 50.8
percent of respondents believed that domestic violence was caused by poverty
(GCSD 2002:27). However, none of the respondents in the public survey cited
socio-economic conditions and inequalities resulting from the transition to a
democratic society, although this was discussed by approximately one third of
key informants. Incidentally, 27.3 percent of respondents from the public
opinion survey believed that domestic violence was caused by stress (GCSD
2002:27), which may have been the result of socio-economic conditions
resulting from the transition.
59


Consistent with other Mongolian research (Griffin et al. 2001; Janes
and Chuluundoij 2004; Janes et al. 2006; Nixson and Walters 2006), the
findings of this study indicate that key informants, and to a lesser extent,
survivors perceive domestic violence in Mongolia as a consequence of the
recent rapid socio-economic transition. The transition to a market economy
resulted in massive changes and challenges, for society and within the family.
Respondents recognized that, as a socialist society, everyone was equal and
society controlled peoples lives; family life was discussed openly. Now
individual life is a private issue and no one discusses this in front of others to
guard their reputation and avoid gossip. Moreover, in a democratic society,
every social protection is gone; social programs, including health care and
education, diminished or disappeared and Mongolians were deprived of the
social security net that had been provided in the past. Many men found
themselves unemployed and unable to provide for their families, which
contradicts traditional roles and family structures as well as creating stress and
pressure on the entire family (Janes and Chuluundorj 2004; Nixson and
Walters 2006).
Studies from within Mongolia have shown that social stresses resulting
from the transition were said to influence domestic violence, but also
psychological problems, marital breakdown and alcoholism (ADB and WB
2005; GOM and WB 2001). This was discussed by key informants as leading
to depression, loss of hope in the future, nervousness and anxiety and men
were believed to use domestic violence to vent stress or release tension,
anxiety and frustration with society. Consistent with results from Russia,
respondents believe that solutions addressing domestic violence should be
aimed at decreasing social stresses, such as poverty, unemployment and
alcoholism, which are said to influence abuse (Home 1999).
60


Alcohol Use and Abuse
Alcohol use and abuse were most often recognized by survivors (58.3
percent) and key informants (89.5 percent) as contributing to domestic
violence in Mongolia. Survivors and key informants said that alcohol was
inexpensive and available everywhere, in every shop; it is often of sub-
standard quality and does not meet health codes. Seven survivors (58.3
percent) described situations of alcohol abuse when their husbands were
intoxicated and became angry. Survivors said that when men drink, they
sometimes disappear, but more often they become aggressive and abusive,
oppressing their families. Survivors also said that when men needed money to
buy alcohol, they sold things from the household, which led to arguments and
incidents of domestic violence. Some respondents said that alcoholism is a
consequence and mechanism for dealing with stress from the transition and
has become a chronic problem in society. When asked directly, nine survivors
(75.0 percent) and all of the key informants stated that alcohol use contributes
to domestic violence.
I am a cook and used to work in the countryside. My husband had
never worked. He just eats and drinks. When he is sober, he is okay,
but when he drinks, he abuses the family. He used verbal abuse and
broke things in the house and sometimes hit me, but when the
children grew up, my daughter took my side and so he beat them too.
This is why I got a divorce and left him. (Survivor, 2005)
My husband drinks a lot. He is kind of an alcoholic. We have been
married for eight years and we have two kids. In my opinion, during
these eight years, my husband has never been responsible for the
household and economic issues. I had to work and take care of the
house. (Survivor, 2005)
The main family problem is alcohol because it is very cheap. Small
and big shops on every comer have alcohol. Even those selling
vegetables or bread, are also allowed to sell vodka. Because of this
61


availability of alcohol, and it is cheap and everywhere, men abuse
wives and their children. This is the main cause of the domestic
violence and the main cause of poverty is alcohol because if men
find just 500 Tg or 1000 Tg, some of them bring it to home and buy
rice or flour or bread, but some of them, no, they just buy a small
bottle of vodka... (Key Informant, 2005)
According to Bhatt (1998), substance abuse aggravates domestic
violence and is the cause of physical and psychological morbidity, divorce and
even death. In a study of womens perceptions of domestic violence in
Chiapas, Mexico, Glantz and Halperin (1996) found that women said that
alcohol causes men to feel superior and to display that superiority though
physical violence. In their study of intimate partner violence in China, Xu and
colleagues (2005) found that women associated domestic violence with
perpetrator alcohol abuse, frequent quarreling and either partner having
extramarital affairs. According to a study of womens perceptions of intimate
partner violence in the Philippines, more than half of women said that their
husbands were drunk when they lashed out (Hindin and Adair 2002). Women
recognized that drunkenness was not necessarily the cause of the argument,
though it may have resulted in abuse.
Various researchers have associated domestic violence with substance
abuse; however, in the majority of studies, no causal relationship has been
shown or statistically proven (Buel 2002; Moore and Wesa 1997). Abusers
who attain sobriety often continue to abuse their partner. Although there is
consensus that those who engage in domestic violence often drink and that
intoxication often accompanies violence, there is far less agreement about
whether the use of alcohol simply covaries with partner violence, is a
contributing cause of partner violence, or simply is an excuse for aggression
(Fals-Stewart and Kennedy 2005).
62


