NAIROBI, Kenya, Nov 21 – “Hii ni mchezo ya watu wakubwa” (this is how grown ups play) is perhaps a statement that has coerced underage children into keeping silent following acts of sexual abuse, thereby leading to an increase in the number of child sexual abuse cases in Nairobi.
Between April 2008 and March 2009 Nairobi Women’s Hospital recorded a total of 2,805 survivors of sexual abuse cases; 91 percent were women and 9 percent men up from 6 percent in 2007-08.
Between April 2007 and March 2008 the hospital saw a total of 2,750 survivors of gender based violence. 2,338 were survivors of sexual violence and 412 were survivors of domestic violence. Of these 1,028 were children (896 girls and 132 boys).
Nairobi Women’s Hospital Deputy Programs Manager Alberta Wambua says the numbers indicate that women and children are most vulnerable and that the numbers could also mean that there are many other victims out there who are not accounted for.
“Most of the people who come here live in
Ms Wambua observes that some child sexual abusers brainwash their victims into silence and submission. She proposes civic education as a means of empowering victims of sexual abuse, adding that authorities advocate for policy change and implementation to help curb gender based violence.
“Child abusers are hardly strangers and they use the child’s natural fear, some make them feel guilty or embarrassed and threaten them with punishment or violence. Some make the children believe that they brought the abuse upon themselves or that whatever happened between them was not wrong. People, including children, need to know what gender based violence is; where they can seek help and what appropriate referrals to make,” she explains.
Ms Wambua adds that victims of sexual abuse have to be tested for HIV, Hepatitis B, STIs – as well as pregnancy – before any preventive drugs are administered. She states that the drugs must be given within 72 hours of abuse adding that there is great need for authorities to be sensitised to know that in the event that someone reports a rape case, then they have 72 hours to ensure that they get medical attention.
“It is very important for a survivor to get medical attention in 72 hours otherwise they are at risk of contracting sexually transmitted infections and unwanted pregnancies. The doctor will conduct tests for sexually transmitted infections as well as pregnancy (before the specified time frame elapses) and if they are negative he or she will administer Post Exposure Prophylaxis (PEP) to prevent HIV, a Hepatitis B vaccine, antibiotics to prevent STIs and a pregnancy contraceptive,” she however notes that there are people who get overwhelmed with the ordeal and refuse to take treatment.
Ms Wambua also explains that the victim needs to go through three other subsequent HIV tests as a precautionary measure adding that the first PEP treatment will be administered for one month. Apart from that the victim will also need to go through post exposure counselling to help them re-adjust.
“Another HIV test will be conducted after six weeks followed by another after three months and the final one after six months. The Hepatitis vaccine will be given again after one month and after six months. Counselling which helps them cope is also crucial for both the victim and his or her family, because they need to know how to handle the victim,” she states.
She further explains that part of the counselling includes adherence counselling because of the Post Exposure Prophylaxis, which is used to prevent HIV infections.
“The PEP treatment sometimes disturbs victims psychologically. Some ask why they need to take the medicine if they are HIV negative and it gets worse for the victims because of the mentality associated with HIV treatment. We however have to advise them to take this treatment as well as the follow-up treatment that needs to be done,” she says.
She states that the victim’s ability to move on with their life is the greatest challenge. Survivors who are able to move on with their lives serve as a great inspiration for other victims.
“When victims who were abused in the past come up and tell us that they are getting married it shows they have been able to move on with their lives. It gives hope to other victims because they hear encouraging stories from people who suffered the same abuse and were able to pick up their lives,” she observes.
A Rape Kit is a collection of equipment which is used to collect evidence and preserve it for the government chemists. Evidence that is usually collected includes the perpetrator’s pubic hair and bodily fluids like sperm. The Rape Kit contains the PEP, emergency contraceptive, Hepatitis B vaccine, antibiotics, a scalpel and gloves.
Victims of sexual abuse have been known to experience feelings of anger, resentment towards self and others as well as confusion. Family and friends of victims are encouraged to remain supportive of the victim. These are signs that your child has been sexually molested;
– Many times the sexually abused child is old enough to verbally make direct statements about the abuse and his/her perpetrator.
– Inappropriate sexual behaviour or play in an immature child.
– Recurrent abdominal pain without medical diagnosis
– Bedwetting or soiling
– Genital or anal trauma
– Sexually transmitted disease
– Genital bleeding or discharge
– Sleep disturbances (recurrent nightmares)
– Depression and social withdrawal
– Aggression, temper tantrums, impulsiveness
– Guilt and low self esteem
– Feelings of helplessness
– Hysterical reactions
– Excessive masturbation
– Suicidal threats
– Runaway behaviour
– Fear of intimacy and sexual dysfunction
– School problems and truancy
– Substance abuse