“What’s love got to do with it?” A hospital ethnography on sexual violence response and care in Bangladesh

Bangladesh is considered to be one of the fastest growing economies in South Asia, having achieved milestones in both human and economic developments. Much of the country’s economic success can be attributed to women’s participation in the ready-made garments sector (RMG) and microfinance-based entrepreneurship. While women and young people are at the core of Bangladesh’s development discourse, it also has one of the highest rates of violence against women (VAW) in the region, making it a gender and development paradox. According to the WHO’s Violence Against Women Prevalence Estimates (2018), 50% of women in Bangladesh face one form of intimate partner violence in her lifetime, while 2 out of 3 women are said to have experienced some form of violence, harassment, and/or assault in their lifetime. And yet, the public health response to VAW in Bangladesh remains limited, albeit large-scale national implementation of the VAW prevention and protection programs. This research therefore looks into the public health response to VAW in Bangladesh.
Through in-depth hospital ethnography at the Forensic Medicine and Toxicology Department of Dhaka Medical College Hospital, this research brings forward the complex story of colonial medico-legal procedures that continue to dominate the construction and proliferation of authoritative knowledge on female bodies and sexuality. Over a century old medical
jurisprudence defines what constitutes as rape/sexual assault and the procedures in obtaining medical evidence from gendered bodies. Despite High Court’s judgment to repeal the highly discriminatory, scientifically challenged, ‘two-finger’/virginity test to determine whether a rape had occurred or not. Women’s ‘virtue’ and ‘character’ take the center stage in a sexual assault investigation rather than the crime itself. While rape cases remain under reported, ethnographic research also brought forward an unexpected finding – the misapplication of the special protective law, Nari O Shishu Nirjatan Daman Ain 2000, as a re-scripting tool to young people having consensual sexual relations outside of marriage. In a society where marriage and class mobility are intricately connected, sexual relations outside wedlock become a familial crisis, which is then ‘corrected’ using the strict protective law to recreate their daughter’s social virginity. Female doctors at the medico-legal center navigate through the procedural complexities and try to provide a sort of bureaucratic sympathy and care.
The research also brings forth the generational difference between young people as they experience love and sex and the stakeholders’ generation that implement class-based ideals on how sexual relationships, and therefore what constitutes as sexual assault. There is a sociality of consent that requires further investigation. Lastly, this research demonstrates that the existing patchwork developmentalist approach to VAW policy in Bangladesh, creates incoherent medico-legal rules, procedures, and therefore care provision for victim-patients. Through critical class analysis, this thesis demonstrates the subjective nature of ‘female medicine’ in Bangladesh requiring a wider conversation on what is considered to be ‘care’ for sexual assault and women’s health in general.