Help stop the abuse

This is the real story of an unfortunate two-year-old who was admitted to the All India Institute of Medical Sciences, Delhi on January 18, 2012.

The child was unconscious with a smashed head, fractured arms and multiple human bites all over the body.

Her parents were not known and she was being taken care of by a teenager who had eloped a year ago with her boyfriend. The child was admitted to the hospital with a history of a fall in the bathroom on January 16 by the teenager claiming to be her mother.

Falak’s story, though a case of an extreme nature, is one of innumerable cases of battered child syndrome, which is a concept that is common in India. Let me explain what the term means.

A battered child is a physically maltreated child. It characterises the clinical manifestations of severe physical abuse among children. Another form of abuse is the shaken infant (the baby is shaken vigorously with the intent of hurting), prevalent among infants.

Child maltreatment includes a spectrum of abusive actions or acts of commission and lack of action.

Abusive actions can be physical, psychological or even sexual. Physical abuse may be defined as intentional injury to a child by a care giver and can be in the form of slapping, beating with any object resulting in bruises, lacerations, fractures, trauma to head, injury to internal organs, burns etc.

Psychological maltreatment includes intentional failure to provide verbal and  behavioural actions necessary for the development of the child. Subjecting the child to isolation and  terrorising them  fall under this category.

Sexual abuse refers to any act perpetrated on a child intended for the sexual gratification of the adult. The abuse may be perpetrated by family members, acquaintances and rarely by strangers. Child abuse is caused by three major components: Child+ care giver+ stress = abuse

*Parent factors: Single parents, teenage mothers, poor socio-economic status, financial crisis, domestic violence, alcoholism, etc, can be a trigger for abuse. Ten to 40 per cent of abusive parents have experienced abuse in their childhood. Increased violence in communities leads to increased child abuse. As per a 2003 UNICEF report covering a study of 30 countries, child abuse results in 3,500 deaths  annually.

Death rates in Spain,Norway and USA are 0.1, 0.3 and 2.4 per lakh  respectively.
A study by the Ministry Women and Child Development in 2007 involving 12, 447 children reported 69 per cent of physical abuse and 53 per cent of sexual abuse in one or the other form.

A study in Kerala, where 1,668 mothers were interviewed revealed the use of verbal disciplining and physical abuse in 62 per cent of the cases. Mothers are said to use the harsh method more often than fathers, the study also stated.
When to suspect child abuse?

*Delay in seeking medical advice
*Inconsistent history
*Wounds of different ages

The treating doctor will have to inform the police to initiate legal action. Creating awareness among the public that corporal punishment to discipline a child is harmful and not rewarding will help bring down the number of abuses in the country.  Support to the affected families in order to prevent recurrence is important too. Seven nations — Austria, Denmark, Finland, Germany, Iceland, Norway and Sweden have laws that prohibit physical punishment of children. Let us spare the rod and save the child.

(The author is a child specialist and hypnotherapist at Apollo Clinic, Bangalore.)