Improving the First Stop in Trauma Care

Nurses sit at a critical intersection in addressing gender-based violence. Their unique and intimate relationship with patients allows nurses to identify patterns of violence, provide trauma-informed support, and advocate for structural and systemic interventions that address root causes.

Dr. Lucy Mkandawire-Valhmu and Dr. Leso Munala, faculty at the University of Minnesota School of Nursing, are addressing gender-based violence and the health disparities faced by survivors. They are using community partnership to train the next generation of health care professionals.

“Violence in the lives of women has an important impact on their health outcomes,” explains Mkandawire-Valhmu. “That is our role as nurses. When women are experiencing violence, we can help them to heal. We can assess them properly.”

Munala’s work with immigrant and refugee women in Chicago revealed profound systemic barriers. “This experience deeply shaped my understanding of how systemic inequities and structural violence disproportionately affected marginalized communities,” she reflects.

Health care systems can and often do perpetuate harm when they fail to acknowledge and address historical and ongoing trauma. “Black women and Native women are very hesitant to disclose experiences of violence,” Mkandawire-Valhmu explains.

Gender-based violence is much more common than many people realize. According to research published by the Minnesota Women’s Foundation and the University of Minnesota Humphrey School of Public Policy, half of Minnesota women report having experienced sexual violence, and one-quarter report physical violence from an intimate partner.

Because of these understated and consistent numbers, nurse researchers are working in partnership with community organizations to create innovative approaches to provide culturally appropriate and trauma-informed care.

Representation and Mentorship

Addressing the mistrust many communities feel toward health care systems requires fundamental shifts in who provides care and how that care is provided.

Phumulani and Isuroon are examples of organizations that demonstrate the power of community-led initiatives. As the doctors point out, these organizations provide culturally specific interventions and resources to African immigrant and Somali women facing gender-based violence, with programs ranging from health care provider training to legal advocacy. They advance policy at the state and national level that is protective and supportive of survivors of gender-based violence.

However, gaps still exist. “We don’t have any Ph.D.-prepared Somali nurses. That representation matters,” shares Mkandawire-Valhmu.

Without culturally responsive approaches that acknowledge such lived experiences, health care settings can retraumatize rather than heal.

Community-Centered Solutions in Minnesota

Minnesota has emerged as a leader in addressing gender-based violence through innovative approaches that center community expertise. The state established the nation’s first Office of Missing and Murdered African American Women, representing a significant policy advancement. “It’s the first of its kind in the nation,” notes Mkandawire-Valhmu.

Both professors emphasize that meaningful change must be driven by affected communities themselves.

Says Munala: “Even the most marginalized communities hold the keys to their own empowerment. If we listen, if we support, if we collaborate.”

As Minnesota continues attempting to address gender-based violence through health care transformation, the path forward requires sustained commitment to community partnership. In Munala’s words, “Health equity and social justice are achievable, but only through collective action.”

Resources

Phumulani: Support services for African immigrant women experiencing gender-based violence

Isuroon: Health advocacy and support for Somali women in Minnesota

Minnesota Office of Missing and Murdered African American Women: Policy initiatives and resources

Nursing Voices of Color: Mentorship program at University of Minnesota School of Nursing

Violence Free Minnesota: Coalition focused on making Minnesota a violence-free state