Tackling child sexual abuse: Awareness, identification and prevention

Child sexual abuse is a critical issue that we need to be discussing in schools and at home.
Published January 19, 2018

These articles have been produced in partnership with Aahung, a non-profit organisation that has been working since 1994 to improve sexual and reproductive health and rights of people in Pakistan.

Aahung works extensively on child sexual abuse through its Life Skills Based Education curriculum implemented in about 400 primary and secondary schools around the country.

The organisation works closely with teachers and caregivers on helping children stay safe and runs media campaigns to raise awareness.

Following is an account, as told to Sadia Khatri, by two para-counsellors who teach grades 4 and 5 in Karachi and have implemented Aahung’s Life Skills curriculum at their school.

There are certain topics that are difficult for children to broach – the most glaring of these is child sexual abuse. But, in the past year we have noticed a shift.

Students are becoming more vocal and are sharing their problems, both with teachers and with each other. On several occasions, students have approached us on another’s behalf.

In 2016, our school introduced Life Skills, a single-period class dedicated to discussing a range of social and psychological issues, including gender inequality and bullying.

Within Life Skills, we have been able to raise a conversation about child sexual abuse.

We want to remove misconceptions around the issue of abuse, equip children how to defend themselves, and teach them how to say “No”.

In situations where abuse is occurring, we want to encourage them to speak up about it by assuring them that there is nothing immoral about the topic.

We started off by accommodating Life Skills during our 20-minute assembly. This proved difficult. There were too many students – we have 300 in each class – and not enough time. We had to restructure the whole programme to run it smoothly.

Now, Life Skills is a slotted period in each grade – so the children know it is part of their time table, they are familiar with the teacher who takes their class, and they know exactly what to anticipate during the discussion.

The first step of the programme is to build a relationship with the students based on comfort and trust. We assure them that the conversations will remain confidential.

Before initiating the topic of abuse, we segregate the children, sending either all the boys or all the girls to art class.

This is because there are some differences in how we contextualise the lessons, especially when talking about the body.

It is also because children open up more when they are in the company of their own gender.

We start by establishing the fact that there is nothing immoral in talking about abuse. It can happen anywhere, with anyone. Some of us also experienced abuse when we were children.

If any of the students are in an unsafe situation, we encourage them to tell their parents.

We assure them that their parents will understand and support them, and that we are available to intervene if necessary.

At first, children hesitate: “We don’t have any issues, Miss. We have no problems.”

But once one or two children speak up, others begin to open up as well.

We try to create an open and safe space where they can share anything. We have to keep reminding them: our goal here is not to create fuss about your issues, or to report them anywhere.

Our goal is to help you relax and feel better. We explain to them how some problems can be resolved just by sharing them – how speaking up can be therapeutic.

Of course, not all children are comfortable verbalising their issues. To be inclusive, one of our activities involves handing out pieces of paper on which they can write down their thoughts.

We want to give them a healthy outlet. Sometimes just writing on paper is a healthy way to vent.

If they wish to share these with the teacher, they may; otherwise they are encouraged to tear up the papers and throw them away.

The idea here is to solidify trust by assuring children that they will not be forced to do anything.

Some incidents occur on the streets and at tuition centres but we have found that most abuse occurs in home spaces.

Last week, a girl confided to us in writing. She had been undergoing abuse by her cousin, who came to take care of her while her mother was away. With the girl’s consent, we offered to mediate and called in her mother.

At first, the mother was shocked. This is a common reaction – parents often find these revelations hard to believe. Sometimes they react with strong opposition, claiming that we are mistaken.

Before initiating Life Skills, we held information sessions for all parents, to ensure that we had their support.

Even though they were all on board and had given their consent, when it comes to confronting the truth, not all of them want to accept that their child is in danger.

In their minds, abuse is immoral. The log kya kahein ge [what will people say]? mentality feeds their worry – they fear for their reputation in society, and if the child is a girl, they fear for her future.

We have to assure parents that the matter will stay confidential, and that our greatest concern is their child’s safety. Eventually, they come around.

