GENEVA/LONDON - One in six women worldwide suffers domestic violence -- some battered during pregnancy -- yet many remain silent about the assaults, the World Health Organisation (WHO) said last week. In its first global study, the WHO also said physically- or sexually-abused women were more likely to suffer longer-term health problems, including distress and suicide attempts. The United Nations agency called for changing behaviour through education programmes and training more health workers and police to investigate signs of mistreatment.

"Women are more at risk from violence involving people they know at home than from strangers in the street. There is a feeling that the home is a safe haven and that pregnancy is a very protected period, but that is not the case," WHO's director-general Lee Jong-Wook told a news conference. "Domestic violence remains largely hidden."

The Women's Health and Domestic Violence Against Women study is based on interviews with more than 24,000 women in 10 countries, ranging from Japan and Thailand to Ethiopia and Peru. It paints a harrowing picture of broken bones, bruises, burns, cracked skulls, dislocated jaws, rape and fear. Husbands or intimate partners are the main perpetrators.

"Every 18 seconds, somewhere, a woman suffers violence or maltreatment ... We must put an end to this shameful practice," said Spain's health minister Elena Salgado, current president of WHO's annual health assembly.

Domestic violence can be sparked by dinner being late, not finishing the housework on time, disobeying or refusing to have sex, the report said. In many cases women agree that a man is justified in beating his wife under certain circumstances.

In terms of symptoms -- pain, dizziness, mental distress, miscarriages -- the findings across the 15 urban and rural settings were "remarkably consistent", according to Claudia Garcia-Moreno, the study's coordinator. "The striking thing we found is the degree that this violence still remains hidden. Between one-fifth and two-thirds of women interviewed had never spoken before to anyone of the experience of their partner's violence," she added. This sense of helplessness was "a torture in itself".

Other countries covered in the 7-year study, issued on the eve of the U.N.'s International Day for the Elimination of Violence against Women, included Samoa, Bangladesh, Namibia, Tanzania and Serbia and Montenegro. Between 4 and 12 percent of women who had been pregnant reported being beaten during pregnancy -- more than 90 percent by the father of the unborn child. "Most of the violence that pregnant women were experiencing is a continuation of the violence going on before," said Lori Heise, a member of the core research team from the Washington-based group PATH.

Reuters