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An Integrated Systems Model for Preventing Child Sexual Abuse
Perspectives from Latin America and the Caribbean
A. Jones, E. Jemmott, P. Maharaj, H. Breo
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eBook - ePub
An Integrated Systems Model for Preventing Child Sexual Abuse
Perspectives from Latin America and the Caribbean
A. Jones, E. Jemmott, P. Maharaj, H. Breo
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About This Book
This book sets out an integrated systems model which utilizes a public health approach and 'whole of society' philosophy for preventing and responding to child sexual abuse. It guides those engaged in policy, practice and planning concerning gender based violence and child abuse towards a more systemic approach to tackling these problems.
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An Integrated Systems Model for Preventing Child Sexual Abuse
Perspectives from the Caribbean
Introduction
She was nine when he first raped her, though he wasnât the first to try. Of her four brothers, two had tried but this brother, older by a decade, succeeded. And so it went on and on, raped by him repeatedly for years. Though she was the only girl in the family, she did not have the support she might have expected from her mother. Mummy was simply swamped by the dominance of males in the household, by their incessant demands and expectations and by her own economic dependence, which kept her trapped in subservience. Protecting Amber was too much a call on any leftover strength she might have had. Becoming mute, deaf, unseeing and unfeeling was, she believed, the only option she had for getting through each day. She could not hear Amberâs story or feel Amberâs pain.
When Amber was 15, she decided it was enough; she told her father. In retelling her story three years later, Amber still recalled Daddyâs slap â the blow to the side of her head so powerful, as if his hand squashed into the mess of her brain. In visualizing this violence, she peeled back her fatherâs fingers one by one, pulling them from her brain matter so that it could close around the hole ... but then, whap! another slap to the other side ... the hole never closed. âHow dare you say that about my son, heâs a good man and you, YOU! You loose and wild. ... You get out of this house right nowâ.
And so Amber left. The sexual abuse was common knowledge in her village â male sexual conquest and its bedfellow, female subjugation, was expected and, if anything, a matter for celebration. For the determinedly heteronormative masculinity that defined behaviour among the men in her community, this sport may have been as common as cricket; who knows. The fatherâs denial of wrongdoing, a foil which protected status and honour over the protection of his daughter reflected a perversion of family values that was deeply troubling. Amber had harboured a kindling of belief that he would be enraged. She was right â he was enraged ... at her. It wasnât that he didnât know â everyone knew, EVERYONE. It seemed that to speak out the truth was the greater violation.
But Amber wasnât done; though homelessness and the lack of child protection services forced her into another oppressive relationship â this time with an older man â and a temporary home with his mother, where she was seen as a burden and where she paid for her keep through sex with her older boyfriend, she was nothing if not resilient. She reported the abuse to the police. The news carried to father and son even before Amber had left the police station; no chance here for justice. And so she reported it to the social services. But they were very, very slow to act, and in the meantime Amber was ostracized and demonized by everyone in that close-knit community ... no scrutiny here please, no saying what else will be discovered. Undaunted, Amber pressed charges herself.
She told the court her brother had been sexually abusing her for years and years. She was now charging him. She told how her mother had refused to protect her for years and years, and she was now charging her mother. She told how her father had slapped her face for daring to bring news against the brother, who is the favoured one, and she was now charging her father. Amber was meticulously charging everybody, without legal counsel.
The mother gave witness that she, too, had been abused as a child, and it had made her scared and timid. So when she watched her daughter Amber, who is confident and loud and ready to charge people, she knew for a fact that this was not how girls behave when they have been raped; hence her daughter was lying. And the father gave witness that Amber had been caught with a boy in the school having sex, that he was ashamed of this girl child of his and was furious that she was now trying to besmirch the good name of her brother, his lovely son.
And Amber just stood there all by herself in the box and kept her heart and slugged it out.
But she lost the case.
The story of Amber (not her real name) is that of a young woman who participated in an innovative psychotherapeutic/ecological project designed by the writers of this book for girls in the Caribbean who had experienced child sexual abuse. The project, called R.I.S.E (Respect, Inspiration, Self-esteem and Empowerment), was an initiative of the Sweet Water Foundation (www.sweetwaterfoundation.ca), a non-profit agency that is headquartered in Canada with a sister branch in Grenada and whose mission is to end sexual violence against women and girls (Chapter 6 has more on R.I.S.E).1 Amber is not typical of the girls in the project: there is no âtypicalâ victim of sexual abuse; each story is unique. Yet as much as this is true, underlying factors driving abuse behaviours and social determinants that increase childrenâs vulnerability are not unique to any individual. Because she has a name and a story, Amber is more likely to have an impact than the nameless thousands of children who are subject to sexual victimization each day; the sheer number of cases seem to anaesthetize readers. Is it possible then to acknowledge the trauma of the individual child while at the same time dealing with the common factors that underpin abuse as a societal problem so that collective responses might better prevent it in the first place? We believe it is. This is the purpose of the book; to move beyond individual experience, as crucial as provision of services is to protect the child who is at risk of harm and to find ways to collectively address societal, attitudinal, behavioural and institutional failings that enable child sexual abuse to thrive.
