Leaders deny dowry abuse a problem

By Amy Wise

Mr Vasan Srinivasan says dowry abuse is only a small problem in Victoria’s Indian community

12 June 2018

Prominent leaders of the Indian community in Victoria are unconvinced dowry abuse is going on in Australia and say new laws to abolish the practice are unnecessary.

President of the Australia India Society of Victoria, Dr Gurdip Aurora yesterday said he had never come across dowry-related violence during his 40 years in Melbourne.

“I have never encountered anything in Melbourne,” Dr Aurora said. “There are problems in India because the guys in India are greedy.”

The practice of dowry, in which a bride’s family provides valuables to her husband or in-laws before or after their marriage, only took place when people married in India and came to Australia as migrants, he said.

Dr Aurora’s comments are at odds with the findings of Victoria’s Royal Commission into Family Violence, which found dowry, an old tradition in many Asian and Middle Eastern cultures, is still practiced in migrant communities in Victoria, despite being illegal in India for decades.

The Commission also heard evidence that dowry abuse was linked to family violence, murders and suicides in Victoria.

As a result, the Victorian Government last week introduced a bill to expand the legal definition of family violence to include dowry-related abuse.

Federal Labor MP Julian Hill, who recently called for a Senate inquiry into dowry abuse, said the Victorian Government had led the way on tackling family violence in Australia.

He said just because “someone claims to not have seen [dowry abuse] doesn’t mean it’s not a problem”.

“There is credible evidence that [dowry] is a driver of family violence and based in many cases on a view of women that is unacceptable in modern Australia,” he said.

“There have been proven case studies of murder, suicide and violence.”

Mr Vasan Srinivasan, of the Federation of Indian Associations of Victoria, echoed Dr Aurora’s scepticism, saying dowry abuse is only a “small problem” in Australia.

Instances of family violence in Indian society were often the result of greed or poor mental health rather than dowry, he said.

“We’ve got enough laws to protect our women in this society. I don’t see that we need a special law for dowry,” Mr Srinivasan said.

“There are some newcomers who are migrating and because of the peer pressure they want to buy a house. They start asking, ‘Why work? Can you get some money from your father?’

“I don’t call it dowry, I call it greed.”

Mr Hill said those who deny the problem exists were typically men who were not at risk of family violence.

He said while the evidence needed to be examined carefully, there was a strong case for the Federal Government to follow Victoria’s lead by making an explicit provision in the law that requests or demands for dowry before or after marriage were a form of economic abuse.

Nobody knows it but me

By Amy Wise

Loneliness is still not well understood and many find it a source of great shame.

Loneliness in Australia is on the rise and it’s not just the elderly who are suffering. But how do we address a problem that few people acknowledge and fewer still want to talk about?

When Sarah* was in her 20s, she saw a psychiatrist. There must be something dreadfully wrong with me, she’d decided. She was stressed out all the time, and she had no friends. Even her family was absent.

The psychiatrist was young and inexperienced. Here’s a script, he said. It wasn’t until years later that she discovered there wasn’t, in fact, anything “wrong” with her.

She was simply a young, single mother living in Melbourne on a low income with no support network. A little boy to care for, not much money, bills to pay, hardly anyone to talk to and few moments of joy.

In reality, Sarah, now 42, was awfully lonely.

“Basically it was just really hard for me to maintain housing and money. I had no other problems. I didn’t have a substance issue or anything like that. I just had an extraordinary amount of stress and anxiety over being alone, essentially,” she says.

We think of the lonely as older, frail people, whose wives or husbands or friends have died, leaving them alone and vulnerable. We are living longer and this is the sad reality for many Australians.

But to be young or middle-aged and lonely is also possible, and increasingly, probable. Researchers point to loneliness as an emerging public health issue, with new research showing more than one quarter of Australians say they feel lonely for at least three days every week.

The statistics are concerning to academics and governments. In the UK, a government inquiry led to the appointment in January of a new minister to lead action on loneliness, while in Victoria the MP Fiona Patten last month called for a Minister for Loneliness to help address the negative physical and mental health effects of loneliness.

