I saw her name on the fax paper that I received as I prepared for her admission. A case of a young teenager who had overdosed on her antidepressants after she got into an argument with her mother. I scan through the paper. She was allergic to a few drugs. I take out an empty patients chart and start filing away the paperwork in advance to get a headstart. Its always tedious when you get an admission as there is a lot of paperwork. But it is also an opportunity to meet someone new who has experienced life like no one you have met in school or church. People who slip through the sidelines of mainstream life to fade forever and you wonder what happened to them. They just move away from your neighbourhood because something unaccepatable to society, happened. And they resurface in the hospital. The only place where they hope to find a cure for their ailments. Before, it was the temple that was a shelter to their unanswered and unheard prayers. As I look through the faxed infomation, something caught my eye- she had been sexually abused by one of her uncles since she was in kindergarten and it didn’t stop till she was in 6th grade, a young child on the threshold of metamorphosising adolescence. And when she needed all her spirit, this broken spirited angel was attacked by another one of her uncles who started to ravage her being. Her silence and bewilderment was taken advantage of by lust crazed men who destroyed this beautiful girl. She spoke to no one, she couldn’t scream. She didn’t know she had to. and she didn’t know what to do. Only that it made her feel mixed, lost and ashamed of herself. Depressed. Unhappy. She started to cut herself on her arms with a razor. To express and feel the pain that ravaged inside of her. She told her friend in school who told her to speak about it. When her secret was uncovered, all hell broke loose. Her family rifted apart as some defended her while others demanded her silence as the men who were responsible had married and had children of their own. How inconvenient it would be for them if it was brought out now! Its best to forget. They have forgotten. And so can you. The young teenager was overwhelmed by all the waves that was forming and it drowned her feeble attempt at revealing the turmoil that ravaged her insides. When the case when to court, she couldn’t stand by what she had revealed as fear, shame and anxiety held her tongue. Charges were dropped. And she reeled through the hurtful experience of testifying at an age when even being heard by a small audience caused anxiety and stage fright, forget about a traumatic experience that ravaged her for 6 years of her childhood.

I remember talking to her 8 months ago . I was new to the hospital and full of energy and enthusiasm and the ways of the instittution was still unlearnt. She couldn’t sleep. I sat down with her and asked why she could not sleep. She said that she couldn’t stop the images from flooding her mind. She revealed her story to me and as tears fell down her cheeks, I felt the wetness of my own. I wish I could stop crying when my patients tell their story. It is regarded as unproffessional and weak. But I couldn’t stop the flow of my tears. I cried with her and as she told me that she felt guilty and worthless, my heart just shattered. Anger ravaged through me and all I wanted was to kill those men who had done this to her. She covered her face and cried her tears. I held her hands. I told her to never feel guilt. She had done nothing. It was those men who should be ashamed. Such is shame. It victimizes those who cannot defend themselves. And as she sat there, I saw how helpless she felt inside and outside. The childhood dreams which nourish our growth and propel us towards adulthood had been replaced by nightmares which overwhelmed her and prevented her from sleeping. She was being deprived of emotional nourishment mentally and physically. Even as I told her that she should focus on positive things, I felt my voce grow hollow. I did not believe in my own words. What would I have done if this had happened to me. I would be in her place and she would have been talking to me. As she walked back to her room , I remember watching her through blurry eyes.

 

She was back and as I spoke to the interviewer who was supposed to bring her to the unit after interviewing her and her mother, we discussed her. Her mother sat there. She narrated how her daughter was fighting and arguing with her all the time. She would escalate in seconds. She had become more promiscuous,. She had found her home with ” hickies all over” She was doing drugs. She had stopped painting and doing all the things she loved. This was the third time she had tried to kill herself unsuccessfully. Her father had left her when she was young and would now have nothing to do with her as he felt she out of control. The counselor pitched in, ” she must feel abandoned by the male figure in her life and to be subjected by abuse has shaken her trust and sense of security. He paid a paltry amount of child support and the mom worked the whole week to make ends meet.

 

As I saw her, I could not believe how beautiful she was. Her hair had grown long and her eyes looked melancholic. I asked her” Do u remember me? I remember you from the last time you were here.Your hair has grown long.” She smiled a quick half smile.

