We're going to have a few more people trickling in
because we have so many people from the community coming today.
All right.
Okay.
Welcome. I'm Louise Shaw.
I'm the curator at Global Health Odyssey Museum,
soon to be the David J. Sencer CDC Museum.
This program,
"Pathways to Prevention: Ending Violence Against Women,"
is being held in conjunction
with the exhibition in our gallery
called "Off the Beaten Path: Violence, Women, and Art."
It was curated by Randy Jayne Rosenberg
for Art Works For Change,
which is based in Oakland, California,
and it's up until September 9, 2011.
And the exhibit has literally been around the world
and is going around the world.
There's actually a version of it in Dakar, Senegal, right now.
First of all,
I want to thank someone that is not here at CDC any longer,
and that's Rodney Hammond, who is the director
of the Division of Violence Prevention.
And when I sent him the link to this exhibit,
in around 24 hours, he said, "We're in,"
and he found the money for the exhibit.
So, it was, I think, very visionary of him being there.
The premise of this exhibit is that art can be a catalyst
for discussion, awareness, and change,
particularly when addressing issues of social justice.
Violence against women is truly a public-health issue
and the premise of this exhibition
very much complements CDC's mission
to prevent violence before it happens.
The panel came about
after discussions with community organizations,
many of whom are based here.
We were really working out of the box here at CDC.
Those of you who work at CDC know
so many of our discussions
are actually for internal employees of CDC.
So, by the way, I'll reiterate --
There will be people still trickling in
because they're going through security.
And I want to thank all the folks
that came together to help us --
and many of them are here, I can't name them all --
that really helped us conceptualize
what this panel should be.
And I also want to thank Sara Harrier in DVP
who really stood up to the plate
and really took charge of getting the content organized.
I also want to thank the entire museum staff,
especially Judy Gannt,
for allowing this entire exhibit to happen
and for this panel to occur.
And Nasheka Powell was incredibly helpful
in helping us get the P.R. and the word out about the exhibit.
And I want to give an extra-special thanks to --
I don't think she's in the room -- Michelle Langer,
who had came on to be Outreach and Community Coordinator
for this particular project, and she's been fantastic.
Lastly, we are considering a second panel
in conjunction with the exhibit
that would deal with global issues
and immigrant women's issues here in the United States.
And if you're interested in that,
just give me a nod afterwards, because we want to make sure
we can get people to come to another panel.
And the attendance here today is terrific.
So, now I'd like to turn the program over
to Dr. Linda C. Degutis, the director
of the National Center for Injury Prevention and Control,
which oversees the divisions of Violence Prevention.
She has a stellar curriculum vitae,
and we have a brief biography of her in our biography.
And, Dr. Degutis, thank you so much.
DEGUTIS: Thanks very much.
[ Applause ]
Thank you.
Well, good morning
and thanks to everyone for coming.
We're really excited about the exhibit that's here
and very pleased to be able to have this panel
and discuss some of the issues
related to violence against women.
We have four panelists,
and their bios are in the programs that you have.
So, rather than spending a lot of time
giving you their bios again,
I think you'd probably rather hear more from them
and have an opportunity to have some discussion
and exchange of ideas with the panelists.
I just want to tell you a little bit about the Injury Center.
We are about to celebrate our 20th anniversary.
It's one of the younger centers at CDC.
And we're responsible for doing work in violence,
in prevention of other types of injuries,
unintentional injuries,
and certainly the Violence Prevention Division
is our largest division in the Injury Center,
and they do work in violence against children,
violence against youth, violence against women,
all kinds of adult violence.
And so, we have a number of areas
that we've been focusing on very strongly,
but certainly this is one of the most important areas for us.
So, the panelists that we have brought together --
and, Sara Harrier, I would also like to thank her
for the work she has done on this.
We have Jim Mercy, who's now the acting director
of the Division of Violence Prevention,
and he's going to provide a history
of violence as a public health problem
and discuss that in a little more detail.
Ulester Douglas,
who's the associate director of Men Stopping Violence,
and he'll give us a bit of a national perspective
and also some local and international perspectives
on men stopping violence.
Sarah Cook, who is from Georgia State University.
She's an associate professor.
She will talk about survivors and advocacy
and some of the research in violence against women.
And then we have Nicole Lesser, who is the executive director
of the Georgia Coalition Against Domestic Violence,
who really has been focusing a lot on victims' rights.
And she's really committed to creating systemic change,
and we'll talk about that
and talk about collaborations that are necessary
in order to do that.
So, rather than spending much more time going through this,
I'll let Jim start,
and then the panelists will just follow each other.
And we'll do questions at the end
so that everybody has a chance to do their presentation
and then, you know, we can have a discussion
and questions at the end.

