Child abuse : patterns of physical and sexual child abuse presenting at Karl Bremer Hospital and the knowledge and perceptions of the Ravensmead Community on child abuse
Thesis (MMed)--Stellenbosch University, 2015.
Background Child abuse is a serious and devastating problem rooted within our communities. According to the South African Police Services (SAPS) crime statistics of 2006 & 2007, the four most common crimes committed (and attempted) against children were rape, common assault, and assault with attempt to do grievous bodily harm. Because this problem has it's roots within our homes and communities it must be unpacked from a community level. Aim and objectives: This study aims to describe the patterns of child abuse in the Northern Suburbs of Cape Town and to gain insight into the knowledge and perceptions of the Ravensmead Community regarding child physical and sexual abuse. Methods This was done by exploring the knowledge and perceptions of the Ravensmead community on various aspects of child physical and sexual abuse including perceptions of victim and perpetrator profiles, responses to victims of child physical and sexual abuse, their knowledge of and access to avenues of help. The study also describes the patterns of child abuse in the Northern Suburbs of Cape Town as documented in the case record reviews of children presenting to the Karl Bremer Hospital at the Rape crises Centre. In order to explore the knowledge of the Ravensmead community of child physical and sexual abuse, the researcher designed a structured questionnaire and conducted a door-to-door survey. A total of 279 respondents were obtained. Specific areas of enquiry included knowledge of definitions, perceptions of perpetrators, perceptions of predisposing circumstances and perception of avenues for help and where education programs should be aimed. Patterns of Child physical and sexual abuse presenting at the Rape Crises Centre at Karl Bremer Hospital was determined by conducting a case record review. Information regarding victim and perpetrator profiles, injuries sustained and home circumstance as documented in these case records was described. An in-depth interview conducted at the Rape Crises centre with parents of child victims of physical and sexual abuse provided qualitative information relating to patterns and perceptions of child physical and sexual abuse. Data from these three methods was then triangulated. Study design The researcher has chosen to do a descriptive study using methodological triangulation. The aim of the research is to describe the patterns of child abuse (physical and sexual) and to gain further insight into the perceptions and knowledge of the Ravensmead Community regarding child sexual and physical abuse. This was undertaken using a descriptive study design. A combination of qualitative and quantitative methods was used to enhance the overall validity of the results. Setting Ravensmead is an impoverished community in the Northern Suburbs of the Western Cape. The high rate of crimes committed against children in this community is a reflection of the situation in the rest of the country. The Karl Bremer hospital Rape Crisis Center is the centre to which all cases of child sexual abuse and child physical abuse occurring in the northern suburbs of Cape Town presents. Staff is trained in offering the necessary medical, medico legal and psychological support to victims abuse. Results Only 15% of respondents to the questionnaire survey demonstrated a comprehensive understanding of what constitutes child abuse. Although respondents demonstrated understanding of some characteristics relating to victim and perpetrator profiles they failed to recognize certain circumstances that predisposes to child abuse. The In-depth interviews also found that most families of victims of child sexual abuse did suspect that the abuse could occur under the circumstance, which it did. The perception that children are sometimes to blame for the abuse is still held by some members of the community although they are in the minority. Few respondents were able to identify avenues for help other than the police station. However, the in-depth interviews demonstrates that several fears exist regarding reporting abuse to the police, reducing the practical accessibility of this service. The mean age of victims presenting to the Karl Bremer Hospital Rape Crises centre was 6.18yrs and 36% of cases presented was during the period from November to January. Absence of visible injuries could not exclude the diagnosis of sexual or physical abuse. Information relating to home circumstances and perpetrator profiles was lacking. Conclusion The research suggests that knowledge regarding child physical and sexual abuse in the Ravensmead community is lacking. Barriers exist to accessing avenues for help within the community. Greater community empowerment is required in order to effectively combat the problem of child physical and sexual abuse.
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