Opinions

Strangulation is a deadly tactic. Believe victims.

On Sept. 6, a little girl, Ashley Johnson-Barr, played in the fall weather at her local park in Kotzebue. She will never return to play there again. Her body was found on September 14. The autopsy conducted by the State Medical Examiner's Office revealed "signs of trauma that include strangulation and sexual abuse," according to a statement released by the Department of Law. Furthermore, this same autopsy reported "distinct ligature marks" around her neck, facial injuries and "large amounts of mud/debris" on her body.

What are ligature marks? According to Richard Harruff, Chief Medical Examiner of the Seattle-King County Medical Examiner's office, these are visual results of strangulation. Dr. Harruff outlines two types of strangulation — manual and ligature. Manual strangulation takes place when a person uses their hands to compress the neck.

Ligature strangulation refers to "neck compression produced by an object that can be used for tying, such as a rope, cord, belt, shoelace, wire or electrical cable." Ashley Johnson-Barr, like the victim in the recent Justin Schneider case, experienced strangulation. These victims were not choked; they were strangled. Strangulation is a violent and effective tactic that is misunderstood, deadly and consistently downplayed.

Strangulation results in cerebral hypoxia — this means that there is not enough oxygen delivered to the brain to maintain the functioning of the brain and results in a loss of consciousness. A victim who is being strangled may lose consciousness in as little as 10 seconds — seconds that are often filled with confusion, disorientation and disbelief. Although victims may recover consciousness, if strangulation stops oxygen for a longer period of time — say four minutes — they could die.

If victims consistently experience bouts of non-fatal strangulation where critical areas of the brain do not get enough oxygen or neurological input, they may experience diminished brain functioning resulting in memory loss and minor strokes. A particularly concerning characteristic about strangulation is that victims can be strangled with no physical signs or symptoms on their body. In the absence of physical injuries, victims themselves, family members, untrained health care providers, and other first responders may assume that there is little danger or injury. However, a victim who has been strangled can develop symptoms such as swollen airways and difficulty breathing for up to three days after the strangulation incident. Even without physical marks, a victim who has been strangled can die three to four days later.

Alaskans must do a better job of understanding the severity of strangulation, and we must do a better job to protect victims. One way is to learn how tactics work, and to use the correct terms when describing those tactics. For example, victims who are strangled are not choked and do not pass out, even though these terms are often used to describe what happens when a victim is strangled. Victims lose consciousness because there is an intentional act to cut off oxygen flow to their brains.

Another important factor to consider is the link between strangulation and increased risk of homicide. Dr. Nancy Glass reported in 2008 that non-fatal strangulation is an important risk factor for homicide in domestic violence victims. This means that when victims report that their partners have "choked" them — even if there are no marks — those victims are at higher risk of being murdered by their partner. Dr. Glass rightly points out the need to factor the real risks of non-fatal strangulation when conducting lethality assessments with abused women. In other words, strangulation is deadly, and it should never be taken lightly.

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Alaskans must collectively do more to support victims, listen to their experiences and provide relevant and timely services. We must collectively do more to prevent violence, and acknowledging what we know to be true is a good place to start. The recently released "2016 Felony Level Sex Offense Crime in Alaska Supplemental Report" highlights the following:

The most common victim is a 14-year-old female.

The most common suspect is a 19-year-old male.

The most common space where the assault occurs is in the home.

Alaska has one of the highest rates of sexual assault in the country and is especially dangerous for Alaska Native women and girls who continue to experience the highest rates of sex offense victimization across all age groups. Fifty-four percent of the reported victims identified as Alaska Native. The dangers that women currently face in our communities is profound in light of statistics like these, and in light of current sex offense cases.

We know enough now to do a better job responding to and preventing sexual assault and domestic violence. Now is the time to act. Contact your local domestic violence and sexual assault program in your community and ask what you can do. Contact the Alaska Native Women's Resource Center and ask how to better support Alaska Native survivors and communities. Contact the Alaska Network on Domestic Violence and Sexual Assault to learn more about sexual assault and domestic violence prevention and intervention efforts in our state. Contact the Council on Domestic Violence and Sexual Assault and ask how we can change practices and policies to provide better protection for survivors. Contact your local school board to find out if students have access to sexual and dating violence prevention classes. Contact your elected officials and let them know that sexual assault and domestic violence are serious crimes, and that the impacts reverberate in the family and community, damage our economy, and brutally reinforces intergenerational and historical trauma.

Finally, believe. Believe survivors, and believe that we can make a difference. As Alaskans we can lift each other up, hold each other accountable and protect the most vulnerable. It is our collective responsibility.

Carmen Lowry, Ph.D., is the Executive Director of the Alaska Network on Domestic Violence & Sexual Assault.
Dr. Tracey Wiese, APRN, FNP-BC, PMHNP-BC, is an Advanced Nurse Practitioner certified in both Family Practice and Psychiatric Mental Health.

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