Thank you, Linda.
Well, it's really wonderful to be here,
and I want to thank the museum and the leaders of that
for hosting this exhibit.
I think it's fantastic.
And what an opportunity to meet with and talk with
the people in our community who are working on this issue.
I want to start by having you imagine something.
Imagine if a disease suddenly appeared in the United States
and that this disease affected 20% to 30%, let's say,
of women during their lifetimes.
Imagine, also, that exposure to this disease
led to mental health problems
like depression and anxiety disorders.
Imagine if this disease also led to health problems
such as reproductive health problems,
sexually transmitted diseases, including HIV,
and even things like heart disease,
heart attack, and stroke.
Also imagine if the disease was, in a sense, infectious,
if the children exposed to this disease
also would grow up to engage in this disease
and, in a sense, replicate it.
What would we do if this disease suddenly appeared?
You know, I really believe that we would do anything we could
as a nation, as a country,
to stop it and control it.
But the truth is that this disease exists today,
and it's violence against women and girls.
And it's been with us year after year
for time immemorial.
I imagine and I would wager that every single person in this room
has been exposed to violence against women
in one form or another during your lifetimes,
either from your own experience
or that from a family member or friend,
and that you've experienced the feelings
that are evoked by the exhibit that's in the museum --
feelings of powerlessness and anger.
These are experiences and feelings
that we don't often talk about, unfortunately,
despite the fact that we all encounter these things,
often numerous times during our lifetime.
And that's the real power of this exhibit, isn't it?
That it helps bring us together to discuss these things
and bring them into the light.
Violence against women and girls
is an enormous problem across the world.
It encompasses a broad range of behaviors,
ranging from things like homicide and honor killings
to child sexual abuse to teen dating violence
to physical violence between spouses,
rape, emotional abuse, stalking,
even the use of rape in war.
Just to give you a sense of the magnitude of this problem,
let me share with you just a few statistics.
WHO did a 10-country study of violence against women
in the early part of this decade,
and they found that the prevalence
of physical and sexual violence
in the studies within these 10 countries
ranged from 15% of women
who had experienced physical or sexual violence
at the hands of their husbands or partners,
15% in a city in Japan
to 71% to a province in Ethiopia.
The average was
somewhere in the neighborhood of 40% to 50%
among the countries they studied.
In the United States,
we estimate that about 4.8 million women
experience assaults or rapes
at the hands of an intimate partner each year.
And almost 2,400 women are killed by their partners --
were killed by their partners in 2007.
In 2002, the World Health Organization estimated
that 150 million girls throughout the world
had experienced child sexual abuse
with physical contact.
Just think about that number for a minute.
If these girls constitute a country,
that would make them
the eighth-largest country in the world.
That's the magnitude of the problem,
and that's only one small facet of this problem.
As we shine the light on this issue,
I would like you to take three key messages
from my remarks.
One is that violence gets under the skin.
The second is we need to remember the impact on children,
and the third, that prevention is possible.
Violence gets under the skin --
What do I mean by that?
Well, in the exhibit,
there's a powerful set of photographs
about a woman who was raped and violently assaulted
when jogging in Chicago, along the lakefront, I believe.
And her husband documented this,
and you'll see the physical injuries on these photographs
that she suffered.
And those physical injuries
are a very critical part of this problem,
but they're only part of the consequences
of violence against women.
Violence literally makes us sick.
We did a study
of the Behavioral Risk Factor Surveillance System data
a few years ago,
and we found that a history of intimate partner violence
was associated with an increased risk of heart disease,
heart attack, arthritis, stroke, and activity limitations.
And we also know from other research
that intimate partner violence is a major cause
of depression and anxiety disorders in women.
There was a unique study done
in the state of Victoria in Australia
a number of years ago,
and what they did was
they tried to estimate the total health burden
experienced by women in that state in Australia.
And then they tried to look at
the proportion of that total health burden
in reproductive health-age women
that was accounted for by different risk factors.
They looked at smoking.
They looked at drug and alcohol abuse.
They looked at obesity
and things that we normally think of as risk behaviors
for health problems.
And they also looked at intimate partner violence.
And they found something pretty amazing.
They found that 9% --
and this was far greater than any other risk factor.
9% of the total health burden
in that population for women reproductive-age
was accounted for by intimate partner violence.
Why does this problem get under the skin?
Well, we know from neuroscientists
that one of the reasons may be
that this type of exposure to stress --
extreme stress -- actually damages the brain,
that the brain is still plastic even into young adulthood.
That certain parts of the brain,
particularly the part that regulates emotions.
And we know that the highest risk
for intimate partner violence
and many types of these violence is at young ages.
So it's quite possible that the exposure,
the stress of intimate partner violence,
damages the brains in ways
that contribute to premature mortality.
Another line of research that's just emerging is
research on what's called "telomeres."
Telomeres are --
And I'm not a cell biologist, so I'll do my best explain this.
Telomeres are the caps on the chromosomes,
and they help regulate a chromosome's replication
and are very important to how cells replicate and heal
and things like that.
And the length of these telomeres is critical.
The shorter the length,
the more likely that the chromosome is degraded
and not able to function optimally.
Well, we know that children and women exposed to abuse
have shorter telomere lengths,
suggesting that they are affected by this abuse
in ways that could lead to premature aging.
I said, "Remember the impact on children."
Children are victims of violence against women, too.
I don't like the term "violence against women"
'cause "women" is a term for adults.
But this is a problem that starts in childhood.
Teen dating violence is the prime example.
Many of the same consequences I talked about for adult women
affect adolescents exposed to this violence
in teen relationships.
Talking about sexual violence again.
We found an amazing result
in a survey done in the mid-1990s
of the women who were raped,
who self-reported they were raped in the United States.
Over 50% experienced that rape when they were children.

In studies around the world,
where countries have collected data on sexual assault --
all sexual assaults --
we find in those countries that had that --
This is very few countries.
But that from, you know, 35% to about 60%
of the sexual assaults first occurred during childhood.
So, this is a problem that begins in childhood,
and we can't separate adults from children
with respect to the impact of violence against women.
We should say "violence against women and girls."
And, of course, the impact goes beyond the biological.
The exhibit talks about the impact of these things
on the family and the community, as well.
But prevention is possible, and that's what CDC is about.
That's what the Division of Violence Prevention
is trying to make a reality,
is that we can actually prevent these events from occurring
in the first place.
I want to talk briefly about
four ways we're trying to do this.
One is to bring light to the issue.
In the same way
that this exhibit brings light to the issue,
what CDC is good at is using data
to bring light to the issue.
One of the things we're doing globally
is surveys of violence against children.
And I want to tell you the story about Swaziland.
Swaziland -- In 2007, we did a survey with UNICEF
of sexual violence against girls in that country.
The UNICEF director Jama Gulaid tells a story,
and he talks about how before these data were available,
when he'd talk about this problem
with legislators in that country,
they would say, "This is a foreign problem.
"It's not our problem.
"This is something that foreigners talk about,
not a problem in Swaziland."
But once he had the data, they could no longer say that.
They could no longer avoid --
and it led, these data led to a series of policy changes,
of education strategies, of programmatic developments
that I believe are beginning to transform Swaziland
in regards to this issue.
In this country,
we're also getting ready, within the next year,
to release information
from a national intimate partner and sexual violence survey.
The last survey devoted to this for the nation in this country
was in the mid-1990s.
This is a survey
that will have data for states as well as the nation
on intimate partner violence, sexual violence, and stalking,
and will be in the field perpetually.
So, we'll no longer have to wait for 15 years
for new information.
We'll update it each year coming out.
Extremely important for advocates
and people who need data -- need local data --
to make the case.
We're also making an investment in healthy relationships.
We believe this is the key -- building healthy relationships
and also building them at a young age.
So, one of our major initiatives is on teen dating violence
and a program called "Dating Matters."
This is bringing together the best of the available evidence
on what can be done in schools, what can be done with parents,
what can be done with regard to teachers
and policies in a community,
and what can be done
with regard to state-of-the-art communication strategies,
all brought together to address this issue.
And we're applying this
in inner-city neighborhoods around the country
and see if we can make it work.
Also, changing the social and cultural context.
I love the picture in this exhibit
of the woman holding the frying pan in front of her,
because it illustrates what communities can do.
And this is a story I've heard for many years,
where in some countries, the women go --
When they find about a household where a man is beating a woman,
they'll surround that household
and beat on pots and pans to bring attention to the issue,
make a statement as a community that we will not tolerate this.
In the United States, we're doing something equivalent.
It's called "Green Dot." It's a bystander program.
And it's being implemented and evaluated
in Kentucky right now.
And the idea is to provide high school kids
skills and strategies they can use
to be good bystanders, to be good community members,
to stand up against this issue, sexual violence,
in their communities, in their schools.
So, a very similar thing
in a very different cultural context.
And, finally, building prevention capacity.
I really think it's critical that we make the fields fertile
so that we can plant prevention in communities
and that the people will know --
the communities, the coalitions, the health departments will know
how to make prevention work.
It's not easy to apply effective evidence-based strategies.
You need partnerships, skills, other sorts of capacities
that help make these things work easily and right.
So, in addition to the frustration and anger
that this exhibit evokes,
it also evokes feelings of possibility and hope.
And I hope and actually believe
that when my 2-year-old daughter
visits the Global Health Odyssey museum
in 10, 15, or 20 years,
that there will be an exhibit proclaiming
that the prevention of violence against women and girls
has been a major public health achievement
of the ensuing years.
You know, women and girls across the world,
all of us deserve no less.
Thank you very much.
[ Applause ]

