Interview with La Maison des Femmes
An interview by Alexa Chabouté with Ghada Hatem-Gantzer
Ghada Hatem-Gantzer is an obstetrician gynaecologist. In 2016 in Saint-Denis, she created La Maison des Femmes, a place where women are protected and helped, especially victims of violence. She was furious at the absence of appropriate places for women, so she fought for the De la Fontaine hospital in Saint-Denis. That is where she works. Quickly, La Maison des Femmes adopted a rather holistic approach of management: the beneficiaries can access a professional, multidisciplinary team that helps their patients (psychologists, doctors, social mediators…)
What was the trigger that pushed you to open this safe place for women?
My first thought was “do women need a health place linked to this theme of violence?” That was my starting point. A place like that, that would help women express the physical and psychological pain they went through when confronted to violence.
That place seemed necessary to me, that’s why I started organising myself to create it, to create funds, recruit different teams…For me, the help should be complete, so we needed all those professionals. Then, we added justice and judiciary help, as well as the presence of the police. The base of our job is already to work with those women. The base of it was a health and violence space.
What is the classic welcoming process when a woman goes to La Maison des Femmes for help? Who are they redirected to after they arrive?
For us, the welcoming process allows for an evaluation of needs. Why? What is her problem? Can we help her? If she wants to leave her home, if she’s homeless or she has debts, she clearly can’t ask us for help. So we’ll redirect her immediately. If a woman comes because she’s gone or is going through violence and that violence impacts her health, she’s come to the right place. That’s when we evaluate her health and the illnesses she has.
- Does she have injuries?
- Does she need to be cared for right there, right then?
- Is she in danger? Because if she’s in danger, of course, we need an emergency response.
- Do we need to call the police?
- Do we need to go to her home?
- Do we need to find her an emergency home?
- Does she have wounds that need an official report from our coroner?
Then, we’ll evaluate her mental state and determine if she needs assistance. Does she need to see a psychiatrist for treatment after all those things? That’s part of the first welcoming process. Once we’ve done this general evaluation, we’ll suggest that she meet a psychologist, a psychiatrist, a coroner. There’s always a nurse who will be her specialist, meaning that she will be taken charge of by a doctor or a midwife to provide updates on the steps she’s taken, her health and her situation. We also evaluate the presence of children.
- Does the couple have children?
- Are they directly victims of violence?
- Are they also present when there is violence? It makes them victims just as much as their mother. It also tells us that the child doesn’t look like they’re okay.
We consult with our paediatrician and suggest a collective type of help via speaking groups. We have some about domestic violence, sexual violence and mutilations. We’ll give her access to different activities to improve her self-esteem. She can do karate, theatre, ball games, therapy art, drums. That’s for her mental state. For her physical state, we have osteopaths and kinesitherapies, so we’ll have a coordinated healthcare that we give these women. It can include reparation surgeries, meetings with our jurists, and if needed filing complaints with the police that come once a week. This helping process is case by case: each type of care is adapted to each woman’s needs.
According to a report from the Haut conseil à l’égalité, the governmental budget allotted to women’s rights went from 29,6 million in 2016 to 22 million in 2017. What are, in your opinion, the solutions to compensate this huge lack of budget?
There’s a public health policy. So we’re not completely disconnected. Our affiliated ministry isn’t women’s rights. So, indeed, these budget changes don’t affect us directly since even some women’s rights don’t fund us. I think it’s a bit complicated to know the exact part of the budget allotted to women since part of it comes from health, the other from housing…What I can say for us in the health sector, is that we demanded that the government promise to support structures like ours. Maison des Femmes or whatever it might be called, that’s what’s important. The government understood that it’s public health issue and that it has to invest money in it. Today, it’s a commitment that is not operational yet, and it is our goal to insist and push it in that direction.
On that subject we can talk about the works from the Grenelle des violences conjugales, which started in 2019. We noted that they don’t have the expected effects for women’s rights despite the development of many different learning tools. According to your expertise, what would be the possibilities of improvement to go beyond simple tools and to have a real acting capacity on the handling of domestic violence and their prevention?
I don’t have a general solution. We have a very local action and stay anchored in the on-site work that we know. Many structures can welcome women and accompany them and handle their health issues: these structures have to work in a network, especially if they can’t afford the administrative and legal aspects.
There needs to be more emergency housing that we can give out quicker. The justice system needs to act faster because we also know that during procedures violence still happens, including serious violence and sometimes femicides.
Perpetrators also need to be handled and accompanied, because even if one is sent to prison, he’ll get out eventually. If he’s violent, and even more so when he gets out of prison, we didn’t do much because the danger is still there. So, we need a better protection of the victims and a better training of the police. We need to be fast and evaluate the danger, and when the danger is real and serious, we can’t pretend that it’s going to be alright.
We need a brave protection policy, that can mean the eviction of the violent partner rather than the woman. It concerns many ministries, and in the end, education is needed, so it affects the Education Ministry. It’s both an in-depth and collective work. If not all those affected participate, there will always be people who will fall through the net, there will always be lacks and risks, there will always be violence.
Which subject(s) do you think is/are not too touched upon in the Grenelle?
I don’t know if the education and prevention aspect was investigated enough, and of course the aspect of the handling of the perpetrators.
