Introduction

Violence against women, also referred to as gender-based violence, is a violation of human rights that occurs in all cultures and in every country across the world (Krug et al, 2002, p 7). It causes profound suffering, limits women's full participation as citizens and is a stark marker of gender inequality. One of its further consequences is to undermine children's health and development (Humphreys, 2007). Recognition of the pervasiveness and profound effects of such violence on women's health has led to violence against women being identified as a public health priority issue by the World Health Organization (2005).

This chapter explores violence against women as an example of gendered health inequality and it is argued that good health policy and practice must address this manifestation of gender inequality. Social work is well placed to contribute to this process because of its commitment to social justice, understanding of the social determinants of health and ability to traverse the ‘gap’ that often exists between health services and other players essential to a comprehensive response to gender-based violence. These include activist women's groups that have been pivotal to placing this issue on the public agenda. The author draws on her experience as a social worker in the health sector, in various roles that have focused on assisting health personnel to recognise and respond more appropriately to the many ‘silent’ survivors of genderbased violence they encounter in the course of their work.

Recognition of the extent of violence against women and activism to address it has taken various paths around the world. In Western democracies, this recognition was achieved largely through the activism of second-wave feminists, commencing in the early 1970s and focusing initially on violence against women by intimate partners and ex-partners (domestic violence) and on sexual violence. In countries with strong links to the West, such as Japan and South Korea, feminist activism has also been a driving force, with sex tourism an initial focus of action (Radford and Tsutsumi, 2004; Postmus, 2007). In some developing countries, activism against gender-based violence has been associated with women's empowerment through engagement in other human rights struggles (see, for example, Martins da Silva and Kendall, 2002; Boesten, 2006; Johnson and Brunell, 2006), often influenced by the ‘globalisation of human rights discourses’ (Radford and Tsutsumi, 2004, p 6), an issue taken up later in this chapter.