Fantastic opening remarks, Jim.
Thanks for such a great set-up.
Very honored to be here today.
I thank Jennifer Bivins, the executive director --
president and chief executive officer
of the Georgia Network to End Sexual Assault
for passing my name along to Sara.
Thanks, Jennifer.
And I wasn't terribly nervous about this morning
until you all came in the room
and I looked across this sea of faces
and I see local, state, and federal leaders in this issue.
I see our coalition directors.
I see folks from Men Stopping Violence.
I see all you folks from the CDC.
I've had the pleasure to work with many of you
but not all of you.
It's an intimidating crowd, and now I'm a little nervous.
[ Light laughter ]
Linda said I was going to talk about some research directions,
and I will,
although Jim did a fantastic job.
And I'm going to begin with a poem of sorts
by a woman who's a survivor,
and it chronicles
kind of her history in the movement.
Circa 1986 --
campus Organizer, emergency room companion,
sexual abuse prevention educator,
support group leader.
1988 --
Child Protection social worker.
Circa 1990 --
Graduate student interested in violence against women,
advocate.
1993 --
May 18th,
11:00 P.M. exactly --
Attempted rape victim,
burglary victim, attempted murder victim,
emergency room patient,
occupational therapy patient,
surgical patient.
1993 to 1994 --
Witness,
depressed woman,
woman struggling with
Post-Traumatic Stress Disorder anxiety,
permanently disfigured hand,
multiple scars in her scalp.
1994 --
Lobbyist for Violence Against Women Act,
continuing as an advocate.
1997 --
Faculty member in Department of Psychology,
continuing therapy patient,
state coalition leader.
Circa 2003 --
Survivor, mother.
2011 -- Thriver.
2011 --
Sarah Cook.
That's my personal story
and my experience in the movement.
Beginning as an advocate,
becoming a victim,
surviving a near-fatal attack of sexual assault,
and today, thriving.
I thrive because of the work that the CDC does,
the money through the Violence Against Women Act
that channels down to the local level
and changed my community of Charlottesville, Virginia,
so that when I emerged from that dark night of May 18th,
my community surrounded me.
I had immediate services from the local rape crisis center.
I was cared for appropriately in the emergency room.
I had a great experience with law enforcement.
I had a judge that insisted
a defense attorney stop insinuating
that my experience was simply a sexual tryst gone awry.
I had family and friends
and even a psychology department,
as wacky as they can be, support me.
And that's why I can stand here today
and talk about that harrowing experience
and call myself not a survivor, but a thriver.
Despite those some welcome and unwelcome credentials,
I find that some of my most promising insights
about sexual assault prevention come from being a mother.
I'm a mother of two boys, though, not girls.
I was fearful of having girls.
I didn't want to have to tell them
about sexual assault and domestic violence.
But what I found as a mother is that if I don't begin doing
sexual assault and domestic violence prevention
for and with my boys and their pals,
as potential perpetrators or potential victims,
they don't have a shot.
Here's what I do
and what I'm interested in following through
with some research,
and some of my students are already beginning this --
I'm talking continually about body integrity and consent.
When they wrestle on the floor,
and those who are parents know it's always fun when it begins,
but at some point, it turns terrible.
But the refrain in my household is, "It's your body.
"You are responsible for what you are doing to it --
with it," excuse me.
"And if your brother says, 'Stop,' you must stop."
And to the other, "If you say 'Stop,'
and the other person doesn't stop" --
usually his brother --
"You need to come and tell me about it."
And that's what we work with day in and day out.
It is getting better. It is getting better.
But when I am with families with kids -- usually boys --
and they hear me do this, I see they begin to say it, too.
And I think that if we can move
some of our prevention efforts --
not all of them,
but some of our prevention efforts --
out of this domain of sexual assault prevention,
the good touch/bad touch, all of those issues,
and make this a part of our normal child development,
our child rearing, our healthy development,
we're going to be a lot better off in the future.
I see some folks nodding,
and some of you who are nodding know
that you've influenced me in what I'm saying today.
But sexual assault, domestic violence prevention
can't belong just to "the movement,"
can't belong just to the Division of Violence Prevention.
It needs to belong
to the division of the United States society
and parents and teachers and clergy
and anyone who interacts with children.

I also want to say a few words about a global --
jumping out to a global perspective.
And I'm thrilled to hear
that the CDC plans on having another panel
to talk about global issues.
Because as much as we have understood the problem
here in the U.S. --
and we still can go miles and miles and miles
with understanding the problem --
we have a lot of work to do
to understand the problem on a global level
and the ways in which violence against women
and coercion, really, is expressed.
My recent work in South Africa
shows the enormity of the problem,
where violence occurs in families
as much as it does in communities,
where mothers talk about
the difficulty of sending a child -- a male child --
to take out the garbage in the township
because of the very real possibility
he may be raped on the way home.
On the other hand -- That's kind of an extreme form.
On the other hand, there are ideas
within the community that we're working in,
the Xhosa culture in South Africa,
they talk about showing love in a rough way.
That we, in terms of language
and moving to helping people understand
the continuum of coercion that exists
in sexual interactions and other interactions,
that many countries have cultural practices and language
that sometimes is so far below the surface,
it takes a lot of listening
and it takes a lot of formative research
and qualitative research and developing relationships
to really understand that the tools and the theories
that we've developed here in the United States
can help us understand the nature and the scope
of violence against women in other countries.
And, of course, partnering with folks in those countries
is critical, as well.

The third point that I wanted to make --
One being about prevention, prevention beginning at home,
moving prevention outside of our "movement,"
outside of what belongs to us as our issue, in a sense.
I'm talking a little bit
about trying to understand sexual violence specifically
on a global level.
And the third is a research direction
that I think we need to pay more attention to here,
domestically, at least, first,
and that's the issue of consent.
And this is related to the prevention issue I spoke of
with kids.
I've done a lot of work in measurement issues,
and the issue of consent
is probably the least well-understood
and defined part of our definitions of sexual violence.
And yet, it's the one idea or construct, concept
that the justice system relies on
for establishing that very fine line
between criminal and non-criminal behavior.
And I'm hoping
that with some recent work that I've done at Georgia State
and some graduate students are doing,
that we can begin to unpack how we understand consent,
how children understand consent
as they grow and develop through adolescence,
and how adults understand consent,
so that we can begin to inform prevention efforts
not only around behaviors that we do and don't do,
but how we understand consent and body integrity
throughout our lives.
Thank you very much.
[ Applause ]