These are positive steps, but loneliness is still not well understood and many find it a source of great shame. It will be difficult to address such a pervasive problem if people cannot talk openly about it or know how to seek help.

Anyone can feel lonely

At its core, loneliness is a normal, human emotion that many of us feel when we’re unsatisfied with the quality of our relationships. We can have friends but still feel we’re not truly connecting to anyone, or we may be living alone and feel isolated. The feeling often settles when we satisfy our need for social connection, but it becomes harder to budge when we can’t, as when a partner dies or family moves away.

Swinburne University loneliness researcher Dr Michelle Lim says the risk factors for loneliness, such as people living alone, are rising. Loneliness can touch anyone, with young people particularly at risk.

“People don’t normally think of young people as a lonely cohort. But we do know, especially from 15 years old to 25 there’s a peak period of loneliness there,” Lim says.

Sarah was only 18 when she gave birth and first experienced isolation. She was already reserved and shy, but having a baby meant her friendship group shrunk further.

“And even then they continued on to uni and that type of thing and I was at home with a baby. Gradually those friends sort of fizzled out as well and I guess my shyness took over a fair bit,” she says. With no formal training, Sarah worked part-time in low-paid jobs alongside people with whom she had nothing in common.

“I just kind of entered into jobs that were sort of bottom-of-the-barrel type occupations that were full of people I couldn’t really relate to, who had lots of issues, like factories and stuff like that,” she says.

Splintered lives

Suzanne Leckie, a psychologist with mental health charity SANE, believes loneliness is becoming more common, with people who telephone their help centre or visit their online forum leading profoundly isolated lives.

“I think we live in communities and families that have become splintered. Marriages are breaking down, communities are becoming much more anonymous where you don’t necessarily know your neighbours’ names, we’re much more mobile,” Leckie says.

A recent loneliness survey by Lifeline Australia underscores this view, finding over a third of Australians don’t have someone to confide in when they feel lonely. Lifeline’s executive director for research, Alan Woodward says personal connection with other people is a major factor in suicide.

“From Lifeline’s perspective we have some visibility of that in that 33 per cent of the calls that come to our telephone crisis line where the caller is explicitly disclosing their suicidality, the most frequently reported issue is one of feeling loneliness or needing support from others,” he says.

Sarah’s family is not close, a main reason she feels alone.

“There’s not a lot of us and you know, we’re not averse to each other, we don’t fight or anything, but we also don’t have a strong connection,” she says. Sarah also believes community breakdown is partly responsible for her separation from family.

“Part of the reason I don’t have a lot of contact with my family is because my siblings both have had to go work overseas in order to get more money so they can afford to buy a house,” she says.

A stigmatised feeling

Kevin Sharp’s country ballad, Nobody Knows, is all about not being able to talk about loneliness. ‘The nights are lonely, the days are so sad… And I’m dying inside but nobody knows it but me’, go the lyrics.

There’s a strong social stigma surrounding loneliness, meaning most people find it a shameful subject to broach. Melbourne psychologist Catherine Madigan says people fear being negatively judged.

“(But) it’s not that there’s something wrong with the person,” she says. “I have people telling me all the time how early they have to get up to get to work, and they say by the time they get home they’re exhausted.

“So it’s not like they’ve got energy after work to be going out and meeting people. It takes time to socialise. And people who are introverted, they may want to make friends but they can find socialising quite draining, so a little bit goes quite a long way.”

Sarah agrees loneliness is stigmatised. “I never really call it loneliness because there’s an element of sort of derogatory pity that goes along with that word. If you’re seen as lonely you’re seen as a bit pathetic,” she says.

Online communities can offer a safe outlet for people to admit to their struggles. A search of SANE’s online forum reveals more than 200 anonymous discussions on loneliness, including this recent post:

“I feel by myself, no one to talk to, no one to be there for me,” they write. “My fiancé always works and odd hours at that and my only family is my sister who is busy with her own family. I’m scared because when loneliness starts creeping in I start to feel like I’m a piece of shit or I’m worthless or I can never do anything right and I must admit those thoughts are coming.”

