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Addressing child abuse in Mumbai

© UNICEF/India 2007
The Multidisciplinary Child Protection Center at the Nair hospital

By Vidya Kulkarni

Maharashtra: Fourteen year old Sneha (name changed) suffered from recurrent dizziness and vomiting. Her mother thought that it could be due to weakness and took her to the nearby Nair Hospital, a public health facility run by Mumbai Municipal Corporation.

Preliminary investigations revealed that Sneha was two months pregnant. Shocked by the news, the mother did not know what to do next. Following the doctor’s advice the mother and Sneha visited the Multidisciplinary Child Protection Center (MCPC) located in the hospital premises.

Here Sneha opened up for the first time to share her painful experiences of sexual abuse by one of her relatives. In due course the Center ensured she got all required support for her physical as well as emotional and psychological healing.

As with Sneha, incidences of child sexual abuse usually become known only by accident. While there are no visible signs of abuse, the child suffers immensely from guilt and shame.

According to a just-released 13-state National Study on Child Sexual Abuse commissioned by the Ministry of Women and Child Development and conducted by Prayas, UNICEF and Save The Children, abuse is a startling everyday reality for as many as half of the country’s children. The report states that more than 53% of children in India are subjected to sexual abuse, but most don’t report the assaults to anyone.
 
Even when the problem gets identified, lack of social awareness on the gravity of the issue and ways to deal with it makes it difficult to ensure any kind of support to the victimized child. The MCPC intends to fill this gap by working with the medical system and coordinating support services holistically to protect the best interests of the child. MCPC, a joint venture of Nair Hospital and UNICEF, was started in February 2006 with Forensic Science as the nodal department for this initiative.

The idea of setting up such a holistic and hospital based center to address the issue of child sexual abuse was originated by two Mumbai based organisations Amrae and Advait Foundation, both working for children and having a close association with UNICEF.

The concept was further explored with a group of stakeholders including doctors, police and members of the judiciary, before it got translated into its present form. In a span of one and a half years the center has been able to extend need-based support to over 25 girls and boys.

© UNICEF/India 2007
Ms. Archana Khedekar, project manager

The rationale for setting up such a center in a hospital is quite simple. According to Vijaylakshmi Arora, child protection officer- UNICEF, “Vulnerable populations often approach hospitals with health complaints. The health service providers are in a position to identify signs of abuse upon their patients. Thus the medical system is potentially powerful and capable of providing treatment beyond physical healing.”
  
The case management follows a multi-system approach, wherein the social worker coordinates with all concerned departments within the hospital as well as outside. A Quick Response Team involving a panel of doctors from every department; gynecology, pediatrics, forensic science, surgery, psychiatry and others, has been formed. Whenever any incidence of CSA is identified, the nodal department informed the concerned medical departments to carry out investigations.

The center makes sure that procedures are non-threatening and sensitive to children, who are already traumatized having faced abuse. Ms. Khedekar, Project Coordinator  said, “Repeated disclosure of the happenings can add to the trauma faced by the child. Therefore personal history of the child is recorded by the social worker and it forms the basis for further required investigations for medical purposes, evidence collection, age estimation and other reasons.”

Each case is followed up to the end. This involves taking the parents into confidence, securing appropriate shelter for the child, working with the police and also with the judiciary, thereby having an opportunity to influence the enforcement and prosecution machinery to be child friendly. The workers at the center accompany the child at every stage. Family visits are crucial to motivate family members to take required course of action to protect the child.  

At present the center is primarily focusing on treatment and healing of the child. Says Mrs. Khedekar, “preventive measures are imperative in order to really protect the child from abuse. The center is planning to engage in community and school based work with the help of voluntary and community based organisations. There is a need to develop parental skills to enable them to identify and deal with incidences of CSA in their families and communities. Similarly the teachers should become aware and equipped with knowledge of handling victims of abuse. They should know what to do and who to approach in cases of dire need.”

Given the alarming and widespread nature of the problem, the need of the hour is to make such systems and procedures integral to health systems across the country so that children get support when most needed. 

 

 

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