Thanks, Sarah.
Your comments reminded me
of an experience that I had this morning.
I have two children, and they are 11 and 4.
And my husband is away.
He's in Savannah.
And I was trying to get here in time for this panel discussion,
and my son, for some unknown reason,
asked me today whether it's okay to keep a secret.
And, you know, I'm trying to get my makeup and my hair
and look nice for this discussion,
and I had to stop and say, "Okay, here's an opportunity."
So, just kind of continuing on the theme
to talk about, you know, what kind of secrets are okay
and what kind of secrets aren't.
And, you know, I think I'm going to revisit
the conversation again tonight
because I don't think I did the secrets that aren't okay
enough justice.
So, thank you for bringing that to me.
I'm Nicole Lesser.
I'm the executive director
of the Georgia Coalition Against Domestic Violence,
but I wasn't always in this position.
In fact, I've only been here for two years.
And I want to tell you a story
about a family that I worked with
that, really, I consider to be why I am here today.
This is the story about Matthew.
I was doing work with many clients,
mostly adult women, and many of them had children.
And over and over again,
I saw that the criminal justice system
wasn't involved in their cases.
Many of these women
never reported the violence to the criminal justice system,
and that was their choice and that was okay.
But the family courts were very involved in their cases.
They were going through divorces,
and they were having custody battles.
And over and over again, I saw the judges giving custody
to the very men who were abusing not only the mother,
but the children.
In this particular case,
this little boy had not seen his father for two years
because he had been abused by the dad.
He had broken his arm when he was 2.
Two years later, Matthew was forced to spend
supervised visitation with his dad,
who lived in another state at this point.
The mother had fled the state and was living in another state.
So, he had to drive four hours to another state
to have his supervised visitation.
Surprise, surprise, these visitations went fine.
You know, I don't think most people are going to misbehave
on their supervised visitations.
And eventually this father
was able to get shared custody of his son.
So, this 4-year-old boy who did not know his father
had to go four hours away to spend a week with his dad,
then come four hours back, spend a week with his mom,
four hours back.
I told you, I have a 4-year-old son.
I can't imagine having to send my son away,
so far away
into the arms of someone who he was not safe with,
who he didn't even know.
She called me, begging me to try to stop the visitation.
I am not a lawyer. I'm a social worker.
[ Sighs ]
It was an interstate case. This was complicated.
I wasn't able to stop the visit.
He came back and complained about pain in his rectum.
She brought him to the doctor,
and the doctor diagnosed him with a strep infection
but said that kids can get strep infections
from multiple ways
and couldn't prove that this was a sexual assault.
The boy deteriorated.
Matthew deteriorated, began to bite his nails,
rip his skin off his fingers,
soil himself when his dad was coming for a visit
to pick him up,
and eventually disclosed
that his father was putting his fingers in his rectum.
I don't know how we do this work,
where we technically don't say to women, you know,
"You should leave this abuser,"
because, of course, this is about safety.
But somewhere, the message is passed
that you don't deserve this abuse
and you shouldn't have to stay in this abusive relationship.
How do we say to women that they should leave
when judges are handing children on a platter to perpetrators?
So, it was at that moment,
after having case after case after case
of children having to go with their battering parents
and this particular case that I said,
"I can't do this work anymore.
"I can't do it in this way.
"I'm not having any effect here.
"I'm just literally and figuratively
putting on band-aids."
And that's why prevention became so important to me
and why I decided that I really wanted to work on system change
and state- and national-level work.
And prevention is a big part of that.

In terms of the history of the domestic violence movement,
I'm looking out across the room
and I do see many of my friends in this movement,
and so I know I'm not telling you anything new.
But domestic violence services and programs began
from a grassroots women's movement.
It began with women taking other women into their homes.
It began, figuratively, with the pots and pans
that we were hearing about earlier.
Maybe some of you were even involved in that,
and if you were, I thank you from the bottom of my heart
for blazing that trail,
for opening up your homes
and taking the risk to save other women.
I am only here doing this work
because of the work done before me.
Eventually, there were more and more and more women,
and people began to realize
that they couldn't provide the services they needed to
just by having women in their homes,
and domestic-violence service programs came into being.
And with the funding that followed,
there became a professionalism of this work.
Now we're able to track services,
but there's been very little funding for prevention.
When I was doing a lot of work
with immigrants and refugees in another state,
we actually lost funding for that
because they thought we were just doing prevention work.
So, at times, prevention has been seen at legislatures
as a dirty word.
And I really hope that the CDC's work on shining this light
will change that concept.

But because the funding didn't come as much
as the funding for services came,
providers tended to stay in their silos.
They see victim after victim after victim,
and it's very hard when you're doing that kind of work
to step away from a survivor who's in front of you
and go out and do prevention work.
But now there is a recognition
that domestic violence is a public health issue,
that it's on epidemic proportions.
Still, the funding hasn't followed suit,
so we're trying to be creative.
Advocates are nothing but creative.
And even without the financial resources to do so,
we're trying to find ways to bring prevention into our work.
And I was asked today to give you some examples
of how we're doing that.
Some of these are very, very simple.
We started by adding the word "prevention" to our mission.
In fact, every time I talk to someone at the CDC,
they ask me, "Is prevention in your mission?"
And I'm so happy to be able to say it is.
And hopefully that's not just a word,
but a requirement of our work
because it's in our mission.
There are other things that we're doing.
They mainly focus on collaboration and partnership.
I was very excited --
and this is my second time at the CDC.
I was very excited to be invited a few weeks ago
to come here for the Delta Prep Symposium.
Georgia is not a Delta-Prep state
and yet, we were now being invited to participate
and hear about the great work
that these programs have been doing.
Basically, programs that have gotten money from the CDC
or from Robert Wood Johnson Foundation
to do prevention work.
Well, we may not be able to have the funding, but that's okay.
Maybe we can get the funding somewhere else.
But the opportunity to learn about everything
that the CDC has learned
and to get that knowledge and bring it into our work
was so exciting to me.
So, those kinds of partnerships
and continuing to talk with the CDC
about ways that we can partner around prevention.
There are lots of other ways that we're collaborating.
So, for instance, we have a grant
to work with the medical community --
doctors and nurses -- about helping them to recognize
the warning signs of domestic violence,
how to ask about domestic violence,
and to have resources available.
That's not a primary prevention.
Obviously, if somebody is there
and answer "yes" to those questions,
they're already experiencing the abuse.
But can we prevent the abuse from escalating?
Can we prevent the abuse from having the tragic ends
that we see here in Georgia all the time?
Georgia is ranked 10th worst in the nation
for men killing women.
And we can do better.
And so, by talking with different populations --
the medical community, the clergy.
That's another project that we have
along with the Commission on Family Violence --
They're here today --
to work with faith communities,
to get all the bystanders who are involved in this --
who can be involved in this issue to be addressing it.
We try to think of other creative ways.
We have a new communications coordinator,
and she used to work at the Boy Scouts.
So, I said, "Can you please see if they would be interested
in doing cellphone drives for us?"
Cellphone drives help us raise
a little bit of unrestricted cash,
but it also brings awareness to the community.
So, we are partnering with the Boy Scouts,
and hopefully then the Girl Scouts,
to have them start running cellphone drives.
But this gives us an opportunity
to work with those boys and girls
and to have them, as leaders in their community,
bring information about domestic violence and prevention
another place where they are.
You know, we often find that we're trying to get into schools
and yet, the school system won't let us in --
not because they don't care,
but because they have time in learning.
And, you know, this is another way
to be able to work with children to do prevention.
We've also started a teen dating violence working group
that's bringing all the folks
that are working on teen dating violence in the state --
And if I've missed anyone and you're interested,
please let me know.
One of the other things that we're doing is
really trying to look at social media research.
We have a CDC communications person on our board,
and he's taught us a lot about social marketing research.
And so, we're looking at making sure
that when we do posters and we do brochures,
that they're communicating the messages
that we want them to
and that they're not inadvertently communicating
messages that are harming our cause.
So, learning about social perceptions
and what works.
Another issue that we're trying to work on is
here in Georgia, the African-American community
makes up about 30% of the population,
and yet over 60% of the homicides that occur
are to African-American women.
And so, we're starting to do research as to,
"Why is there that disparity and what can we do, as a movement,
"to bring that statistic down,
"to make sure that these women
"are getting the services that they need,
"that are culturally competent
and will prevent future homicides?"
We're also working on training.
We're very excited
that the Georgia Commission on Family Violence,
at their annual conference this year,
will be focusing on prevention
and will even have some speakers from the CDC.
So, we're sending a message throughout everything we do --
or we're starting to -- throughout everything we do
that prevention is a key piece of this.
We're also starting to work with legislators.
We're starting to work with teens.
We're trying to get programs in the schools
that are actually evidence-based,
so we're encouraging Dating Matters.
I can't tell you how many programs I know
create their own teen dating violence program.
Why? They already exist, and they've already been vetted.
Use this that we know works.
So, we're sending that message to our programs.
So, there are lots of different ways
that we can integrate prevention,
and we welcome continuing to work with the CDC
to help us, you know, find other avenues
to bring that to the work.
So, thank you.
[ Applause ]

