healthcare interventions it is logical to introduce a formal screening process, the presence of which has been demonstrated to increase identification of violence from 5% to 30% in patients. 55 In establishing a screening process it is essential to avoid further harm to victims, which is easily possible if the process involved mandatory reporting for instance, and that led to repercussions inflicted by the perpetrator or the victim’s family. Such a process must therefore be well thought out and relevant for the context of Samoa, where privacy and confidentiality can often be hard to achieve. One good suggestion made to the Inquiry is the use of tablets in the triage section of the new hospital to allow screening questions to be answered without having to answer out loud in front of relatives or possible perpetrators. One of the pre-requisites for having a patient-centred screening process, and for dealing with victims of family violence in general, is the provision of comprehensive and regular training on how to deal with victims and perpetrators. This has been identified as a key area of improvement by the SLRC56 and others throughout the Inquiry. Indeed, that much was obvious from the reports of attitudes of doctors and nurses in blaming victims and treating family violence as none of their concern, a problem that once again shares many similarities with that found within the police force. The solution is also the same for healthcare professionals to have regular and comprehensive training on the range of family violence topics recommended for all police officers. This training is also pre-supposed by the introduction of proper documentation procedures for matters of family violence and would include developing the capacity of the staff to meet these requirements. A broader issue that will take longer to address is the total absence of any allied health services, the importance of which is of the utmost importance in helping to break the cycle of violence. Indeed, 63% of female respondents to the SFSS 2017 identified counseling as required by victims, placing it above all other possible responses. The need for counseling has been documented already in this Report but allied health services need to be much broader and all encompassing. An insight into the value of such services can be found in the ‘Moving on Art as Therapy’ programme for children that were carried out in 2010 following the tsunami in Samoa the previous year. It was observed that the impact on children who had witnessed the event was substantial, in much the same way as it is for children who witness family violence. Upon conclusion of the programme it was found that it helped children and the community support the open display of their feelings and emotions and as a result facilitated cognitive, behavioural and emotional adjustment.57 Currently no consideration is given to children who witness family violence yet the Inquiry has found that it substantially increases the risk of becoming a victim to or perpetrating violence in the future. Allied health services such as these could be used by the courts, the police and healthcare professionals to once 55 Ramona Boodoosingh and Penelope Schoeffel. (2015). “Addressing Violence against Women in Developing Countries: The Case of Samoa.” Document 82 Inquiry anthology. 56 Samoa Law Reform Commission. (2016). Convention on the Elimination of All Forms of Discrimination Against Women Legislative Compliance Review Final Report. Document 89 Inquiry anthology. 57 S Kehaolani Manoa-Slade. “Making emotions visible – expressive arts as therapy in Samoa.”(1 December 2017). Samoa Planet. Retrieved from http://www.samoaplanet.com/making-emotions-visible-expressive-arts-therapy. Document 67 Inquiry anthology.

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