The Increasing Plight and the insufficient Response
In the 1990s, it was estimated that only 10% of children in danger of abuse received appropriate support(9) and had appropriate management, in terms of alert and disclosure.(10) Currently, based on WHO resources, still only a limited number of children that are exposed to maltreatment have a thorough follow up(11). It is pertinent to note that educations institutions, like nurseries and schools, have poor medico-social structures that are relevant to child maltreatment and therefore do not seem to be able to play a decisive role in the detection and reporting of child abuse,(12) while such abuse is overwhelmingly committed inside and outside families.(13) The percentage of children exposed to violence has also dramatically increased by the plight of refugee children.
Within the growing turmoil of unsafe environments for many children around the Globe, migrating and displaced children are at risk of some of the worst forms of abuse and harm. Often dependent on human smuggling, they can easily fall victim to traffickers and other criminals. Many are subjected to extreme forms of abuse and deprivation during their journeys. In the recent years, nearly 50 million children have migrated around the world, across borders or been forcibly displaced – and this is a conservative estimate. More than half of these girls and boys fled violence and insecurity – 28 million in total. These children may be refugees, internally displaced or migrants, but first and foremost, they are children: no matter where they come from, whoever they are, and without exception.
In all circumstances and all livelihoods, unhappy children are a stigma of failed humanity.
Children in armed conflicts are killed, mutilated, kidnapped, displaced, ill-treated, neglected, persecuted, exploited, trafficked, impoverished, separated, forced to labor.
Children do not bear any responsibility for the bombs and bullets, the gang violence, persecution, the shriveled crops and low family wages driving them from their homes. They are, however, always the first to be affected by war, conflict, climate change and poverty.
Children in these contexts are among the most vulnerable people on earth and this vulnerability is only getting worse. The number of child refugees under the United Nations High Commissioner for Refugees (UNHCR) mandate has more than doubled in just 10 years – this shocking statistic is simply unacceptable.
According to a recent CDC study published in Pediatrics, most of deaths are preventable(14) and more than half the world’s children - that’s a billion kids between the ages of 2 and 17 years - experienced some type of violence in the past year(15).
What must we do?
Recognizing the pervasive and unjust nature of CAN and VAC, almost all nations (196) ratified the 1989 United Nations (UN) Convention on the Rights of the Child, which recognizes freedom from violence as a fundamental human right of children. Now, over 25 years later, the UN has launched a new Agenda for Sustainable Development to end all forms of violence against children.(16)
Many of those Sustainable Development Goals 2030 are relevant to the aim of ending violence on youth and children(17). New partnerships should capitalize on this momentum – and on growing appreciation of the toxic effects of violence on the developing mind.
The Global Partnership to End Violence against Children has a critical role to play in helping the world achieve Global target 16.2. This book is part of such a strategy.(18) It is also a training tool. The International Society for the Prevention of Child Abuse and Neglect (ISPCAN) has developed modules and curriculum materials to support its mission of creating sustainable child abuse and neglect systems of prevention, protection and treatment throughout the world.(19)
Professionals from social services, law enforcement and the courts are also welcome and encouraged to participate in this curriculum.(20) The scope of the curriculum is medical in nature, so it will teach these professionals a wide range of information and skills they need in their specific roles of children protection; it will also provide, based on a multicultural pool of resources, a valuable knowledge base of medical and psychosocial issues, so health professionals [but also in other relevant sectors] can have a better understanding of how best to help children.(21)
(1) UNICEF. (2012). Inequities in Early Childhood Development: What the data say. Multiple Indicators Cluster Surveys. New York, NY: UNICEF.
(2) Medline Plus. U.S. National Library of Medicine,. 2008-04-02.
(3) Equality, development and peace. New York, NY, United Nations Children’s Fund, 2000.
(4) Shalhoub-Kevrkian N. The politics of disclosing female sexual abuse: a case study of Palestinian society. Child Abuse & Neglect, 1999, 23:1275– 1293.
(5) Sidebotham P, Golding J. Child maltreatment in the ‘‘Children of the Nineties’’: a longitudinal study of parental risk factors. Child Abuse & Neglect, 2001, 25:1177–1200.
(6) Schein M et al. The prevalence of a history of sexual abuse among adults visiting family practitioners in Israel. Child Abuse & Neglect, 2000, 24:667–675.
(7) Oral R et al. Child abuse in Turkey: an experience in overcoming denial and description of 50 cases. Child Abuse & Neglect, 2001, 25:279–290.
(8) Xu J, Murphy SL, Kochanek KG, Arias E. Mortality in the United States, 2015. NCHS Data Brief, No. 267. Hyattsville, MD: National Center for Health Statistics; 2016.
(9) Felitti VJR, Anda R, Nordenberg D, et al. Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: the adverse childhood experiences (ACE) study. Am J Prev Med. 1998:14(4):245–258
(10) Runyan DK et al. Children who prosper in unfavorable environments: the relationship to social capital. Pediatrics, 1998, 101:12–18.
(11) RF, Butchart A, Felitti VJ, Brown DW. Building a framework for global surveillance of the public health implications of adverse childhood experiences. Am J Prev Med. 2010;39(1):93–98pmid:20547282
(12) J.A.Usta, Z.R.Mahfoud, G.AbiChahine, G.A.AnaniChild Sexual Abuse : The Lebanese situation , 2008
(13) Olds D et al. Preventing child abuse and neglect: a randomized trial of nurse home visitation. Pediatrics, 1986, 78:65–78.
(14) Centers for Disease Control and Prevention. Up to 40% of annual deaths from each of five leading US causes are preventable. https://www.cdc.gov/media/releases/2014/p0501-preventable-deaths.html Accessed January 30, 2017.
(15) World Health Organization, United Nations. Global Status Report on Violence Prevention 2014. Geneva, Switzerland: WHO Press; 2014
(16) ibid
(17) United Nations. (2015). Transforming Our World: The 2030 Agenda for Sustainable Development. Resolution adopted by the General Assembly on 25 September 2015. Available at: undocs.org/A/RES/70/1 (accessed April 2016).
(18) Transforming Our World: The 2030 Agenda for Sustainable Development. United Nations General Assembly; Seventieth Session. September 18, 2015; New York, NY
(19) Children’s Bureau. The national child abuse and neglect data system 1998. Washington, DC, United States Department of Health and Human Services, 1999.
(20) Ludwig S. Child abuse. In: Textbook of Pediatric Emergency Medicine. 4th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2000:1669-1704
(21) Levesque RJR. Sexual abuse of children: a human rights perspective. Bloomington, IN, Indiana University Press, 1999.