Dr. Eva M. Moya Dr. Silvia M. Chavez Baray Daniel Silvadoray Patricia O. C arrete October 2012

1. CAP² Project: Voices and Images of Migrant WomenDomestic Violence and Sexual and Reproductive Health [UTEP IRB 336186-1] Dr. Eva M. Moya Dr. Silvia M. Chavez Baray Daniel Silvadoray Patricia O. Carrete October 2012 Photo by Laura Acosta

2. VOICES AND IMAGES OF MIGRANT WOMEN PROJECT PARTNER ORGANIZATIONS FAMILIAS TRIUNFADORAS, INC Centro Comunitario Presidio Dolores in San Elizario Programa Compañeros in Ciudad Juárez Casa Amiga in Ciudad Juárez Fiscalía del Estado en Chihuahua Sponsored by the College of Health Sciences CAP² Translation by the Department of Languages and Linguistics at UTEP

4. Photovoice Is a Participatory Action Researchmethod that employs photography and group dialogue as a means for vulnerable individuals to deepen their understanding of a community issue or concern. The visual images and accompanying stories are the tools used to reach policy and decision makers. The aim of is to improve conditions by making changes at the community level. (Wang, 1994)

5. Photovoice Aims • To record and reflect on the strengths and weaknesses of the community from through the lens of residents affected by a social condition. • To promote critical thinking and formative research rooted in themes or issues and the local perspectives through small groups dialogue and the use of photography. • To empower and mobilize affected communities to address policy and decision makers. • To portrait everyday life realities using a personal and human perspective. • To advocate and mobilize communities.

6. Participant Characteristics

7. Community Groups

8. Manifestations of Domestic Violence

9. STOP “When you are part of an abusive relationship and a person tries to talk about it (violence), we immediately hang the ‘stop’ sign. We isolate ourselves from everyone that tries to make us deal with the situation that we try to avoid. I lived this way for fear to be pointed at and discriminated. To accept that we are victims is seen as something bad and shameful within our families and society.” Norma

10. PAIN AND HELPLESSNESS “These are my legs. When I was physically abused, I went through a lot of pain. I have lived a serious and traumatizing experience of domestic violence that I don't wish on anyone. To me, this was dramatic and disturbing; I lived all this in front of my children. It made me feel powerless to look at them scared and feel I couldn't help them. Let's raise our voices and don’t let ourselves be abused!” Anonymous

11. I, LIKE YOU “I, just like you, suffered physical, mental and sexual violence. I was scared to face reality due to fear, shame and ignorance; I put up with blows, humiliations and offensive comments for a long time. I was scared of speaking out and ask for help. Little by little I was sinking into a dark hole. I said “Enough!” I had the courage to stop the domestic violence, raise my voice and ask for help. Today, I live free, relaxed and ready to move on. Now I tell you. Just like me, give yourself the courage to decide and say enough María

12. LOOKING FOR LIGHT WITHIN THE DARKNESS "Disappointed, used and humiliated- that’s how I feel. With no right to life, ashamed before my family’s criticism, and social prejudice, and to what other people might say. Worried of the threats from the aggressor’s family, few women decide to get out of emotional violence. We doubt of our own fears. My aggressor’s words made me feel crazy. They said I wanted to get attention. That is emotional abuse. My partner’s alcoholism and other addictions dragged me down and left me hopeless. Today, I raise my voice; I found a ray of light in the darkness. I live happy, with no abuse or humiliation. However, I still feel singled out by society. It is important to protect the victim and make laws against aggressors.” Mayra

13. DESPERATION AND DESOLATION "She was afraid of dying when she suffered though emotional and physical abuse. She got a feeling of desperation and loneliness as a result of her immigration status and from not having any family nearby. She has fought on her own to take care of her daughters, even though she has had a partner for four years but he is her daughter’s stepfather. Her husband, an American citizen, sometimes gets home late and drunk. He torments and tells her that he won’t “give her the immigration papers.” She went into depression, and when she heard the train passing by her house, occasionally thought about suicide. She has no support from any family member. However, having a career and the love for her daughters has made her stronger to keep going. They keep quiet for fear of getting deported or separated from her daughters. We allow the abuse, more so if we are undocumented. Raise your voice. Share your experiences. Report the aggressor. Look for help, you are not alone. Youhaverights, use theresources.” Imelda

