WOMEN RESEARCHING WOMEN

DESCRIPTION OF THE METHODOLOGY

SELECTED FINDINGS OF A SURVEY ON DOMESTIC VIOLENCE IN GUYANA

SELECTED FINDINGS OF A SURVEY ON WOMEN’S REPRODUCTIVE AND SEXUAL HEALTH IN GUYANA

RED THREAD                                                                                          APRIL 2000

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IDB PROJECT NAME: Study on Issues of Reproductive and Sexual Health, and of Domestic Violence Against Women in Guyana

IDB PROJECT NUMBER : TC-97-07-40-9-GY

IDB PROJECT GROUP LEADER: Claire Nelson

EXECUTING AGENCY: Red Thread Women’s Development Programme in conjunction with Dr. Linda Peake
 
 
 

RED THREAD

173 CHARLOTTE STREET, GEORGETOWN, GUYANA


The purpose of the two studies on Domestic Violence and Reproductive and Sexual Health was to:

  1. investigate the attitudes to and perception of domestic violence as well as the extent and nature of violence experienced by Guyanese women;
  2. investigate the state of Guyanese women’s attitudes and behaviour towards and knowledge of, their reproductive and sexual health.


1. DESCRIPTION OF THE METHODOLOGY

1. As an organisation which consciously works towards democratic transformation and empowerment, Red Thread views research with and for women as a necessary element of any strategy for transforming women’s lives.

2. In May 1998 a total of eight women from Red Thread were chosen to form the Research Team for this project. All eight were/are community-based women from Linden, West Coast Demerara, West Coast Berbice and Georgetown, five of them educated to primary level and three with 1 or 2 years of secondary education. Two have previously carried out participatory research after training by Dr Peake; the other six were trained as part of this project design. The eight women are: Cora Roberts, Halima Khan, Vanessa Ross, Daywattie Lilman (injured her foot during the fieldwork and dropped out of the team), Shirley Goodman, Joy Marcus, Joycelyn Bacchus and Chandradai Persaud. They range in age from the late 20s to the 50s.

3. In addition, the project was guided by an advisory body of six men and women. The members of the Consultative Team, all of whom are based in Georgetown, were selected for their location and/or experience, and they are: Ameena Gafoor, Women Across Differences; Frederick Cox, Guyana Responsible Parenthood Association; Andaiye, Red Thread; Vidya Kissoon, Help & Shelter; Janice Jackson, CAFRA; Hazel Halley-Burnett, Women’s Affairs Bureau; Magda Pollard, (then) chair National Commission of Women, Christine King, Guyana Association of Professional Social Workers.

4. For most of May and all of June 1998, training of the Research Team focused on an introduction to concepts and skills in social science research. This included an introduction to research methodologies including participant observation, experiments, archival research, survey research and secondary research. Attention focused particularly on the latter two. In terms of secondary sources we examined the 1992 Living Standards Measurement Survey, the 1992 Household Income and Expenditure Survey and the Interim Report for the 1991 census (the census was not finally published until late in 1998 and was thus unavailable during the training period). Survey research training included learning about survey design, random and non-random sampling, questionnaire construction, in-depth interviews and interview techniques. Training was also given in transcribing interviews and coding of questionnaires.

5. During July and August 1998, the Research Team working with Karen de Souza modified a CAFRA, Trinidad and Tobago questionnaire on domestic violence for local use; this questionnaire was then revised by the Consultative Team and further modified. The Research Team field tested the questionnaire as part of the training, following which the questionnaire underwent its final modification.

6. The months of September to early December in 1998 were spent in the field in Georgetown conducting the survey on domestic violence. The months of January and February in 1999 were spent coding the questionnaires on domestic violence and transferring data from the questionnaires to coding sheets. A similar process was carried out on the reproductive health questionnaire which was conducted in June and July 1999.

7. Dr Peake wrote the final draft report on violence in September and October 1999, again with continuous feedback from the Research Team. The reproductive health data was analysed and written up in November and December 1999. The methodology report was prepared in January and February 2000.

