so sad when i read e following article....got it fr e web while i was doing my research......i believe e article is talking abt m'sia....but i tink e same things happen here in s'pore......where e statistics r much much lower....but which may juz b under-reporting......really disheartening 2 read abt all these.......but more pple shld b educated.......

fr: http://www.protectionproject.org/vt/2002/ne416.htm

HEALING THE SEXUALLY ABUSED CHILD

Yeang Soo Ching

MANY child sexual abuse cases go unreported, either because of the shame of it or because reporting the matter would mean a loved one going to jail, thereby depriving the family of a breadwinner.

This paucity of reports, and therefore the lack of correct statistics, tends to give us a false sense of security.

Statistics compiled by the Welfare Services Department show that in 2000, a total of 934 child abuse and neglect cases were reported to the department. Of these, 258 cases related to sexual abuse.

However, police statistics on child sexual abuse during the same year paint a more gloomy picture - 1,217 rapes, 198 incest, 614 outraging of modesty and 98 cases of sodomy.

From January to May 2001, according to statistics from the National Population and Family Development Board, 73 cases of incest were recorded. The board's statistics for 2000 showed 136 such cases.

Child sexual abuse is a crime punishable under the Penal Code, the Child Protection Act 1991, the Women and Girls Protection Act 1973 and the Child Act 2001.

The law relating to incest and rape was recently amended, and under the Penal Code (Amendment) Bill 2001, those charged with incest face a heavier penalty compared with non-incest rape.

For incest, the law provides for a jail term of not less than six years and not more than 20 years, and 24 strokes of the rotan. Rapes carry a jail term of not less than five years and whipping.

Suspected cases of child sexual abuse can be reported to any of three agencies: Welfare Services Department, the police and hospitals. Unfortunately, researches by non-governmental organisations show that a mere 10 per cent of sexual abuse cases are reported.

When seeking medical assistance, it is best to contact the SCAN (Suspected Child Abuse and Neglect) team in any government hospital because ultimately, in cases of suspected child abuse, private clinics will refer them to these hospitals.

The SCAN team comprises paediatricians, a gynaecologist, psychiatrist, medical social worker, a representative from the Welfare Services Department and the police. If a SCAN team is not available, cases should be referred to the hospital's accident and emergency section.

Dr Irene Cheah, a consultant paediatrician with the SCAN team at KualaLumpur Hospital, says child sexual abuse victims treated at the hospital are sometimes as young as two years old, but the majority are above five.

While the abuse is more prevalent among girls than boys, there are cases of male victims aged between eight and 10. "Victims younger than five are unable to reveal what has happened, so parents must be sensitive to achild's behaviour.

"In the majority of young children, there is no penetration, merely fingering and fondling to arouse the child. Later, penetration does take place. "Long-term sexual abuse is often shrouded in a veil of secrecy. The child is made to feel she agreed to it and, therefore, she will not expose the perpetrator. It's their little secret. This is what we call the 'accommodation syndrome'.

"In her book, there are two types of child sexual abusers - paedophiles and the happily married man who craves a sense of power. Abusers are usually known to the victims and are in positions of trust or responsibility.

Sexual assault, on the other hand, is usually carried out by strangers and is usually a one-off attack. While the emotional trauma for a sexual assault victim is as great as that of the sexually abused child, there is usually family support for the assault victim.

For the abused child, however, there is often a lack of family support, especially if the abuser is the father.

During a physical examination in the hospital, a police representative is usually around to collect the chain of evidence.

The examination depends on the history of events, and is generally an external one of the genital area. A full examination is conducted when other forensic evidence is required.

An internal examination, which can distress the child, is only done under anaesthesia. Checks are done for pregnancy and sexually transmitted diseases.

The child is warded, and if emotionally traumatised, is sent for psychiatric treatment.

"In the short term, the child may seem to be coping, but there are always long-term implications such as highly sexualised behaviour leading to promiscuity.

"Parents should pay serious attention when a child says someone has been touching her. If sexual abuse has taken place, they should be supportive and ensure the child continues her normal lifestyle but with increased awareness of safety. But some parents just want to forget the whole thing and don't report it," Dr Cheah laments.

Universiti Putra Malaysia's Professor Dr Kasmini Kassim, a senior consultant in child and adolescent psychiatry, concurs.

