Your own child could be a victim of abuse. Are you ready to deal with the issue?

Listen to the little voices

Child abuse has been with us, perhaps from time immemorial, but it is just that Sri Lankan society is only now beginning to recognize it for the evil that it is, responding with tougher penalties.

There are many forms of child abuse, but probably the most repugnant is sexual abuse and an increasing number of parents are now anxious about the well-being of their children. But just how ready are you to deal with the issue, with regard to your own child? And, how sure are you that your child is not a victim?

Parents must recognize that offenders are rarely persons unknown to them. They can come from within the family circle, the school or from any other group in which the child is a participant.

But how does a parent broach the subject of abuse with a child without causing undue alarm? The best way, doctors believe is to make a child aware of his/her body and also teach them how to look after it. This can be done, for example, by naming the parts of the body together with the child and explaining to the child that he/she should always wear clothes covering the private parts.

Children, when they reach five years of age, may be taught to wash their private parts and to bathe by themselves. This leads to their understanding that these organs are indeed 'private' and they will then instinctively resist any outsider's interference. They should also be told that if they are being fondled, kissed or touched by anyone in a manner which is uncomfortable, they should resist it. Perhaps more importantly, they should have the confidence in you to tell you about it.

This confidence cannot be achieved overnight. It is gained by being a good listener to your child, especially when he/she is trying to tell you something. Parents should also engage in common activities with their children, sharing their experiences so that a good rapport exists between them. 

It is also helpful if children are advised about threats. Abusers frequently threaten their victims with dire consequences if they reveal their 'secret' and children usually comply with them. But if parents have instilled enough confidence in them that they will be there for the child no matter what, then such threats will be of little value.

All this only shows that child abuse can be stopped- or at least detected very early, but only if parents are alive to this possibility and have instilled enough confidence in their children to talk about it.

The many myths that surround suicidal behaviour

1. People who talk of suicide don't commit suicide- They do. Most people who kill themselves have given definite warnings of their intentions- which have been ignored. 

2. Suicides are sudden and happen without a warning- Most typical suicides occur after the person has given many behavioural clues about their intentions. 

3. Suicidal people always want to die- Most suicidal people are undecided about living or dying and they gamble with life, leaving it to others to save them. Also, in Sri Lanka, many people use a suicidal attempt with the aim of gaining attention or winning demands. But the methods they use- pesticides and insecticides usually- are fatal. 4. Once people become suicidal, they are suicidal forever- In most people, the intention to die is only a passing phase. But of course, such thoughts may recur later when faced with stressful situations. 

5. Improvement following a suicidal 'crisis' means the risk of suicide is over- definitely not. Many suicides occur within about three months of such improvement, when individuals gather enough energy to put their thoughts into action. 

6. Suicides occur commonly in upper social classes- If at all, suicides are very 'democratic'- it occurs proportionately among all sections of society. 

7. Suicidal behaviour is rare in children- Suicides do occur among children under stress and such incidents are only promoted by the indiscriminate reporting by the media, of the methods used to commit suicide. 

8. Most suicidal individuals are mentally ill. Although most suicidal people are unhappy and are under stress, they do not necessarily experience a mental disorder.

Second opinion

Medical mess gets shot of relief

There are sceptics who doubt the veracity of this announcement but we must, until proven otherwise, assume it is so. This must no doubt be a relief to all medical undergraduates presently in training in the state-run medical schools who only recently were parading the streets demanding just that- a guarantee of employment in the state sector.

Even if the present crisis seems to be settling it is still worthwhile to assess why there was a crisis at all. After all, medical graduates do not materialise overnight- they are produced only after five years of training and so there should be no difficulty in anticipating how many would need jobs and when such needs would arise.

Indeed, there is no such difficulty. What there is however, is poor planning and infrastructure development where the left hand apparently does not know what the right is doing: the Health Ministry-which administers the country's hospitals- being caught unawares by the number of graduates produced by the Higher Education Ministry- which runs the country's universities.

Our policy makers are adept at being flexible enough to grant each and every demand of politicians but when a discrepancy exists between two ministries, there is a mass of red tape that is used to cover the lapse. Our bureaucrats in the state sector are adept at citing these ARs and FRs to explain why something cannot be done, even if it will be for the good of the country.

To cite a recent example, there were queries raised about a university academic holding a position in a medical faculty as well as in the University Grants Commission. For all we know, that should have been welcomed and not queried, for that academic would be in a unique position to see problems in both institutions from either perspective and in the long run, serve both institutions better. Indeed, this innovative new faculty which this academic heads has made progress in a short span of time and his record speaks for itself and probably because of that sanity has prevailed and the academic continues his good work.

But these are the blunders made by bureaucrats who rule state institutions. They result in disastrous consequences such as the recent spate of protests where we saw the ugly sight of medical students taking to the streets asking for job security. Of course, the government cannot continue providing these jobs indefinitely, but then that is no excuse not to provide these jobs when the country is so understaffed in the medical sector.

What we can now hope for is, first that the cadre increase for doctors will be implemented as announced and then that it would be done in a sensible manner to serve the needs of the country at large- and not as a political panacea to keep disgruntled undergraduates at bay for a few more years.

You could save a life

Kerosene oil poisoning: Do not make the victim vomit- this causes toxic chemicals to enter the lungs. Do not give the child to eat or drink until medical help is sought.

Insecticide poisoning: Wash the victim well with soap and water immediately to remove any traces of the chemical from the skin.

Overdose of drugs: Make the victim vomit by placing a finger at the back of the child's throat.

Snake bite: Get the victim to lie down and reassure him that help has been sought- anxiety can aggravate the harmful effects of snake bite. Immobilize the affected limb with a splint( if it is the leg) or a sling( if it is the arm). Do not apply a tourniquet and never attempt to slash the wound with a knife to "drain the bad blood". Also, never attempt to suck out the venom.

Dog bite: Flush the wound with soap and running water.

Insect stings: If the sting is visible and still in place, try to remove it with tweezers( small forceps). A cold compress may be applied to reduce the pain and swelling. Other home remedies are of limited value. What must be remembered is that medical help must be sought in all these situations and the sooner it is done, the better it is- it may even make all the difference between life and death.

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