While the findings of this study cannot be generalized, alcohol use and
abuse was recognized by the majority of survivors and key informants as the
leading factor contributing to domestic violence in Mongolia. Over half of the
survivors described personal situations of domestic violence in which their
husbands were intoxicated and became angry or jealous, which led to
incidents of abuse. These results are consistent with descriptive studies from
Mongolia that have identified alcoholism as a factor contributing to domestic
violence. A Mongolian public opinion survey showed that 77. 4 percent of
respondents believed that domestic violence was caused by alcoholism
(GCSD 2002:27) and that family disputes most frequently occur when alcohol
was consumed. Moreover, in an examination of the current trends in family
development in Mongolia, Dagvadorj (2002) found that unemployment,
decreased family income and a lack of will to overcome problems contribute
to alcohol abuse, especially among men. This often leads to family crisis,
violence and a loss of basic human rights for women and children in
Mongolia.
Unemployment, Lack of Male Education
and Female Empowerment
Survivors (16.6 percent) and key informants (47.4 percent) recognized
unemployment as another social stress contributing to domestic violence. In
addition to alcohol, five survivors (41.7 percent) also discussed their
husbands unemployed status and his feelings of insecurity or decreased
involvement in the family as contributing to personal situations of violence.
Male unemployment was said to lead to money problems and arguments, and
respondents said that when women questioned their husbands contribution to
the family or criticized him, this often led to arguments and incidents of
domestic violence. Survivors also said that when men are unemployed and
63


women work, men are often jealous or think that women feel that they are
better than men, which leads to abuse. When asked directly, nine survivors
(75.0 percent) and all of the key informants (100 percent) stated that
unemployment contributes to domestic violence.
Both key informants (21.1 percent) and survivors (16.6 percent)
recognized lack of education among men and low levels of male involvement
in the family as factors contributing to domestic violence. Respondents said
that, from a young age, Mongolian girls are taken care of and educated,
whereas boys are taught to be strong, work hard and provide for their family.
During the transition, girls received an education while men worked in the
countryside or abroad; now women have more education and men have no
basic livelihood or self-esteem. One key informant discussed how, during the
transition, men were forced to forfeit an education to work and earn income to
provide for their families. As a result, there may be some resentment, on
mens part, because they had to fulfill their obligations to the family.
You see, when we changed from a socialist society, men went
abroad to China to work in shops and in the countryside, men
stayed home to do the herding. It was the mans job to put bread
on the table, to feed families... Women went to school and got an
education. Now women have educations and better jobs and good
salaries and, perhaps, men feel sometimes depressed or lower.
Men say, Yes, I could have been a scholar and had a good job,
but I had to feed my family. Now women have these good jobs
and colleagues and men feel like they have, in a way, been left
behind. So maybe, I dont know, this violence is a way for them to
become empowered and show their dominance physically. (Key
Informant, 2005)
While survivors discussed the increased role of women in the family
and workforce, key informants specifically discussed female empowerment
(26.3 percent) as contributing to domestic violence. Key informants and
64


survivors discussed how women are taking an active role in sustaining
families and contributing income to the family. This not only challenges
traditional roles that the man provides for the family, but also decreases mens
involvement in family life and creates pressure and stress within the family.
Before, during socialist times, both men and women had equal
education and this caused fights because women wanted to work.
Now women have more education and they have become
empowered. This causes stress and men decide not to settle things
not by talking, but in physical way with violence. (Key Informant,
2005)
In Mongolia, women are more empowered than other Asian
countries. They normally have more education or the same than
their husbands and they put pressure on them and they say that
men need to see what their friends are doing and how well they
are doing. This may sometimes trigger physical violence from
husbands. In many families, the woman works hard and some-
times the husband does not have a job or cannot get one or earn
money and he becomes frustrated and drinking is a big problem
in addition to that and that often contributes to violence. (Key
Informant, 2005)
Women take a more active role in sustaining families and family
incomes, so the empowerment on the other side, young girls
wanting to have better education and better opportunities for
decision-making, but also probably not only being not welcomed
by husbands or partners, but creating an environment where there
are contradicting beliefs and ways of thinking within the family.
(Key Informant, 2005)
There may be some social stresses that have created the
opportunity for females, for the most part, to more easily get jobs
and employment. Society is shifting in that there is more and
more college graduates who are female than male. Males are
dropping out of the educational system at a much earlier age to
take, what end up being, lower paying jobs, so it creates a social
stress. Women are delaying the age in marriage; there are drops
65


in fertility rates, increases in abortion rates. Just the normal social
stresses... (Key Informant, 2005)
Some researchers have found no association between partners
unemployment status and domestic violence (Heise 1998; Xu et al. 2005).
However, Eisikovits and colleagues (2004) showed that violence occurred
more frequently among families with economic hardships and violent men
tend to be younger, with lower levels of education. According to Faramarzi
and colleagues (2005), the strongest predictor for physical abuse among
Iranian women was womens attitudes of acceptance of male dominance,
followed by low levels of male education, low income and unemployment.
When men find themselves unemployed and unable to provide for their
families, this contradicts traditional roles and family structures as well as
creating stress and pressure on the entire family (Wang 1999). Other
researchers have suggested that when poverty and unemployment reduce the
ability of men to attain certain ideals of successful manhood, particularly
those based on ideas of men as providers for the family, violence against
women may become normalized as men take it out on women they can no
longer economically support (Jewkes, Levin and Penn-Kekana 2002).
Key informants and, to a lesser degree, survivors recognized
unemployment as one of the leading social stresses contributing to domestic
violence in Mongolia. Moreover, almost half of the survivors discussed
personal situations in which their husbands unemployed status and feelings of
insecurity or decreased involvement in the family contributed to both alcohol
use and domestic violence. Both key informants and, to a lesser degree,
survivors also felt that lack of education among men also contributes to
domestic violence. While these results are not generalizable, they are
consistent with a Mongolian public opinion survey in which 21.1 percent of
respondents believed that domestic violence was caused by low levels of male
66


education (GCSD 2002:27). Additionally, other studies from within Mongolia
confirm that unemployment and low levels of education contribute to
incidents of domestic violence in Mongolia, in addition to the rapid social
changes of the transitions to a democratic society (Chuluunbaatar 2002). All
of these factors serve to intensify existing imbalances in power between men
and women.
Survivors and key informants discussed how, in Mongolia, women are
more empowered than in other Asian countries. Consistent with research by
Wang (1999), respondents believed that this empowerment of women puts
stress on men and contradicts the traditional view that they are the provider
and decision-maker in the family; men feel inadequate and unable to provide
for their families and they resort to alcohol and domestic violence to relieve
this stress. It has been suggested that when poverty and unemployment reduce
the ability of men to attain certain ideals of successful manhood,
particularly those based on ideas of men as providers for the family, violence
against women may become normalized as men take it out on women they can
no longer economically support (Jewkes, Levin and Penn-Kekana 2002; Wang
1999).
The Influence of Traditional Values and Personal Attitudes
None of the survivors and only 26.3 percent of key informants
discussed traditional values when asked to describe the factors that contribute
to domestic violence in Mongolia; however, the majority of survivors (58.3
percent) and key informants (73.7 percent) said that traditional values play a
role in influencing domestic violence when asked directly. Some survivors
and key informants stated that these beliefs might be stronger, or more
common, in the countryside as opposed to urban areas.
67


