During a recent visit to Botswana, a friend invited me to participate in the funeral rites for her cousin. Abandoned by a husband who had abused her for most of her life, the deceased woman had raised five children alone.
We arrived at the mortuary where her children awaited; the nearest of kin went inside to fetch the body. In accordance with tradition, the deceased woman’s maternal uncle acted as the head of the family and took charge of the rituals. During the ceremony, he didn’t mention that she had died from AIDS. But everyone knew that some of the children might also be infected. If so, their only hope would be the government’s new program to give antiretroviral drugs to everyone with HIV/AIDS.
But a funeral was not an appropriate occasion to talk about AIDS. It was time for kinsmen to send her joyfully into the next world and for the ancestors to welcome the woman into their realm. I joined in the feasting.
Seated next to me was a teenager with beautiful round eyes and a warm voice. She adjusted her scarf just enough to reveal severe burn marks on the right side of her face. “A group of hoodlums threw her on a bar-b-que pit,” a woman explained. The girl nodded, showing me the dark grill marks on her right arm, thigh and leg. “I don’t know why they did this to me except that I talked back to them when they were rude,” she said. Other women shared horror stories. In bars or at home, day or night, some women never felt safe, and violence was a constant threat behind sexual coercion. Girls contracted AIDS because they were powerless to defend themselves against older men who believed in the superstition that virgins could cure them.
Not so long ago, one-third of Botswana’s females aged 15 to 24 were infected. And although rates have declined, violence associated with alcohol abuse remains a social problem of epidemic proportions.
But this isn’t a scenario that unfolds only in Africa. Violence against women and girls is global. It is a societal pathology that takes a variety of malevolent and deadly forms in many cultures, across many classes. It is the most prevailing violation of women’s human rights globally and a major reason why women and girls do not feel safe at home or in the streets. In the United States, there is a strong link between intimate partner violence and HIV. For example, women in relationships with violence have four times the risk for contracting sexually transmitted diseases, including HIV, than women in relationships without violence.
Gender-based violence is also an urgent economic and social development issue. According to the World Health Organization, domestic violence and rape rank higher than cancer, motor vehicle accidents, war and malaria in the global estimates of risk factors for women. Domestic and sexual violence in the United Kingdom costs the country £5.7 billion per year, including costs to the criminal justice system, health care costs, housing and the loss to the economy. In the United States, the health care cost of intimate partner rape, physical assault and stalking totals $5.8 billion each year, nearly $4.1 billion of which is for direct medical and mental health care services. Lost productivity from paid work and household chores and lifetime earnings lost by homicide victims total nearly $1.8 billion.
What is the UN doing about this? The UN Secretary General, supported by UN Women, has taken the leadership through the UNiTE to end violence against women campaign. At the UN Commission on the Status of Women meeting in 2013, hundreds of NGOs gathered together to prevent and end violence against women and girls. In its “Agreed Conclusions,” (a consensus document that provides policy guidance for the UN and governments), the Commission strongly condemned violence against women and girls and noted the important role that men and boys can have in prevention.
I plan to return to Botswana very soon to catch up on the good news. I heard that the Harvard AIDS Initiative is working closely with the government to combat date rape and other forms of violence against women and girls as part of their HIV/AIDS prevention program.
 Costs of Intimate Partner Violence against Women in the United States, United States Department of Health and Human Services, 2003.