Responding to child sexual abuse

Nothing is more important than protecting our children, yet nations throughout the world continue to struggle to do so effectively. Child sexual abuse has been reported so many times but the numbers of unreported instances are far greater, because the children are afraid to tell anyone what has happened, and the legal procedure for validating an episode is sometimes difficult and sometimes development practitioners also find it difficult to deal with it. This essay is an attempt to discuss the steps that a development practitioner should take when responding to a case of child abuse. Basically there are five steps involved which include identification of the problem, disclosure, legal resources and rehabilitation but however these steps vary within countries and regions.  

It is important for us to first of all understand what child abuse is all about and also be able to identify child abuse indicators. This assists development practitioners to respond comprehensively to a case of child abuse. According to the UNCRC (1989) a child is any person under the age of 18. Children have evolving capacities depending on their age and developmental stage. In working with children, it is critical to understand these stages, as it will determine the method of communication with individual children. It will also allow the caseworker to establish an individual child’s level of understanding and their ability to make decisions about their care. As a result, the caseworker will be able to make an informed decision about which method of intervention is most appropriate for each individual child.

According to the IRC report of 2012 there is no set definition of child sexual abuse. The World Health Organization (1999) defines child sexual abuse as the involvement of a child in sexual activity that he or she does not fully comprehend, is unable to give informed consent to, or for which the child is not developmentally prepared and cannot give consent, or that violates the laws or social taboos of society. Child sexual abuse is evidenced by this activity between a child and an adult or another child who by age or development is in a relationship of responsibility, trust or power, the activity being intended to gratify or satisfy the needs of the other person. This may include but is not limited to, the inducement or coercion of a child to engage in any unlawful sexual activity, the exploitative use of a child in prostitution or other unlawful sexual practices, the exploitative use of children in pornographic performances and materials.

In simple terms child sexual abuse is defined as any form of sexual activity with a child by an adult or by another child who has power over the child. By this definition, it is possible for a child to be sexually abused by another child. Child sexual abuse often involves body contact. This could include sexual kissing, touching, and oral, anal or vaginal sex. Not all sexual abuse involves body contact, however forcing a child to witness rape and or other acts of sexual violence, forcing children to watch pornography or show their private parts, showing a child private parts, verbally pressuring a child for sex, and exploiting children as prostitutes or for pornography are also acts of sexual abuse.

Child sexual abuse can take place within the family, by a parent, step-parent, sibling or other relative; or outside the home, for example, by a friend, neighbour, child care person, teacher, stranger or anyone. When sexual abuse has occurred, a child can develop a variety of distressing feelings, thoughts and behaviours. No child is psychologically prepared to cope with repeated sexual stimulation. Data from IRC supported gender-based violence (GBV) programs collected in conflict-affected settings highlight the frequency of sexual violence toward children. For instance, in the Central African Republic, nearly half of GBV survivors receiving support from the IRC are girls under the age of 18. In Sierra Leone, 73% of female survivors aided by the IRC are under the age of 18, with 23% under the age of 11.  Almost all cases were sexual violence, specifically rape (97% for 0-11 year olds and 96% for 12–18 year olds). It is widely acknowledged that child sexual abuse occurs more often than the reported numbers show. Children comprise a resilient group of the population but are vulnerable given their age, size, dependency on adults and their limited participation in decision-making processes. (IASC, 2013)

Responding to child sexual abuse is one of the difficult tasks that child programmers face and it is important that child programmers are equipped with the necessary skills and knowledge before they respond to child abuse since they may cause more harm to the victim.  Sexually abused children and their families may require assistance from child protection services, the criminal justice system and counselling and support services. No one group can totally meet the needs of the sexually abused child. Effective intervention must be child-centred and involve multi-disciplinary teamwork.

1.      Identification of the abuse

This is the first step where the development practitioner identifies the abuse. It is a bit difficulty for the communities together with child programmers to identify child sexual abuse. First of all it is important for the development practitioner to understand what child sexual abuse is all about. Sometimes children report sexual abuse immediately after the incident. At other times the abuse goes on for months or even years before it is discovered by someone or before the child reports. Children do not often report because they are afraid. The perpetrator may frighten the child into hiding the abuse by threatening to harm the child or the child`s parent. In some cases perpetrators tell children they will be harmed by monsters or other creatures that young children are typically afraid of if they tell about the abuse. The abuser often knows how to manipulate children and promises them gifts of attention in exchange for playing sex games.