Almost all of the survivors and key informants discussed how, in
Mongolia, the man is considered the head of household and he is traditionally
responsible for making decisions in the family. Women are responsible for
taking care of the household chores and raising children. Traditionally, the ger
is divided so that the man sits in the west, which is the most powerful position
and survivors and key informants said that men are to be put/served first and
women are expected to respect and obey their husbands, even worship them.
One survivor said that husbands think that they are the king, master and
boss (Survivor, 2005).
Key informants and survivors recognized that women, in general, have
more education than men and greater opportunities in the workplace. They
believed that this empowerment of women puts stress on men and they feel
inadequate and unable to provide for their families and fulfill their traditional
role as the family provider. When women question husbands contribution to
the family or criticize him, this often leads to arguments and incidents of
domestic violence.
I really hate that traditional belief that the man is the head of
household and should be first. Traditional beliefs and culture has
a big influence on domestic violence, especially in countryside.
The ger is divided in that the husband is from the west side and the
woman is from the east. In the womans area, they dont really
separate man and woman, but in the west, it is so much more
powerful that the man is the head of the family and that he makes
decisions. So you cant make your husband do certain things.
(Survivor, 2005)
Even when women are beaten by their husbands or verbally abused,
they always try to give them tea first and food first because women
respect the man as head of the household. So men think that even
though I beat her or put her down, she still has to respect me and
serve me. (Survivor, 2005)
68


Traditionally, men are considered the head of the household. They
should be respected and they have to sit in front of the open fire of
the stove. The woman has to sit on the left side and the man has to
always sit at the top because he has to be well respected and served
first. The man does not do the housework, taking out garbage and
cleaning house... Women say something to the man that they are
making money, looking after the home and men are not working,
but he still thinks he is the head of the house and exercises power
over them and thinks that the woman should be subordinate to him
and he gets angry; he doesnt accept this criticism. This exists
everywhere at all levels. Even among younger generations, there are
still these traditional values. (Key Informant, 2005)
Key informants also discussed traditional Mongolian songs and
proverbs that reinforce the belief that, in the family, the man is to be held in
higher esteem than the woman. Some key informants said that men believe
that women are slaves for men and servants for the home. Respondents
discussed Mongolian adages such as A man should beat his wife once a
month, Womens hair is long but their minds are short and There is no
need for a donkey to amble between husband and wife, and said that these
phrases were used to reinforce the mans dominant position in the family and
the fact that he is the head of the household, the decision-maker and the
disciplinarian.
Three survivors (25 percent) did not believe it was traditional values,
but female personal attitudes, that influenced domestic violence. These
survivors believed that Mongolian women are shy and calm and that they
believe domestic violence is a private issue. Key informants also recognized
that Mongolian women are shy and calm, although they did not differentiate
between these attitudes and traditional values. Respondents claimed that
victims often address situations of violence on their own, in order to avoid
conflict, dissolution of the family, shame and loss of family reputation. They
are quiet and accepting and view domestic violence as normal or a private
69


issue. This, in turn, results in men, and women, viewing domestic violence as
normal or acceptable in Mongolian culture.
I believe traditional values have nothing to do with the spread of
domestic violence, but Mongolian personal attitudes have a lot to
do with this. Mongolian women are typically shy and calm and
think maybe this will stop or not happen again because it is better
to raise kids with husband and keep family together. (Mother of
Survivor, 2005)
Women are more calm and shy. They dont say words against their
husbands. They hide what is happening at home. They dont talk
openly about domestic violence and they dont talk to friends and
family. (Survivor, 2005)
Violence may be related to tradition, you know, like an Asian
country culture that men should be sort of macho and the head of
the household, who does everything, and that women should be
quiet and accepting. So many women are accepting that this is a
normal thing and not talking about violence if it is happening and
they keep it a secret. It is the mentality or culture and the tradition
that women accept it and men start to believe that it is okay or right.
(Key Informant, 2005)
Only one survivor (8.3 percent) and just over one quarter of key
informants (26.3 percent) believed that traditional values had little or no
influence on domestic violence. One key informant claimed that this might be
the opinion of the general public; however, there are no studies that have
shown that there is a correlation between traditional values and domestic
violence. Another key informant believed that this might be more common
among ethnic minorities, such as among Kazaks in the west.
Numerous researchers claim that all societies have forms of violence
that are socially proscribed and/or tolerated through social customs and norms
(Bhatt 1998; Eisikovits, Winstok and Fishman 2004; Jewkes, Levin and Penn-
Kekana 2002; Johnson and Sigler 2000). Societies with strong ideologies of
70


male dominance often endorse rigid gender roles and cultural norms. Studies
from Iran (Faramarzi, Esmailzadeh, and Mosavi 2005), Taiwan (Hou, Wang
and Chung 2005), Korea (Doe 2000), Japan (Yoshihama 2005), Vietnam
(Krantz et al. 2005), Bangladesh (Naved et al. 2006), Palestine (Haj-Yahia
1998), India (Bhatt 1998) and China (Liu and Chan 1999; Xu et al. 2005) have
demonstrated that domestic violence is one form of maintaining hierarchical
order in the family in patriarchic societies with strong traditional values.
China is and always has been a patriarchal society (Liu and Chan
1999; Xu et al. 2005). In traditional Chinese families, family structure is
hierarchical and the husband is often the final authority on numerous family
issues. Such beliefs are deeply rooted in Chinese culture, language and social
life and emphasize hierarchy in the family (Xu et al. 2005). Chinese womens
social and family status is clearly depicted in traditional Chinese aphorisms
such as Beating is love and scolding is intimacy. A man is entitled to beat
his wife to discipline her and phrases such as I bought my horse and married
my wife. I can ride them and beat them as I like and If you go three days
without beating your wife, she will climb up on the roof and move away all
the tiles are common cultural beliefs.
Myths about domestic violence thrive in Russia. Home (1999) discuss
that throughout Russian folklore and religious literature, women were
believed to possess magical and evil powers, which called for rules and
punishments to control them. Girls leam from an early age that the man is the
head of the household, the protector and the leader in society. Women were
considered sinful and they were required to devote themselves solely to
domestic duties, while men were responsible for physically disciplining
disobedient wives. There are several well-known Russian proverbs that
support and endorse violence against men such as If he beats you, he loves
you and Beat the wife for better cabbage soup. As late as the end of the
71