8. Lessons learned for replicability related to why the research process was successful: (a)women of different educational and other backgrounds worked collectively through a recognition of and respect for their differences; (b) scheduling was flexible and responsive to what was happening on the ground; (c) a high level of personal commitment, especially during the fieldwork period; (d) training and practice were sufficient to ensure that the team felt comfortable with their task; (e) quality control was monitored on a daily basis; (f) the small size of the team facilitated cohesion, coordination and maintenance of standards.
 

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2. SELECTED FINDINGS ON DOMESTIC VIOLENCE

1. The whole question of what we mean by domestic violence is problematic. The term we have chosen to use to discuss violence against women is that of domestic violence. We prefer this term to either marital or family violence because unlike these, it encompasses a wider range of relationships within which violence against women takes place. However, the use of the word ‘domestic’ is itself problematic for three reasons: (i) It is a term that makes us think of violence as being conducted within an atmosphere of privacy or being encompassed within walls, although it is maintained by very ‘non-domestic’ factors, namely structural relationships of gender that disadvantage women, and children, in both domestic and non-domestic arenas. (ii) We need to embrace a definition of ‘domestic’ that comprises the full range of domestic spaces and relationships that take place within them, regardless of marital status or living arrangements. In other words, we need a definition which does not assume only a married couple living under the same roof with their children. (iii) The term ‘domestic’ primarily conjures up an image of violence against adult women by men, simultaneously blinding us to forms of violence that have a generational basis. However, we are also concerned with violence against children, and this requires us to pay close attention to the role played by women in domestic violence. It is women who commit the majority of violent acts against children (and the elderly) in Guyana.

2. Secondly, what do we mean by the word ‘violence’ within the term ‘domestic violence’? Unlike most other groups in the Caribbean, including women’s organisations and professional social workers, we take violence against children to include what is normally considered acceptable discipline. We know that the boundary between what is abuse and what is discipline i.e., between acceptable and unacceptable behaviour, is culturally and geographically variable. In Guyana, and in the wider Caribbean, the line is clearly drawn in favour of including corporal punishment as punishment rather than abuse. However, this is not the line taken by Red Thread who are opposed to the notion that corporal punishment is an effective and acceptable mode of discipline.

3. Drawing on previous definitions and the points outlined above (as well as the research findings we report) we define domestic violence as any act, including the threat of acts, committed by a person with whom the victim has or had a conjugal, love or sexual relationship, or a relationship of dependence, which impairs the life, body, psychological well-being or liberty of a woman and/or children.

4.The findings below differ somewhat from those of Danns and Shiw Parsad (1989), who conducted the only other study on domestic violence in Guyana in 1988. Differences in findings are most probably due to the different methodologies employed and cannot be interpreted to mean that levels of violence have changed.
 
 

Domestic Violence Analysis

In 1998 Red Thread conducted a questionnaire survey on domestic violence in Greater Georgetown of 360 women. The survey approximated a random design and took the form of a multi-level cluster survey. A random design was deliberately chosen because it is the most guaranteed approach for achieving a sample representative of the population it is taken from.
 
 

1. Perception of Domestic Violence

Nearly four out of every five respondents perceived violence in the family to be very common in Guyana (76.8%).

2. Definition of Domestic Violence

With regards to the kinds of behaviours that the respondents defined as domestic violence everyday physically violent behaviour such as fighting, beating, or hitting, was recognised by 83 per cent of respondents. Moreover, 50 per cent of the respondents also defined domestic violence as verbally abusive behaviour such as curses, threats, and humiliation.

3. Experience of Violence as a Child

a. Over 30 per cent of the respondents said they experienced abuse as a child (32.1%). However, that ‘getting licks’, slaps, and beating is not perceived as abuse is evident in the varying answers to differently worded questions regarding discipline and abuse. For example, although only 32.1% of all women said that they experienced abuse as a child, 84.2% said that they had experienced licks, slaps, beating.

b. In approximately eight out of ten cases of childhood abuse it was the respondent’s mother or other female relative who had administered this abuse. However, for sexual abuse it was invariably male relatives who were responsible.

