LET ME be clear! Evidence suggests that both parents and even healthcare providers, miss a good number of child abuse and neglect cases; therefore, we need to be extra vigilant in order to detect or identify or diagnose a child who is being abused or neglected.
According to the World Health Organization (WHO) “all forms of physical and emotional ill-treatment, sexual abuse, neglect, and exploitation that results in actual or potential harm to the child’s health, development or dignity,” must be of concern to us if we will succeed in detecting and curbing child abuse and neglect.
Admittedly, some adults abuse children inadvertently. Also, socio-cultural and even religious norms and practices blur what constitute child abuse and neglect, but there must be no justification for a child to be neglected or abused sexually, physically or psychologically.
As the experts opine, when “A caregiver persistently or extremely thwarts a child’s basic emotional needs” it is worrying. Worrying for the child! And worrying for society as a whole – because abused or neglected children may grow up with psychological deficits that society has to contend with in future.
The pressures of life in uncertain economic times pregnant with hardships may demand that parents leave their young ones with (abusive) caregivers. Similarly, parents themselves may abuse their own children.
So, what should we look out for when suspecting child abuse or neglect?
- Injury in a child who cannot speak or when a child who can speak says or signals s/he has been abused;
- More likely (but not always) when the child is in the care of adults other than their biological parents – not to exclude biological parents entirely;
- When the caregiver does not appear particularly and proportionately concerned about the injury;
- When the explanation of how the injury occurred does not make sense and obviously could not have resulted to that severe injury, trust your instincts;
- Bruises on the body, ear or neck of different shapes or ages (fresh or old with scar(s) which show the injuries were sustained at different times; and
- Blood stained under pants of girls must arouse your suspicion. Do not ignore it until proven otherwise! But keep in mind girls are menstruating at earlier ages now…
What do you do if you suspect child abuse or neglect?
Do not take the law into your own hands!
Please send the child to the hospital for a thorough evaluation because there may be hidden injuries such as rib fractures that must be diagnosed and treated.
In some cases, too, an obvious injury to a child may not be due to abuse or neglect but from an underlying disease.
For example, a child with brittle bone disease (Osteogenesis imperfecta) can have broken bones without physical abuse. In that case, your health care provider will re-assure you if that is the case and offer management options.
Let us continue to seek the best interest of children as we mould them to be better than ourselves while protecting them from child abuse and neglect.
Always remember it is difficult to pick out child abuse or neglect especially in nonverbal children.
Furthermore, the absence of witnesses in most instances does not help either. But if you can afford, install visible cameras to show you are keeping an eye on your child 24/7. I do not find hidden cameras useful because your interest must be to prevent harm and not to detect harm after it has been occasioned: it may be too late.
And please be patient with doctors and nurses when you report with child abuse or neglect because careful and thorough history and investigations are required to arrive at reasonable conclusions. Do not be surprised if caretakers are separated to elicit (in)consistency.
Finally, child abuse and neglect are complex but can be curbed if we, including government, put our minds to it.
BY Dr. Omane Boamah