nineteenth century, the Russian wedding custom of passing a whip from the
brides father to her husband was observed.
Because domestic violence occurs between family members, behind
closed doors, it is often considered to be a part of normal life. In many
societies, such as Taiwan (Hou, Wang and Chung 2005), Japan (Yoshihama
2005), Iran (Faramarzi, Esmailzadeh and Mosavi 2005); Bangladesh (Naved
et al. 2006), China (Xu et al. 2005) and Vietnam (Krantz et al. 2005),
domestic violence is viewed as a private issue and has been generally
concealed, ignored or overlooked. Cases are often not reported because
women may fear further repercussions from perpetrators, family shame or loss
of reputation (Balci and Ayranci 2005; Chowdhury et al. 2006; Eisikovits,
Winstok and Fishman 2004; Ellsberg 2006; Faramarzi, Esmailzadeh and
Mosavi 2005; Jewkes, Levin and Penn-Kekana 2002; Johnson and Sigler
2000; Naved et al. 2006; Xu et al. 2005).
The majority of survivors and key informants believed that traditional
values play a role in contributing to domestic violence. Only a small portion
of respondents did not believe that traditional value or female personal
attitudes influenced domestic violence. These results are inconsistent with a
Mongolian public opinion survey in which only 9.6 percent of respondents
believed that domestic violence was caused by traditional values (GCSD
2002:27). Some survivors and key informants stated that these beliefs might
be stronger in the countryside as opposed to urban city centers. Consistent
with a number of studies (Bhatt 1998; Doe 2000; Faramarzi, Esmailzadeh, and
Mosavi 2005; Haj-Yahia 1998; Hou, Wang and Chung 2005; Krantz et al.
2005; Liu and Chan 1999; Naved et al. 2006; Xu et al. 2005; Yoshihama
2005), domestic violence is considered to be one form of maintaining
hierarchical order in the family in patriarchic societies with strong traditional
values.
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Like many other Asian countries such as Japan (Kozu 1999;
Yoshihama 2000, 2005), Korea (Doe 2000), Taiwan (Hou, Wang and Chung
2005) and China (Liu and Chan 1999; Xu et al. 2005), respondents stated that
Mongolia is a male-dominated culture with rigid gender roles and cultural
norms. According to UNIFEM (2004), discriminative views of men and
women are reinforced from childhood in Mongolia, which respondents also
discussed. At a young age, boys are expected to be strong and brave, whereas
girls should be modest and compassionate. Boys are taught to herd animals
and compete in sport and girls learn to raise children and care for the home.
However, Mongolian women, in general, have more education than men and
greater opportunities in the workplace; men are often unemployed or forced to
take lower paying jobs. Survivors and key informants believed that this
empowerment of women puts stress on men and contradicts the traditional
view that they are the provider and decision-maker in the family.
Respondents stated that in Mongolia, the man is considered the head of
the household and he is responsible for making decisions in the family and
earning income. Women are responsible for taking care of the household
chores and raising children. They are expected to respect and obey their
husbands. Key informants discussed traditional Mongolian songs and
proverbs that reinforce the belief that man is to be respected and held in higher
esteem than women. These phrases are used to underpin mens dominant
position as the head of the household, the decision-maker and the
disciplinarian.
While these findings are not generalizable, they are consistent with
results from a report on traditional gender concepts in the family in Mongolia
by Enhjargal (2002), which found that non-progressive cultural beliefs still
exist in Mongolia. Most men believe that they have the right to govern the
wife and family and even use violence against them. UNFPA (2003) claims
73


that the attitude that considers women inferior still exists in Mongolia and
many believe that the man should lead the family and punish women who do
not obey. Moreover, a Mongolian public opinion survey showed that 42.9
percent of respondents believed that gender divisions affect domestic violence
(GCSD 2002:34). While 26.4 percent of respondents believed that patriarchal
traditions negatively impact family relations by repressing women, only 16.7
percent of respondents believed that traditional beliefs had no impact on
modem relations in the family (GCSD 2002:38).
Female personal attitudes were also considered to contribute to
domestic violence. Survivors and key informants discussed how Mongolian
women are shy and calm. Consistent with numerous other studies (Faramarzi,
Esmailzadeh, and Mosavi 2005; Hou, Wang and Chung 2005; Jewkes, Levin
and Penn-Kekana 2002; Krantz et al. 2005; Naved et al. 2006; Xu et al. 2005;
Yoshihama 2005), Mongolia women appear to quietly accept domestic
violence as normal or a private issue. Respondents said that victims try to deal
with situations of violence on their own, in order to avoid conflict, dissolution
of the family, shame and loss of family reputation. Key informants felt that
this, in turn, results in men, women and children viewing domestic violence as
normal or acceptable in Mongolian culture.
Jealousy and Family Disputes
Jealousy and family conflict were recognized by two survivors (16.6
percent) and one key informant (5.3 percent) as contributing to domestic
violence; however, jealously was discussed by four survivors (33.3 percent) as
influencing their own personal experiences with domestic violence. Survivors
said that men were often suspicious of their activities and had them followed
on numerous occasions. Men also got jealous because survivors were
74


