Physical Child Maltreatment in Nepal

Presentation
on
Physical Maltreatment

CHILD ABUSE OR CHILD MALTREATMENT
• Child abuse or child maltreatment is physical, sexual,
or psychological maltreatment or neglect of a child or children, especially by a
parent or other caregiver.
• The World Health Organization (WHO) defines “, child abuse and child
maltreatment as "all forms of physical and/or emotional ill-treatment, sexual
abuse, neglect or negligent treatment or commercial or other exploitation,
resulting in actual or potential harm to the child's health, survival,
development or dignity in the context of a relationship of responsibility, trust or
power ”.

TYPES OF CHILD ABUSE
Child Abuse
Physical Psychological NeglectSexual

PHYSICALABUSE
Physical contact that causes
feelings of the intimidation,
pain, injury, other physical
suffering or bodily harm.

WHAT IS PHYSICAL ABUSE ?
• The WHO defines the Physical abuse as “, Intentional use of physical force
against the child results in- or has a likelihood of resulting-in harm of child’s
health, survival development or dignity. This includes hitting, beating, kicking,
shaking, biting, strangling, scalding, burning, poisoning and suffocating. Much
physical violence against children in the home is inflicted with the object of
punishing ”.
• In other words, Physical injury of a child by a person who is responsible for
child’s welfare, under circumstances which indicate that the child’s health or
welfare is harmed or threatened.

SIGNS OF PHYSICALABUSE
 Bruises, welts on face, neck,
chest, back
 Injuries in the shape of objects
(belt, cord)
 Burn marks on arms and legs
 Fractures that don not fit the
story of how an injury occurred
 Unexplained lacerations or cut
 Internal injuries

FACTORS PREDISPOSING TO PHYSICALABUSE
Parental characteristics
Characteristics of child
Environmental characteristics

PARENTAL CHARACTERISTICS
 Violence
 Poverty
 Parental history of abuse
 Socially isolated
 Low self esteem
 Less adequate maternal functioning

CHARACTERISTICS OF CHILD
 Number of children's
 Child temperament
 Position in the family
 Additional physical needs if ill or disabled
 Activity level or degree of sensitivity to parental needs
 Occasionally the abused child is ill eg. Brain damage, hyper active or
physically disabled.

ENVIRONMENTAL CHARACTERISTICS
 Chronic stress
 Problem of divorce
 Poverty
 Unemployment
 Poor housing
 Alcoholism
 Drug addiction etc..

SYMPTOMATIC BEHAVIORS
Injuries that don't match the child’s story
Untreated medical care or dental problems
Wears long sleeves out of seasons
Nightmares or insomnia
Depression, anxiety, withdrawal from friends
Expresses a reluctance to go home
Frightened of parents and other adults etc.

MYTHS AND FACTS ABOUT CHILD
MALTREATMENT
Its only abuse if it’s violent
Only bad people abuse their children.
Abuse does not happen in good families
Most child abuser are stranger
Abused children always grows up to be abuser

DIAGNIOSIS
Unexplained or suspicious injuries particularly on body parts
Sudden unexplained change in behavior (very quiet, withdrawal or displaying
sudden outburst of tear)
Any injuries for which the explanation seems inconsistent.
Being mistrust of adult, particularly those with whom a close relationship
would normally be expected.
Having difficulties in making friendship
A change observed over a large period of time either in term of behavioral or
physical signs (eg. the child losing weight or becoming increasingly dirty )

EFFECTS
Lack of trust and relationship difficulties
Core feelings of being “worthless”
Trouble regulating emotions
Maltreatment children may grow up to be maltreated adults.
Ill health, including high rates of chronic conditions, high risk health behavior
and shorten lifespan.
Physical abuse as a child can lead to physical and mental difficulties in future
including re-victimization, personality disorder, post traumatic stress disorder,
depression, anxiety, suicidal ideation, eating disorder, substance abuse and
aggression.