Good morning, everyone.
ALL: Good morning.
DOUGLAS: As Sara said, it's quite an interesting feel,
being in the presence of so many of my colleagues.
I don't do it often.
Normally, I'm somewhere across the country or across the world,
you know, speaking to an audience
that I'm not familiar with.
So, it is a very special feel.
And, also, as part of that,
not accustomed to my boss being in the audience, either.
[ Laughter ]
So, there's Shelley, and I'm like, "Okay. Yeah."
You can imagine that feel, so...
It's good to be here.
I'm Ulester Douglas,
and I'm with Men Stopping Violence.
I saw the art exhibit last week.
And for those of you who haven't seen it,
I strongly recommend that you make the time
after this panel discussion to experience it.
It was powerful.
And one of the primary thoughts and feelings I had
as I looked at it was
the reminder that these women have been violated
physically, sexually, and otherwise
primarily at the hands of men.
And for the most part,
men who have gotten away with it,
men who were not held accountable,
and it made me think about the work we do
at Men Stopping Violence.
And even though we acknowledge that this violence
that we see acknowledged in the exhibit
are done primarily by men, our language --
This is one of my biggest beef, and I talk a lot about it.
Our language continue to not represent that.
There's so much obfuscation about who is doing what to whom.
So, many times, and we know this,
when communities talk about violence against women,
and we really are talking about men's violence against women,
but we do not acknowledge it.
Even when we said,
"Panel discussion -- Ending violence against women,"
who is committing the violence?
Are we talking about women's violence against women?
Most of the time, we're not.
I mean, we know that that exists
and that's an important part
of ending intimate partner violence,
but I want us to --
I want to encourage us to really do something about that,
because I think it has implications
for prevention work.
Who are we trying to prevent or what are we trying to prevent?
We are talking, for the most part,
about men who are committing these crimes.
And a good place to attend to that
is looking at the statistics.
Anytime you see them,
notice again how that obfuscation is well-represented.
So, for example, you know,
every year in the United States,
intimate partner violence accounts for 1,500 women dying.

How about "every year in the United States,
"approximately 1,500 women are killed
"by a man with whom she was in a relationship,
an intimate relationship?"
Why do we hesitate to say that?

I want us to pause for a moment and think about that.
Why do we hesitate to say,
"These women have been killed
by men who claimed to love them"?

Protecting men's interest?
I won't go there right now, in the name of time.
I have 15 minutes or less.
[ Laughter ]
At Men Stopping Violence,
we're clear that prevention is key,
and that is our focus, primarily in engaging men.
And we go about doing that in a number of ways,
but I want to start by giving you a brief summary
and I want to encourage you to go our website
and check out our community accountability model.
There's an article called
"The Men Stopping Violence Community Accountability Model."
I think it's pretty good,
and there's some similarities with the CDC's ecological model,
but we do part in some ways.
The short of it is that, you know,
there is the individual, of course,
with whom many of us deal,
and in this case, working with men.
There's the individual man,
be it intervention or prevention.
Then, of course, he's in other communities.
We start with the primary community,
which comprises usually his family of origin,
significant others, gangs.
That's an important community that he's part of.
But he's also in a microcommunity,
which is made up of schools, workplace,
and so on and so on.
And then we have the macrocommunity --
government, justice system,
corporations, and so on,
and then, of course, a global community.
So, there are the different ecological points.
I think it's really important for us
because then, as part of our prevention efforts,
we make clear decisions
about where in that ecological spectrum
to intervene or to do our prevention work.
So, it's very strategic.
So, I want to highlight at least two of those programs we do
as a way to illustrate how we, you know, engage with men.
Even though we've been around for 30 years
and early on, of course, best known
for our intervention work with men who batter women,
we do so much more than that.
And part of our efforts is to really make the point
that this is about prevention.
But communities have a way,
even when we talk about prevention --
"What about the men you work with?
What about the men who batter?"
You know, we want to come back to the individual man
and then how we work with him.
So, as a strategy,
we understand that that space where men enter --
and these are men,
many of whom were sent by the criminal justice system,
others who want to learn about the work
who have never admitted to being violent towards women
still participate in this 24-week course.
We thought, "Why not use this space as a laboratory,
as a tool for prevention?"
And so one of the requirements we have, for example,
of men who enter that space is that, at half-point --
about 12 weeks --
he's required to bring men in from his community
to witness his work.
And that at the 24 week,
he's expected to do a project, a community project,
that involves taking part of one of the lessons he's learned
and that really impacted him
and share it with four other men in his community.
Now, for those of you who are familiar with such programs,
one of the responses I get when I talk about this
across the country and across the world is,
"Do you really get men to do that?"
Underlying, in part, one of the things we talk about
at Men Stopping Violence --
and Shelley just wrote a powerful piece about --
an article about engaging men,
which talks about the low expectation we have of men.
And that is something we need to really pay attention to.
But at Men Stopping Violence,
we do have high expectations of men,
and that's one of the expectations.
You go out there and find four men
who are part of your circle.
Because at the end of the day, when we're talking about
prevention and accountability work,
it is about a circle of men.
Men need men to hold men accountable.
And you may not be surprised
at the many men who come into a program
who have committed violence against women,
and their brother don't know about it.
Their boss don't know about it.
It is privatized.
And you want to keep a problem in place,
privatize it.
[ Chuckles ] It's true.
Privatize it.
So, he's required to --
And of course, many men resist it,
but at the end of the day, most of the men do it.
What happens --
again, it may not be surprising to you --
is how many men come into that space as witness --
They're there to witness their friends,
their colleagues, their co-workers work.
And they invariably say,
"Whoa, I see me in this. I need to be here."
That is a common refrain.
And what it underscores again
is that we believe that all of us men
are implicated in some way.
We are on the continuum.
And we do not do this binary,
this destructive binary of good guys/bad guys.
All men have sat in that classroom,
that somewhat invisible classroom --
abstract, but real --
where we got really clear instructions
about what it means to be a man, a husband, a father.
And the dominant narrative, that dominant instruction,
has been a destructive one.
And whether or not we play out that instruction
by the use of physical or sexual violence towards women,
we still have been impacted, all of us.
And part of the work at Men Stopping Violence
that we do is invite men to look in the mirror and say,
"In what ways am I contributing to the problem?"
Because, again, as I mentioned,
when we look at our ecological model,
we believe those different ecological points,
be it the primary community, the micro, macro, or global,
these communities contribute to the problem,
and thus community accountability,
and these communities have the potential
to make a difference.
So, these four men, in turn, are better educated
because we know part of prevention --
an important part of prevention work is education,
because we know the misinformation
that's out there about this issue.
It is maybe amazing to us sometime, like, "What?
You didn't know that? You think this?"
We need to educate our communities.
And so these four men, in turn, are better educated,
are often encouraged to do some work themselves,
and, again, spread the word about this crime
and the importance of doing something about it.
Another one of our programs that we are quite proud of
is our "Because We Have Daughters" program,
as another example.
When we talk about engaging men, one of the sad realities,
in terms of men being motivated to do this work,
is that we have found that it's seemingly got to be seen
as in our self-interest as men.
There's not a lot of motivation.
Even though we say we are concerned,
we have found that what really gets men going
is when the issue comes home
and he can see, somehow, that "I am a part of this.
This is not about just women's work."
I've got a stake."
It's about getting a stake in it.
And, so, the idea was "Because We Have Daughters,"
and "daughter" here represents a broader view.
It could be a sister, mom, co-worker,
a woman in his life that he cares about,
but represented in that very powerful way by "daughter."
And men have responded well to this
because if you are in a group and you ask men,
"What if you found out
"that a man sexually assaulted your daughter?
What would you do?"
What do you think men say?
Yeah, "I'll kill him."
[ Chuckles ]
Violence, right?
No, we don't want you to kill him.
But that response, I think, does say something
about the deeply felt --
Everything I just felt there about what --
to imagine his daughter being violated.
The desire to protect, to do something about it.
And so we say, "Well, you have an opportunity to work,
"to do some things that can create safer communities
"for your daughter and for women in general.
You can make a difference."
And so, we bring men and their daughters, nieces, together
primarily through play, very creatively,
that creates this possibilities for him
to learn about a world he often doesn't see,
learn about the world
through the eyes of his daughter or niece.
And it begins to create an awareness that,
"Wow, I really have to stay engaged and do something
because I do want a better world for my daughter."
So, that's prevention.
These are men who may never see our 24-week course
or our 3-hour course we teach at the court
or the trainings we do in the community.
But that's a very creative way to engage men
to work towards prevention that we're quite proud of.