"I had a case where two sisters told their mother they were being raped by their stepfather, but their claims were dismissed as false. Then when the mother was dying of cancer and requested to see the girls, they refused. They had never let go of their anger," she says.

She sees an average of 10 cases of child sexual abuse a month, ranging from sodomy to molestation to rape. Age groups vary, from infants to adolescents.

"Where the child has been sexually abused for years, it takes a while for her to open up. In my therapy sessions with the child, I assess the language she uses, her behaviour, how she plays with anatomical dolls I provide her, etc."

"Survivors" , as she calls them, are referred to her by parents, teachers, police, and sometimes by the court when sexual abuse issues are raised in custody tussles.

"Most cases of sexual abuse occur within the family and are covered up, only to be revealed when related conditions, such as venereal disease and pregnancy, show. I have cases where the pregnant child is forced to point the finger at others when actually it's the work of her own family member." A counselling-related problem Dr Kasmini faces is that survivors stop coming for sessions after a few months. In her opinion, a follow-up period of one year is ideal, and thereafter an open period for counselling whereby survivors can drop in to see their counsellors anytime they need to.

"The main objective of counselling is to let the child know it's not her fault. Some children come in depressed, crying. Some can't sleep, some can't study, some play truant. Then slowly it all comes out.

"The root of the problem is her feeling of guilt, of doing something dirty. We have to emphasise that she has done nothing wrong, that she was taken advantage of and not her fault."

She cites a case where the girl was continuously raped by her father, then forced to become a prostitute by her mother, who reinforced in the girl the belief that she had been soiled and no one would ever marry her anyway.

It is paramount, says Dr Kasmini, that survivors be assured that while the past may remain in their memory, they can still go on living a good life ifthey change their attitude and concept of the world.

Besides counselling, she uses psycho therapy (going back into the past to unravel the whole picture), in which the objective is to relieve bitter and painful memories in the unconscious, and bring them out to the conscious level so that they can be dealt with. Medication is prescribed to those who are depressed or have other psychiatric disorders.

"At times, family and marital therapy is needed as well. Some wives become frigid as a result of past sexual abuse and the husband has to be counselled along with her. In family therapy, the man is asked to revealhis feelings about the matter and to show support for the survivor insteadof shunning her."

Video-taping survivors' response is also carried out with their permission or that of the parents if they are very young. The tape can later be used as court evidence.

Dr Kasmini says no notes are taken as the survivors talk. It's all heart-to-heart, observation of body language and great empathy."I feel for them, sometimes cry with them and most of all I empathise.

It's mentally draining but it's fulfilling to work with survivors."

Professor Dr Sham Kasim, of UPM's Department of Paediatrics, says knowing the manner of the sexual abuse is very important for counsellors because quite often there is no evidence of trauma or laceration.

"If the child is very young, penetration would cause massive trauma. In young children, the abuse is sometimes oral or sitting on the child, or fingering. Only 30 per cent of victims will show a ruptured hymen during a physical examination. If the abuse has been carried out over time, the wounds do heal."

So history, such as the time a child started having sexualised behaviour unusual for her age, or when she tried to tell (but was not listened to), or whether someone saw the act, etc, is very important.

In the past, doctors used to write "child has not been raped or sexually abused" because they could not find physical signs.

"Now they have been advised not to do that, but instead to delve into the history and to document their findings properly, especially if the abuse happened some time ago," Dr Sham says.

History sometimes point to the mother as the original perpetrator. There are cases, especially in second marriages, where mothers make their daughters accommodate the conjugal rights of the husbands.

"They see this as a way to retain their husbands who have lost interest in them sexually. So the daughters become the de facto wives," says Dr Sham.

He laments the fact that quite often, mothers bring their abused children for a medical examination just to ensure the hymen is intact and refuse to report the matter.

"All they care about is the question of virginity. They are embarrassed and instigate the victim to retract the police statement even after it has been made. Every member of the family, including the victim, thinks along the same line: 'How can we send our dad to jail for the next 10 years?'."

And so the child abusers continue to get away with it. Society must listen more to its conscience, and act in good faith for the sake of all our children.

The Globe and Mail (Canada)
April 15, 2002