Valen­tine Smith (PhD)

Se­nior Fel­low CCLCS

The phys­i­cal mal­treat­ment of chil­dren is a so­cial prob­lem and med­ical prob­lem in Trinidad and To­ba­go. Child abuse is not new to the coun­try, but die to the pro­lif­er­a­tion of in­ter­net use, cel­lu­lar phone and so­cial me­dia, the is­sue has been ‘made pub­lic’, or as the young peo­ple say, ‘is blow­ing up’.

To be sure, the his­to­ry of child mal­treat­ment, ne­glect, and phys­i­cal in­jury is a long one, par­tic­u­lar­ly in post-colo­nial states like ours. Child-rear­ing meth­ods long ago were of­ten aus­tere and se­vere; harsh pun­ish­ments in­flict­ed by par­ents and the oth­er adult au­thor­i­ties were com­mon­place, in fact, nor­ma­tive.

Long ago par­ents had to­tal sov­er­eign­ty over their chil­dren. In the colo­nial era, phys­i­cal pun­ish­ment in the name of dis­ci­pline rarely could be viewed as too harsh, as the sys­tem was one based on op­pres­sion, ex­ploita­tion and abuse. As was the case with the salve mas­ter and the slave, the whip­ping and can­ing of chil­dren was the pre­rog­a­tive of par­ents and teach­ers. Cor­po­ral pun­ish­ment was the reg­u­lar dis­ci­pli­nary fare, with the dic­tum ‘spare the rod and spoil the child’ cap­tur­ing the child-rear­ing spir­it at the time.

It took a cer­tain or­gan­ised in­ter­est in med­i­cine to dis­cov­er child abuse as a med­ical prob­lem. The key in defin­ing and le­git­imis­ing child abuse as a med­ical prob­lem. The ap­pear­ance of the ar­ti­cle, ‘The Bat­tered Child Syn­drome’ in a pres­ti­gious med­ical jour­nal, opened the prover­bial flood­gates (Kempe et al., 1962). The ed­i­to­r­i­al un­der­ling the med­ical se­ri­ous­ness of the prob­lem, gives vis­i­bil­i­ty and le­git­i­ma­cy to bat­tered chil­dren as a sig­nif­i­cant med­ical prob­lem in so­ci­ety, one that had be­fore been un­ac­knowl­edged or ig­nored.

They de­scribed the syn­drome with char­ac­ter­is­tics that in­clude the vic­tims be­ing usu­al­ly un­der 3 years old and ne­glect­ed, hav­ing trau­mat­ic in­juries (es­pe­cial­ly to the head and the long bones), and hav­ing par­ents who them­selves had been bat­tered as chil­dren and who de­nied the abuse of their own child.

Child abuse is not an iso­lat­ed so­cial phe­nom­e­non, and it is root­ed in the so­cio-cul­tur­al land­scape of the so­ci­ety. Re­search has shown there is a high­er in­ci­dence of child abuse in fam­i­lies sub­ject to so­cial stress­es such as work­ing-class fam­i­lies, ‘bro­ken’ fam­i­lies, and fam­i­lies with four or more chil­dren. The in­ci­dences of this vi­o­lence are al­so ex­ac­er­bat­ed by is­sues such as pover­ty, so­cial ex­clu­sion and iso­la­tion and men­tal dis­tress.

Vi­o­lence against chil­dren is root­ed in the prac­tices of child-rear­ing so­ci­etal cul­ture, es­pe­cial­ly in the use of force in adult-child re­la­tions, and in the so­cial struc­ture, par­tic­u­lar­ly in the ex­is­tence of pover­ty. Fur­ther, chil­dren are vic­tims of so­cial forms of child abuse such as mal­nu­tri­tion, pover­ty, poor ed­u­ca­tion and med­ical ser­vices, and phys­i­cal abuse in schools and oth­er child car­ing or­gan­i­sa­tions.

When schools and oth­er child­care set­tings em­ploy prac­tices that are not con­ducive to op­ti­mum child de­vel­op­ment, such as cor­po­ral pun­ish­ment and oth­er de­mean­ing and threat­en­ing, neg­a­tive dis­ci­pli­nary mea­sures; they con­vey a sub­tle mes­sage to par­ents say­ing that this treat­ment is ap­pro­pri­ate as it is sanc­tioned by ed­u­ca­tion­al au­thor­i­ties.

Par­sons (1951) point­ed out that when de­viance is seen as will­ful, it tends to be de­fined as a crime; when it is seen as un-will­ful, it tends to be de­fined as sick­ness. In Trinidad and To­ba­go, be­cause of the way chil­dren are de­fined and the sta­tus as­cribed to them, they are much more like­ly to have their be­hav­iour de­fined as will­ful.

It must be not­ed that chil­dren, by na­ture have a de­pen­dent sta­tus in our so­ci­ety. All so­ci­eties are de­signed to some ex­tent to pro­tect their chil­dren, and we are no dif­fer­ent. As such, when cas­es of child abuse in­crease, there is ar­guably the propen­si­ty to arouse a pro­tec­tive re­sponse in so­ci­ety by in­sti­tu­tions such as the child pro­tec­tive ser­vices, or­phan­ages, and the ju­di­cia­ry. This can be seen as be­ing man­i­fest­ed in in­crease in the num­ber of safe hous­es, the in­crease in laws re­lat­ed to child labour, child abuse and child pro­tec­tion.

In terms of view­ing child abuse as a med­ical is­sue, the move in this di­rec­tion demon­strates a pub­lic health ap­proach to the prob­lem, as op­posed to the old the­o­ries which were re­strict­ed to cul­tur­al and fa­mil­ial is­sues.

In this sense the med­ical fra­ter­ni­ty is seen a pro­tec­tive in­sti­tu­tion. The pro­tec­tion of the child aligns with the pro­tec­tive re­sponse of med­i­cine, and this rel­a­tive­ly new ap­proach en­cour­ages in­creased pro­tec­tion for our chil­dren, and utilis­es the links with the state and oth­er au­thor­i­ties to re­duc­ing the lev­els of child abuse in our so­ci­ety. And in a broad­er, more holis­tic ap­proach, one can sub­scribe to the view that in a de­mo­c­ra­t­ic so­ci­ety like Trinidad and To­ba­go, ear­ly med­ical in­ter­ven­tion is more jus­ti­fied than le­gal or civ­il in­ter­ven­tions that come as a re­sponse to the ac­tions of the abusers.