14. DEAR GRANDMA "They are a close-knit family despite the ravages of domestic violence. They were left under the care of their grandmother when their father killed their mother. Grandma is quite old and tries her best to be healthy so she can spend more time taking care of them. If I had not left the abuse, I think, perhaps my two children would be in this same situation. Despite the existing programs for victims of violence, we need more guidance and support through schools, church community centers and the community.” Alejandra

15. THE WRECKLESS DRIVER “It makes me sad that people do not respect the rules. The owner of this trailer does not care about others. He goes into my neighborhood extremely fast, where there are children and people of all ages walking or exercising. This behavior is dangerous and puts the community at great risk.” Anónima

16. THE GOLD CAGE “Maria suffered so much violence. Everyone appreciated her for who she was. She was always so passive that she never complained and endured so many injustices. We should not accept a life like that, let’s defend ourselves against violence. Domestic violence exists because we accept it and keep silence, due to fear, shame and stigma. We need to find strength and communicate more about the need and find solutions to our hardships. Let’s get closer to the people that suffer domestic violence, talk to them. It’s time to lift our face, and expose our suffering, so that it doesn’t happen again. Have the courage to stop the cycle of violence.” Belia

17. THE ESCAPE “I was overwhelmed by my problems and hardships. As I passed by the restroom, I imagined being like toilet paper which, when flushed, would disappear, and along with it, all my problems and the pain I felt by my aggressor’s words. And nothing would hurt then. At that moment, I did not care about my children’s future. It is important to be aware of the importance of emotional abuse. Avoid criticism. Support those who suffer violence. We should educate ourselves about the different kinds and signs of violence.” Norma

18. VIOLENCE AGAINST WOMEN “Physical and emotional abuse affects everything in our lives. In my sister, it (abuse) affected her nerves, she now has facial paralysis. We need to help women so that they recognize when they're being abused so they can escape and don't allow be crushing and humiliating. Leaving the fear behind, reporting the aggressor, seeking shelter and protection is vital. The Violence Against Women Act grants protection to women so they can get on with their life. Without economic independence they may not have enough money and may end up in the streets. I alsolivedin domesticviolence.” María

19. Impacts on Sexual and Reproductive Health

20. TOOLS… WHAT ABOUT ME? "We are all familiar with the first four tools, but not as familiar as with the last two; as women we assume we have to take care of others, fix things or situations, but we rarely take care of ourselves. If I ask myself: When did I do my last mammogram? When did I get a gynecological exam? What did I recently teach my daughter about her self-care? We must raise our self-esteem and accept ourselves as valuable and important. In our home and in our personal life we need greater awareness of the right tools for personal care.“ Berenice

21. NAKED WOMEN “When I cover myself with my hands and say "no more", it is because I don’t want to be forced to have sex without being respected and loved. I am learning how to say no. By being submitted to the violence of our culture and our partner, we are not exercising our right to demand when we want to have sex. It is important to recognize where our sensuality ends and abuse starts. Let’s learn to say when and how we want to have sex!” Berenice

22. SHAME “Many women aren't happy, they live with fear and are afraid to say they have a Sexually Transmitted Disease (STD) such as HIV/AIDS for the risk to be pointed at or discriminated. We need more education to stop the discrimination against other people.” Elsa

23. LIKE DIRTY WATER “I felt like dirty water after being forced to have sex: dirty, used and worthless. I thought it was my duty to have sexual intercourse with my husband even if I didn't want to. When he wanted to have intercourse, instead of telling me that he wanted me, he said I want to “use” you," and that made me feel like a disposable object. This made me feel humiliated and subdued. As women we must not allow them to degrade us and see us as objects. There should be respect and understanding in a relationship.” Lourdes

