It is increasingly acknowledged that child sexual abuse is one of the most significant public health problems in present day society. It has also been demonstrated that child sexual abuse occurs among people of different cultures and in different countries, and it is therefore necessary that it is viewed as a complex and universal problem.
The exact nature in which child abuse occurs and is approached is viewed with the complex interactions of factors including but not limited to: individual character, family, cultures, religious beliefs, as well as contextual social factors. Regardless of the nature of the abuse or the manner in which it is tackled within any society, such sexual abuse has lasting psychological effects on its victims and as a result, there is an increased interest in research that aids practitioners to identity and treat victims of such abuses.
Child Abuse in Sub-Saharan Africa
Many children in Sub-Saharan Africa have been found to be subject to sexual abuse and exploitation by incest, child rape, and transactional sex. Recent trends have shown an increase in the incidence of reported child abuse in Sub-Saharan Africa, thought in part to be due to the HIV/AIDS epidemic as sexual predators now target younger individuals in the belief that they are less likely to be infected with the virus.
In addition, a lot of these forced sexual relationships also take place as a form of exchange with older individuals (both male and female) offering the young child various forms of incentives to participate in such activities.This has come to be referred to as 'economically coerced sex' and while this has been found to be common in conditions of deprivation and poverty, it is also known to occur among higher income social classes.
Even more heartrending are the cases of young children who have been assaulted or abused by older adults, often family members, friend and adults in positions of authority in their lives. Such children are often cautioned against complaining by threat of violence or by being convinced that they are in part responsible for what is happening to them. There is often a lot of secrecy surrounding such abusive situations, a fact that is further compounded by the shame and fear felt by the abused child.
The traditional African society attaches a lot of importance to the display of respect and reverence for elders and as such the average African child is often in awe of an older individual and is very likely to obey every instruction coming from an adult especially when such an adult is a family member or holds a position of authority in that child's life. This characteristic also makes it especially difficult to get a child to admit to being victimized or abused.
The Impact of Child Abuse
For individuals who have suffered abuse at one point or the other in their lives, there are usually long-lasting physical and psychological effects. These can be manifested as a variety of pathological behaviors and clinical symptoms. While it is acknowledged that up to a third of abused children do not demonstrate any specific symptoms, a lot of them do demonstrate highly sexualised behavior in the course of normal play and other day-to-day activities as well as evidence of Post Traumatic Stress Disorder (PTSD) and these are increasingly being taken to be core manifestations of sexual abuse trauma.
Researchers have also identified that the most damage occurs through the impacts on a child's self-esteem and self-image as well as the effects of stigmatization when the abuse is uncovered. The impact of sexual abuse on children is multifaceted and is often dependent on the specific contextual circumstances within which such abuse occurs.
Identification and Management of Child Abuse
It is increasingly acknowledged that pediatricians can play a huge role in the identification of children suffering child abuse. Consequently, many pediatric training courses include modules that focus on child abuse and management. However, there is room for other healthcare professionals in handling this trend.
In Sub-Saharan Africa, many children are often seen by general practitioners within community practices and are usually only referred to pediatricians in special circumstances. There is therefore a need for such practitioners to be able to identify signs of possible child abuse as well as have knowledge of the recommended course of action as well as the notification of relevant bodies uniquely equipped to deal with traumatized youths.
References
Kellogg, N. (2005) 'The Evaluation of Sexual Abuse in Children' Pediatrics 116(2): pp. 506 - 512.
Kendall Tacket, K. A.; Williams, L. M. and Finkelhor, D. (1993) 'Impact of Sexual Abuse on Children: A Review and Synthesis of Recent Empirical Studies' Psychological Bulletin 113(1): pp. 164 - 180.
Lalor, K. (2008) 'Child Sexual Abuse and HIV Transmission in Sub-Saharan Africa' Child Abuse Review 17(2): pp. 94 - 107.
Pereda, N.; Guilera, G.; Forns, M. and Gomez-Benito, J. (2009) 'The Prevalence of Child Sexual Abuse in Community and Student Samples' Clinical Psychological Review 29(2009): pp. 328 - 338.
Olubunmi Aregbesola - I am a busy mother of three young children who is also working through a PhD in Health Care Management at the University of ...
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