Dr Ancy George
ABSTRACT: child abuse is the third leading cause of morbidity in children. Analysing the incidence and educating parents and health professionals will be helpful in preventing child abuse and reduces disability or premature death. Homoeopathic remedies are found to be effective in such cases due to the holistic approach for the management.
KEY WORDS: CHILD ABUSE, HOMOEOPATHY, POCSO ACT
INTRODUCTION
Child abuse is defined as ill treatment to children, perpetrated by adults, in a manner that is unacceptable. A child may be abused within the family, in an institutional setting and rarely by strangers. It can be by terrorizing, isolating, ignoring, rejecting and corrupting. Child abuse is more common than is suspected. High index of suspicion is needed to recognize the condition. There are different types in which the child get abused, ie; physical, emotional, sexual, derivational, fabricated – induced illness (FII), neglect or child labour. It can be any behaviour directed towards a child that endangers or impairs a child’s physical or emotional health and development.
EPIDEMOLOGY
Child abuse is a significant problem that often goes unrecognized until severe injury or death has occurred. It is increasing day by day and became the third leading cause of death in children between one to four years of age. India has largest number of children in the world (375 million) , nearly 40% of its population. 69% of Indian children are victims of physical, emotional or sexual abuse. Among the states New Delhi, has an over 83% of abuse rate and 89% of the crimes are committed by family members. Now a days there is no much difference in the gender in which the abuse rate is more. Even boys are sexually abused like girls. More than 70% of cases go unreported and unshared even with parents or family.
CLINICAL MANIFESTATIONS:
It is very important to see the presenting symptom. A Child who went through sexual abuse may show symptoms of shock, or suddenly stop talking or interacting with people or fearfulness to particular person or to go to certain places, they may go through depressed mood. Most of the cases children do not disclose abuse even though they are close with parents. It can be due to guilt feelings or fear, misrepresents moral standards by telling the child that it is normal. Sex offender pressures the victim into secrecy regarding the activity by describing it as a secret between us.
There are different varieties of child abuse and dependence on the type the physical impressions / manifestations change. Physical abuse includes striking, kicking, burning, biting, hair pulling, choking, throwing, shoving, whipping or any other action that injures a child. Those children who are abused physically may have burns or bruises in the body parts.
Emotional abuse is when a parent or care giver harms a child’s mental and social development, or causes severe emotional harm.
Child neglect occurs when someone does not provide the necessities of life to a child, either intentionally. This can include physical neglect, such as withholding food, clothing, shelter or other necessities. Emotional neglect includes withholding love or comfort or affection. Medical neglect occurs when medical care is withheld.
MANAGEMNET
Children should be told about good touch and bad touch from the age of three to four. Parent’s should ask their children not to allow any person to touch their private parts. Children should also raise alarm in case an uncle or aunt unnecessarily kisses or touches them inappropriately. Parents should ask their children not to take along any person in washroom. When their kid tries to tell something regarding abuse, parents should listen to them and give necessary support. Should not discourage them because that can lose confidence in parents. If it is suspected that a child has been abused, the child should be taken to a paediatrician or a trained health care professional. Physician who suspects that a child has been abused must notify the local child protective services office or law enforcement agency.
A paediatrician’s role is to take decisive action to safeguard children from harm. A child sensitive approach is essential to handle this problem. Recognizing children in distress, assessing need of children and increasing capacity of parents to meet their children’s need. Careful history taking from care givers and physical examination should be done. Examination should be done in the presence of parent preferabily mother. Parent’s has the full right to decide whether to perform a physical examination. One copy of medical certificate should be handed over to parents. Special care and emotional support has to be given. In addition to asking parents, care givers or other witnesses for a a detailed description of the circumstances surrounding a suspicious injury, assessing child’s general medical, social, developmental history will be helpful. Strengthen the family and community connections and support by conducting awareness programmes. Ensure protection of rights of children in conflict with the law.
POCSO ACT 2012
The protection of children from sexual offences ( POCSO )Act, 2012 is applicable to the whole of India. The POCSO act 2012 defines a child as any person below the age of 18 years and provides protection to all children under the age of 18 years from sexual abuse. It also intends to protect the child through all stages of judicial process and gives paramount importance to the principle of “best interest of the child “.
Children have the right to be protected from all exploitative and vulnerable situations that have been discussed. But that is possible only if you make yourself aware of the real problems and risks that children face and of the remedies that are available in law and policy to change the situation in the best interest of children.