Suzanne Leckie says people talk more openly online.

“The online communities can really step in and fill a void. They don’t meet all needs but I think they can be a bit of a stepping stone. People can practice their social skills … and then use that increased confidence out in their own life,” she says.

Loneliness is not depression

Many people mistake loneliness for depression. Depression can lead to loneliness, but people who are lonely are not always depressed. Lim thinks it’s important to draw this distinction.

“People often think it’s a little bit more sinister than it is, and it gets worse and then it actually affects their mental health. When in fact we can actually tackle loneliness first and that would be good for not just your mental health but your physical health,” she says.

Years of loneliness have meant Sarah now has debilitating social anxiety, which has prevented her from finishing university studies.

“I was doing health science which sort of meant I had to deal with people a lot and I just found that … being alone has affected the way that I interact with people. It’s been 20 years of sort of spending a lot of time alone and I think it’s really affected my ability to speak fluently and comfortably in social situations,” she says.

How to help

Volunteer programs abound to help lonely people connect with others. Relationships Australia runs Neighbour Day, which encourages people to get to know their neighbours in small, non-threatening ways that hopefully opens the doorway for people who are lonely.

Campaign Manager Sam Robinson says people overwhelmingly maintain those connections.

“It’s not about being best friends (but) neighbours are very important to our social infrastructure,” she says. “It doesn’t have to be a big thing, for a lot of people they have no one to talk to. Simple smiling and waving. In the good times it’s great to know your neighbours but in the difficult times it’s even more important,” she says.

While these programs work well for many, they often don’t succeed with the chronically lonely, who have few social skills and often a mental health issue.

Leckie says projects that creatively give people the skills to help them forge connections work better. For instance, one GP whose patients were not responding to medication decided to create a gardening club at the rear of his surgery.

“And people got getter, because they had a reason to get out of the house, a reason to get together, something to talk about, a common purpose. They had a topic to discuss and things to do alongside each other,” she says.

Lim has worked in this way with young people with psychosis, a highly stigmatised condition. They were asked to improve one relationship in their lives and were taught how to send the right friendship signals.

“That social confidence actually really helped them get out there. And a lot of them started to seek work and got jobs and went back to school, things like that,” she says.

Meanwhile, Sarah still bravely confronts her solitude every day, sometimes attending informal meet-ups arranged through social networking sites.

“It’s pretty tacky,” she says, “But at the end of the day you have to do things like that otherwise you just sit at home and sort of feel shitter really.” Mostly, though, she’s learnt to be a better friend to herself.

“I always have hope that I’ll make more connections with people, but I truly don’t think that will happen. I’ve thought, actually no I’m just gonna sort of self-soothe.”

Together but no connection

Mandy* sips on her tea as she calmly describes the way loneliness eased itself into her marriage and gradually intensified its grip, bringing with it an acute sense of loss.

The 42-year-old teacher and mother-of-two from outer eastern Melbourne was 30 when she met Joe, a kind man with a good job who was grounded and secure. They bought a home with views in the foothills of the Dandenong Ranges, and started a family.

But happiness was elusive. After a while, she felt there was no intimate connection between them. Her husband, a practical man raised in Africa, didn’t share his feelings or emotions and wasn’t comfortable with physical contact. There was sex, but there were no hugs, there was no hand holding.

“As time passed I realised that what I needed was more emotional connection, and that life wasn’t just about the practicalities,” she says.

“I remember having so many conversations with him saying I need intimacy. But I would say to him a hundred times, ‘I don’t mean sex, I’m not talking about sex’.

“We did have sex but it wasn’t intimate. It was just practical. It was the same as him giving me a cup of tea. It would be like, there you go, my job’s done. That sort of thing, like not emotional at all.”

Mandy says she understands many men find it difficult to express themselves, especially when masculinity is still so bound up with notions of physical strength, self-reliance, restricted emotions and sex disconnected from intimacy.

Her family advised her to stick with her marriage because men were just like that and she had to live with it. They also counselled her to seek intimacy and emotional support from friends because no man could offer everything. They didn’t want to see her alone.

Mandy thought about this and tried to do as they advised.

