'Every child born into the world is a new thought of God, an ever
fresh & radiant possibility'.
'Children are the bridge to heaven'.
'Every child comes with a message that God is not yet
discouraged by humanity'
Our brain always gets entertained by the aforementioned quotes on
children. Whenever we see a beautiful healthy baby, we tend to say ''Ohh..So
sweet/Cho chweet'' & on the other extreme when we see poor or underprivileged
baby, ''Oh My God... '' is the 1st line that our tongue passes. Does our duties
& responsibilities get a full stop mark right there?? Do we ever try to
have a deep sneak at the so called 'active-healthy' babies or the
'poor-underprivileged' babies? I realize the fact that, the general population
must be giving a sarcastic expression especially after going through the 'deep
sneak' term. I agree that we don't have enough time to look into the matters
behind the babies. But the most blessed professionals who can do this 'deep
sneak' job seriously are paediatricians.
According to a report by CPS (Child Protective Services) around
the world in the year 2006, 64% of all the child abuse cases comprise of
domestic neglect, 2%-Medical neglect, 16%- physical abuse, 8.8%- Sexual abuse,
6.6%- Psychological abuse. Whenever we hear about the term 'Child Abuse', we
always draw a picture of sexual abuse in our visual cortex. But as evident from
this report, child abuse is much more than sexual abuse. According to dept
of Woman & child welfare of the Govt of India in 2007, approximately 53% of
children are victims of sexual abuse. We can always use the term 'Iceberg
phenomenon' to child abuse because we see a fraction of the
real occurrence in our society.
Now let's refocus on the roles of a pediatrician towards the
prevention of child abuse. Other than the parents, if someone has the legal
access to examine the body parts of a baby, he/she is a pediatrician.
Pediatricians are close to the parents. So he/she is positioned in the best
possible place to assess the risks & consequences of child abuse. According
to a report from AAP (American Academy of Pediatrics), the universal prevention
of child maltreatment must begin with an approach that assess the care giver's
strength & deficits. So the key term is ''Anticipatory guidance''. A
pediatrician must be ready to tackle all the issues which may impose risks of
child abuse. So identifying the possible risk factors is a cornerstone for the
prevention this issue. For example, a mother suffering from post-partum
depression is often a source of negligence for the baby. So the
pediatricians must have an eagle's eye on psychological aspects of the parents
as any negative change in parent's psychology will definitely affect the child
care at home. Another crucial situation is the evaluation of a child with
disabilities. Most often, the children with physical/intellectual disabilities
become the victim of maltreatment. Here the biggest reason is the parental
frustration. Same is the risk, when the baby is a product of unplanned
pregnancy. So the pediatricians must look for the aforementioned factors
(parental depression, unplanned pregnancy, child with disability) carefully to
assess the risks of child abuse.
After doing 5 months of Pediatric rotations in USA, I realize that,
the Americans are much more aware of these issues than Indian (Now, don't drag
me into the controversy that I am biased in favor of US). Each & every
examination room in USA pediatric hospitals has the child abuse report forms
hanging on the wall. It is the role of the pediatrician to report any suspected
case of abuse. I guess we lack that part in India. There should be more
awareness among paediatricians about this issue. Fixed follow-ups of all child
patients in regular intervals should be strict in Govt hospitals & careful
assessments during these follow-up visits can reduce the risks of child abuse
to a great extent. I strongly feel, instead of following the
American culture, we must follow at least this useful & important aspect
which can keep our babies secured.
Special thanks to Aamir Khan’s 'Satyameva Jayate'' & Prof
Howard Dubowitch ( Dept of Child abuse, University of Maryland school of
Medicine) as they have inspired me to type about this topic.
It is indeed a very serious problem in Indian scenario as SJ has pointed out and to my horror,53% of the abused where found to be young boys! The solution you have given is practical and very do-able in our hospitals provided there is a concern for it.I have seen the so called "child clinic" in my hospital where they just take the anthropometry of school going children and rarely have a one-on-one chat about issues like these. In my opinion there should be a separate section of say,Child Psychology, in such hospitals where it would be mandatory to get your child checked once in a year to pick up issues at home or at schools at an early age when the damage is not done. Many private schools have a psychologist to assess whether the mental well being of a child is taken care of or is disturbed by any problems. This is a good thing and should be implemented in other schools as well.
ReplyDeleteLastly,it is the child's parent who has the biggest responsibility of keeping an eye on his child,where he's going, whom is he meeting after school,etc.
good one
ReplyDelete@Aniket & Geetu: Thanks for sharing your opinions :)
ReplyDeleteA very excellent article Abhishek providing good insight into the topic of child abuse !!! A child who is well understood in terms of emotions and well nourished grows up into a healthy adult who not only respects his/her own emotions and well-being but also cares for those around him. In a way, it prevents them from becoming into sadist and selfish elements who indulge in activities like child abuse .. !! Well done Abhishek for choosing this topic !
ReplyDelete