24. SAFE ALLEY “The alleys are dangerous places to walk alone; you never know who might be there or know what might happen to you. However to me these alleys make me feel safe. I know that there, I will not I find my aggressor, because I know that he doesn’t visit these places. The fear of reviving the physical, verbal and sexual abuse has edge me to take these paths.” Maria

25. REACHING OUR DREAMS “The effort that we put into being educated and employed is important. Education and a well-paid job are two objectives that we immigrants set ourselves for in this country. However sometimes this gets disrupted, by unscrupulous people who take advantage of the situation, paying less than the minimum wage, while often harassing employees sexually, psychologically and physically. These injustices truncate our dreams. Domestic and other types of abuses exists because of the fears grounded in oppression and ignorance. We have to raise our voices and complaint.” Luisa

26. Recommendations to Improve Sexual and Reproductive Health Services

27. VIOLENCE, FREEDOM, AND RESURRECTION Invisible Cage ““In violence, a woman, like a beautiful flower, must not learn to grow between rocks. Nor much less, be stifled or oppressed by a glass cage that alters its form and clouds her vision. With her inner strength, the flower grew and broke the cage; the remains were left on its sides. Women, like flowers are free to grow and live in an environment free of violence. “ Berencice Breaking Out of the Cage Resurrection

28. AGAINST SEXUAL ASSAULT “I see a Latina that is not afraid of saying out loud that she was raped. This relates to my life. Speaking out and seeking support services is a way to generate consciences among woman and man that have been assaulted. It is important to reach out and report, access health and counseling services and to meet other survivors. Wehavetospeakout and be strong”. Lucia

29. FREEDOME “As immigrant we have (or not have) the right to health services and education. There are limited services regarding human sexuality and sexual health in our community. It is important to educate our Hispanic community and our youth about the risks and consequences of early pregnancy, sexually transmitted diseases, date violence and assault. We need to pay more attention to our mind and to our body. Seekcarewhenyouneedit.” Sofía

30. WHAT OUR CHILDREN REALLY THINKING? “Here we see a very thoughtful girl; sometimes we really don't know what our children are thinking when we see them serious or concerned. We need to listen to them, their concerns, worries and dreams. There are children in the streets, children that are growing alone, and involved in drugs who do not have anyone to go to or to speak with. Let’s take the time to be with them, generate confidence, pay them attention and show them that we love them." Maribel

31. DON’T MESS IT UP "When young people have strong values and are informed about their sexuality it is more likely to be in a violence-free relationship. We need to provide more and better guidance on sexual and reproductive health in the home, schools and workplaces. Education on human sexuality to young people must be a priority.“ Yudith and Sofía

32. HEALTH PROMOTION EVERYWHERE "When I was little girl I lacked information on sexual and reproductive health. When I go to my daughters' school I see so many pregnant teens that I would like to see more effective sexual and reproductive health education in schools. In my community there are many shops where you could leave brochures about services and programs. I recommend promoting sexuality education in other places like public spaces, through the media, printed ads and through promotoras”. Alejandra

33. SEXUALITY EDUCATION "Condoms are a great way to prevent sexually transmitted diseases such as HIV/AIDS. We need to raise awareness and have bilingual programs on human sexuality and reproductive health.” Elsa

34. NEGLECTED BOOKSHELVE "Sometimes we see free information and we do not take it into account, we ignore it, because we say that it will not happen to us. Ignorance, fear, taboos and the shame will not save us from sexually transmitted diseases or unwanted pregnancies, no matter our age and background. Having access to information and education that is easy to understand as well as having other woman and man like promotoras(es). I learned through the years that we must not blind ourselves to violence and abuse because of ignorance or the fear to know.” María and Alejandra