Now, one of the opportunities we have right now is
to really support communities across the country
in their own prevention efforts.
As many of you may know,
the Office on Violence Against Women,
Department of Justice,
for the first time --
this year, actually, the grants went out --
awarded, I believe, around 22 grants
to programs across the United States
to work on engaging men in prevention --
in preventing male violence against women.
That's the first time.
And I say first time -- I'm emphasizing first time
because, understandably, that office,
the Office on Violence Against Women,
you know, much of the resources have gone
to support and victims' services.
And rightfully so.
And I think they realize,
as we have realized at Men Stopping Violence,
that men have got to be part of the solution.
Again, if we're talking specifically,
and often we are,
talking about male violence against women.
We can prevent it if men decide to stop it,
to be part of the solution.
And so they awarded these grants.
And we are the T.A. providers for that grant.
And we're really, really quite proud of that
because it acknowledges --
It the Department of Justice saying, "Here's an organization.
"We recognize their experience
"in working with men over 30 years,
"who have insights and have demonstrated it
"and can really support these grantees
"in thinking well about how to develop these programs
"and do it in a way that really advances prevention
in male violence against women."
So, that's part, a really key part,
of our prevention efforts, and we're quite proud of it.
Time wouldn't allow -- We've got about 2 minutes.
So, that's some of the pieces we do on the national level,
and, you know, we do some stuff on the global level, too,
and we'll do a whole lot more if folks like me like to fly.
[ Laughter ]
Yeah, that's an issue I have to deal with.
Because we do. We get invitations.
And oftentimes,
it's the kind of thing that I want to do and like to do,
and, you know, resources is always an issue.
So, recently,
we were invited, actually, by the State Department
to do some work in the Caribbean.
And you may not be surprised if you can hear my accent.
I'm from the Caribbean.
And I jumped on it like,
"I don't care what happens on that plane.
Get some drugs. I'm going home."
You know?
And it was a really powerful experience
because, again, you know,
some recognition by the State Department
about our important work,
and it was some amazing work we did in the Caribbean
around prevention.
And I don't have time to get into it,
but just to hint that that is one example
of our own global reach.
So, we look forward to engaging with all of you, CDC,
in continuing our prevention efforts.
And, again, check out our website or our Facebook
to learn more about how we, every day,
are really working to make a difference
in creating safer communities for women and girls.
Thank you all.
[ Applause ]

Well, things --
Certainly a lot to talk about and discuss,
so I wanted to see if anybody in the audience
has any questions that they want to direct to the panelists.

Go ahead.
KANNY: I have a comment.
DEGUTIS: Okay. And you know what would be helpful, too,
if you can identify yourself so that we know who you are.
KANNY: Sure. My name is Dafna Kanny.
I'm with the alcohol program here at CDC
in the Chronic Disease Center.
I want to kind of comment on Ulester's --
That sentence that 1,500 women
are being killed by men every year.
And the main risk factor for that --
I mean, going upstream a little bit,
because this is the outcome, is somebody's being killed.
And the main risk factor might have been excessive alcohol use,
and I'm not talking about alcohol dependency.
I'm talking about more of binge drinking,
occasional consumption of excessive drinking.
I think it's important to think beyond the outcome
and try to go upstream
and see what are main risk factors.
Because of society here in the U.S.,
but also globally,
excessive alcohol use is acceptable,
is the norm,
and nothing is really done about it,
because we don't really see any differences
or different changes
in the prevalence of excessive alcohol use.

DOUGLAS: You know, I appreciate the concept
of risk factors and protective factors,
and there's a whole lot to say about what you just said.
I think it's also important that we hold up a risk factor
we don't often think about.
And the biggest risk factor in those numbers there
is being born woman, girl.
KANNY: Yes.
DOUGLAS: And I wish we'd do more about acknowledging that.

