Key words: Child Sexual Abuse, complications, prevention, treatment, Nigeria.
Handling Child Sexual Abuse – Nigeria. What complications can follow Child Sexual Abuse (CSA)? Can CSA be prevented? Is there hope for treatment of victims negatively affected? Does the Nigerian government have effective laws that can protect its citizens?
Child sexual abuse has many definitions. There is a definition from the World Health Organization (WHO). The Centre for Disease Prevention and Control (CDC) states that CSA is the involvement of a child in sexual activity. This sexual activity violates the laws or social taboos of the society.
Since the legal age of maturity is needed for consent, sexual activities involving an adult and a child are CSA. This holds, even if the child gives an assent.
The Effects or complications of CSA.
Not every child that is sexually abused will be affected or impacted in the same way. The aftermath of CSA differs in each affected child. The aftermath will depend on factors such as the biological make up of the child, the severity of the abuse, etc. The presence or absence of other forms of child abuse will also play significant role. These make up what is known as resilience.
1. Biological complication:
Many parts of the brain are negatively affected by child sexual abuse. This is because the brain is still developing. And if the abuse occur before or during the critical brain developmental period, it can halt brain development. It can also destroy these brain areas.
These brain areas get reduced in size. The areas affected are the areas for memory and emotions, etc.
2. Psychological complication:
These psychological impacts are brought about by the fact that the victim feels betrayed. There is also lack of trust on the perpetrator. These psychological disorders most often will continue until adulthood.
These can include delinquency, depressive disorders especially major depressive disorder, anxiety, schizophrenia, Bipolar Disorders (BD).
There could be Post Traumatic Stress Disorder, where the victim have flash backs about the abuse. This flash backs can come as intruding thoughts, dreams or night mares. There could be dissociation.
Also anger, guilt, self blame and shame may occur. Eating disorder may also present. This self blame may be brought about by the blame from the family and the community on the victim. Self blame may also result when the perpetrator is a family member.
The victim may resort to abuse substances such as cannabis, codeine, cocaine and even alcohol. These are used as poor coping skills to alleviate the psychological issues due to the abuse.
There could also be low self esteem and poor sleep. There could also be somatization disorder where by the victim can continue to feel pain at the vaginal area. She could also have internal heat all over the body or only around the head.
There could also be deliberate self harm (DSH) and death by suicide.
3. Cognitive complications:
The child may have amnesia, or loss of memory on events surrounding that part of childhood. This is a safety valve nature puts in to prevent more chaotic out comes.
The IQ drops and the child starts getting poor grades in school. There is also poor attention, concentration and remembering.
Very young children may draw the sexual scenes or act them out. And even disinterest in academics and even dropping out of school.
4. Social complications:
Those who were sexually abused in childhood may have issues in interpersonal relationships later in life. They may not be able to have lasting relationships, be it in courtship, marriage or at work. This is because they find it difficult to trust. They could also experience violence in their relationships.
They may also have issues with their sexual life. This is due to the psychological pain that may exist during intercourse. These victim maybe unable to have satisfying sexual relationships. And the victim may see sex as an obligation and not an act to enjoy.
The victim can become a commercial sex worker. That means that the child can start having sexualized behaviours. Not because she enjoyed the abuse, but because she uses it as a bad or poor coping skill. It gives her a sense of control of her body. There could also be other forms of inappropriate sexual behaviors.
Early marriage. Parents may decide to give out their female victims out in marriage. This could be to the perpetrator or to older men. Others send the victims if pregnant to live with the perpetrator until after delivery.
Some may end up never marrying because of stigma or being a single mother. The victim could be revictimized in adulthood as rape. Or the victim could become a perpetrator of child sexual abuse in adulthood.
5. Physical complication:
Young children may restart bedwetting.
The child will become disvirgined with the tearing of the hymen, during contact sexual abuse. There could be physical traumas to the perennial areas and vagina.
Other gynecological issues will include sexually transmitted infections (STI), including HIV/ AIDS. The male victims may also have erectile difficulties and ejaculatory issues. There could be sexual issues, like difficulties in getting aroused, orgasms, etc.