working. Such jealousy typically resulted in marital conflict, loss of
employment and domestic violence.
My husband drinks a lot and sometimes disappears. During this
time, I needed help. I asked other men to help me with things and
my husband would get jealous and beat me, both physically and
mentally. (Survivor, 2005)
My daughter used to be a barber and cut hair and he got jealous
because she touched mens hair. She worked at the State Depart-
ment store, so he went there and made a scandal and now she
doesnt work there anymore. (Mother of Survivor, 2005)
Women take responsibility for themselves and they work hard
and it makes men jealous, thinking that the woman thinks she is
better than the man. They become more abusive, aggressive and
mad, sitting around drinking. (Survivor, 2005)
Family disputes were recognized by a small percentage of survivors (24.9
percent) and key informants (5.3 percent) as contributing to domestic
violence. One survivor discussed how their daughter was the argument
between her and her husband.
I used to work in the market and my husband stayed home with
the kids. He used to beat my oldest daughter all the time. She was
the main argument between us because she had lived with her
grandparents for the first four years of her life and when she
returned, my husband said that she did not look like his child so
he beat her. (Survivor, 2005)
Studies have shown that partners jealousy has been a risk factor for
emotional, physical and sexual abuse (Gage 2005; Hindin and Adair 2002;
Xingjuan 1999). Xingjuan (1999:1498) found that in Beijing, 40 percent of
women who had suffered violence from partners said that suspicion was the
first reason for abuse; men were often jealous or thinking that women were
75


having extramarital relations. Conflicts over household affairs, economic
problems and problems with children were other issues discussed.
Overall, jealously was recognized by a small portion of respondents as
contributing to domestic violence; however, one third of survivors discussed
jealousy as influencing their own personal experiences with domestic
violence. These results are consistent with research from within Mongolia in
which jealousy was said to be the cause of almost one quarter of domestic
violence cases in Mongolia (CHRD et al. 2002:24) and a 2002 Mongolian
public opinion survey in which 42.6 percent of respondents believed that
domestic violence was caused by jealousy (GCSD 2002:27).
While survivors did not suffer from any forms of sexual abuse, these
results are consistent with studies in which jealousy is a risk factor for
physical and emotional abuse (Gage 2005; Hindin and Adair 2002; Xingjuan
1999). Survivors also said that men were often suspicious of their activities
and had them followed on numerous occasions. These results are consistent
with research from China, where suspicion was the first reason for abuse
(Xingjuan 1999); however, Mongolian women did not discuss infidelity or
extramarital relations as the reason for being followed. While this may have
been the case, survivors more often recognized mens feelings of inadequacy
and insecurity leading to jealousy, marital conflict and domestic violence.
Xingjuan (1999) also found that conflicts over household affairs,
economic problems and problems with children often led to domestic
violence. Men were sometimes jealous because survivors were working and
this led to arguments and incidents of abuse. Family disputes were recognized
by a small percentage of survivors and key informants and only one survivor
discussed how their daughter was the cause of arguments and abuse. These
results are somewhat consistent with descriptive studies in Mongolia in which
marital conflict has been found to contribute to domestic violence (UN
76


Human Rights and Gender Team 2004). Additional studies from within
Mongolia found that relationship conflicts were the cause of 51.2 percent of
cases of domestic violence in Mongolia (CHRD et al. 2002:24). Less than one
third of respondents discussed marital conflict and its association with
domestic violence.
Being Exposed to Violence as a Child
The use of violence against a partner is a learned response to anger or
other emotions (Moore and Wesa 1997). Psychological evidence shows that
the highest risk marker for a man to use violence against his wife and children
is early exposure to violence in his childhood home (Ellsberg et al. 2000;
Jewkes, Levin and Penn-Kekana 2002; Martin et al. 2002; Walker 1999).
These studies found that children who either experience violence themselves,
or witness violence between their parents, are more likely to use violence
when they are older. Being exposed to domestic violence as a child was
discussed by only three key informants (15.9 percent) as contributing to
incidents of domestic violence later in life; however, the personal attitude of
the child was also recognized as a determinant for later perpetration. This is
inconsistent with results from descriptive studies in Mongolia, which have
associated a history of violence in the family with domestic violence (UN
Human Rights and Gender Team. 2004).
77


CHAPTER FIVE
NEGATIVE EFFECTS OF DOMESTIC VIOLENCE AND THE ROLE
OF HEALTH CARE PROVIDERS IN ADDRESSING AND
TREATING VICTIMS OF DOMESTIC VIOLENCE
IN MONGOLIA
Domestic violence is a significant cause of female morbidity and
mortality worldwide and represents an obstacle to economic and social
development (Chang et al. 2005; Diop-Sidibe, Campbell and Becker 2006;
Heise 1998; Moore and Wesa 1997). In addition to physical and psychological
consequences, domestic violence has been found to negatively affects
employment situations, overall productivity and participation in public life
(Diop-Sidibe, Campbell and Becker 2006; Panda and Agarwal 2005).
Domestic violence negatively affects womens productivity, autonomy,
quality of life and physical and mental well-being. Emotional trauma from
domestic violence has long-term effects on both adults and children and
results in decreased economic production in terms of lost workdays, resources
drawn form the health care system and lost educational opportunities for both
women and children. According to the United Nations Fund for Women
(CHRD et al. 2002), women cannot lend their labor or creative ideas fully if
they are burdened with the physical and psychological scars of abuse.
The aim of this phase of the study was to understand the negative
effects of domestic violence on womens health and well-being as perceived
by Mongolian survivors who have experienced domestic violence and key
informants who address violence. Additionally, understanding womens
health seeking behaviors, as well as their interaction with, or lack of
78


interaction with, the health care system will inform practices on how to
identify and address domestic violence that increase patient comfort and
willingness to disclose and/or seek health care services.
Negative Effects of Domestic Violence on
Womens Health and Well-being
Survivors and key informants described a wide range of negative
effects on womens health and well-being as a consequence of domestic
violence. Notably, their responses overlapped almost unanimously.
Respondents recognized physical injuries, as well as psychological or
emotional effects of abuse, resulting in ill health. Respondents also
recognized, and survivors suffered from, poor overall health as a result of
domestic violence. Physical effects and injuries resulting from domestic
violence were said to include bruises, head injuries, broken bones, scars and
poor overall health. Other maladies such as nervousness and anxiety, heart
conditions, headaches and fainting were also recognized as negative effects on
victims health and well-being.
Of the 12 survivors of domestic violence in this study, ten survivors
(83.3 percent) suffered from physical forms of domestic violence. While none
of the survivors directly stated that domestic violence negatively affected
pregnancy outcomes, three of the 10 survivors (30 percent) who were
physically abused suffered abuse during pregnancy. Of these three cases, one
resulted in high blood pressure and third trimester complications and another
in the miscarriage of twins. The third survivor had a successful pregnancy
outcome after she and her children escaped from the countryside to
Ulaanbaatar to seek refuge. One key informant discussed how domestic
violence negatively affects pregnancy outcomes:
79


