This post contains descriptions of domestic and intimate partner violence which some readers may find distressing. If you or someone you know needs support, 1 Tok Kaunselin Helpim Lain offers immediate tele-counselling and referral services across Papua New Guinea: +(675) 7150-8000.
Gender-based violence (GBV) in Papua New Guinea (PNG) is not only a social issue, it is a major public health crisis that continues to overwhelm families, communities, and the health system. Despite increasing awareness, the burden remains extremely high, with PNG consistently ranked among the most dangerous places in the world for women.
The Scale of the Problem
The magnitude of GBV in PNG is staggering. National and international data consistently reports extremely high prevalence rates.
According to the Papua New Guinea Demographic and Health Survey 2016–2018, 56% of women aged 15–49 years had experienced physical violence since the age of 15, while 28% had experienced sexual violence [2]. More recent studies suggest that up to 65% of women in PNG experience some form of gender-based violence during their lifetime [3]. Earlier community-based studies reported that as many as two-thirds of wives had experienced physical assault by their husbands, with even higher rates documented in some parts of PNG [1,5]. These figures highlight the near-normalization of violence against women in many communities across PNG.
GBV as a Driver of Morbidity and Trauma
From a clinical perspective, GBV contributes substantially to trauma presentations seen in PNG health facilities. Domestic violence is a major cause of assault-related injuries, including fractures, burns, lacerations, abdominal trauma, and soft tissue injuries requiring emergency and surgical intervention [6]. Ponifasio reported in 2002 that approximately two-thirds of female abdominal trauma cases in PNG were caused by husbands or intimate partners [8].
Common mechanisms of injury include blunt assault, cutting injuries, strangulation, burns, and repeated physical assault. In many hospitals, these injuries represent a significant but often under-recognised component of the surgical and emergency workload.
Underlying Drivers: Culture, Gender Norms, and Inequality
GBV in PNG is deeply rooted in complex socio-cultural and economic factors. Patriarchal norms continue to reinforce male dominance and control over women, while practices such as bride price, polygyny, and rigid gender expectations contribute to unequal power relations [1,7]. Violence is often viewed as a private family matter, resulting in silence, underreporting, and limited intervention.
In some communities, violence against women has become socially tolerated or normalised, making prevention and behaviour change particularly difficult.
Health Consequences Beyond Physical Injury
The effects of GBV extend far beyond immediate physical trauma.
Women experiencing violence commonly suffer from depression, anxiety, post-traumatic stress disorder, chronic pain, and psychological distress. Reproductive health consequences include unintended pregnancies, unsafe abortions, sexually transmitted infections, and increased HIV risk [7].
Many survivors also experience social isolation, economic dependence, substance use, and long-term emotional trauma that affects not only individuals but entire families and communities.
Barriers to Reporting and Care
Despite the high burden of violence, GBV remains significantly underreported across PNG.
Major barriers include:
- Fear of retaliation or further violence
- Social stigma and shame
- Economic dependence on perpetrators
- Lack of trust in police or legal systems
- Limited access to counselling services and safe houses
- Cultural expectations discouraging disclosure
As a result, many women never present to healthcare facilities or formal support systems, creating a hidden epidemic that remains poorly documented.
Practical Guidance for Healthcare Workers
Healthcare workers in PNG are often the first professionals to encounter survivors of gender-based violence. Even brief clinical interactions can provide important opportunities for support, safety, and referral.
When healthcare workers suspect or identify GBV, several practical steps are important:
1. Ensure Immediate Safety
- Assess whether the patient is currently in danger.
- Determine whether it is safe for the patient to return home.
- If immediate risk exists, involve hospital social workers, welfare officers, police, or family support services where available.
2. Provide Confidential and Trauma-Informed Care
- Speak with the patient privately and respectfully.
- Avoid blaming language or judgement.
- Use supportive phrases such as:
- “You are not alone.”
- “What happened is not your fault.”
- “Help is available.”
Confidentiality should always be maintained unless mandatory reporting is required.
3. Document Injuries Carefully
- Record the history clearly and objectively.