4. Knowledge of Domestic Violence

Over one in three of the respondents knew someone currently experiencing domestic violence (35.5%).

5. Experience of Domestic Violence in Current Relationship

a. There were 237 respondents (65.8%) currently involved in a relationship or union of some kind. Of these 27.7% (or one in four) had experienced physical abuse; 26.3% (or one in four) had undergone verbal abuse; and 12.7% (one in eight) had suffered sexual violence. The corresponding figures for all women are that 20.7% (or one in five) had undergone physical abuse; 19.1% (or one in five) experienced verbal abuse; and 9.5% (or one in ten) suffered sexual abuse.

b. Of the 83 women currently in a relationship who claimed to have experienced abuse, over 50 per cent (53.5%) had experienced psychological symptoms, such as depression and anxiety, and 7 per cent had sustained physical symptoms such as cuts and bruises and broken bones. Twenty of the women in current relationships had required hospital treatment for the abuse they had received.

c. One hundred and one women responded to the question, "Which of the following do you think causes or caused your partner's abusive behaviour?" This figure indicates that over 40 per cent of the respondents in current unions had experienced abuse of some kind at some point during their current relationship (42.6%), which corresponds to approximately 30 per cent of all the respondents having experienced abuse of some kind (31.6%).

6. Experience of Domestic Violence in Previous Relationships

a. A total of 197 respondents (64.6%) had been involved in previous long-term relationships regardless of their current union status. Of these 41.9% (or two in five) had experienced physical abuse with a previous partner; 32.2% (or one in three) had experienced verbal abuse with a previous partner; and 12.2% (one in eight) had suffered sexual violence from a previous partner. In terms of all respondents the corresponding figures are: 26.6%, (or one in four), had experienced physical abuse, 20.1%, (or one in five), verbal abuse and 6.8%, (or one in fourteen), sexual abuse. Apart from the figures for sexual abuse (which are identical) women reported having experienced higher levels of physical abuse (32.2% compared to 27.7%) and verbal abuse (32.2% compared to 26.3%) with their previous partners than with their current partners.

b.Ninety-nine women responded to the question on what caused their previous partner's abusive behaviour. This figure represents (50.2%) of the respondents in previous unions and 30.9% of all respondents. Again this figure is higher than for women in current relationships (42.6%) who responded to this question. Approximately 50 pre cent of these women answering this question said that jealousy (55.4%) or her partner’s hot temper (47.5%) was at least one of the likely causes of her partner’s abusive behaviour.

c. Very few women – sixteen – who had experienced abuse in a previous relationship were experiencing violent behaviour in their current relationship.

7. Violence in the Community

a. Nearly 50 per cent of the respondents thought some areas in Guyana have more frequent incidences of family violence than other areas (49.8%). Of the women who felt that incidences of family violence occur more frequently in certain areas of Guyana, over 40 per cent felt that these were poor urban areas, closely followed by Afro-Guyanese areas.

b. The majority of all the respondents felt a minimal risk in their communities of being raped (76.0%), followed (72.0%), robbed or assaulted (63.8%), or having their property stolen (56.7%). However, between 20 to 40 per cent did feel at risk. Moreover, more than 60 per cent of all respondents said they take precautions in their community to avoid being raped, followed, robbed, assaulted, or having their property stolen (66.3%).

