Holistic approach needed on Child Sexual Abuse

Child Sexual Abuse is a “silent-violent epidemic” as described by the American Medical Association that requires our urgent and unwavering attention. Daily news is rife with stories of children being abused. Recent Child Sexual Abuse incidents present daunting circumstances. Sunil Rastogi, a 38-year-old tailor, was arrested by police investigating sexual assaults on three girls aged between nine and ten in eastern Delhi in January this year. Similarly, a four-year-old girl was allegedly sexually assaulted in a private school in Bengaluru.

Child Sexual Abuse is a widespread global problem with grave life-long outcomes that affects not just the victim, but also the offender, the families and the communities that surround them. Globally there are 1.9 billion children i.e. 27% of the world population affected by CSA. In India, Ministry of Women and Child Development (MWCD) study done in 2007, has cited that 53.22% of Indian children have faced some form of sexual abuse.

The number of offences registered under rape category under the Protection of Children from Sexual Offenses Act. POCSO was up to 44% nationally in 2013. (2540 registered-2013 and 3858 registered in 2014).

CSA is an extensive problem, and even the lowest prevalence includes a huge number of victims. Two main issues have been identified that make it difficult to estimate exactly how many children are victims of CSA. Firstly, the way abuse is defined plays an important role. Secondly, the cases reported by the official organisations usually underrate the number of victims as many cases never get reported.

There are many complicated circumstances surrounding the issue of CSA in India. A forbidding silence is at the root of this bane fuelled by fear of indignity, denial from the community, social stigma, and gap in communication between parents and children about this issue. Many instances of CSA don’t include penetrant sex, victims usually clean themselves following attack, and hence the medical investigation does not provide any evidence of sexual assault.

One of the causes of CSA is the condition of Pedophilia, in which a person’s sexual arousal and gratification depend on fantasising about and engaging in sexual behaviour that is atypical and extreme. According to the World Health Organization, Pedophilia is defined as the fantasy or act of sexual activity with children who are generally 13 years old or younger. Pedophiles are usually men and can be attracted to either or both sexes. How well they relate to adults of the opposite sex varies. Scientific data reveal that it manifests during puberty and remains stable for the further life – this is the reason why the inclined persons are aware of the problem and could prevent CSA by not acting out theier fantasies concerning children.

The prevalence of pedophilic disorder is unknown, but the highest possible prevalence in the male population is approximately three to five per cent.

In the current circumstances, a holistic approach is required to tackle CSA from its root. A three-pronged approach to tackling the malaise of Child Sexual Abuse, through increasing awareness, bolstering mechanisms for Primary Prevention, and ensuring swifter prosecution is the need of the hour.

Using the public health and socio-economic models, primary prevention looks at child sexual abuse perpetration at all levels of society, including whole communities, organisations, families and individuals, whereas preventing re-offense is aimed only at the individual perpetrator, who has already committed sexual abuse against a child. Preventing child sexual abuse before they occur (primary prevention) is, therefore, a key priority. The Berlin Prevention Project Dunkelfeld (PPD) Germany is one such initiative that aims to prevent Child Sexual Abuse (CSA) by targeting men who are distressed by sexual fantasies involving children and fear they may sexually abuse children, and who seek help without being mandated to do so. In 2005, the Institute of Sexology and Sexual Medicine at Charité – University Clinic of Berlin started the “Prevention Project Dunkelfeld” which has now developed into a nationwide network of outpatient clinics providing treatment for self-identifying and help-seeking non offending pedophiles outside of the legal system. It aims to help these men to guarantee continuous sexual self-control to prevent child sexual abuse and child pornography consumption. The project has been supported by the German Government is now financed by the national insurance system.

An inspired extension of this effort is the Program for Primary Prevention of Sexual Violence (PPPSV) in India. A collaborative initiative of King Edward Memorial Hospital Research Centre, Pune, Berlin Institute of Sexology at the Charité, and an advisory council of experts from India, the objective of PPPSV project is to enhance awareness generation activities and focus on prevention by treatment. In this context, a free and confidential treatment will be offered for people seeking therapeutic help with their sexual preference for children and/or early adolescents. This treatment option will be restricted strictly to non-offenders.

As a society, we have a collective responsibility to prevent child sexual abuse. While science is a starting point to deal with many of the problems we face today, social context remains an inherent aspect. When we are dealing with the issues like Child Sexual Abuse, in order to develop any action for the future, it is essential to engage with the broader community and come up with a collective knowledge base with an acceptable solution for CSA.

Experts, government bodies, local residents, interest groups and representatives from various civil society organisations, media as well as many other stakeholders view the issue from their own ways of understanding that results in a shared perspective. More than one perspective and embracing multiple points of view definitely lead to a more sophisticated approach to problems, especially such complex problems. Educating the public about the true nature of child sexual abuse is everybody’s responsibility. The wide dissemination of accurate information to the public will help break the silence and taboo that surrounds Child Sexual Abuse, and may facilitate the formulation of effective solutions to the problem.

Vijaya Rahatkar is the chairperson, Maharashtra State Women’s Commission and Laila Garda is the director, Research, KEM Hospital Research Centre, Pune.

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