DEGUTIS: Other questions or comments?
McGHEE: I have a question
about the lady at the left there.
DEGUTIS: Can you introduce yourself?
McGHEE: Yes. I'm Natlyn McGhee.
I'm a nursing instructor at Georgia Perimeter College.
You said that mothers were afraid
to let their sons take the trash out
for fear that somebody would rape them.
And I wondered, so who is doing the raping?
Are women raping these boys? Are they being raped by men?
That's my question.
COOK: That's a comment by a mother
that emerged in a focus group of parents
in the Langa township in Cape Town, South Africa.
And primarily,
women were afraid of violence against their children
from other community members --
men, primarily, in the township.
They also -- similar to the dynamics in our country --
point to recent immigrants
as people who are doing bad things
in their communities.
That may be perception, and it may be reality.
We don't know.
But I use that example to show in the extreme
that people in other communities
do identify and call sexual assault what it is
and recognize it.
And then, if you remember at the other extreme,
there is language around rape and sexual assault
that's cast in very normative terms
about being "loved in a rough way,"
or "That's how he shows me he loves me,"
which those experiences
are tantamount to rape and sexual assault.
So, I use those two examples just to point out the continuum
and the complexity of violence against women
and the difficulty with which --
the difficulty that exists
to try to understand what people's experiences are
and how you really have to dive
into the culture and the language
to try to understand that range of experience.
Thanks for your question.
BROWN: Yes, thank you. My name's Pam Brown.
I'm with the Delta Prep program at the CDC.
My question is one about political will,
and I guess I'll direct it first towards Nicole,
and, Ulester, you may --
or any of you on the panel, really.
But I see you all probably in a role of advocacy,
and political advocacy is very much a part of your work.
And I'm curious
as to the type of reception or response that you get
if you have attempted to frame the issue
of violence against women as a public health issue.
Does that resonate at all with policymakers
who are not familiar with public health?
LESSER: Not in my experience.
I do think that in places where health
and public health education and awareness are higher,
that you have more of a chance.
So, if there's generally been, you know, cultural efforts
to bring all public health issues to the forefront,
that people are more open to it.
I think when they think of --
I think for some people, for some legislators,
it's easier to talk about in that context, you know,
rather than it being violence against women.
You know, "Oh, it's a public health issue. Okay."
But I think by doing that it also lessens the immediacy
of needing to do something about it.
If they have a huge list of things
that they have to choose from to do something about.
I think getting a community to understand
this is larger than just, you know,
him losing his temper or abusing drugs
or, you know, that this is a public health epidemic.
It's the same as
any social marketing that we have to do that --
send these messages over and over and over again.
Like James talked about earlier, if this were any other disease,
people would be doing something about it.
So, I think over time,
as we help people to see the immediacy
along with -- I don't know -- the comfort
in talking about it in that way, that they will respond more.

DEGUTIS: Sure. Go ahead.
GARBER: I'm Anthony Garber.
I'm with Men Stopping Violence
and also with Performance Consulting.
And this morning, I want to express my gratitude
for a panel being convened for such a subject as this.
And I'm coming alongside, Jim, the notion
that this is a public health epidemic.
Ulester, recognizing that it is of global proportions,
as you cited the very statistics.
I'm wondering what your thoughts are
on the local and global community climate
that is, from a legislative and judicial perspective,
dealing with human trafficking?
So, any thoughts that you would share on this epidemic
with the thought of human trafficking in mind?
MERCY: You know, I don't know as much
about the work done on human trafficking,
but just in terms of the openness
to addressing these issues in legislatures globally,
I think it's incredibly more open now
than it was just 5, 10, 15 years ago.
We've been working in Africa, in, as I mentioned, Swaziland,
but Tanzania, Kenya, now Zimbabwe.
And I'm constantly amazed by the willingness
of the members of the ministries in these countries
and the legislators to take this issue up.
Even though it's of huge proportions in these countries,
I think the work on human trafficking
has opened some of those doors,
so I think there is a connection,
because that has had more visibility in some ways.
But I am really encouraged and hopeful
by the willingness of people in key positions.
There's resistance.
I don't mean to paint a picture that isn't accurate,
but I'm always struck --
I expect to meet resistance, and when I don't, I'm just --
It gives me a lot of hope.
LESSER: I'd like to respond to that --
to respond to that, as well.
I think the difference that we're seeing
in the responsiveness around human trafficking
versus domestic violence --
and, obviously, they're very related --
is that people don't blame the victim as much
in human trafficking.
MERCY: Hmm.
LESSER: And when you for some reason think
that she was responsible or she should have left
or if only she hadn't worn that outfit or if -- whatever,
all the different reasons that people blame victims,
it's easier to push it off.
With human trafficking,
you picture somebody being kidnapped,
somebody being forced by someone from out of their family
or maybe sold by a family member,
but the perpetrator
is not someone who's professed to love them.
And until we get people to understand
that the abuser is responsible for this and not the victim,
you won't have that same response.
DEGUTIS: Okay. Here.
MERCY Thank you.
DEGUTIS: Yeah.
McEWEN: My name is Amy McEwen.
I work in Neuroscience of Injury.
My question for you all is if you all have any thoughts
on this being a generational thing --
He abused, the father abused, the son abused --
It doesn't stop even though the son or the grandson
hated to see his mother or grandmother
treated like that,
he comes along and does the same thing.

MERCY: Now feel really embarrassed
to talk about brain architecture with a neuroscientist.
[ Laughter ]
McEWEN: I work in neuroscience.
I'm not a neuroscientist.
[ Laughter ]
MERCY: That makes me feel a little better.
But I don't even work in it.
I think that's definitely an issue.
I think we have a sort of problem that, in a sense,
is self-replicated,
in terms of intergenerational transmission,
both culturally and from within families.
It doesn't mean that people that are exposed to this issue
are automatically going to repeat these behaviors.
I want to emphasize that.
It's actually a very small proportion.
But it only takes a small proportion
to continue to create and perpetuate
this cycle of violence that we see.
So, I think it's an issue.
COOK: I'd love us to focus on that larger proportion
that choose not to perpetuate in later relationships.
Because although there are theories
and there's data pointing
to different numbers of people that go on to perpetrate
after having experienced,
many, many more do not, choose not to perpetrate,
and that's, I think, a critical piece.
And I think it's also important to recognize that
if you grow up in a household or an environment
where there is violence,
in making a choice to kind of escape some of that --
"Choice" may not be the best word
because there are lots of influences on it,
but people aren't forever damaged.
People can survive from those circumstances,
and I think that's a piece that we often forget, too.
And we owe it to victims to remember that they can survive.
DEGUTIS: A bunch of hands up in the back.
[ Sound system buzzes ]
WOODARD: I'm Stan Woodard. I'm an artist here in Atlanta.
I have a comment,
but I want to go back to the human trafficking idea,
and then I have a question about media.
In human trafficking,
I've noticed that when they talk about young women
who are victims of sexual slavery,
they're often referred to as "child prostitutes,"
and that doesn't seem quite right.
And then I think it's also important,
unless I'm wrong about this,
the media has characterized Atlanta
as the hub of child sexual slavery
and human trafficking in the United States.
So, you know, I hope that we can, you know, recognize
our own -- the U.S.'s own -- involvement in this
and not just go to third-world, emerging countries
to talk about it.
But my other question, my main question is,
to any of the panelists who might be able to talk about
the role of protected free speech
in perpetuating violence against women
and against all of us.
Around the time I saw the show, the Supreme Court had ruled
that video games are protected free speech,
as the state of California was trying to restrict
children's access to violent video games.
I don't play games much, but I've seen some of the games
that, you know, 8-, 10-, 12-year-olds play.
And they're really very disturbing --
You know, worse than anything you'd see
in an R-rated movie.
Is this anything that you can speak about
as relating to, you know, the ongoing problem
of violence in general
and violence against women, specifically?