In the case of the mother last week, she believed us only once we showed her the child’s handwritten note. She could not believe that it was happening in her house.

Since then, she has become much more alert. Now she takes the child with her everywhere.

Since we usually live in close-knit neighbourhoods, it’s rare for parents to confront their child’s abuser. Their intervention is limited to heightening their child’s safety – as with this mother, who cannot say anything to her child’s abuser because they are part of the same family.

Once, another mother said to us: “I can only ensure my child’s safety. You have no idea what will happen if I take a public stand. If I accuse the abuser, he will unleash a storm in my home.”

Often children themselves are afraid of their parents. Given the gap in communication between parents and children, their fear is not misplaced.

It starts early on. When children start asking questions about changes in their body, they are either dismissed or given a nonsensical answer, or their prying is treated as something immoral.

Then there is the manner in which we talk about sex. When a child is born in the family, parents offer different, misleading explanations: one says the child came in a basket, the other says it was dropped off in the night.

Being children, they obviously consult each other and realise there are discrepancies – this heightens their curiosity and makes room for even more misleading information.

Parents’ dismissal builds mistrust, and children do not feel fully comfortable discussing everything around them.

A supportive outlet is shut off, and as a result, children going through trauma or abuse feel even more insecure.

Their mental health deteriorates and they fear admonishment from their parents. Often they begin to internalise guilt and blame themselves, afraid that if their parents find out, they will be held responsible.

There are several changes that parents must make in their behaviour.

First, they need to talk openly with their children, and resist the impulse to sweep sensitive topics under the carpet.

Second, parents must stay informed and involved in their children’s day-to-day activities.

You should know where your child is going and with whom they are spending their time.

One way to solidify trust is to create a habit. For example, ask your child how their day went before they go to sleep at night.

Your child might not always have a lot to share, but at least they will realise that there is space for them to speak to you.

Once they know that you care, they will begin to feel safe discussing anything with you.

Lastly, believe your children. Your child should feel confident confiding in you.

They should not approach you with the fear of admonishment, but with the conviction that they will be believed.

Implementing the Life Skills programme has not been a smooth process. Selecting teachers is the key challenge.

When the course was introduced, many teachers were initially hesitant taking it on and felt the content was too sensitive.

Untrained teachers cannot run these classes, so all of us first have to undergo training by Aahung.

But workshops aside, teachers first need to have the confidence that is required to discuss abuse.

They need to be emotionally well-equipped to talk to children. This is not always the case.

Some female teachers have trouble with boys. Others, who had received the training, backed off when it was time to deliver.

We are six teachers handling grades 4 and 5. There are also teachers who run Life Skills sessions at the secondary school. At least through our efforts, some of the children are now safe.

But the process does not end there. Children can be fragile even after they are out of danger. Sometimes you have to provide extra care.

For example, there is a girl who often shows up out of nowhere to see us. We know she has been through abuse, so we never turn her away.

Sometimes she wants to share something simple – nothing related to her trauma. But we know that she is seeking comfort and that it is important for her to be listened to.

Furthermore, we have to ensure that students who have experienced abuse feel safe in their new classes.

If they have a trusting relationship with a particular teacher, we try to adjust their class so they don’t have to deal with anyone new.

At the beginning of the school year, there was a student who refused to sit in her new class. When we placed her back with her former teacher, she calmed down again.

Delivering the Life Skills workshops can be a challenging experience, but the teachers who have been implementing the programme have seen how vital and transformative it can be for children who are being abused or are survivors of abuse.

If you have been a victim of sexual abuse, you can contact the following organisations for counselling: Aahung, Rozan, Sahil, Madadgaar

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Child sexual abuse cases in Pakistan run in thousands each year (4,139 cases were registered in 2016), and those are just the ones that are reported, making it evident that not enough is being done to protect children from abuse.

This brings us to the fundamental question: can abuse be prevented? There is a simple answer to this: yes, in some cases.

While there is no way to ensure that a child will never be abused, there are measures that can be taken to lower the chances that abuse will occur, and to ensure that any abuse is not ongoing.