LONG TERM IMPACT
Shaken baby syndrome (permanent neurological damage 80%, or death
30%) spinal cord, neck and rib or bone fracture
Impaired brain development (fail to form and grow properly)
Poor physical health (allergies, arthritis, asthma, bronchitis, high blood
pressure, immune dysfunction)

RISK FACTORS
Alcohol and drug abuse
Untreated mental illness
Lack of parenting skill
Stress and lack of support

PREVENTION
According to Deborah Daro four common theoretical perspectives on
prevention are:-
Psychodynamic theory---posits that if parents better understand and accept
their role as parents they will be less abusive.
Learning theory – is that if parents better understand how to care for their
children, they will be less abusive
Environmental theory– is that if parents have access to more and better
resources, they will be less abusive.
Ecological theory--- is that child abuse will be decline if network of community
support can compensate for individual, situational and environmental
shortcoming.

POSSIBLE APPROACH TO PREVENTING CHILD
MALTREATMENT
Education
Support groups
Home visitation
Community programs and board public policies
Individual and family therapy

TREATMENT
Help and encourage the child to talk about the maltreatment without any
embarrassment
Reduce the intensity and frequency of behavioral and emotional symptoms
Clarify and change distorted, inaccurate, or unhealthy thinking pattern that
might negatively affects the child view of self and others.
Help the child develop healthier attachments
Strengthen the child’s coping skills
Enhance social skill
Educate the child regarding self-protective strategies.

Poverty and other socioeconomic disadvantages, such as unemployment
Family disorganization, dissolution, and violence, including intimate partner
violence
Lack of family cohesion
Substance abuse in the family
Young, single non biological parents
Poor parent-child relationships and negative interactions
Parental thoughts and emotions supporting maltreatment behaviors
Parental stress and distress, including depression or other mental health
conditions
Community violence

HOW ABUSE OCCURS?
A combination of individual, relational, community, and societal factors contribute
to the risk of child maltreatment and abuse. Although children are not responsible
for the harm inflicted upon them, certain individual characteristics have been
found to increase their risk of being maltreated.
Disabilities or mental retardation in children that may increase caregiver burden
Social isolation of families
Parents' lack of understanding of children's needs and child development
Parents' history of domestic abuse

WHAT TO DO IF YOU SUSPECT ABUSE
If you suspect child abuse, it’s important to report it. It isn’t a private matter or a
family problem. A child’s physical and emotional well-being, and maybe even her
life, could be at stake.
Depending on the situation, there are many ways you can help the child:
• If he needs medical care right away, call 911.
• Take him to the hospital -- it’s a haven for abused children. Doctors can check
for signs of abuse and give medical care.
• If you think someone like a baby sitter or day-care worker has abused your
child, keep her away from that person and contact police.
• Help the child get therapy to start healing the emotional damage of the abuse.
• Make sure she feels supported and knows this is not her fault.

PARENTS ANONYMOUS
Parents Anonymous is designed to be both a prevention and treatment
program that strengthens families that are at risk of becoming (or already are)
involved in the child welfare system, have behavioral health challenges, or
face other family problems. Services offered include weekly support groups,
in-home parent training, helpline services, and other supportive ongoing
functions.
The Parents Anonymous program aims to mitigate the impact of (and
prevent) Adverse Childhood Experiences (ACEs) for parents/caregivers and
their children and youth. Parents Anonymous Groups for parents/caregivers
are facilitated by a trained Group Facilitator and a Parent Group Leader.

Parents Anonymous is a self-help group for people who have abused their
children.
Recognize the value and expertise of the life experiences of parents
Advocate and model shared leadership between parents, agencies and
policy makers to ensure evidence-based results that benefit families.
Advance an innovative conceptual framework and ambitious research
agenda on Parent Leadership and Shared Leadership that promote the
strengthening of families and communities.
Strengthen families by improving social, emotional, and behavioral well-being
of parents/caregivers, children, and youth.

Prevent child abuse and neglect by ensuring safe, stable, and nurturing
relationships for families
Mitigate the impact in parents/caregivers of ACEs and prevent them in
children and youth.
Reduce risk factors, increase protective factors, and significantly reduce
harmful behaviors towards children by supporting the empowerment of
families.
Enhance the social and emotional well-being of children, youth, parents, and
caregivers by increasing parental and child/youth resilience, achieving
positive personal growth and change, and improving family functioning, self-
esteem, and happiness.
Foster an International Network of Nationally Certified Parent Leaders
through Training, Action Planning, and Guided Practice on “10 Exemplary
Leadership Practices”.

CHILD MALTREATMENT IN NEPAL (Resources)
According to Kanti Children’s hospital,
In Nepal, CWIN reported 3584 different type of child abuse cases over six
month (Jan-Jun 2008). Among 432 cases of child domestic violence 16% were
of in school.