“I contemplated that for a long time. I gave that a red hot go. But I just kept thinking, ‘It’s not good enough for me’. And just coming back to, if I feel alone in my marriage, I may as well be alone. I would rather be alone.”

Not wanting to end her marriage, Mandy began a frenetic search for the closeness and understanding she needed, which alienated her friends and led to an eventual fall into depression.

“I felt sad, I was really sad a lot of the time,” she says. “Initially I couldn’t articulate what I was feeling the way I can articulate it now. I just knew I felt shit, and I knew I hated everything and was constantly upset. I was seeking intimacy from every single person in my life other than my husband, because I knew I wasn’t going to get it from him.

“I’m not talking about affairs but being very needy of everyone, to the point that I was quite destructive.”

Her depression meant she did not function well and there were days when she was frozen with inertia. She also drank a lot. Mandy’s husband bore her cups of tea, and busied himself with the children and housework.

“But he couldn’t let me talk, or ask me how I felt or what I was going through. I guess like a lot of men he had that sort of attitude of, like, ‘Chin up, you’ll be right’. No matter how many cups of tea he made me it wasn’t going to help,” she says.

They saw a counsellor together, and alone, but Mandy sensed that her husband, while saying the right things, could never fulfill her in the way she needed. After 13 years of marriage, eight months ago she asked him to leave.

Today she feels less lonely, though she is single. She stopped drinking after separating, and relies on a healthy network of friends. She’s also kept up the counselling, which she credits with teaching her self-love.

“In my marriage I was seeking intimacy and emotional connection constantly, but then once we separated… that seeking stopped because I don’t need it to make myself feel good about myself anymore. I have that within,” she says.

Mandy says she now has more energy for others and has never doubted her decision.

“I was so caught up with the marriage and trying to make it work … that I didn’t have the energy for my kids, especially,” she says. “By taking myself out of that situation I feel less lonely because I can connect with them and with other people.

“I was drinking every day by myself, every day without fail. I went through that for a long time but then I did come out stronger and better and happier.”

*Names have been changed for privacy reasons.

Listen: the full interview with Swinburne University researcher Dr Michelle Lim

Swinburne University researcher Dr Michelle Lim talks about how we can help people through loneliness.

 

Alan Woodward, Executive Director for Research at Lifeline.

Suzanne Leckie, psychologist with mental health charity SANE Australia.

Colonoscopy a battle for some

Jan Maling battled to ensure her husband Neil got a colonoscopy, but it took far longer than it should have.

A colonoscopy is not a procedure many would queue for, and yet we are, in the thousands. Some spend anxious months – even years – in a very long line and only reach the front by battling the system.

Jan Maling’s pet name for her husband is “Tiger” but her efforts to fast-track his colonoscopy show a fierce strength and courage of her own.

In November their doctor said Neil, 77, needed a colonoscopy, quickly, to confirm bowel cancer. But six weeks went by with no date from the Bendigo Hospital.

“He was anxious the whole time. He would say to me, ‘This cancer’s not on holidays, it’s just gnawing away, moving through’,” Jan says.

Like Neil, thousands of Australians with bowel cancer symptoms, or who test positive to blood in their stool through the free bowel cancer screening program, are waiting months for a colonoscopy to learn if they have cancer.

Charity Bowel Cancer Australia wants this changed, and recently petitioned Canberra politicians to guarantee a colonoscopy for those in need within 120 days.

While four months is nowhere near the four weeks that cancer experts deem optimal, it is better than a system that now sees nine in 10 Australians who test positive to blood in their stool wait between 116 and 181 days for a follow-up colonoscopy.

Anger and anxiety sparks action

Faced with these delays, many are being forced to game the system – like changing their address – or they get vocal.

Jan Maling soon emailed the hospital CEO because every day spent waiting for a diagnosis seemed like a week.

“I said ‘There seems to be a delay, what are you going to do about this deplorable situation?’,” she says.

Tests had shown Neil had bleeding and low iron levels, and despite being a fit long-distance walker, he was unusually tired. All signs of bowel cancer.