Many cases of pregnancy have been complicated by physical
abuse of the partner. On the other hand, the mental pressure,
when the atmosphere in the household is stressful and there are
conflicts every night, even if it is not physical, it doesnt allow
women to relax and to prepare and enjoy the pregnancy, but it
rather becomes the subject of quarrels and fighting and it becomes
quite stressful, so because there were no definite studies, maybe
there are international studies available and maybe we should be
looking to that, to really account for the affect of domestic violence
on the course of the pregnancy and ensuring safe delivery. (Key
Informant, 2005)
Both survivors and key informants stated that although physical effects
were the most obvious, constant pressure and mental stress were the most
influential negative effects on womens health and well-being. Many of the
survivors said that they were under constant pressure from their spouse or his
family. Whether this was manifested in their husbands jealous behavior,
concerns about where to live or time and resources to seek medical treatment,
stress was a major factor contributing to ill effects on all of the survivors
health and well-being. The majority said that although they had divorced or
escaped from their husband or partner, they were still nervous and afraid or
scared all the time.
Mental effects are worse, I think, because physical abuse, such as
bruises, can be treated. Mental effects cannot... When my husband
was alive, I was always mentally scared and depressed because he
made me feel bad and questioned me all the time. (Survivor, 2005)
Respondents recognized that victims are often ashamed and do not share what
is happening to them, keeping it inside and not seeking help. Key informants
stated that psychological or mental issues are not given much attention in
Mongolia, although there is a desperate need for these services. Survivors also
felt that this type of abuse was not often recognized or treated.
80


I could not believe all of these bruises, not to mention her general
health. I think women are really struggling to survive and live that
way. They dont really go to the hospital because they are ashamed
to say that they were beaten, so they will try to stay at home and
they deal with the consequences. So not only physical, but also
psychological disorder. (Key Informant, 2005)
Health, there is pain, broken bones and bruises. Mentally, in
Mongolia, they dont pay attention to the mental issues, only the
physical. So many women have issues mentally after domestic
violence... (Key Informant, 2005)
Depression, loss of potential/motivation for work, isolation from
society and divorce or dissolution of families were recognized by key
informants as negative outcomes resulting from domestic violence. Survivors
noted feeling sad and depressed as a result of domestic violence and said that
they sometimes became frustrated or short-tempered with children more
easily. They associated domestic violence with not only leading to loss of trust
in men, but also in oneself and lowered self-esteem or self-respect.
So many women are now injured, more often they have a head
injury and if you have a head injury, you will lose your potential,
your capacity to work, to think, physically. Secondly, they are
depressed and they dont like to work because they dont want to
be among people, among their colleagues, among the community.
(Key Informant, 2005)
It makes it difficult for her to focus on raising the family and it can
make it even more difficult for her to participate in a social unit, so
there would be more dissolution of families which would cause more
social strain and it would limit the capital building capacity of family
units, so there would be increases in poverty, increases in
homelessness. There are lots of economic and social effects. (Key
Informant, 2005)
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Health status worsens, women lose their belief to live, performance
of job decreases, especially for women, it makes a lot of stress, and
then sometimes it leads to divorce or being beaten by their husband.
(Key Informant, 2005)
There are mental abuses. Even after, you still have thoughts of how
husband treated you badly. You still have all the bad words you
heard from your husband. Especially when you are lonely, you
remember these things... I sometimes wonder why I have to
experience so many kinds of violence. I dont know. Maybe because
I am so calm and I keep things inside and I am nice and that is why
maybe I experience all of these things. Now, I really want to have a
home or apartment, to live with my son, but I will need a partner or
husband to help with the income. Now though, I dont really trust
men and always see the bad side of them. (Survivor, 2005)
Violence can have direct consequences on womens health and it can
increase womens risk of future ill health (Diop-Sidibe, Campbell and Becker
2006; Ellsberg 2006). Domestic violence has been found to be associated with
acute medical conditions such as multiple injuries to the face, neck, head,
breast or abdomen, as well as other types of bodily injury, disability,
complications in pregnancy, chronic pain, sexual dysfunction and headaches
(Bhatt 1998; Campbell 2002; Diop-Sidibe, Campbell and Becker 2006;
Ellsberg et al. 2000; Ellsberg 2006; Faramarzi, Esmailzadeh and Mosavi
2005). Death of the victim, by suicide or homicide has been found to be the
most detrimental effect of domestic violence on womens health and well-
being (Campbell 2002; Ellsberg et al. 2000).
Violence during pregnancy is associated with depression, high blood
pressure, miscarriages, low birth weight infants and maternal morbidity and
often results in complications such as rupturing of the uterus, premature labor
and in the most extreme cases, fetal and/or maternal death (Bacchus, Mezey
and Bewley 2004; Bhatt 1998; Panda and Agarwal 2005; WHO 2002).
Women whose relationships are abusive before pregnancy are at an increased
82