Identification of the abuse can be field based, community based or office based. It is important as a development practitioner to take note of the indicators of child abuse as they assist in the identification phase. Victims of child sexual abuse may display two forms of indicators namely behavioural and physical. The indicators can best be understood and summarised by the table below:

Physical Indicators	Behavioural Indicators
·         Difficulty in walking or sitting ·         Torn, stained or bloody underclothing ·         Pain or itching in genital area ·         Bruises or bleeding in external genitalia, ·         Vaginal or anal areas ·         Venereal disease, especially in pre-teens ·         Pregnancy	·         Unwilling to participate in general or normal duties ·         Withdrawn, fantasy or infantile behaviour ·         Bizarre, sophisticated or unusual sexual behaviour or knowledge ·         Poor peer relationships ·         Reports sexual assault by caregiver

The problem should be identified, the abuse stopped, and the child should receive help. The long-term emotional and psychological damage of sexual abuse can be devastating to the child.

Safaids (2011) noted that in Zimbabwe, the Government established child protection committees (CPCs) under the National Action Plan for Orphans and other Vulnerable Children (NAP for OVC) phase 1. These committees have been instrumental in the identification of child abuse cases including sexual abuse at ward level. The committees comprise the key stakeholders and key community leaders which are very important in as far as the promoting the psychosocial well-being of children is concerned. They have assisted in reporting cases of child abuse and they have dealt with some issues at community level. They have assisted development practitioners in the identification of child abuse cases. Another form of identification of abuse cases is the use of telephones for instance Child Line Zimbabwe identifies most child abuse cases through telephones. After identifying the abuse there is need for the development practitioner to understand more about the issues surrounding the abuse.

2.      Understanding the abuse / Disclosure

This is one of the important steps in responding to cases of abuse. It is at this section that the development practitioner gets to know more on the issues surrounding the abuse. There is need for the development practitioner to listen or focus much on the content of the abuse not on the context. The goal and purpose of this stage is to safely and slowly assess the child’s situation and his/her experience of sexual abuse to help determine the child’s and family’s immediate and eventually, longer-term needs (Ferris, 2007). Very detailed questions about the child’s sexual abuse should be asked once a safe and trusting relationship has been established between the caseworker and the child survivor, and only when the child is ready and wants to share such details (Butler, 1997). In the initial aftermath of sexual abuse the priority-need areas to assess are the child’s health and safety needs and longer-term needs such as access to justice the need for targeted and on-going psychosocial services can take place once the initial crisis period has ended or when it is most appropriate to do so (Adams, 1984). The areas to focus on developing a context for the child and his/her situation and the child’s family composition, its current living situation also understanding what has happened to him/her (Chioto, 1984). Understanding who the perpetrator is whether he/she can access the child and understanding if the child has already received care and treatment (Wideman, 1989).

Children will either disclose abuse directly by describing what has occurred or indirectly through behavioural signs and indicators. Discovering or suspecting that a child has been sexually abused can be a distressing experience. Most people feel a range of emotions including anger, sadness, shock, disbelief, disgust and helplessness. It is important to stay calm and not convey these feelings to the child as this may prevent the child from making further disclosures. The child’s feelings about themselves may be influenced by your initial reaction as a development practitioner to the abuse (Crosse, Kaye, Ratnofsky, 1993). If the child senses a horrified response, this may reinforce and perpetuate a child’s feelings of guilt and shame.

There is need to employ art or play therapy at this stage, as this will assist you to gather more information about the abuse since some children may not want to speak out or open up. According to Facts for Families (2011), if a child discloses to you as a development practitioner that he or she has been sexually abused, it is important to do the following: Tell the child that you believe them. This will encourages the child to speak out and also to have a sense of trust in the development practitioner. This also assists you as a development practitioner to be able to acquire more information about the abuse from the child. Make it clear that whatever has happened is not the child’s fault. The child at this point needs comfort and the development practitioner should therefore avoid blaming the child for the cause of the abuse. The development practitioner need to accept and believe what the child said. Reassure the child that they did the right thing in telling you. Many abusers threaten the child to prevent disclosure (Sumba and Bwibo 1993).

As a development practitioner you should do everything possible to comfort and reassure the child. Explain what action you will take next. Do not make promises that you will not be able to keep, nor promise the child confidentiality. The child has enough secrets and needs someone to act on their behalf to stop the abuse.. 

3.      Reporting child sexual abuse

Child sexual abuse is a criminal offence thus it should be reported despite that it’s in which form. A protective concern exists if parents or caregivers are unwilling or unable to protect the child from further abuse, or if child sexual abuse is likely to continue without statutory intervention. According to Cowen (2001) as a development practitioner you need to report child sexual abuse if you have a reasonable belief that a child is being or has been sexually abused. You need not to prove that sexual abuse has occurred. A reasonable belief exists if a child tells you that they have been sexually abused. It is important to note here that children rarely lie about sexual abuse. A reasonable belief also exists if a child displays some of the indicators discussed earlier in this assignment and there is no other satisfactory explanation.

