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HEALTH INTERACTIVE WITH DR. AMINU MAGASHI Our Society and Child Sexual Abuse
For those who are following events either broadcasted or published by the Mass Media will agree with me that, sexual abuse in many parts of Nigeria has become a reoccurring decimal with so many reported cases of child sexual abuse by fathers and immediate blood relatives . To hear that a father has impregnated his teenage daughter or a senior brother has lured his young sister in to sexual intercourse which has led to pregnancy, delivery and dumping the baby in a dustbin is no longer sensational news. Other children are sexually abused, assaulted and raped by neighbors, friends of their families or at times teachers in schools. That closeness between the assaulter or rapist with the victim at times makes it almost impossible to reveal or report the case to another dependant and that silence by the victim also complicate the whole situation by throwing the child in to more physiological trauma, depression, mis-trust of the opposite sex and at times may be tilted in to promiscuity if the sexual abuse becomes a regular occurrence.
Let us examine both Incest (sexual contact between blood relatives) and sexual abuse of children (sexual contact between an adult and a minor) which are all considered by most psychiatrists , child activities and development workers to be acts of violence in which the perpetrator asserts power and control over someone who is defenseless, dependent, and trusting. Occurring in families of every race, educational background, and income level, sexual abuse is most commonly inflicted by fathers, brothers, stepfathers, or stepbrothers, although it is not unknown for mothers to abuse their children sexually (with boys abused by their mothers about twice as often as girls). Fathers who commit incest at times also have histories of childhood sexual or physical abuse themselves, as well as emotional deprivation, personality disorders, alcohol abuse, and unemployment. Their own low self-esteem and anger often turn them into victimizers of even more helpless family members. The mothers of these abused children also often have a history of being abused as children, and may be victims of domestic abuse, or emotionally unavailable owing to depression or physical illness. Such backgrounds also predispose women to physical abuse of their own children.
According to Harvard Guide to Women’s’ Health , one out of every 4 adult women have been involved in a non-voluntary sexual encounter before the age of 18, making women 2 to 4 times more likely than men to have been sexually abused as children. Some investigators believe that 10 percent of all sexual abuse is Incest and the rest involving close friends of the family, teachers, babysitters, or health care professionals—or, much more rarely, strangers.
Although incestuous activity can begin even in infancy, it typically begins with genital fondling or oral-genital stimulation when the child is between 8 and 12 years of age. When the victim reaches puberty, the incest may proceed to sexual intercourse. Being the eldest or the only daughter seems to increase a girl’s risk of being sexually abused.
Sexual abuse of young children can lead to scarring and permanent damage to the genitals, rectum, mouth, and throat, and even, in severe cases, death. Abused girls and young women are at high risk for acquiring Sexually Transmitted Diseases, particularly Gonorrhea , Trichomonas, Chlamydia, Syphilis and AIDS. Because many abused children are prevented from receiving routine medical attention, these problems are often neglected until they become quite serious. After puberty, sexually abused young women risk becoming pregnant. Other problems are severe bleeding, brutal tear of the hymen and at times shock.
The long-term effects of childhood sexual abuse and incest generally correlate with the amount of force used and the amount of physical violation involved, as well as with the nature of the relationship and the age difference between the victim and the abuser. Many women with a history of childhood sexual abuse are not aware of any long-term damage, though for others , physical and emotional scars can last a lifetime and spark a chain of abuse that may continue for generations.
Women who were sexually abused as children develop high rates of depression, substance abuse such as Alcohol and Drugs , self-destructive behaviors, eating disorders, and multiple personality disorder. Many develop post traumatic stress disorder as children and live in a state of constant fear and anxiety: some develop learning disabilities or specific delays in speech and motor functions or social skills. Many abused children grow up thinking of themselves as “bad” because a person they loved and trusted treated them so badly. Reflecting on their childhood, many women feel worthless and guilty and persist in the belief that somehow they were at fault for permitting, stimulating, reporting, or not reporting the abuse.
Adult Sexual Dysfunction is common among victims of childhood sexual abuse, usually involving aversion to sex, distrust of men, and pain during sexual intercourse and anxiety about intimate relationships. It may also involve difficulty setting sexual boundaries, with the result that some victims of childhood sexual abuse become promiscuous teenagers, prostitutes, homosexuality or participants in pornography. As many as 4 out of 5 girls who are severely sexually abused will end up as sexually abused women, usually by spouses or other sexual partners. Prone to “re-victimization,” these women are also more likely than other women to be sexually abused by health care providers.
Even as children, victims may have a hard time knowing the boundaries of intimacy and may develop what psychiatrists call a “disorder of hope” in which they either idealize or despise new acquaintances. The result, in either case, is disappointment and a confirmation of their own helplessness in facing the rest of the world.
Psychosomatic disorders such as conversion disorder (hysteria) and somatization disorder are common in women with a history of childhood incest and sexual abuse. These often manifest themselves as chronic pelvic pain, abdominal pain, or other gastrointestinal problems. Many women who were sexually abused as children have kept this knowledge a deep, dark secret for years. Some do not come to realize the full extent of the crime until they are adults and begin to talk to other women who had more normal childhoods.
Often women find it therapeutic to tell their stories to other women, usually in the form of psychological counseling or support groups for survivors of incest or childhood sexual abuse. Many also seek psychotherapy or other psychiatric attention for specific psychological problems that often result from childhood abuse.
Overall, the society must be vigilant and in the watch out for this phenomenon especially parents, health care professionals, teachers, childcare providers, social workers, or other persons who cares for children must report known cases of child abuse. The abused child must be kept under protective environment immediately and given a medical and psychological examination as soon as possible so that effective intervention can be taken.
Anyone who becomes aware of someone who sexually abuses a child—including the abuser’s private therapist—is also required to report the abuser. NGOs and Child activists need to set up sexual counseling centers where information and counseling shall be provided both to the victims and at times the assaulters and of course to the larger society , awareness creation need to be sustained .
Dr. Magashi is the Executive Director of Community Health and Research Initiative, Kano , Nigeria and can be reached at healthinteractive@hotmail.com
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