This book is about the systemic nature of child sexual abuse, the systems within which abuse flourishes and the systemic failings of societies to tackle its social determinants and drivers. Building on an earlier book on child sexual abuse in the Caribbean, Understanding Child Sexual Abuse: Perspectives from the Caribbean (Jones 2013) (the first of a three-part series) which established the presence and significance of Caribbean research and theoretical perspectives on child sexual abuse, the primary objective of this second book is to promote an Integrated Systems Approach for Preventing and Responding to Child Sexual Abuse. Targeting activists and professionals from a range of disciplines, our aims are to guide those engaged in policy, practice and planning concerning gender-based violence and child abuse (social workers, educators, police officers, health professionals, the judiciary and NGOs) towards a more systemic approach to tackling these problems.
The focus of this book is on child sexual abuse (CSA) in the Caribbean for several reasons; first, though child sexual exploitation and abuse are widespread, these problems are largely hidden in the region, and the harm caused is therefore often underestimated. Additionally, while data on risk and prevalence are routinely gathered in many countries, this is not the case in the Caribbean, where no comprehensive CSA data systems exist. This is despite the fact that the Caribbean has many of the negative social and health consequences linked to the sexual victimization of children; for example, the lowest age of first sexual activity in the world (outside countries permitting child marriage):
42.8% of Caribbean children who were sexually active had their first sexual intercourse before the age of 10. Many (47.6% females and 31.9% males) said this was forced or coerced. (HalcĂłn et al. 2003)
The region has the second-highest HIV prevalence rate (after sub-Saharan Africa), with sexual abuse and coercion an important factor and females 15â24 years being the most vulnerable group (PAHO and CARICOM 2006), and the third-highest rate of teen pregnancy in the world (often the result of CSA or coerced sex; PAHO 2011). Commercial sexual exploitation (sex-for-trade) is constructed as a ânormalâ form of economic security for some women and in many instances adolescents, too (Jones 2013; see also Chapter 2).
Alongside these problems, despite exceptionally high levels of literacy and academic and professional attainment, the region has suffered decades of outward migration, leaving countries depleted of specialist staff and resources to tackle the problem (Salmon et al. 2007). In some Caribbean countries the ratio of professional social workers to children is too low to respond effectively to the number of CSA cases; child and adolescent psychiatric services are overstretched beyond capacity in the few countries where they exist, and there are no specialist services for the treatment of harmful sexual behaviours. While some excellent antiviolence programmes exist (e.g., Muturi and Donald 2006) and professionals are often highly skilled, CSA has become entrenched in part because of institutionalized inertia caused by inefficient criminal justice systems, lack of accountability and inadequate resources. Government responses are constrained by a financial climate characterized by reliance on narrow economic bases (primarily tourism) and the servicing of high levels of public debt, which can divert resources away from tackling problems such as gender-based violence (Barriteau 1996). These circumstances undermine the capacity of governments in the region to effectively identify and confront hidden problems, such as CSA. Overall standards of living in the Caribbean compare favourably with other low- and middle-income countries (with some exceptions), but economic progress does not necessarily equate with good services for the protection of children; this requires specific and concerted attention.
This chapter sets the tone for the rest of the book and weaves elements of Amberâs narrative through its key messages, reminding us that whatever else, our ideas must relate to the real world. In tackling this most entrenched of problems, discussion is useful only if it is the precursor to action. We begin by summarizing the Caribbean human rights position in respect of sexual violence to women and girls. Next, we make a case for the use of intersectionality as an analytic lens for examining the interrelationship of the multiple factors implicated in the abuse of children. Third, we engage the reader in a number of conversations: conversations about the language and meanings of abuse, conversations about rights, culture and values, conversations about sexual scripts. We then introduce the integrated systems model, which brings focus to bear on the underlying social factors that perpetuate abuse, risk and vulnerability and the ways in which these intersect. This model is a nested and contexted structure, which in the case of child protection means the recognition that âchildren are embedded in families or kin, which live in communities, which exist within a wider societal systemâ (Wulczyn et al. 2010, 9). Finally, in pursuit of our goal to influence policy and programme makers to adopt a public health prevention strategy in confronting child sexual abuse, we highlight the main principles of this approach and show how it can be aligned with the integrated systems model.
Human rights
The social realities from which the material for this book is derived are particular (though not unique) to the Caribbean region. Yet the understandings and recommendations derived from our analyses have international relevance. Our starting point is that CSA is first and foremost a human rights issue. In terms of progress on human rights and with some notable exceptions where there are major deficiencies â for example, in respect of gay rights, treatment of migrants and refugees (particularly notable is the treatment of Haitian refugees; Ferguson 2003) and equal access of opportunity for disabled people â the Caribbean meets many international indicators. For example, most people enjoy freedom of speech, religion and association; democratically elected governments; independent press; universal access to education; low infant and maternal mortality; and independent judiciaries. Women participate in all spheres of social life, having no legal constraints on their freedoms. When it comes to sexual and physical violence however, the Caribbean provides some of the most alarming statistics in the world. Though statistics differ from one country to the next, the overall picture is one where human rights violations are an everyday experience for many women and children (Contreras et al. 2010). Deeply embedded within Caribbean histories and contemporary realities, these breaches of human rights impede social and economic progress and undermine the regionâs standing at the international level. On April 30, 2013, the Caribbean News agency Caribbean 360, in reviewing the US Department of State Country Reports on Human Rights Practices for 2012, stated: âThereâs seemingly no let-up in the United Statesâ condemnation of Caribbean countries in their human rights practicesâ. Factors relating to gender-base...