According to UNICEF SOUTH ASIA,
• In CWIN, of 223 recorded cases of rapes of women and children in 2002,
78% were of children below 16 years of age.
• Domestic violence cases 77% women in Nepal are family members, 58% of
victims complained for daily abuse.
• Street children in Kathmandu cases 73% are physical, mental and sexual
abused by their family members.

According to Central Child Welfare Board (2073/74)
 Physical Punishment
• 19 cases recorded
• 88% got serious type of punishment
• One student loosed light of eyes
• 70% cases are found in private schools
• 95% punishment by male teachers

 Child Abuse, misbehavior and rape
• 44 children have been raped
• 48 % from unknown person, 41% from known people and 11 % from relatives
• 43% are of ages 11 to 14 years
• 1090 rape cases reported in Nepal police(62 % are girls under 18 age)
 Early marriage
• 29 child marriage case come in to record
• 71% child marriage by family and 29% by themselves
 Kidnapping and murder
• 12 children have been kidnapped
• 16 murder case recorded

CHILD MALTREATMENT ORGANIZATION’S IN NEPAL

NAMASTE CHILDREN NEPAL
Namaste Children Nepal is a non-governmental organization founded in
2005, which works for the homeless and parentless children in Nepal. The
major objective of this organization is to provide proper shelter, quality
education and health care to the children. It aims at giving privilege to those
children whose parents either left them with no supportive hands or to those
whose parents are imprisoned. This non-governmental organization ensures
that no child is deprived of the rights and the life s/he should be granted with.

CHILDREN WORKERS IN NEPAL (CWIN)
Established in 1987, Child Workers in Nepal Concerned Centre (CWIN) is a
pioneer organization in Nepal for the rights of the child and against child labor
exploitation. CWIN is an advocate organization for the child's rights with focus
on children living and working under the most difficult circumstances. CWIN's
main areas of concern are child labor, street children, child marriage, bonded
labor, trafficking of children, children in conflict with laws and commercial-
sexual exploitation of children.
As a watchdog in the field of child rights in the country, CWIN acts as a voice
of children through lobbying, campaign and pressure to the government to
protect and promote children's rights in the country, and to end all kinds of
exploitation, abuse and discrimination against children.
As a concerned organization to the children at risk, CWIN has been also
undertaking a number of socialization, support and rehabilitation programme
through its various programmes.

CHILDREN AND WOMEN IN SOCIAL SERVICES AND HUMAN
RIGHTS (CWISH NEPAL)
Children and Women in Social Service and Human Rights (CWISH, Nepal) is a
nonprofit organization, established in 1993 with an aim to ensure social justice,
protection and promotion of human rights especially the rights of children. In
order to achieve this aim, it has been working in three programmatic pillars:
Child Protection, Rights To Education and Family Empowerment.
CWISH has been the founder of some child rights related consortium as well as
the member of various such national and international consortiums. Till date,
the services of CWISH have reached to 170,123 Children, 158,156 Women,
313962 Parents and 798 Institutions. Besides them, around 1,107,981 people
from 35 districts have been indirectly benefited by CWISH.

INTERNATIONAL SOCIETY FOR THE PREVENTION OF CHILD
ABUSE AND NEGLECT (ISPCAN)
Its Data shows that 5 children die every day because of child abuse, while many more
suffer life long consequences. Over 1 billion children worldwide experience violence
annually. For 40 years, ISPCAN has worked to reduce this preventable
tragedy. Founded by Henry Kempe in 1977, ISPCAN is the only international non
profit organization that brings together the range of professionals that work toward the
prevention and treatment of child abuse, neglect and exploitation.

They support the professionals who help treat and prevent child abuse to
continue to learn and share best practices as they progress in their
careers. Bringing together these highly trained individuals to create a network
of learning, sharing and support is what ISPCAN is all about. ISPCAN has
continuing education resources, opportunities for you to share your research
and treatments in our conferences, data collection tools, and best practices
from all over the world to share. Healthy foundations for children create a
lifetime of happiness and productivity for the individual and for the entire
community.
Work with us to end child labor, sex trafficking, sexual abuse, and all forms of
physical and emotional abuse. It will take all of us to end neglect and violence
against children around the world.

Thank you for
your patience !!

Physical Child Maltreatment in Nepal

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