risk of injury during the pregnancy than at other times (Moore and Wesa
1997). Although some cases of pregnancy may trigger violence, most victims
report that they were also abused before becoming pregnant and that domestic
violence often escalates during pregnancy (Saltzman et al. 2003; Campbell,
Garcia-Moreno and Sharps 2004).
Psychological effects from domestic violence may also cause long-
term health consequences such as mental anguish, fear, nervousness, anxiety,
low self-esteem, depression, hopelessness and a sense of isolation from
family, friends and the community (Bhatt 1998; Coker et al. 2000; Diop-
Sidibe, Campbell and Backer 2006; Ellsberg et al. 1999; Faramarzi,
Esmailzadeh and Mosavi 2005; Fischbach and Herbert 1997; Glantz and
Halperin 1996; Hou, Wang and Chung 2005; Krantz et al. 2005; Moore and
Wesa 1997; Xu et al. 2005; Yoshihama 2005). Moreover, women often lack
the self-confidence and economic resources to achieve and maintain
independence. While physical effects are often more obvious, feminist authors
claim that psychological effects of violence may have more impact and long-
term effects on victims than physical injuries (Amoakohene 2004; Heise,
Pitanguy and Germain 1994; Hou, Wang and Chung 2004; Krantz et al. 2005;
Naved et al. 2006; Panda and Agarwal 2005; Xu et al. 2005).
The majority of survivors experienced physical forms of domestic
violence resulting in injury and long-term health effects. However, many of
the types of violence that survivors reported were classified as less severe
(Jewkes, Levin and Penn-Kekana 2002; Schafer, Caetano and Clark 1998).
Survivors and key informants unanimously agreed that victims of domestic
violence suffer from overall poor physical health and they described physical
effects and injuries resulting from domestic violence including bruises, head
injuries, broken bones and scars. The most extreme consequence of domestic
violence is the death of the victim, by suicide or homicide (Campbell 2002;
83


Ellsberg et al. 2000), which was recognized by only a few key informants.
Other maladies such as nervousness, anxiety, heart conditions, headaches and
fainting were also recognized by survivors and key informants as negative
physical effects on victims health and well-being. While none of the
survivors directly stated that domestic violence negatively affects pregnancy
outcomes, three of the 10 survivors who were physically abused suffered
abuse during pregnancy.
Despite the more obvious effects of physical injuries resulting from
domestic violence, the impact of domestic violence on survivors health and
well-being was found to be mainly psychological. Consistent with other
studies (Bhatt 1998; Coker et al. 2000; Diop-Sidibe, Campbell and Backer
2006; Ellsberg et al. 1999; Faramarzi, Esmailzadeh and Mosavi 2005;
Fischbach and Herbert 1997; Glantz and Halperin 1996; Hou, Wang and
Chung 2005; Krantz et al. 2005; Moore and Wesa 1997; Xu et al. 2005;
Yoshihama 2005), survivors and key informants identified health implications
resulting from domestic violence, including nervousness, anxiety and constant
pressure and mental stress, as the most influential negative effects on
womens health and well-being.
Survivors said that at the time of the abuse, and even years after they
had divorced or escaped from their husband or partner, they experienced
feelings of fear, sadness and depression, loss of trust in men, and in oneself,
and lowered self-esteem or self-respect. These findings are consistent with
research in which psychological effects of domestic violence are recognized
as having a greater effect on womens health and well-being than physical
injuries (Amoakohene 2004; Heise, Pitanguy and Germain 1994; Hou, Wang
and Chung 2004; Krantz et al. 2005; Naved et al. 2006; Panda and Agarwal
2005; Xu et al. 2005). While these results cannot be generalized, they are
consistent with research from Bum and Oyuntsetseg (2001) on the effects of
84


domestic violence among Mongolian women in which 23 percent of
respondents talked about negative effects on their self-confidence, while 10
percent mentioned loss of patience affecting their ability to properly care for
their children.
In addition to physical and psychological consequences, key
informants recognized loss of potential/motivation for work, isolation from
society and divorce or dissolution of families as negative outcomes resulting
from domestic violence. Survivors also said that they sometimes became
frustrated or short-tempered with children more easily. These results are
consistent with studies in which domestic violence has been found to
represent an obstacle to economic and social development (Chang et al. 2005;
Diop-Sidibe, Campbell and Becker 2006; Heise 1998; Moore and Wesa
1997), as well as negatively affecting employment situations, overall
productivity and participation in public life (Diop-Sidibe, Campbell and
Becker 2006; Panda and Agarwal 2005).
While these findings cannot be generalized, they are consistent with
recent studies in Mongolia that have highlighted the effects of domestic
violence beyond immediate injury. According to a Mongolian public opinion
survey, 46.7 percent of respondents described negative consequences of
domestic violence including divorce, collapse of stable family life, and loss of
family happiness (GCSD 2002:28). Research by Bum and Oyuntsetseg
(2001), on the effects of domestic violence among Mongolian women, showed
that 30 percent of respondents noted decreased interest in work, 20 percent
recognized negative effects on social status and approximately 17 percent of
respondents said that they participated less in public activities. However,
nearly half of the women neither reported cases nor took any action.
85


Negative Effects of Domestic Violence on Children
Survivors and key informants also discussed negative effects of
domestic violence on childrens health and well-being, as well as their own.
Of the ten survivors who suffered from physical forms of domestic violence,
three survivors (30 percent) said that their spouses also physically harmed
their children; husbands or partners sometimes hit children when they were
lashing out at women. None of the women commented on whether children
ever suffered from injuries that needed health care or if health care was ever
sought for children.
Survivors and key informants both discussed psychological effects of
domestic violence on children. Survivors said that their children were often
removed from school by their fathers and made to work around the household
or collect bottles for money. Respondents believed that children are often
scared, depressed and stressed because of domestic violence in the home,
which sometimes results in children dropping out of school or running away
from home. Many survivors said that their children were afraid of their father
and hid or went to the neighbors when he came home drunk. Some children
slept on the streets to escape violence in the home and some became involved
in criminal acts. Survivors did say that they feared that their husband would
become more aggressive toward children and this was a major reason for
leaving the household and/or seeking help.
My husband had taken my oldest daughter out of school and
when I went to the NCAV, I put her back in school... Even now,
he is dead, and my daughter is afraid and scared every day of her
life. She now has some king of heart condition because she is
always scared and living in fear. (Survivor, 2005)
I used to work and when I came home late, the house was clean
and dinner ready, but I did not know how this happened. While I
was at work, he made the kids clean and prepare dinner and he
86