8. Women’s Responses to Violence, including Knowledge and Use of Services

a. Approximately 40 per cent of women in current relationships, (41.3%), which corresponds to 30.6% of all respondents, replied to questions on their response to the first abuse they experienced in their current relationship. More than half said that their partner, in response to his own abusive behaviour, begged forgiveness (55.1%) or promised never to do it again (9.2%). However, nearly 30 per cent said that their partner's response was to ignore his own abusive behaviour (27.6%).

b. The majority of the women said that they either accepted his apology (50.9%) or did nothing and tried to accept the situation (19.1%). Far fewer women took an active stance to their partners’ abuse. Nearly one in five women (19.1%) of the women said that they retaliated and fought back – physically or verbally. However, very few women talked to their partners’ about the situation (4.5%) and even fewer left the relationship as a result (1.8%).

c. At some stage in their current relationship, approximately 40 per cent of the women experiencing violence with their partner sought help (37.4%). Of those who did seek help, most went to either the police (39.5%) or a relative (34.2%) rather than to a friend (15.8%), neighbour (5.3%), priest (2.6%) or counsellor (2.6%). For most of these women, the outcome of seeking assistance was that their partner received a warning of some kind (40.0%) or that nothing changed (31.4%), that is, the abusive behaviour continued. For only 20 per cent did the violence actually decrease as an outcome of seeking help.

d. Of those women who went to the police (n=13) only seven of their partners received a warning. Of the twelve women who had gone to the police the last time they sought help, only two had any action taken against their partner. When asked if they had ever reported their case to the police at one time or another, most of the women who had experienced domestic violence with their current partner said that they had not done so (78.9%), indicating that only one in five cases of domestic violence are reported.

e. While more than 50 per cent of the women experiencing violent behaviour in a previous relationship did not seek help in response to the violence (52.9%), more than 40 per cent had sought help at one point in time or another (46.1%). For the majority of women who had experienced violence with a previous partner, what they considered as having stopped the abuse was that the relationship had ended (73.1%), indicating that in seven cases out of ten, violent relationships are not brought to an end by a behavioural change in their male partner’s behaviour.

f. More than 50 per cent of all the respondents indicated that they had knowledge of where abused persons could go to seek help (57.7%). Out of the respondents who said that they did know where abused persons could go to seek help the most common response was that of Help and Shelter (45.1%), followed by the police (27.7%) and a priest (5.3%). Very few respondents specified Red Thread (2.9%), the Women’s Affairs Bureau (2.4%), or another women’s organisation (2.4%). None of them mentioned the Genesis Home. Respondents were also unlikely to refer to a professional such as a counsellor (2.4%) or a lawyer (0.5%).

g. The majority of women, or more than 65 per cent, had no knowledge of the Domestic Violence Act (67.5%); this was especially the case for Indo-Guyanese women (77.3%). Of the women who did have some knowledge of the Act, only a few (15.3%, or one in eight) knew what the Act provided for.

9. Women’s Association with Violence

When asked if they had ever initiated violence within an adult relationship, nearly all respondents said that they had not (83.1%, n=267), leaving 16.9% (n=53) who asserted that they had initiated violence.

10. Attitudes and Behavioural Practices Relating to Violence Against Children

a. Women were also asked how children should be punished and how they punished their children. When the 70 per cent of women who agreed that children should be punished were asked about how children should be punished, the most common response was hitting, slapping, and/or lashing. Out of all the respondents hitting was seen as the most agreed upon form of punishment by nearly a third (30.8%). A slightly smaller percentage believed privileges should be withdrawn (26.2%) or that children should be grounded (18.1%).

b. A slightly higher proportion, over 40 per cent of all the respondents (42.5%), responded to the question, "From what age do you think hitting children should begin?". Out of these respondents, most of the women indicated that toddler (26.5%) or pre-school ages (27.2%) were the most appropriate ages to begin hitting, followed by between one and two years (16.9%) and school age (six years old and older) (16.7%). Very few women indicated that from birth (2.9%) or between six months to one year of age was appropriate (5.1%). Very few indicated that there was no special age to begin hitting (3.7%).

c. A total of 179 women responded to the question, "What do you hit children for?". This is 64 more women than the number who said hitting is acceptable and 115 more than the number who earlier admitted to hitting their children. This number is 55.9% of all respondents and 72.2% of all respondents with children. In other words, seven out of ten women with children hit their children. Nearly 50 per cent of the responses indicate that one of the main reasons children are hit is for misbehaviour (47.5%), while over 20 per cent of the responses indicate that another main reason children are hit is for disobedience (21.2%). Rudeness or insolence accounted for 7.3% of responses.
 