” How have things been going?”

 

” Not good”, she said

 

” What happened?”

 

” I tried to kill myself by taking all the pills in my bottle after I fought with my mother. I planned to do it day after tomorrow but I just got angry. I didn’t want to live anymore”

 

“I just broke up with my boyfriend 3 weeks ago. I told him everything that had happened to me. He told everyone. We had a fight and he told me that I deserved it. I think he is right ” . She spoke indifferently. The tears no longer spilled as easily as a few months ago. Something was blunting the intensity of her feelings. She looked dazed, unfocussed. I suddenly recalled that her urine had tested positive for marijuana. she was doing marijuana every other day and binge drinking every month to the point where she would have blackouts.

 

” It makes me forget my pain. i just can’t seem to block it out without it. I have already tried to kill myself three times”

 

I completed the paperwork and led her to her room. She went to sleep. I went back to the nurses station. I shut the door and held my head in my hands and cried….

 

I felt helpless that day but today, I want everyone to know her story so that we can protect our children and do everything possible to keep our children safe and secure.

 

Parent Tips for Preventing and Identifying Child Sexual Abuse ( American Academy Of Pediatrics, 2011)

 

What parents should know about child sexual abuse:

• Most offenders are known to the child; they may be family members, relatives, friends, teachers, coaches, babysitters, and others in positions of authority 

• Children most susceptible to sexual abuse have obedient, compliant and respectful personalities. They may be children from unhappy or broken homes, as these youngsters may be eager for attention and affection.

• Children who are victims of sexual abuse can display many or few behavioral symptoms. They may withdraw from family or friends, display poor school performance, experience depression, anxiety, or exhibit aggressive and self-destructive behavior. Or they may not display any outward abnormal behavior.

• Child sexual abuse often involves more than a single incident, and can go on for months or years.

• Sexual abuse includes any kind of sexual act or behavior with a child, and includes activities involving genital contact as well as non-contact events- such as showing pornographic images to children, taking pornographic photographs of a child, etc.

Tips that can minimize your child’s risk of molestation:

• In early childhood, parents can teach their children the name of the genitals, just as they teach their child names of other body parts. This teaches that the genitals, while private, are not so private that you can’t talk about them.

• Parents can teach young children about the privacy of body parts, and that no one has the right to touch their bodies if they don’t want that to happen. Children should also learn to respect the right to privacy of other people.

• Teach children early and often that there are no secrets between children and their parents, and that they should feel comfortable talking with their parent about anything — good or bad, fun or sad, easy or difficult.

• Be aware of adults who offer children special gifts or toys, or adults who want to take your child on a “special outing” or to special events.

• Enroll your child in daycare and other programs that have a parent “open door” policy.  Monitor and participate in activities whenever possible.

• As children age, create an environment at home in which sexual topics can be discussed comfortably. Use news items and publicized reports of child sexual abuse to start discussions of safety, and reiterate that children should always tell a parent about anyone who is taking advantage of them sexually.

• If your child discloses any history of sexual abuse, listen carefully, and take his or her disclosure seriously. Too often, children are not believed, particularly if they implicate a family member as the perpetrator. Contact your pediatrician, the local child protection service agency, or the police. If you don’t intervene, the abuse might continue, and the child may come to believe that home is not safe and that you are not available to help.

• Support your child and let him or her know that he or she is not responsible for the abuse.

• Bring your child to a physician for a medical examination, to ensure that the child’s physical health has not been affected by the abuse.

• Most children and their families will also need professional counseling to help them through this ordeal, and your pediatrician can refer you to community resources for psychological help.

• If you have concerns that your child may be a victim of sexual abuse, you should talk with your pediatrician. Your physician can discuss your concerns, examine your child, and make necessary referrals and reports.

 

For more information, please the American Academy of Pediatrics website

 

http://www.aap.org/en-us/about-the-aap/aap-press-room/news-features-and-safety-tips/pages/Parent-Tips-for-Preventing-and-Identifying-Child-Sexual-Abuse.aspx?nfstatus=401&nftoken=00000000-0000-0000-0000-000000000000&nfstatusdescription=ERROR%3a+No+local+token