would be aggressive with them and then buy candies later to make
it all better. It was a trick... We were divorced three years ago. My
husband had been trying to get the kids to drop out of school and
after we were divorced, my oldest son got involved in crime and
the police blamed it on his family life. He is becoming a llama this
year. Now all I want is for my kids to be happy and educated and
grow up safe. (Survivor, 2005)
I think boys more often receive this violence at home and then
they leave home... They often drop out of school because they are
depressed and tired and stressed. Maybe they dont sleep at night;
they sleep at a friends house or somewhere else. (Key Informant,
2005)
Three key (15.9 percent) informants also believed that, in some cases, children
who witnessed domestic violence at home are more likely to be perpetrators
later in life.
When children see this, they sometimes also become violators, but
in my opinion, it depends on the children, maybe some become, but
most do not like violence and some children protect their mother.
(Key Informant, 2005)
Researchers have claimed that children who witness domestic violence
tend to suffer from higher emotional and behavioral problems than do other
children (Panda and Agarwal 2005). Ellsberg and colleagues (2000) found
that children who grow up in families with violence are more likely to have
strong feelings of guilt, anger, shame and/or helplessness. Other studies have
also found that children who either experience violence themselves or witness
violence between their parents might be more likely to use violence when they
grow up (Ellsberg et al. 2000; Jewkes, Levin and Penn-Kekana 2002; Martin
et al. 2002; Moore and Wesa 1997; Panda and Agarwal 2005; Walker 1999).
Survivors and key informants recognized negative physical and
psychological effects of domestic violence on childrens health and well-
87


being. Three survivors said that their spouses physically harmed their children
and both survivors and key informants both discussed psychological effects of
domestic violence on children. Consistent with research by Panda and
Agarwal (2005), respondents believed that children are often scared,
depressed and stressed because of domestic violence in the home, which
sometimes results in children dropping out of school or running away from
home; however, unlike findings from Ellsberg and colleagues (2000),
respondents did not discuss childrens feelings of guilt, anger, shame and/or
helplessness. While these results are not generalizable, they are consistent
with a Mongolian public opinion survey in which respondents said that many
children lose faith in life and hope for a better future as a result of domestic
violence and are more likely to be uninterested in their studies, drop out of
school and even leave home and live in the streets (GCSD 2002)
Only a small portion of key informants believed that, in some cases,
children who witnessed domestic violence at home are more likely to become
perpetrators of violence later in life, although they said that this depends on
individual attitudes. These results are inconsistent with a Mongolian public
opinion survey in which the majority of respondents (76.3 percent) believed
that a child raised in an abusive environment would develop into an offender
(GCSD 2002:27). Two out of every three respondents also believed that it
would depend on the childs state of mind. However, respondents from this
same survey said that seeing violence negatively affects the emotional well-
being of children and they sometimes grow up to be cruel or timid, depressed
or weak (33.6 percent) (GCSD 2002:28).
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Health Care Seeking Behaviors
Those Who Sought Care
Survivors were asked if they had ever gone to a hospital or health care
provider for treatment after incidences of domestic violence. Women who
suffered from psychological forms of domestic violence never sought help
from a health care professional. Ten survivors (83.3 percent) suffered from
physical forms of domestic violence. Of those ten survivors, three (30 percent)
sought health care at the time of abuse in the past, one from a family doctor
and two from a hospital.
The overall response of health care providers to cases of domestic
violence involved clinical treatment of bruises, broken bones and physical
ailments. In one case, medical providers found it difficult to diagnose injuries
sustained to the head and could not explain why one survivor was fainting and
blacking out. All of the survivors said that they had satisfactory interactions
with health care providers; however, they stated that physicians care for
women only as patients, not as victims, treating only their physical symptoms.
Women claimed that medical professionals did not ask how they sustained
such injuries and that the police must be contacted to file a complaint.
Although there are police on duty at the National Trauma Hospital, survivors
never spoke to them or filed a complaint. Survivors said that there was no
counseling or referral policy at hospitals or health care clinics.
I didnt go to a hospital, I went to a family doctor, several times,
with bruises on my body. They just tried to help me with first aid.
They never asked me how I got the bruises. (Survivor, 2005)
The hospital will always accept women as patients, not as domestic
violence victim. They offer clinical aid, but if you have a problem,
you have to go to the police. (Survivor, 2005)
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It was winter when he beat me this time. He kicked me a lot and at
my intimate areas. I didnt go to the hospital for four or five days and
then I realized that I couldnt really walk. When the doctors saw me
and x-rayed me, they thought that maybe I had been hit by a car. I
was hurt really badly... Usually they just treat me like a patient. I told
them about the case, and they tried to help me as a patient with
treatment, but never as a victim. This was at a private hospital with a
female doctor. (Survivor, 2005)
Health care providers, in the emergency room and primary care
settings, are often the first point of contact with victims of domestic violence
who have suffered from physical injuries; they often provide the first response
to the needs of victims in violent situations (Gremillion and Kanof 1996;
Schraiber and dOliveira 2002). According to Fischbach and Herbert (1997),
health professionals are in the best position to identify, counsel and empower
women who experience domestic violence. In practice, most health care
providers have yet to recognize domestic violence as a health problem, even
though it precedes and contributes to poor overall health, injuries and fatalities
(Schraiber and dOliveira 2002). Domestic violence is characterized as a
problem that is difficult to approach or ignored by health care providers. This
is partly due to the fact that women who have suffered from domestic violence
rarefy disclose or talk about such events to health care providers. Health
personnel are often afraid or uncomfortable in their interaction with these
women and lack the relevant knowledge, tools and skills to communicate with
victims of domestic violence (Heise, Pitanguy and Germain 1994).
Ten survivors suffered from physical forms of domestic violence, of
which three sought health care at the time of abuse. Consistent with other
studies (Buel 2002; Campbell 2002; Ellsberg et al. 2000; Gremillion and
Kanof 1996; Heise et al. 2002; Heise, Ellsberg and Gottemoeller 1999; Krantz
et al. 2005), many of the negative consequences that survivors and key
informants described included cuts and bruises, broken bones, depression,
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