3. SELECTED FINDING ON REPRODUCTIVE HEALTH

1. In this part of the study our aim is to provide information on the reproductive and sexual health concerns of Indo-Guyanese and Afro-Guyanese women in the 1990s. We divided our study to look at three groups of women; adolescents, older women of childbearing age and menopausal women. We focused on these three groups because their requirements and health problems are often different yet little is known of the differences and similarities between them in terms of their knowledge of and practices related to reproductive health.

2. In the 1990s in the Caribbean birth rates declined, life expectancy rose, and infant mortality rates (IMR) and maternal mortality rates (MMR) fell (Massiah 1992). However, although mortality rates have fallen, fertility rates are still high, with many territories having over 40 per cent of their populations under the age of fifteen. But this mostly positive picture is not one that applies to Guyana.

3. In 1996 the population in Guyana was estimated at 770,000, with 51 per cent of the population being female. While in 1960 the population growth rate was 3.3 per cent, by 1997 this had been reduced to 0.8 per cent. Life expectancy declined drastically from 70 years in 1985 to 66 in 1996 (69 for women and 63 for men). There has been a general decline in fertility rates, currently at 2.6 per cent per annum (but at 3.2 per cent in 1980). The crude birth rate in 1970 was 33/1,000, in 1987 it was 24/1,000, and in 1998 was 30/1,000. Infant Mortality Rate (IMR), another key health indicator, appears to be declining. The drop in the IMR in the late 1990s has been due to a reduction in deaths from acute diarrhoeal diseases. However, the most recent figures are still much higher than all other countries in the Caribbean (except Haiti). Figures on the IMR are: 54/1,000 in 1980; 44/1,000 in 1986; 35/1,000 or 53/1,000 in 1990; 44/1,000 for 1990-1995; and 24/1,000 in 1998. Guyana has one of the highest Maternal Mortality Rates (MMRs) in the Caribbean. PAHO (1997) indicates the MMR for 1990-1995 was 172/100,000 live births (compared to only 20 for Barbados and 82 for Jamaica). Low Birth Weight (LBW) is between 18-20 per cent of live births, a rate that is higher than in other CARICOM countries. Guyana is one of the few countries left in the Anglophone Caribbean where malnutrition is still a significant problem (UNICEF 1999). The incidence of Sexually Transmitted Diseases is rising, with Guyana having the highest rate of infection in the Caribbean.

Reproductive Health Analysis

A questionnaire survey on women's reproductive health was conducted in Greater Georgetown. One hundred and sixty-five women were randomly chosen for inclusion in the survey which comprised a multi-level cluster survey. Fifty-three of the respondents are teenagers, 60 women are of childbearing age, and 52 women are of menopausal age.

1. Contraceptive Knowledge and Use

a. The majority of respondents (84.2%) claimed that they know what contraceptives are.

When asked which contraceptives they were aware of the majority of respondents knew of IUDs (commonly referred to as the ‘five year stop’) (49.4%), condoms (79.4%) and the birth control pill (73.1%). Slightly fewer knew of injectables (51.9%) and tubal ligations (commonly referred to the ‘stop’) (32.5%) with 30 per cent referring to abortion as a method of contraception (30.6%). Approximately 20 per cent referred to foam methods (26.3%) and bush remedies (21.9%). The least mentioned methods are gel (16.9%) and the diaphragm (12.5%).

