Preventing Child Abuse

JOINING HANDS FOR HEALTH

(The Nassau Guardian’s Editors Note: As concerned adults, we want to protect children from sexual abuse, but we can't always be there to do that.

We can, however, teach children about sexual abuse in order to increase their awareness and coping skills. Without frightening children, we can provide them with appropriate safety information and support at every stage of their development.

Today, Joining Hands for Health will focus on the Suspected Child Abuse and Neglect (SCAN) Programme and some of the strategies that are engaged to prevent sexual abuse of children).

Child sexual abuse is any incident of sexual contact between a child and another person, whether an adult or an adolescent. These people are usually in a position of authority, and use these children for sexual purposes. The sex act may include: fondling or touching their private parts, exhibitionism, sodomy, exposing the child to, or involving the child in dirty videos and books and vulgar behaviour.

Who abuses children? Information from reported cases show that most offenders are males, they may hold a white or a blue collar job, or no job at all.

Strangers can abuse children; these incidents are more likely to involve force and usually occur only once. However most offenders are not strangers. The child knows more that 85% of the offenders, it may be a father, uncle, brother, grandfather, stepfather, neighbour, family, friend, or the baby sitter. Typically child sexual abuse will occur repeatedly within a long-term relationship, because the offender abuses his position of power.

Child sexual abuse may eventually involve sexual intercourse, but it typically begins with touching, which may include oral sex. Any child could be the victim of sexual abuse.

It is everyone's responsibility to do whatever he or she can to prevent sexual abuse. Anyone who knows or even suspects a child is being sexually abused has the right to report it, to help these children.

What can children be taught about, who has the right to touch their bodies?

Children need to be taught that their bodies belong to them and no one has the right to touch them in a way that they are not comfortable with or hurt them. It is ok for their bodies to be touched by a doctor if they are getting an examination or their parents if they are giving them a bath.

They should be taught that they could say no to a request that makes them feel uncomfortable even if it is a close relative, family or friend. That they can tell a trusted adult about abuse even if they are afraid of what may happen. Teach your children their boundaries, what their private parts are and who has the right to touch them.

Does communication play any part at all in preventing child sexual abuse? Yes, good communication is the key. Parents need to listen to their children, keeping an open communication with them at all times, believing what their children tell them.

It helps when a parent talks with their children instead of at them. Good communication allows parents and guardians to always know where their children are and what they are doing.

Some people may say it is too early or they don't know when to teach their children about sexual abuse. Children should be taught at an age-appropriate language they can understand, about the difference between safe and unsafe touches.

They should be taught to feel good about themselves and know they are loved, valued and deserve to be safe. They should also be taught about the proper names for all body parts, so they will be able to communicate clearly and know when something is not appropriate.

Why do you think most children don't tell about their abuse? Children hardly ever tell about their abuse because they are frightened and most of the times are told not to tell by the offender.

Children often want to tell, but they are afraid they will not be believed or protected. A lack of communication with parents is often another reason why children don't feel they can talk to their parents about what has happened.

What response should you have toward a child who has been abused? We ought to respect that child and understand that whatever feelings the victim is having is normal. We should be able to empathize with that child, letting them know that we regret what has happened to them.

We should be able to support the victim by reassuring them that they did nothing wrong and it was not their fault. Counseling should also be provided for the child. Explain to the child what will happen next, for example: Interviews, hospital procedures, or admission.

The offender may be prosecuted, which may require the child having to go to court.

Many young children today are sexually active or exposed to sexual knowledge at an early age. Children are encouraged to stay away from persons who suggest, encourage or engage in the promotion of sex outside of marriage; parents should establish standards of conduct at an early age and not allow anyone to violate their standards; supervise what children watch on television or what type of books or pictures they look at; encourage children not to entertain sexually-explicit material through the form of music, television, movies, print or the internet; dress fashionably, but modestly, not exposing parts of their bodies that are meant to be covered.

When parents or caregivers force or encourage children to sit on someone's lap, hug or kiss them, they may inadvertently be encouraging sexual abuse; also, when we allow our children to use the internet or watch television unsupervised, they can become exposed to pornography.

What advice would you give to parents leaving children at home alone? If there is absolutely no other way out and you have to leave children home alone, ask a reliable neighbour to watch your home. Give clear instructions for children to follow:

- Don't give out information over the phone that you are home alone.

- Don't open the door to strangers who may come asking to use the phone, for a drink of water, or to use the toilet, or even saying that the child's parents had sent them for something.

What advice would you give to children who have to walk home?

- Instruct children not to take short cuts.

- Not to walk through bushy areas.

- Never to get into a car with a stranger, or any car without your permission.

The Team Approach has been implemented through the SCAN Programme - one of the key initiatives developed and put in place by the Ministry of Health to strengthen family health nationally.

This approach recognizes that no one individual or group, working alone, can effectively address this complex problem. Rather, an active partnership of all the agencies involved in dealing with any aspect of this issue is fostered through the "Team Approach".

The Partners of this Multi-Disciplinary, Multi-Sectoral Team include staff from different agencies and ministries, such as: The Accident and Emergency Department, the Children's Ward and Health Social Services at the Princess Margaret Hospital; the Attorney General's Office; the Child Abuse Unit of the Department of Social Services; the Criminal Investigation Department (CID) and the Forensic Department of the Royal Bahamas Police Force; the Crisis Centre; the Guidance Counsellors in our school system, as well as the SCAN unit and School Health Services of the Department of Public Health.

Effectiveness of the Team Approach

The contributions from all members of the team, guarantees for each "at risk" child, a continuity of care. This further helps to ensure that no abused child "slips through the cracks," and gets lost in the system, and thereby, fails to receive the needed level and quality of care needed.

Prior to the implementation of the SCAN Programme, there was no effective way of ensuring that every abused child was receiving needed counseling and follow-up medical care. Now however, there is a protocol in place. Each abused child is now able to access needed help through an established process, which also provides for ongoing monitoring.

For example, abused children would be seen in the Accident & Emergency Department (A&E) of PMH at the SCAN clinic, at which time examinations (physical as well as psycho-social), would be done.

The SCAN team would conduct medical follow-up. The SCAN team would also follow up any referrals made.

The Team Approach serves to minimize the stress the child would suffer from having to retell her/his story, over and over, to different helping agents. Using the Team Approach, a very brief history is usually obtained initially - generally from the parents/guardians/caregivers, or the CID Officers who bring the child in.

The core group who would be responsible for providing restorative care will be in place for whenever the child is able to open up and share her/his story. This serves to minimize the trauma of reliving the experience through repeat interviews. The process is very dynamic and it is proving to be most effective.

The Major Challenges in Implementing the Team Approach centered primarily on people's comfort level. Team members had to change the way they previously worked. It involves, for all members of the team, a considerable amount of reading, talking and living with a very difficult subject.

There were also some initial concerns about the "chain of access or command." That is, which professional group should the child first encounter? The decision was made that this initial contact should be at A&E. After the initial contact, if the child needed to be placed in protective custody, the Child Abuse Unit would take over.

In the final analysis, all team members felt the protocol that was established and put in place, to be in the best interest of the child.

(All of us must do our part to prevent these depraved acts. If you know, or suspect that a child is being abused in any way please call the nearest Police Station. Report your suspicion at once. For more information you may call the Ministry of Health's Information Helpline at 502-4836 or SCAN Unit at 323-6363. "Joining Hands for Health Is presented each week by the Health Education Division, as a public service of the Ministry of Health and the Nassau Guardian.

Posted Wednesday April 2, 2003

The Nassau Guardian