La Maison des Femmes recently organised a collective funding to open a new Maison in Marseille. When do you think it will be possible to open more Maisons des Femmes, or however they are named, everywhere in France or in large French cities?
It’s one of the axes of our commitment and our work. We are trying to link together those who are involved and those who are interested to carry our projects: we give them our skills, our procedure protocols and we help them. We give them the following mode of action:
- How do we get funds?
- How do we approach private foundations?
- How do we solicit the audience?
Simultaneously, there’s this commitment from the State to give a free ticket to each structure that is created. That’s what they committed themselves to in order to fund and keep these types of places alive. Eventually, we need to get the funding that will allow the opening of safe places like these. It’s article
11 of the Grenelle’s commitments.
For us in the health sector, there’s this commitment to creating structures. There’s also one that concerns improving health professionals’ first aid trainings, notably for young doctors. There aren’t enough hours dedicated to those themes, to creating more developed modules about violence for all doctors, not only for gynaecologists and midwifes. Any doctor can have a patient in their cabinet who has medical problems that seem incomprehensible and that are simply the consequence of the violence they’ve endured.
La Fondation des Femmes signed a tribune to plead for a firmer legal punishment, what are the other institutions that should be reformed for a better general handling of this?
The problems are very diverse. Housing, workplace, safety (justice and police). It even involves companies, because more and more of them work with prevention, screening programmes or recognising a suffering colleague. There is, for example, a beautiful initiative carried by several companies that’s called “One in three”, one woman in three, which aims to start talking about violence in the workplace and to see how a company can help: sometimes, it can help with housing, with a salary advance. There are many types of actions that can help women be less alone and less distressed. It’s the Grenelle’s ambition, to identify all the possible integration processes and mobilise the government so that all those actions can be put into action.
Many doctors, lawyers and pharmacists advocate for interprofessional trainings of the agents involved in welcoming and accompanying women and children who are victims of domestic violence. What are the limits to an optimal handling of all these jobs?
I don’t know if “limits” is the right word. In any case, I don’t know how we can implement that interprofessional training. We all have training organs, we can have a general formation that a social worker as well as a lawyer or a doctor can attend. But we need to rely on the initial and continual trainings of those jobs, so that it can be an integral part of their baggage. Then, one can get additional training to complete one’s formation, to go more in depth and enrich it.
It’s better to work on the initial training and then teach every job to work together, because it’s impossible to solve that problem alone. Doctors must work with psychologists, who must work with jurists and lawyers, and so on. The patient needs all these resources, but it’s complicated to mobilise them all and to make them work. It’s a bit of a complex model and it needs a solid and coordinated network. It’s possible that not everyone in different regions of France will be able to do it. It’s probably easier in Ile-de-France (region surrounding Paris). It’s a professional arrangement with the people who want to mobilise in that region.
About the bill about extending the legal time limit for abortion, the assembly of doctors agrees that if this limit is pushed from 12 to 14 weeks, there is a greater risk for women. You replied that the medical staff has to be more trained to avoid complications. Could you tell us more about that?
What was said about the fact that there are more complications was not confirmed by scientific research, it’s a type of fear and reticence. It’s obvious that any medical procedure done by someone who doesn’t know what they’re doing can have severe consequences. The first thing is that people have to know what they have to do, and one can learn how to perform an abortion 14 days later than usual. It went well when we’ve trained, so it’s a false excuse. Moreover, I think it’s also a fear of displeasing or shocking their voters. If we want to push this reasoning even farther, we can say that giving birth is riskier than aborting at seven weeks, so let’s abort everyone because it’s less dangerous. We can’t reason like that.
You’re rather against training midwives to perform surgical abortions, could you explain that?
Performing surgery is a job in itself and I don’t really believe everyone can do it. Of course a midwife who’s done it for 20 years would be excellent at it, but their base job isn’t really that. They operate more in prevention and physiology. Doctors know more about pathologies. I don’t see the interest of orienting them towards this very technical practice while we don’t have enough midwives for childbirths. When there’s a complication, we have to be able to handle it, and therefore use different competences.
About obstruction offences, some doctors already refuse to perform abortions, even at 9 or 10 weeks, which forces women to travel to other regions. If we prolong the legal abortion limit, how can we handle these doctors who refused to perform abortions well before it?
We can’t force someone to do something they don’t want to do. It would be rather stupid. The first thing is to tell doctors that if they don’t want to perform abortions, they can. We can’t force a surgeon to perform surgery on a patient’s nose, ears or bottom when they think it’s not suitable, it’s their right. You have the right to not want to do it, however, you must direct these women to another place without wasting their time. Don’t ask them to come back in 8 days with an echography, because it’ll put them in a difficult position. You have to tell them the truth right away. That’s why knowing the best suited structures is important. It’s the same for abortion at 14 weeks, not everyone will want to do it because a specific technique is required.
Last words: What seems important to me is education: invest in middle schools, high schools and universities to open this debate and give the youth a voice. Many women think what they’re living is normal because it’s the law or their religion. We have to talk about it so that they won’t let this slide as much. The youth absolutely has to have places other than their home, church, mosque or synagogue to talk about their life, their rights, their body, their desires, and so on.
Pour citer cet article : “Entretien avec la Maison des Femmes”, 08/03/2021, Institut du Genre en Géopolitique.