A child may need legal help & protection. Resisting legal action when a child needs the most is a common mistake all of us often tend to make.
HOMOEOPATHIC MANAGEMENT
Homoeopathy is a safe and natural system of medicine that can be incredibly helpful in treating all sorts of children’s health conditions. Homoeopathic remedies are highly dilute medicines that work by stimulating the body’s own internal healing mechanisms. As for every cause there is an effect conditions should be also treated likewise. Hence Homoeopathy stand different from other systems of medicine by treating based on the cause. Homoeopathy is no longer considered as an ‘alternative medicine’. Homoeopathic medicines together with counselling of the child to shape desired behaviour are beneficial in treating most of the cases.
Reassurance from the parents side as well as from other is most needed to take this fear out of the mind of a child. Otherwise there are few Homoeopathic remedies which can take care of these fears also.
In Robin Murphy’s HOMOEOPATHIC MEDICAL REPERTORY discuss some rubrics under chapter children, which is helpful in selecting a proper medicine based on the causative factor.
- Chapter Children, ABUSED , general ailments from being: ANAC , CARC, COLO, IGN, LYCO,NAT-MUR, palladium met, phosphoric acid, staphy
- Sexual abuse from: ACON, ARN, CARC, IGN, NAT-MUR, OPIUM, SEP, STAPHY
- Violence from: ARN, CARC, OPIUM, STAPHY
LYCOPODIUM: Weakly children melancholy, afraid, of being alone apprehensive, loss of self confidence. Child cries before urination, dependent on others, extremely sensitive, constant fear of breaking down under stress. Weak memory and confused thoughts.
PULSATILLA: weeps easily, timid, irresolute. Fears in the evening to be alone, dark, ghosts. Children like fuss and caresses . wants company, highly emotional. craves sympathy. Affected very much by missing the near and dear ones.
PHOSPHORUS: fear of darkness, fear of being alone, lest he die, fear of suffocation, fear of thunderstorm, fear of death, fear of impending diseases, fears something will happen, fear of ghosts, fear of robbers, fear of water, fear of evil, fear of imaginary things, fear of being run over on going out, fear of vehicle approaching him, fear of something creeping out of every corner. Fear arising from the stomach. Fear in the evenings.
HYOSCYAMUS: Fear of being harmed. Fear of loosing something. Very possessive . fear of being injured. Fear of water. Fear of people. Fear of being bitten by beasts. Fear of separation from the dear ones.
ARNICA MONTANA: fear of being struck by those approaching or coming towards him. Full of nightmares and dreams. Fear and horror of sudden death. Fears some dreadful thing will happen. Rises at night with fear and grasps the heart.
BARYTA CARB: fear in children. Fear of others approaching him. Child fears in a crowd or public places. Child has a fear of death. Fear of evil. Fear of strangers, fear from noise, at night in street. fear of people while walking.
REFERENCES:
- Charles kodner. Wetherton Angela. Diagnosis % management of physical abuse in children. American Family Physician, Nov.15,2013,volume 88, No. 10, pg: 669-675
- Neha Gupta.N.K Aggarwal.child abuse.Delhi Psychiatry Journal, October 2012; volume15, No.2
- http://www.parenting.com.
- FT Saulsbury, RE Campbell- Evaluation of child abuse reporting by physicians.Journal of diseases of children,1985- jamanetwork.com. Accessed on 13 Aug 2019
- Botash AS.Child abuse evaluation & treatment for medical providers. Treatment and follow up: responding to families.syracure;NY:SUNY upstate medical university; 2005-2013;http://childabusemd.com/treatment/treatment-respomding-families.shtml.Accessed on 10 Aug 2019.
- http://en.wikipedia.org/wiki/
- Sabarirajan.S,Babu.Ameerkha.s.r.Children’s self comforting habits & homoeopathy. Homoeopathy for all.Feb 2019;pg:66-68
- Murphy Robin.Homoeopathic Medical Repertory.3rd revised edition,B.Jain publishers,New Dehi, pg:327
- Gupta A.K.The problem child and homoeopathy, psychological disorders of children.B.Jain Publishers,New Delhi,2015;pg:30-31
- Boericke William.Pocket Manual of homoeopathic Materia Medica & Repertory. 9th edition.B.Jain.Publishers (p)LTD;New Delhi.2002
Author: Dr Ancy George, PG scholar, Department of paediatrics, Father Muller Homoeopathic Medical College, Mangaluru
Under the Guidance of Prof. Dr Jyoshna Shivaprasad
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