Child abuse often goes unnoticed, say experts

The clinic is full of women with their babies, elders wearing traditional attire and children bearing school bags, all patiently waiting to see Dr Nabil al-Herish. There are other doctors available, but Dr Nabil is their first choice, and he knows each one of them by name. The clinic, located at the heart of the squalid Baqaa refugee camp, located some 30km west of Amman, is one of many places where child abuse often goes unreported. “Child abuse is a common phenomenon in impoverished areas like this, but families tend to conceal these incidents,” said al-Herish, ripping off a rubber glove before writing a prescription for a patient. “I receive children with severe lashings, burns and bruises, but their families always attribute the injuries to accidents, for fear of the law.” Statistics reveal that only 1 percent of child abuse cases are reported by doctors, as compared to 75 percent by police, 10 percent by relatives, 9 percent by government ministries and 5 percent by schools. Al-Herish pointed out that “poverty and ignorance” play a major role in the phenomenon. “I know a number of divorced mothers who spend the day working to make ends meet,” he said. “Children left unattended can become vulnerable to physical – even sexual – abuse by neighbours.” Al-Herish also pointed the finger at health care professionals. “If a doctor suspects abuse, duty compels him to interrogate the child to find out what happened and prevent it from happening again,” he said. “But many doctors don't do that – either because they’re too busy or don’t notice.” Forensic pathologist Hani Jahshan agreed that hospital staff “often fail to be courageous and forthcoming” when it comes to suspected cases of child abuse. “Healthcare professionals need to show greater diligence in detecting abuse,” added Jahshan, who works as chief forensic physician at the Family Protection Directorate in Jordan’s Public Security Department. Children’s rights activists point out that early detection is vital to recovery. “Early detection and immediate care would mitigate the toll of physical and psychological abuse on children,” said Maha Homsi, a gender and education officer at the United Nations Children’s Fund (UNICEF) in Amman. Experts in the field express concern over rising numbers of reported child abuse cases, from 661 in 2002 to 1,423 in 2004. According to Zina Khoury, development manager at the Dar al-Aman child-safety centre, this figure “is probably higher, as many cases go unreported”. Dar al-Aman, which has been operational since 2002, offers psychological, medical, social and educational services for abused children and their families. In an effort to reverse the trend, the government, with assistance from UNICEF, is developing a plan to establish child-protection committees in 10 hospitals countrywide in order to guarantee that proper procedures are followed in cases of suspected abuse. The plan entails training 150 healthcare professionals to spot abuse and help abused children in a respectful manner. “We must be culturally sensitive when we preach citizens on children’s rights,” noted Jahshan. “Otherwise, it might backfire.” In the meantime, chief of paediatrics at the government-run al- Bashir Hospital Samir Faouri urged doctors and other healthcare professionals to keep their eyes open for signs of abuse.