MERCY: Well, in addition to not being a neuroscientist,
I'm not a constitutional lawyer, but...
[ Laughter ]

I think we know a fair amount
about the influence of media on children
and their propensity for violence.
We know that exposure to violence in TV --
We know that direct exposure, witnessing it,
actually has a profound effect.
We know that exposure to violence in TV
affects children's behaviors and actually violent behaviors.
We know less about these other and new types of media,
but what we do know suggests
that they also have a substantial impact
in terms of influencing violent behavior.
So, I'm very concerned about it.
We've begun to look at this issue in various ways,
but it needs more work and more attention.
And I think we do need to be concerned
about the proliferation of these types of games.
WOODARD: Is there any research that confirms or denies,
you know, this impact?
MERCY: Of video games specifically?
I can't tell you. I could find that out for you.
Maybe some of our staff, if they're here,
would know the answer to that.
DEGUTIS: Okay.
The gentleman in the back.
[ Man speaking indistinctly ]

...the Georgia Nurses' Association
statewide conference,
an interesting thing came up about --
And I want to ask you about this and throw it out in general.
A few of the nurses started talking about
their finding or being introduced
or coming to situations of meeting young women --
some young boys but mostly young woman --
who'd been sexually victimized in some way,
somehow, different forms --
from family or on school property or whatever.
But the main thing I kept noticing them talking about was
they're running into the problem and they were reporting it,
but their reporting structure for their school district
within their city or town, both were just functioning --
kind of just not functioning well.
And my thing was,
and what was put to me by some of the women there was,
what can we do when no one around our area
can help us with the situation?
What is the state or regional or whatever resource
that you go to get help
when their entities around them aren't handling the situation?
That's the first question.
Other question is for Mr. Ulester Douglas,
is how was the Caribbean thing?
What did you see there?
[ Laughter ]
I mean, I've heard a lot about the Caribbean in a lot of ways.
One thing I've heard a lot about
was a lot of violence against men,
especially gay, bisexual men in the Caribbean,
but just also I heard the level of violence against women
in the Caribbean.
So, I was wondering what you're finding there.

LESSER: Well, Ricky, I think you are pointing to,
you know, a systemic issue around reporting and response.
I got a call -- I was on vacation last week,
and I got a call from one of my board members whose --
a staff person had been sexually assaulted
while she was on a boat at Lake Lanier.
And when the sheriff came out to discuss --
You know, she called the police, and when the sheriff came out,
he wrote up the police report
but said that he couldn't do anything
because this happens all the time.
And he left her on the boat.
I think, you know,
some states might be doing it better than others.
We have, you know, 159 counties
and something like over 700 law enforcement agencies
in Georgia.
And so, trying to find a way
to get them to consistently respond,
you know, when something is reported --
I don't know if you were talking
just about the hospital's report or --
But that's why this community collaboration
is so important.
You've heard me mention
the Georgia Commission on Family Violence,
now my third time,
because they're the government agency
that works with government agencies
to try to create systemic change.
And we're the community agency
that works with community agencies,
and so we work together constantly
to try to bring exactly those kinds of issues to the forefront
and then, you know, strategize about how we can address them.
The commission has task forces --
I believe about 50 active task forces across the state --
where those kinds of things can be reported,
because you have criminal justice there,
you have healthcare providers, you have schools,
you have all the different systems that can have an impact
coming together and creating solutions.
The key is to make sure we're listening to survivors.
If the survivors aren't at the table,
we're not getting the stories.

DOUGLAS: In the name of time,
because I know we're right near a minute or two away, so...
Let's just say there are a lot of similarities
as within the United States.
I think where the Caribbean lags is in the legislative arena.
They're way behind in policies that protect women and girls.
So, I'll have some time with you
and I'll share the details in the name of time.
Thanks.
DEGUTIS: I think we have time maybe for one more question,
so I think you were waiting for a long time.
AGNEW: I'm Christine Agnew over at Start Strong Atlanta
at the Jane Fonda Center.
And I guess my question is,
what does the landscape look like
in terms of mandates for prevention efforts
statewide, nationally, and then globally?
Because I know a lot of times it's hard to get funding
unless you mandate that something has to happen.
That's a question for everybody.
[ Laughter ]

MERCY: And you mean by "mandates"
where a government agency at the state, federal level says,
"You have to do, like, teen dating violence prevention"?
AGNEW: Yes.
MERCY: I think there are policies around the states.
As you may know,
a number of states have passed policies
that require school boards to do something
to incorporate some sort of education
about things like teen dating violence
into their curricula.
The problem with that, however, is,
as I think Sara brought up, that oftentimes, the --
There's not information or knowledge
about what the evidence base is,
so they can incorporate anything.
They just put something in there,
and that's just not good practice.
We need to link these mandates
with information about what is effective
and what we know about what works.
So, that's all I would say.
COOK: I would add that this --
I think the CDC has been fantastic
in its national leadership
on changing what the word "prevention" means,
at least within the arena of sexual assault prevention.
With the RPE program,
the Rape Prevention and Education Program,
when those funds come down to the states,
those are prevention dollars.
And prevention no longer means
a focus on risk reduction for women
or self-defense training for women,
but it means including men and others
in true primary prevention activities.
And that has been a sea change, I think, at the local level.
I know it hasn't been easy --
Probably the CDC folks can't say this.
But I know it hasn't been easy
changing the culture at the local level,
moving away from a focus on crisis --
and we have rape crisis centers.
We don't have rape prevention centers
or sexual assault prevention centers.
It's been a huge cultural shift. It did come through a mandate.
Sometimes behavior, as we've seen
in many other decades of our country's life --
The behavior has to change first,
and the attitudes and the willingness come second.
LESSER: I'd also just like to say
that I think we need to be very careful
about how we craft mandates.
Here in Georgia, there's actually a law that says
that the Board of Education has to adopt a curriculum.
It doesn't say anything about it being evidence-based.
It doesn't say anything about them working with
the domestic violence and sexual assault folks on that,
who would teach it.
And so, they can adopt it,
but they don't actually have to implement it.
And at the national level,
we actually have multiple recommendations
of the language that should be in these mandates.
So, you've got Break the Cycle, and you've got Liz Claiborne,
and you've got them
all kind of fighting over what it should say.
So, we really need to work together
to coordinate those efforts
and make sure that, you know, what we're bringing forward
is going to make the change that we want to see.
DEGUTIS: Well, I'd like to thank you all
for being here.
I thank the panelists again for their presentations.
[ Applause ]

And I hope that we can take some of the advice that Ulester had
about being a little bit more direct in what we're saying
about what's happening
and not being so timid, maybe,
about expressing what's going on.
And also looking at prevention in a very different way
and looking at prevention of sexual violence
and violence against women and girls
not so much in a reactive fashion,
but more in a proactive fashion
so that we can really work on the prevention strategies.
And I think that's a huge change from where we have been.
There is going to be, as I understand it,
a special tour of the exhibit immediately following this,
so we do hope that you will --
If you haven't seen the exhibit, or even if you have,
you might want to join the special tour.
We really appreciate the opportunity
to have the exhibit and to participate in this,
and it sounds like there's going to be interest
for another panel, given what I've heard.
Do you want a show of hands?

[ Laughter ]
So, that sounds great.
So, thanks very much.