Reproductive issues could range from pregnancy to infertility. The infertility could be due to complications from STI or termination of pregnancy popularly known as D and C.
Other physical impacts include obesity, cardiovascular diseases, diabetes, gastrointestinal issues, gynecological issues and reproductive problems. These could also include liver diseases, lung diseases, and cancer.
The cardiovascular diseases include hypertension, and heart diseases. And death can occur during the process of abuse, during termination of pregnancy, or via suicide.
Handling Child Sexual Abuse – Nigeria: Prevention.
1. Educational Programmes.
a. In schools:
There is need for educational programs from school psychologists and NGOs on sexual abuse issues. These educational programmes should be aimed at increasing the awareness about sexual abuse, as well as preventive skills. This should be part of the primary and secondary school curriculum.
In primary schools, children should be educated about their body parts. They should be told about areas that are private and should not be touched by others.
b. Family education:
The parents should be made to also shoulder some responsibilities of protecting their children against CSA. Unfortunately, most parents in Africa see sex education as a taboo. And because of this, they do not know what to say to their children and when to begin.
Parents should start sex education for their children as early as 2 years of age. It is not a one off talk. Sex education is continuous. Parents should speak to the child with the language and words that they can understand at their age. But each part of the body, should be named appropriately. For example, the breast should be called the breast, the vagina, buttocks, should be so called, etc. Do not use the word bom bom. Let them know that these parts are private and not to be exposed to others except parents and caregivers when need be. So, NGOs should also target parent education on this matter.
Parents should play the roles of not just that of parents, but be friends with their children. This will encourage easy communication between parents and children.
Parents show interest in their child’s daily activities and ask them who they have been with. Choose caregivers carefully.
c. Education for the society:
Societal norms that promote the risk for child sexual abuse should be eliminated. For example, children should not be pressured to take up financial responsibilities. Children should not be exposed to street hawking or child labour. They should not be forced into child marriages.
The media also has its part to play. Information from the media, including social media, should not be sexualized. Even child sexual abuse reports should be reported sensibly and not sensationalized.
The society should be encouraged to promote the reporting of CSA. Because this will go a long way in preventing future occurrences.
Also, stopping the stigmatization of CSA victims will go a long way to encouraging victims to speak out. This will also encourage advocacy.
So, CSA Can be reduced with aggressive mass sensitization, which should include ending violence against women and children. So, advocacy should be encouraged.
The churches should understand that they too have a role to play in ending CSA. Priests, pastors and Imams can preach about it from the pulpits.
The Nigerian law and CSA.
Child sexual abuse is an offence in Nigeria. And it attracts two years to life imprisonment for perpetrators, when convicted.
The laws can be seen at different sections of chapter 21 of the Nigerian criminal code, section 221 and 222. The criminal code applies to the southern part of Nigeria. Then there is the penal code for the northern part. Section 282 of the penal code. Then there is the Child Rights Act, which stipulates that sexual intercourse with a child attracts life imprisonment.
Handling Child Sexual Abuse – Nigeria: Treatment.
1. Medical treatment:
For those who have been sexually abused by physical contact or rape, should be taken to the hospital as soon as possible. This will enable the child be examined while the wounds or sperm deposits are still fresh. And treatment will be started to prevent future complications. It will also ensure that early preventive treatment for HIV is commenced.
2. Psychological and psychiatric treatments:
Psychological treatment is absolutely necessary in order to prevent future psychological and social complications. This should be done by a clinical psychologist.
A psychiatrist should be consulted when the psychiatric conditions have set in. These psychiatric conditions include depression, anxiety, BD, etc.
The parents should give the affected child maximum social support. The child should not be blamed. The mother should be a good listener and comfort the child afterwards. The mother should not scream, or make sensational comments while listening. These could make the child retract her report.
3. Report to Law Enforcement Agents .
The perpetrator should be immediately reported to the police for further lawful actions. Prosecution of offenders will go a long way to deterring offenders.
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