By Melissa Lauber

It starts with a scream, often silent but always deafening. Or maybe with a whisper that drips with contempt and hatred. "But there's usually a sound," said Pamela, who was abused by her husband for more than seven years.

"It's like a little voice in your head, but it's not words. It's the sound of worthlessness, and dreams being shattered like glass, and fear that's so real it can make you throw-up until there's nothing left inside you, not even your heart. I bet there's very few women alive who haven't heard this sound," she said.

Pamela, who now lives in Houston, won't show you her scars. She's determined that survivors shouldn't "glamorize" their wounds. "That can be as addicting as any drug. It's about 'pity me,' and that's not who I am any more," she said.

But Lila, who lives in Maryland, tells her story to anyone she feels will value it. "Women, and I guess men, need to hear these stories," she said. "It's too easy otherwise to feel like you're the only one."

Lila had been married for two years and although she and her husband fought, he was never really violent. One night, however, in a yelling match over the finances, he threw a pair of candlesticks at the wall.

Over the next year, his attacks on her escalated. "He would scream, loud screaming and point his fingers in my face," she said. "Once he hit me and it was like slow motion, like one of those boxing matches on pay-per-view."

Other times, he hit her and all she remembers are the "black-hole feelings."

Lila sought help after the murder of Nicole Brown Simpson. She was one of thousands of women to do so. But it wasn't necessarily the murder that caused her to call a shelter for abused women.

"It was that tape," said Kim Scott, a spokesperson for Heartly House, a shelter for domestic violence victims in Frederick, Md, referring to the much-broadcast 911 message of Nicole Simpson pleading for help.

"The sounds in the tape hit close for a lot of women," said Scott. In Los Angeles, following the week that the tapes were broadcast in the summer of 1994, calls to abuse hotlines went up 80 percent.

It was a phenomena that was repeated throughout the country, despite the fact that for two years the American Medical Association had before been trying to alert the public that "as many as one in three women would be assaulted by a domestic partner in her lifetime."

But the tapes, and the Simpson drama, gave a face to the statistics and awoke a nation to what the U.S. Surgeon General had 10 years earlier called "this nation's number one health problem."

The silence was broken. Discussion of domestic violence entered the town square in a meaningful way.

In the past two years, numerous advances that address domestic violence have been made in the judicial, medical, religious, educational and public arenas.

However, the situation is still grave.

Statistics from the National Coalition Against Domestic Violence indicate that a woman is beaten by her husband or boyfriend every 15 seconds in this country, and that in homes where spousal abuse occurs, children are abused at a rate 1,500% higher than the national average.

A study by UC San Francisco researchers, released in January in the quarterly journal "Women and Health," shows that "domestic violence causes 21,000 hospitalizations annually, accounting for 99,800 inpatient days, 28,700 emergency department visits and 39,900 doctor visits."

According to the FBI, 26% of all female murder victims in 1995 were killed by their husbands or boyfriends. Every five years, family violence kills as many women as the total number of Americans who died in the Vietnam War, the American Medical Association reported.

And so, why don't these women just leave these abusive situations, many ask. According to shelter workers, financial and emotional dependence play a big role.

But more important is fear -- well founded fear. "Women who leave an intimate relationship are 70 to 75% greater risk of severe injury or death than they are ifthey stay in the relationship," said Kathy Wells, director of Hope Place, a shelter in Alabama.

Hope is the lifeline that saves abused women. One of the chief foundations of hope for many people is the recent trend to view domestic violence as less of a "behind locked-doors" struggle and more of a public concern.

A recent survey, commissioned by the Family Violence Prevention Fund, found that "the public no longer blames the woman or excuses the man." This change in attitude is reflected in national and state policies.

A year ago this month, the National Domestic Violence Hotline, a 24-hour crisis assistance program, which receives 10,000 toll-free calls a month, was opened.

Last December, the U.S. Justice Department announced $46 million in grants for 122 communities across the nation to help them investigate and prosecute domestic assaults as crimes and this year, the Department of Health and Human Services will award $72.8 million to states to expand the availability of shelter services to victims of family violence. This funding represents an increase of 52% over the $47.6 million available in 1996.

These measures are all a part of the Violence Against Women Act (VAWA), which was passed as part of the Crime Act of 1994, to address domestic violence. This legislation has dramatically increased the abilities of communities and states to take a proactive stance in ending domestic violence.

However, Bonnie Campbell, director of the U.S. Violence Against Women Office, says that it will take time for law enforcement and social service agenices to become their most effective in addressing domestic violence.

As this time passes, she implores individuals, churches, and organizations of all kinds to begin to take action. "Awareness," she said, "is essential." But action must follow on its heels.

Pamela of Houston responded to Campbell's comments with a heart-felt "indeed!" Tears and tantrums won't quiet the sounds of domestic violence, she said. "But action can. We must act now. Heaven help us if we don't."

Related Sites on Domestic Violence:

Department of Justice's Community Checklist
Violence Against Women
Domestic Violence Information Center
Domestic Violence and Sexual Assault Coalition

See Also These Related Stories: Men Get "Off Sidelines" to Fight Domestic Violence Domestic Violence: A Community Problem Men Who Beat Women Often Believe They Are Justified Religious Leaders Urged to Confront Family Violence Making a Difference: How You Can Help With This Issue Related Books