35. A UNITED COMMUNITY “As a Health Promoter (Promotora) I help and guide the community in many ways. In my community there is a great need for education and services. We need more resources and support from legislators and leaders to provide communities like mine with higher education institutions and sexual and contraceptive education. And the reopening of the already equipped ClínicaGuadalupana, so we can have access to health and a more prosperous community.” María

36. FOR THEM "My children are the most important part in my life. I decided to leave the violence relationship I was in since I knew it was affecting them. Today my children are happy. I tell all the mothers to ‘talk, report and leave the violence behind'. There are many women (and men) who are living in silence. We must be strong and report the assault and violence for ourselves and our children. Remove the bandages that hide fear, shame and isolation and lets raise children happy and free of violence.“ Mónica

37. THE FUTURE "This baby is really happy. The child wakes up every morning with a smile on his face, that's good because this makes us feel happy. I am concerned that in the future, when he grows there will continue to be so many drugs around. A united neighborhood can stop drugs from coming into a community and protect children from the risks of violence.” Maria

38. PROTECT YOURSELF “When you get pregnant please seek care. It is important to remain open-minded and to raise your child with pride and values. Think before having unprotected intercourse. Use contraceptives. Our health is important and no one else can take of our health better than we can.” Karla

39. BREAKING THE CYCLE OF VIOLENCE "These are children living in a place for families victims of domestic violence. When I watch them play, I can see they adopt the role of victims or aggressors, since a very young age. They are in a vicious circle. Let’s break the cycle putting an end to violence at home.” Martha

40. Call to Action to Improve Women’s Health Violence against women has no geographic, cultural or social borders To prevent and address Violence against Women and improve Sexual and Reproductive Health in this community: • Increase the visibility of people affected by violence, their stories, lives, worries, concerns, vulnerabilities and aspirations. • Work for equality. For gender equality, women must live free of violence; equality will be achieved when violence and threats are eliminated from their lives. • Raise awareness about violence against women and their sexual and reproductive health to authorities, law makers, opinion leaders, and the community in general. • Include prevention and attention to violence in every work setting to increase the level of knowledge on its impacts against women, their health and their children. Violence against women put women and their children at risk of suffering different types of emotional and physical health problems. • More and better strategies in those services needed and/or used by women. • Sustainable and permanent funding for services and interventions for women, girls and aggressors through mechanisms effective for that community. • Timely and quality access to sexual and reproductive health through life. Use of a Women’s Health Card. • Education as a tool for women’s empowerment

41. Acknowledgment María, Vargas, Belia, Imelda, Alejandra, Rosa, Maribel, María, Mónica, Luisa, Karla, Elsa, Lucia, Norma, Berenice, Martha, Lourdes, Mayra, Yudith, Sofía and participants that prefer to remain anonymous. Thank you for your participation, insight and strength. The milestones you accomplished are the result of your choice to change the cycles, the personal and family histories and to advocate for the social wellbeing. Thank you for your kindness.

42. ADVISORY COMMITTEE Heidi Renpenning, UNIVISION Omar Martinez, JD, Columbia University Dr. Hector Ocaranza, City of El Paso Department of Public Health Lic. Berenice Córdoba, Consulado General de México Guadalupe Perez-Gavilan ,Consulado General de México Dr. William Wood, University of Wisconsin-Milwaukee Dean Kathleen Curtis, PhD, College of HealthSciences Stephanie Karr, Center AgainstFamilyViolence Karina Zazueta, Indiana University LawSchool Maria Covernali, Familias Triunfadoras, Inc. Frank Desales, Familias Triunfadoras, Inc Carliene Quist, UTEP MSW Program Dr. Irasema Coronado, PoliticalScience UTEP Irma G. Casas Franco, Casa Amiga AC Dr. Michael Kelly, Paso del Norte HealthFoundation Daniel Silvadoray, UTEP MSW Program

43. Thank you For more information Dr. Eva M. Moya emmoya@utep.edu (915) 747-8493 Dr. Silvia M. Chávez Baray smchavezbaray@utep.edu (915) 747-7009