Wednesday, 2 September 2015

Conspiracy of Silence- Childhood sexual abuse is a hidden epidemic withlack of recognition and safeguards

In 2007 Government of India authorised a survey into the childhood sexual abuse. The results were alarming describing ‘conspiracy of silence’ around the issue. Out of 13500 children surveyed in 13 states, about 20% were subjected to severe sexual abuse.
Around 31% of such assaults were by a neighbour or a close relative in family. Childhood sexual abuse is unfortunately common and usually perpetrated by someone known to the victim within or outside family. From scientific literature, it is evident that childhood sexual abuse is widespread in all cultures irrespective of religion, values, society, social class, geographical area and Kashmir is no exception. From our own clinical practice and research in the Valley, it is clear that childhood sexual abuse is a common occurrence and is not restricted to any social class.
Unlike other forms of physical or sexual abuse, nothing seems to be protective here as anyone can be the perpetrator. If a parent or guardian is the culprit, it makes this kind of trauma worse than any form of brutal torture. When someone is abused by a ‘person in trust’, the impact of the horrifying experience is profound and leads to lifelong psychological and emotional scarring which is hard to heal. Such children become confused as the boundaries of relationships get blurred and they struggle to comprehend the meaning of social norms. This shatters their core belief of depending on someone or finding emotional comfort. The victim loses all hope and is never able to trust anyone anymore. This gives rise to very complex situation for a child, who may not be able to understand what’s happening at the time.
As the trust is first causality here, children are afraid to approach anyone for help. If ever they do get some courage or in naivety do mention it to a parent, the outcome is not as you may be expecting. Sometimes it can take decades for them to come out if at all. One would assume that immediately the child will be made safe, reassured and the perpetrator brought to books, but that is not the usual outcome. After a brief phase of anger or frustration, the adults in most cases go into a denial mode and refuse to entertain the idea consciously or unconsciously. Children are even threatened with their life, to keep quite. The elders do not listen to their children in such matters and usually the allegation is out rightly rejected. At times their own mothers shut them up due to fear of stigma, guilt, shame and in a false belief to save the future, both of the child and family. This shatters the abused children of any remaining hope and sends them back into a state of perpetual fear, and at times exposes them to continuous and long term abuse. It also reinforces the feelings of rejection, guilt and belief that no one can be trusted.
The golden rule, ‘always believe the child whatever he or she is saying’ needs to be followed in all cases. Children do not lie is these matters and they do not invent stories. It does not matter whom they are referring to and how respectable and trustworthy the said person is in your eyes. He may be a highly respected social worker, religious leader, faith healer (peer), teacher, doctor, freedom fighter, village elder, politician, father, grandfather, brother, cousin or anyone. The child needs to be taken seriously and saved from any further trauma. In addition to ill formed beliefs, the adverse social and cultural pressures about sexual abuse in our society make it difficult to deal with this subject.
Children can display various symptoms and behaviours if they are being sexually abused within or outside family. Children can present withdrawn, aloof, depressed, angry, challenging, refusing school, start bedwetting, not eating, weight loss, always on edge and fearful, lose interest in activities which they usually enjoy, tearful, not sleeping, stop playing and the list goes on. Some children may start self-harming by head banging, cutting on their arms, or putting themselves in dangerous situations. Some fall into the trap of drug addiction and self-medication. It has varying long term consequences. The outcome is grave if child is not believed by their loved ones, breakdown in trust, and lack of emotional support, repeated and prolonged abuse. People can develop severe forms of post-traumatic stress disorder, personality change, dissociative disorder, depression, anxiety, panic attacks, phobias to name a few. Self-harm and suicidal attempts are common as people see little hope in future. There is severe lack of confidence with poor self-image which can lead to failure in studies leading to school dropout and inability to achieve professionally. They find it difficult to form long term relationships and may avoid marriage. In summary the whole life is shattered, leading to poor outcomes both in terms of health and quality of life, failing to achieve to their potential, may not be able to work and lead a miserable life for no fault of their own.
In our society, there is a strong taboo for any kind of sexual abuse and unfortunately the victims are on the receiving end. They are made to believe that somehow they are not equal or dignified anymore. There is no legal recourse and we do not have systems in place which can help such children. Suppose if a child somehow makes to police and narrates the ordeal, what are they supposed to do? What if a parent is involved, where would the child go? In a country where judges advocate that a rapist should marry his victim, there is little hope for such lonely children. There is no recognised system to deal with perverted people like paedophiles and neither are they identified. And let’s not be naïve they don’t exist in our society.
The Protection of Children from Sexual Offences Act (POSCO) was enacted in all states of India in 2012 except Jammu and Kashmir. It seems that nothing has been done in this matter by the Jammu and Kashmir Government till date and there is no legal framework or procedure in place to safeguard children from sexual abuse. The Jammu and Kashmir Juvenile Justice ( Care and Protection of Children) Bill was passed in 2013 which classifies sexually abused children as ‘child in need’ but does not say anything further about safeguarding or management of such cases and seems more interested in arresting juveniles who are allegedly involved in unlawful activities against the state.
There is a need to recognise the problem and help the victims than going into a denial mode. Work needs to be done on the stigma and social attitude so that when these children do seek help, they are taken seriously and not rebuked. It is better to keep the children’s interest at heart and not the family and society in such cases. One would be doing more disservice by not helping children in crisis and worrying about family name or the accused. It is time to come out of any false belief that such acts don’t happen in our society or culture. It can be happening in your house or the house next door. It is not uncommon in institutions housing large number of children, whether run for imparting mainstream or religious education, or the institutions which bring up underprivileged and orphan children. Unfortunately our state has hundreds of such institutions but there are no checks or procedures in place.
Parents and professionals (teachers, doctors, and police etcetera) should always keep abuse as a possibility if there is such presentation and explore actively to prevent any further damage and long term consequences. Teachers have got the bigger responsibility and should be concerned if a child has suddenly started showing any changes in behaviour or decline in academic performance. Doctors should always keep this possibility in mind while treating young people and children.
Training of professionals including doctors, police, teachers and social workers is needed to help such children with sensitivity, compassion and an effective outcome. Civil society has a big role to play in breaking the shackles, creating conducive environment and raising awareness. There is need of policy and procedure from the State for identifying, treating and safeguarding such children.

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