b. Out of the 135 women (81.1%) who have current partners or were previously in a long-term relationship, more than half reported that their partner does not or did not use contraceptives (63.7%). The findings also indicate that the level of contraceptive prevalence for women was very low. Out of the women with current or previous partners, less than 50 per cent reported that they had used contraceptives (45.2%). Of those women who said that they have used contraceptives (n=60), the majority said that they are no longer are using them (71.2%). Only seventeen women currently still use contraceptives.

c. Over half learned about contraceptives from media sources such as books (70.5%) and television (49.1%). Other such sources –the radio and leaflets – had less of an impact. Among individuals, friends (47.8%) were the most likely source of information, followed by medical personnel (20.2%), especially nurses and doctors. Most distressingly, those sources which are best located to inform about contraception – parents (8.1%) and teachers (7.5%) – rated very low, indicating the need for education of both these sources as to their roles in passing on information about reproductive health.

2. Knowledge of STDs

a. The majority of respondents (83.0%) know about sexually-transmitted diseases (STD), commonly known as ‘bad sick’, ‘leak’ or ‘blue bore’. The majority of respondents do nothing to protect themselves from STDs. Only 46 women responded that they did. Of those women, the most popular form of protection is having one partner at a time (n=45), or abstaining from sex (n=19) or the use of condoms (n=26) (more than one response was allowed).

b. Nearly all the respondents have knowledge of AIDS and HIV (99.4%), with most of the women (84.6%) believing that anyone is likely to contract HIV/AIDS. The respondents were also extremely well informed about how AIDS/HIV is transmitted. Nearly all the women said that people get HIV/AIDS through sex (92.0%) or blood transfusions (87.7%). The majority said that the use of intravenous needles by drug addicts is another way (61.1%). Fewer than ten per cent of the women felt that people get AIDS by kissing (4.3%), or by coming into contact with a person with AIDS (6.8%). However, more than 60 per cent did not know that a person can have HIV without getting AIDS (62%).

c. The sources of information about STDs were very similar to those for information on contraception. Media sources (television = 54.6%; books = 49.7%) and friends (52.8%) constituted the most popular sources, followed by medical personnel (20.2%) , with family members (7.4%) being the least likely source of information.

3. Reproductive Health Concerns and Risks

a. Nearly all the women do not have regular physical examinations by a doctor (84.8%).

Neither do the majority of the women practice breast self-examinations (72.0%). The majority of women do not know what a pap smear is (60.9%). Of the 60 women who do know what a pap smear is, only eleven regularly have them.

b. The majority of women have heard of breast cancer (76.8%) and lung cancer (62.8%). Less than half, however, have heard of cervical cancer (46.0%) and only about one in three have heard of bone cancer (32.3%). Only a few women have heard of other types of cancer (12.8%).

c. The respondents are divided with regards to knowledge of factors contributing to cancer. More than half the women do not know which factors help to cause cancer (54.6%). Of those women who have some knowledge of these factors, the majority name smoking as one factor (77.3%). There is also a strong belief, held by 48 per cent of these women that being hit on the breast (48%) can also cause cancer. Some of them consider sex from an early age to be a factor (17.3%) but very few consider genetic factors (4.0%) or multiple partners (4.0%) as factors.

4. Abortions

a. In this study 116 woman reported not having had any abortions (71.6%). We feel that th social stigma still attached to abortion, plus the fact that the majority of women still believe it is an illegal activity, led some women to state that they had not had abortions even if they had. Hence, we expect this figure is much lower. That abortion is perceived as a form of contraceptive is indicated in the frequency with which it is used. Nearly half of the women who have had abortions, had one or two abortions (55.0%) while 24.4 per cent had three to four abortions, 8.9 per cent had five to seven abortions, and 11.1 per cent had more than seven.

b. The majority of the respondents do not know what the law is in relation to abortion (61.0%) and less than ten per cent believe that abortions are legal in Guyana (6.1%). The majority of the respondents have not heard of the Medical Termination of Pregnancy Act (66.3%).