Jan heard back within minutes, with a phone call offering her husband a colonoscopy in five weeks.

When Neil saw the colorectal surgeon, the surgeon said he wished he’d come sooner. He had advanced bowel cancer, meaning it had spread beyond the bowel to lymph nodes and other organs.

“His treatment will take a year,” Jan says.

After that Jan became so angry she felt she was going to explode.

“I woke up one night and I was hot all over, I was just burning all over I felt so angry. I felt like I could punch a wall or something,” she says.

Instead Jan contacted her local member, Jacinta Allen and became something of a health activist.

Similarly, Mandy de Vries, 51, a mother of two from Darwin, has become a campaigner, after chasing the Royal Darwin Hospital three times to secure a colonoscopy in March after a positive test in December.

“I was classed as a high priority and I didn’t feel that I was being treated as a priority,” Mandy says.

Exacerbating Mandy’s anxiety, hospital staff didn’t have the right surgical expertise. The team supported her decision to instead be treated for advanced cancer at Melbourne’s Peter MacCallum Cancer Centre.

“There’s a motto up here – when in pain, catch a plane,” she says of the health system in Darwin.

Although she’s finished with surgery and treatment, astoundingly she will wait another three months for a follow-up colonoscopy to reverse an iliostomy bag.

Listen to Jan Maling talk about her anger over having to wait for a colonoscopy:

 

A two-tiered system

Already 1 million colonoscopies are performed in our health system every year, and this figure is set to grow as people age and the screening program expands.

Bowel Cancer Australia says there are plenty of specialists to perform this number of colonoscopies, but only a fraction of their clinical time is given in the public system.

Lack of funding for specialist care in the public system is a key reason why people have to wait so long for colonoscopies, it says.

Colorectal surgeon Graham Newstead works in both public and private hospitals, and can see private patients within the week, if needed.

“I can do a colonoscopy and put you at ease next week if I’m worried about your symptoms or worried about your anxiety,” Dr Newstead says.

But he’s limited in the number of colonoscopies he can perform in public hospitals because of the lack of public funding.

Colorectal surgeon Dr Graham Newstead says private patients do not have to wait for a colonoscopy.

Wait worsened by anxiety

Myra Seberry has post-traumatic stress disorder after waiting a year for a colonoscopy.

Long wait times can lead to advanced, untreatable bowel cancer, a recipe for anxiety for patients and their families.

Professor Tim Price is an Adelaide University medical oncologist who was on the expert group that oversaw the development of clinical practice guidelines for the management of colorectal cancer.

Prof Price says health professionals are concerned about patient anxiety, which was why his group recommended colonoscopy be performed as promptly as possible.

“The risk of anxiety alone is enough to recommend prompt referral,” he says.

Myra Seberry, 50, from Scarborough in Queensland, has post-traumatic stress disorder after waiting a year for a colonoscopy that showed advanced cancer. She was only diagnosed after changing her address in order to be seen by a different hospital.

“I went from being a good sleeper and having a very good quality of life to being really anxious,” Myra says.

“It was fear that the same thing was going to happen over again. Every time I get sick is it going to be the same palaver? I go in and they dismiss things?”

Dr Newstead says a positive test result will already provoke anxious thoughts of cancer. If someone then goes on a wait list their anxiety will worsen knowing any cancer may deteriorate over time.

More money but still the blame game

State governments have released some new funding in response to the diagnosis crisis. For instance, the Victorian Government announced $12 million two weeks ago for the most urgent colonoscopy procedures.

But still the states blame the Federal Government for shortchanging hospitals, while Health Minister Greg Hunt recently said colonoscopies were a state responsibility.

Jan, meanwhile, intends to continue to speak out about her husband’s predicament so others may be seen and treated sooner.

“I will do everything in my power to highlight the deplorable situation where people are told to catch bowel cancer early but you can’t do anything about it,” she says.

“You hit a brick wall.”

When to see your GP – top bowel symptoms:

  • Bleeding from the rectum, or any sign of blood in the bowel motion
  • Unexplained weight loss
  • Persistent change in bowel habit
  • Severe abdominal pain