- Document physical findings thoroughly, including diagrams or injury descriptions where appropriate.
- Accurate medical documentation may later assist legal investigations or protection orders.
4. Offer Referral Pathways
Healthcare workers should be familiar with available local referral options, including:
- Family Support Centres
- Hospital social workers
- Counselling and psychological support services
- Safe houses and women’s shelters
- Police Family and Sexual Violence Units
- Community protection services
- Church-based support organisations
Where available, survivors should be offered referral for psychological counselling, trauma support, and legal assistance.
5. Recognise Mental Health Consequences
Many survivors may present with anxiety, depression, suicidal ideation, or post-traumatic stress symptoms rather than visible injuries alone. Healthcare workers should assess emotional wellbeing and refer patients for mental health support where appropriate.
6. Encourage Follow-Up Care
Follow-up appointments provide opportunities to reassess safety, recovery, and ongoing support needs. Continuity of care is particularly important for survivors experiencing repeated violence.
Implications for the Health System in PNG
For healthcare workers and health systems in PNG, GBV presents several major challenges.
High Clinical Burden
Hospitals continue to manage a large volume of preventable injuries linked to violence, placing additional strain on already limited surgical, emergency, and inpatient resources.
Missed Opportunities for Intervention
Without routine screening and awareness, many patients presenting with injuries are not identified as GBV survivors, limiting opportunities for early intervention and protection.
Need for a Multidisciplinary Response
Effective management requires collaboration between:
- Clinical teams
- Mental health services
- Social workers
- Police and legal services
- Community and safe-house networks
Addressing GBV in PNG therefore requires coordinated action across both the health and social sectors.
Priority areas include:
- Routine GBV screening in emergency and outpatient settings
- Strengthening Family Support Centres and referral pathways
- Expanding access to counselling and safe houses
- Training healthcare workers in trauma-informed care
- Improving collaboration between hospitals, police, and welfare services
- Integrating GBV into public health and surgical research agendas
Conclusion
Gender-based violence in Papua New Guinea is not just a societal issue; it is a major public health emergency with direct implications for emergency care, surgical workload, mental health, and national development.
The evidence is clear: violence against women remains widespread across PNG, and its consequences are seen daily throughout the health system. Strengthening healthcare responses, improving referral systems, supporting survivors, and addressing the underlying social drivers of violence must become national priorities.
If you or someone you know needs support, 1 Tok Kaunselin Helpim Lain offers immediate tele-counselling and referral services across Papua New Guinea: +(675) 7150-8000.
This content is provided for general information purposes only and does not constitute medical advice, diagnosis, or treatment.
References
1.Bradley C. Family and sexual violence in PNG: an integrated long-term strategy. Discussion Paper No. 84. Port Moresby: Institute of National .Affairs; 2001.
2.National Statistical Office (PNG), ICF. Papua New Guinea Demographic and Health Survey 2016–2018. Port Moresby, Papua New Guinea, and Rockville, Maryland, USA: NSO and ICF; 2019.
3.Baines L. Gender-Based Violence in Papua New Guinea. Toksave Pacific Gender Resource Team; 2012. Available from: https://www.toksavepacificgender.net/wp-content/uploads/2021/03/Baines_L_2012.pdf
4.Bradley C. Final report on domestic violence. Port Moresby: Papua New Guinea Law Reform Commission; 1992.
5.Toft S, Bonnell S. Marriage and domestic violence in rural Papua New Guinea. Occasional Paper No. 18. Port Moresby: Papua New Guinea Law Reform Commission; 1985.
6.Lewis I, Maruia B, Walker S. Violence against women in Papua New Guinea. J Fam Stud. 2008;14(2-3):183-197. doi:10.5172/jfs.327.14.2-3.183
7.Papua New Guinea Department for Community Development and Religion. National Strategy to Prevent and Respond to Gender Based Violence 2016-2025. Port Moresby: Government of Papua New Guinea; 2016.
8.Ponifasio P, Poki HO, Watters DAK. Abdominal trauma in urban Papua New Guinea. Papua N Guinea Med J. 2001;44(1-2):36-42.
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