5. Reproductive Health – General

a. Less than ten per cent of women knew that there is a relationship between diet and reproductive health (7.1%).

b. The majority of the respondents believe that children should be taught sex education in school (86.3%).

c. More than half of the respondents with current or previous partners said that they discuss or have discussed unsatisfactory sexual matters in their relationship with their partner (59.7%). Slightly less said that they discuss or have discussed things that give them pleasure in love-making. The majority of respondents who have had sexual relationships reported that they enjoyed sex (65.0%). However, while more than half of these women said that they do not treat sex as a duty (52.1%), nearly half said that they do (41.0%).

6. Teenage Respondents

a. Approximately 40 per cent of the teenage respondents have had sex (41.5%). For nearly all of these 22 teenagers this involved sexual intercourse (93.8%) with only one partner (81.3%). More than half had sex within six months after a first date (55.6%) while over 15 per cent waited over a year after a first date (16.7%) before having sex.

b. Teenage girls were most likely to learn about periods from people unrelated to them.

Approximately four out of ten did not know why they get periods (37.7%). Of those who did know (n=33) the reasons given by fourteen of them indicated that they were knowledgeable about hormones and the menstrual cycle. And a few, but a disturbing few, of the teenage respondents did not know that not getting a period could be a sign of pregnancy (13.2%).

7. Respondents of Child-Bearing Age

a. Fifty-three of the 60 women of child-bearing age have been pregnant. Nearly half of these women have been pregnant more than four times (45.1%). Age at first birth is low. More than half of the women were between the age of seventeen and 21 (56.6%) for their first pregnancy, with some under sixteen years of age (15.1%). Less than a third of first births took place after a woman was over 22 years of age. None of the women were over the age of 35 for their first birth.

b. Breast-feeding is common and is seen as nutritious and women breastfed for an average of eight months. The nutritious value of breastfeeding needs to be cautioned however. A practice of mixed feeding is very common with new born babies being fed tea, thin porridges, water and baby formula and then being introduced to solids in a matter of weeks. Nearly all of the women gave their baby food or drink other than breast milk at six months or earlier (82.6%). The majority of women do not think that diet can affect a woman's breast milk (67.3%).

8 Respondents of Menopausal Age

a. Older women in Guyana are often marginalised and isolated. Those living alone (15 per cent of menopausal women in the survey live alone) are in an even more precarious situation. Those who live alone in poverty (40 per cent of menopausal women in the survey live in households with an average weekly income of less than G$5,000) are triply burdened. However, these women still play an important role in economic development (30 per cent of menopausal women in the survey are still in the labour force; 18 per cent are working and 12 per cent are unemployed) and in social and family stability (50 per cent of menopausal women in the survey live in female headed households and over 40 per cent consider themselves to be head of their households). Many have had to re-enter the workforce to support their families. Many support grandchildren (35 per cent of menopausal women in the survey look after children other than their own, most often their grandchildren). Many reach old age without any access to pensions or financial support (over 70 per cent of the menopausal women in the survey do not have access to an NIS pension). Older women then have to face difficulties in relation to health, work and social security and also in facing the ageing process.

b. Nearly all of these respondents (94.1%) are aware that after a certain age a woman can no longer have children and that this is referred to as menopause or more commonly as ‘gone upstairs’. However, far fewer know why this happens (63.3%).

c. The onset of menopause does not appear to have been a traumatic experience for the majority of these women in the survey. Only six sought treatment by going to see a doctor and only five women said that they were frightened or worried when it happened.

Indeed, over half the women in the survey claimed not to experience any of the symptoms of menopause, although significant numbers did. More than 40 per cent of the women experienced sudden mood changes (42%) or physical weakness at the onset of menopause (47.1%). Fewer than 40 per cent experienced hot flushes (37.3%) and night sweats (34%) while fewer than ten per cent of the women experienced problems with bones breaking easily (6%).

d. Regarding sexual activity 31 women reported that they still have sex while 20 women indicated that they do not have sex any longer. Only one woman said that she has more sex since entering menopause.

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