Some easy-to-follow tips for abuse prevention are shared below so that parents and caregivers can empower their children to protect themselves.

Start early and establish strong communication (Age 3)

Usually by the age of three, children are capable of understanding the basic concepts of self-protection and this is a good age to start talking to them about abuse.

Parents need to understand that by talking about abuse, they will not instil fear into the minds of children or rob them of their innocence.

By speaking to children in a way which makes them feel in control, parents can empower children and make them feel more self-confident and capable.

Hence, it is extremely important to establish strong communication between parents/trusted caregivers and children so that children feel comfortable discussing instances of abuse or mistreatment.

Use real names for body parts (Ages 3-5)

Sexual abuse prevention educators recommend using real names for body parts so that children develop a healthy and respectful relationship with their body.

However, if parents are finding this challenging, other names can be used for private parts, as long as they are not negative or derogatory.

While naming body parts, it is imperative that parents identify those parts that are private. Parents should clarify that the whole body is the child’s own, which no one can touch against their will.

By having particular names for the genitals and other private areas of the body, children will be able to communicate their problems more effectively. This will also promote a positive body image and self-confidence in children.

Develop decision-making skills (Age 4 onwards)

A child with good decision-making skills can conclude that informing a trusted adult about abuse may prove helpful.

Parents can assist children to develop analytical thinking skills by helping them make well-thought-out decisions about day-to-day activities.

While this may be a difficult process for parents because children can be stubborn, with time their mental development will allow them to start linking decisions to outcomes and better enable them to think critically.

Discuss touches (Ages 5-9)

Once children have an understanding of the private areas of their body, it is important for parents to start discussing abuse prevention in more concrete terms with clear instructions and examples.

All conversations with children should always take place in a safe, comfortable environment and should be conducted in a pedagogical manner.

The easiest way to start discussing abuse prevention in more concrete terms is to describe “good” and “bad” touch.

All discussions should try to include examples for children to relate to, so that they can start to connect specific feelings evoked with the touches mentioned.

For example, good touches can be defined as those touches that make us feel happy, loved, and comforted, such as hugs from parents, or an encouraging pat on the back from a teacher.

Bad touches, however, are ones that either cause us physical pain or make us feel uncomfortable in any way.

Other preventative measures

Limit time that a child spends alone with an adult one-on-one. It is a good idea to have your child do as many activities as possible in groups when you cannot be there to supervise.

In certain cases where children are left alone with adults, such as tutors, maulvis, or other caregivers, try to unexpectedly check in from time to time on the interaction.

Pay attention to your child’s mood if it changes before they see someone in particular.

One of the best preventative measures is to trust, and act on your instincts if a certain adult makes you uncomfortable around your child.

Unfortunately preventative measures don’t always work, which means that caregivers also need to be aware of signs of abuse.

Obvious signs that abuse is occurring often do not exist because there are usually far fewer physical symptoms than emotional ones.

However, children who are being abused or are survivors of abuse do often exhibit certain characteristics that should be kept in mind:

  • Poor self-esteem, self-confidence, or body image
  • Fear of certain adults or certain places
  • Avoiding going home after school, avoiding going to school, or avoiding going to a certain house/location
  • Sleep disturbances, sleepwalking or nightmares
  • Appetite disturbances
  • Using new words for private parts that have not been taught at home
  • Referring to “secrets” that he/she has with an adult, which cannot be shared with anyone else
  • Acting out sexually or have inappropriate knowledge of sexual content and behaviour
  • Becoming sad, passive, withdrawn, or depressed
  • Regressing to certain behaviours, such as bed-wetting or thumb-sucking
  • Torn or stained clothing
  • Vaginal or rectal bleeding, pain or itching
  • Having difficulty trusting adults or forming new relationships
  • Abusing substances as an adolescent (drugs, alcohol, etc)
  • Cutting him/herself as an adolescent (self-mutilation)

Many of the behaviours and psychological reactions listed above can be a result of emotional upheavals children inevitably experience during their development.

But, if several of the symptoms are noticed by those who are close to the child, then it is important to investigate further whether any abuse has taken place.