Formal and Informal Channels of Communication

11/18/2003

CHILD SEXUAL ABUSE: A SILENT

HEALTH EMERGENCY

P. Vijayalakshmi , MSN
Clinical Instructor

Brief Overview

Introduction
Child Sexual Abuse in India
Definition
Family Risk factors
Health consequences CSA
Nursing Implications
Priority Interventions
Conclusion

Formal and Informal Channels of Communication

11/18/2003

Introduction

Child abuse and neglect is a global

public health concern.
It is a prevailing problem in all
generations, socioeconomic strata
and societies.
WHO, estimates that globally
40
million children aged 014 years
suffer some form of abuse and neglect
requiring health and social care.
The most devastating is child sexual
abuse.

CSA is a silent health emergency.

It goes unnoticed, grossly underreported and poorly managed.
CSA often occurs in places normally
considered safe: homes, schools, places
for leisure activities.
Children lack maturity to understand
and vocabulary to report sexual abuse.
Misconception that sex with a virgin is a
cure for HIV/AIDS.

Child sexual abuse in

India

The Immoral Traffic Act: protects

children below the age of 16 from being
used for the purposes of commercial sex
The Juvenile Justice Act: Section 26
provides for punishment if a person
procures a juvenile for hazardous
employment.
The Prohibition of Child Marriage
Act: makes punishable the practice of
marrying girls under the age of 18 and
boys under the age of 21

More than 53% of children in India

have probably been sexually abused
and many have never shared the
fact of this abuse with anyone.
(A recent study on Child Abuse
India 2007 )

Children who have faced some amount of

sexual abuse
53%
Children who report having been sexually
assaulted
6%
Cases where the abuser was
relationship of trust with the child

in

a
50%

Few Facts

8,945 children go missing in India

every year
5,00,000 children are estimated to
be forced into the sex trade every
year
Approximately
2
million
child
commercial
sex
workers
are
between the ages of 5 and 15 years

Approximately
3.3
million
child
commercial sex workers are between
15 and 18 years
Children from 40% of the total
population of commercial sex workers
80% of these children are found in the
five metros Delhi, Mumbai, Kolkata,
Chennai and Bangalore
71% of them are illiterate.
CRY (Child Rights and You)

What is child sexual abuse?

Child sexual abuse is the

involvement of a child in sexual
activity that he or she does not fully
comprehend, is unable to give
informed consent to, or that violates
the laws or social taboos of society.
WHO (1999)

Family Risk Factors

Socially deprived and disorganized family

backgrounds
Marital dysfunction, as evidenced by
parental separation and domestic
violence
Increased risks of abuse with a
stepparent in the family
Institutional or foster care
Poor parent child attachment
lack of adequate care, supervision and
protection

Health consequences CSA

Child

sexual

abuse

unrecognized

is

problem

major
with

devastating consequences and longlasting

effects

that

negatively

impact on the health and social

development of children.

The nurses role face child

sexual abuse suspicion

Nursing
professionals
have
an
important role in the treatment of
children with suspected sexual abuse
because they can, through care, child
support, spread the love and security
the child needs to face this situation
(Woiski & Rocha, 2010).

Early identification and intervention

of child sexual abuse is a critical
one and it embraces all areas of
clinical practice.
Obtaining of information and care
directed to a sick child requires from
the professional, much more than
technical care.
It
is
primordial
exercise
an
especially attentive listening and
careful observation for the child who
suffered sexual violence.

Keep in mind that children who have been

sexually abused have endured tremendous
emotional distress, which they are not
capable of understanding.
Always try to build a trusting and secure
relationship. Keep in mind that the child
needs empathy, not sympathy.
To build trust, show sensitivity to the child.
Abused children also feel they have done
something wrong and deserved to be
abused, so let them know there is nothing
wrong with them and that under no
circumstances did they deserve the abuse.

The child, family, or other caregiver

should get professional counseling to
help them deal with these complex
issues.
Be sure to assess and
document the childs emotional
status.
Nurses should be aware of laws
protecting the rights of children's
health.
It is necessary to understand the real
needs of the child and his family,
seeking health education as a key
point in all stages of care.

The planning, setting priorities, the

survey of available resources are nursing
actions and the family's involvement in
all stages contributes to the success of
care.

The
singularity,
habits,
family
dynamics, culture and social and
financial situation of the family should
be studied carefully.
care from the perspective of another."
Research in the field of nursing focused
on care for the child victim of sexual
violence is of great importance.

Listening carefully to the reports,

explaining the consequences of
sexual abuse in child health for the
family are fundamental steps.
Guide families ways to educate and
communicate with their children, and
accompany them with respect and
attention.
The speech, the look, gestures, the
information communicated in simple
and accessible language can make a
huge difference in building rapport
with the child.

Nurses

should

understand

and

prioritize the need of interaction with

other professionals in attendance,
seeking to find better solutions for
their actions.

Every health professional has special

moments of contact with children,
adolescents and their families.

Priority Interventions

Advocacy and communication strategies

Law enforcement and criminalization of
CSA
Development of standardized protocol for
clinical care and management
Multi sectoral, multidisciplinary and
coordinated responses
Rehabilitation of CSA survivors
Community-based support, surveillance
and reporting

Conclusion

Child sexual abuse is a public

health and human rights problem
that can no longer be ignored. The
risk and consequences of HIV
infection, unwanted pregnancies,
and physical and psychological
trauma should draw international
attention to this silent emergency.

The silence must be broken through

advocacy and education addressing the
cultural

and

traditional

beliefs

that

encourage this crime.

Respect for the right of the child to

adequate protection and care within and
outside the home must be the basis for
international, national,

community and

family action against child sexual abuse.

Discussion