For more than 20 years, men in Hawaii have gathered annually at the Men’s March Against Violence to take a stand against domestic violence. The critical issue of domestic violence in our community demands our attention — in our small state alone, 50,000 women between the ages of 18 and 64 are harmed every year.

As an emergency room physician, I have treated countless women and children for injuries related to domestic violence, ranging from bruises to broken bones to life-threatening and even fatal damage. I have referred survivors to the many wonderful programs that provide emergency shelter, transitional housing, counseling, legal aid and other resources. However, once they leave our emergency room, only a fraction of victims end up using these services.

All too often, abuse goes unreported for a number of reasons. Sadly, 25 percent of victims believe they are responsible for their injuries. Fifty percent don’t have a permanent income or means of supporting themselves if they leave. Embarrassment, low trust in institutions and fear for their lives can also prevent a woman from seeking help.

The 23rd annual Men’s March Against Violence on Oct. 12 at the state Capitol aims to change that by raising awareness of domestic violence. Not only that, marchers are encouraged to stand up and advocate for peace, respect and non-violence toward women.

If we remain silent and oblivious to the threat of abuse, violence against women and children will continue to persist in our community. A simple show of support and desire to help goes a long way toward reducing the stigma and shame that survivors face, which so often prevents them from seeking help.

There’s a reason we invite all supporters to attend the remembrance ceremony and rally, but ask that the march be reserved for men. Men commit the majority of violent acts against women. Recognizing male risk behaviors based on long-held cultural and societal beliefs is the first step in changing abusive patterns.

At the march, we’ll remember the lives that were tragically lost to domestic violence this year, rally against violence and stand up in support of our friends, family members, colleagues and neighbors affected by this pervasive issue.

I also encourage you to learn the signs of domestic violence. Abuse takes many forms — physical, sexual, emotional, economic and psychological. Denying a partner medical care, controlling their finances, forbidding them from working or forcing isolation are just as abusive as hitting or pushing them.

If you recognize the following red flags in a friend, or in your own behavior, please seek help at hawaiisaysnomore.org:

>> Showing fear around a partner, or fear over a partner’s reaction to bad news or a difficult situation.

>> Isolation from family and friends.

>> Frequent canceling of plans at the last minute, especially if out of character.

>> Unexplained injuries, or explanations that don’t add up.

>> A partner who exerts control over finances, social life or appearance.

>> A partner who calls or texts excessively, exhibiting a need to be in constant contact.

>> A partner who displays extreme jealousy or emotional abuse in front of others, including yelling or insulting.

Join to help eradicate domestic violence in Hawaii. March to let victims know help is out there. March to let abusers know their actions will not be tolerated in our community.

James Ford, M.D., specializes in emergency medicine at Kaiser Permanente Moanalua Medical Center.