It is at this stage that medical and criminal reports are required. Initially the procedures of reporting child sexual abuse was that a criminal report should first be lodged then seek medical attention latter using the criminal report. However the medical report has now superseded the criminal report since the right to life comes first than any other right.  According to Centre for Disease Control (2010) this assists in protecting the child from contracting infections such as Sexually Transmitted Infections (STIs), HIV and AIDS. If the child is sexually abused, Post Exposure Prophylaxis (PEP) should be administered within a period of 72 hours. PEP is a drug that prevents the victim from getting infections such as HIV and STIs.

If you are concerned you must take action, as inaction leaves the child unprotected. To consult about possible abuse and report when necessary is the responsibility of every professional. Legal protection is provided to those who report sexual abuse to the authorities on the basis of reasonable concern. A professional who makes a report with the best interests of the child in mind is protected from any legal action for defamation. A report of suspected child abuse does not constitute a breach of professional ethics. According to Childabuse.com. (2000), in accordance with the legislation, the identity of the reporter will remain confidential unless:

(a) The reporter chooses to inform the child and or the family of the report themselves;

(b) The reporter consents in writing to their identity as the reporter being disclosed;

(c) The court decided it needs this information in order to ensure the safety and wellbeing of the child; or

(d) The court decided that it is satisfied that the interests of justice require that evidence be given.

4.      Legal Resource or Seeking Justice

All cases of sexual abuse should be reported to the police and many Governments have got a specialised department which deals with child abuse cases. For example in Zimbabwe there is the Victims Friendly Unit (VFU) which deals with cases of child sexual abuse and gender based violence (GBV). This department is authorised to accept reports of child sexual abuse based on a reasonable belief and carry out protective investigations; take action where necessary in the Children’s Court in relation to protective concerns for children. The VFU should operate under the following principles:

·             Child sexual abuse victims have a right to protection.

·             Children who have been sexually abused have many needs, including the need to be safe from abuse and the need to be believed, supported and treated with respect at all times.

·             Recovery from the effects of sexual abuse is promoted if the perpetrator is held responsible for the abuse through criminal prosecution.

·             Further victimisation may be reduced when therapeutic programs are mandated by the courts as part of the sentencing option.

The VFU have got a prime responsibility for investigating criminal offences relating to child sexual abuse. A criminal investigation will be undertaken whenever reasonable grounds exist for believing that a child has been sexually abused. Every investigation to be undertaken should be at the best interest of the child. The trial should take place in a conducive environment where the perpetrator and the child are separated as this encourages the victim (child) to open up. However in some African countries like Zambia and Zimbabwe, the term victims’ friendly court is theoretically friendly but practically unfriendly. The courts are not yet well equipped and in Zimbabwe there is only one victim’s friendly court whilst more than 1000 cases of abuse are reported per month (Save the Children, 2012). On the other hand, cases of child sexual abuse have not been reported and are still under reported because of the unfriendly response from the police. Also some child sexual abuse cases have been internally and culturally settled by the communities themselves (Pinheiro, 2006).

5.      Follow-up/Rehabilitation

After action has been taken to protect the child it is important that you are supportive to the child and where appropriate, the family. Reassure the child that they are not to blame. The opportunity to experience a positive relationship with you in whom the child is valued for their intrinsic worth, not exploited by an adult, can enhance the child’s self-worth (Bloom, 1996). Positive, non-judgmental responses from others can ease the trauma of sexual abuse. To minimise the effects of sexual abuse, all victims should be encouraged to receive counselling or support as soon as possible. The identification of child sexual abuse will place the family in crisis. The non-offending parent may need help and guidance from you to manage the home situation, to deal with their own feelings and responses to the sexual abuse, and to respond appropriately to the child.

As a development practitioner you need to remember that effective intervention must be child-centred, involve multi-disciplinary teamwork and be guided by the following principles:

·             Child sexual abuse is unacceptable.

·             All children have a right to be safe and protected from sexual abuse.

·             Child sexual abuse is a criminal act.

·             A child should always be taken seriously if they allege sexual abuse.

·             Intervention should aim to promote the relationship between the child and the non-abusing parent(s).

·             Children who have been sexually abused have the right and need to be in a safe supportive environment. They also have the right to legal and protective intervention and to counselling and treatment services.

·             The first priority of intervention should always be to protect the child and to promote their recovery.

In conclusion the responsibility for the protection of children and young people from abuse and neglect belongs to everyone. Families, the general community, community agencies, police and government, all play a part. Roles may differ, but working in partnership, with a shared understanding of the rights of children, the need to support vulnerable families and take actions when necessary, can help build a safety net for children and young people. Development practitioners need to respond efficiently and effectively to child sexual abuse. It is the responsibility of development practitioners to provide compassionate care to children who have survived sexual abuse. Courage and commitment is required to help children recover and heal from the impacts of sexual abuse.