Faces disfigured by broken noses, jaws and cheekbones and scarred by cuts and burns -- these are the tell-tale signs of domestic violence that may haunt victims even after they leave abusive relationships and attempt to move on to happier, healthier lives. Such outward symbols of a painful past can serve as a constant reminder and ongoing burden, which is why Cedars-Sinai Medical Center has launched an innovative new program designed to address both the physical and emotional remnants of domestic violence.
Through the Fresh Outlook program, as many as 24 victims of abuse may receive reconstructive surgery free of charge during the next year or more, thanks to a collaborative effort involving Cedars-Sinai, medical staff and community organizations. The program’s primary mission is to enable those disfigured by domestic violence -- and without the financial resources to address the problem -- to regain the self-confidence needed to assume productive, fully functional roles in society. So far, three women have successfully completed their surgical procedures, and additional surgeries are scheduled to resume in January 2000. To date, 10 plastic surgeons are donating their time and professional services to support Fresh Outlook.
"Most people who have suffered abuse already have damaged self-esteem, and their self-worth may be derived in large degree by physical appearance," explained Michael Nanko, Ph.D., Vice-President, Continuing Care Services and Psychiatry at Cedars-Sinai. "For these former victims of violence -- who’ve done all the right things to get their lives in order -- physical reminders of past abuse can cause them to walk around with a continuing sense of shame and remorse."
Dr. Nanko is part of the Cedars-Sinai team formed to implement Fresh Outlook, a project also headed by plastic surgeon Harry Glassman, M.D., and Sharon Mass, Ph.D., Director, Department of Case Management. Planning for Fresh Outlook began more than two years ago when the Victory Over Violence (VOV) committee of the Los Angeles County Domestic Violence Council, co-chaired by actress Victoria Principal, approached Cedars-Sinai to partner in a program that would identify battered women who might be candidates for reconstructive surgery.
"The reality is that what you look like affects how you feel about yourself in our society," said Dr. Glassman, a VOV board member as well as Principal’s husband. "For those deformed by abuse, it may be difficult to get back into the work force or resume ordinary lives."
Domestic violence is a problem of escalating proportion. Los Angeles County police report a dramatic increase in the number of domestic violence calls received over an eight-year period: from 17,765 call in 1986 to 72,991 call in 1994. Almost one-half of the state’s domestic violence-related homicides occurred in Los Angeles County. Compounding the problem is the limited number of beds available in shelters -- only 400 in the county -- that are open to victims of domestic violence and their children seeking an escape from their hostile environment.
For those attempting to regain control of their lives after a violent past, Fresh Outlook offers renewed hope and opportunity. In addition to providing high quality reconstructive surgery and related medical services free of charge, Fresh Outlook participants also receive psycho-social assessment and support services throughout their involvement in the program, from the selection process through post-operative care.
"Fresh Outlook participants receive the same level of comprehensive care provided to any Cedars-Sinai patient," stated Dr. Nanko. "This involves a full scope of medical services, including laboratory studies and diagnostic tests prior to surgery, and other medically appropriate services."
Potential patients are being referred through shelters, low-income medical and community clinics, transitional homes, ancillary agencies and service providers dealing with domestic violence victims, counselors, therapists and mental health centers.
Applications are forwarded to the Los Angeles Coalition on Assaults Against Women (LACAAW), which oversees the screening and application process, and are reviewed monthly by a committee of three or more individuals representing members of the Domestic Violence Council, shelter staff, LACAAW and other domestic violence organizations and services.
Applications selected for participation in the program are sent to Cedars-Sinai Medical Center’s Department of Case Management, which reviews them, coordinates financial screening and contacts the candidates for surgery to begin the medical assessment process. The department also coordinates any necessary support services, including child care, transportation and hotel accommodations.
"A partnership of this scope is an accomplishment for any community," said Dr. Nanko. "It’s gratifying to be a part of this collaborative effort, which will benefit a segment of the society that so desperately needs our support."
Materials provided by Cedars-Sinai Medical Center. Note: Content may be edited for style and length.
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