https://imcjms.com/public Ibrahim Medical College Journal of Medical Science https://imcjms.com/public/registration/journal_full_text/73 Tue, 02 Aug 2016 12:13:13 +0000 In Bangladesh, a large number of children are deprived of their basic human rights due to unacceptable health, nutrition, education as well as social conditions. In addition, children are exposed to severe forms of sexual, physical and mental abuses at home, in the work place, in institutions and other public places. The nature and extent of violence against children irrespective of age, sex and class has been increasing day by day. These include physical torture, rape, homicide and sometimes heinous attacks with acid. Children are also victims of child labor and trafficking, both of which are treated as the most severe form of child exploitation and child abuse in the world today. This review article is aimed to focus on the present situation of various forms of child abuses in our country. Data collection is based on secondary sources of information from Dhaka Medical College Hospital, One Stop Crisis Center (OCC),UNICEF, Ministry of Home Affairs, Ministry of Women and Children Affairs, several Dhaka based organizations and news paper clipping. Ibrahim Med. Coll. J. 2015; 9(1): 18-21     Across the globe, children are exposed to different forms of violence that impedes their mental, physical, psychological and moral growth.1 Child abuse or maltreatment as defined by World Health Organization (1999) constitutes all forms of physical and/or emotional ill-treatment, sexual abuse, neglect or negligent treatment or commercial or other exploitation resulting in actual or potential harm to the child’s health, survival, development or dignity in the context of a relationship of responsibility, trust or power.2 The definition could range wider to include societal forms of violence- the effects of poverty, exploitative child labor, lack of adequate health care and education and non deliberate neglect by the state, parents and others. However, the focus here is on interpersonal violence to children. Article 1 of the Convention of the Rights of the Child defines a child as “Every human being below the age of 18yrs unless, under the law applicable, majority is attained earlier”.3 No group of child is immune from being a victim of child abuse, although girls are more often vulnerable of sexual abuse than boys. For all other types of abuse and neglect, statistics are about equal for both boys and girls.   Violence against children is causing increasing concern in Bangladesh as it is not confined to any specific zone. Home, workplace, street, and prisons- everywhere children become easy prey of violence.4 A study was conducted in 2005 about crime statistics by the Ministry of Home Affairs, Government of Bangladesh. The study revealed that there were 555 cases of child abuse reported to the police on that particular year. By 2010, this number increased to 1,542 (Table 1). Table 2 shows the scenario of homicide committed on young children over the years till March 2016. These cases are only the reported cases and may not reflect the real situation of child abuse and violence in the country. Table-1: Year wise reported cases of child abuse from 2001 to 2010     The epidemiology of child abuse can be classified into three sub headings- host of abuse, agent of abuse and environment. These are discussed below: Host of abuse   Child abuse can take several forms. The four main types are physical abuse, psychological abuse, neglect and sexual abuse. a.Physical abuse: Excessive intentional physical injury to a child as a result of punching, shaking, beating, biting, kicking, burning or otherwise physically harming the child. These include- battered baby syndrome, corporal punishment. When an infant or child suffers repetitive physical injuries inflicted by a parent or guardian in circumstances where accident can be excluded, it is most likely to be regarded as physical abuse. The common physical lesions are in the skin in the form of skin bruising.6 Bruising occurs around the limbs and in infants around the ankles. The older child may be gripped by the upper arms in order to be shaken known as Shaken Baby Syndrome that often results in permanent neurological damage in 80% of cases or death in 30% of cases. This sort of abuse in young children of 1-2 yrs may cause important regions of the brain to fail to form or grow properly resulting in impaired development.These alterations in brain maturation have long-term consequences for cognitive, language & academic abilities.7       c. Child neglect: Child neglect includes failure to provide basic physical, emotional, medical and educational need a child.1   a. Child labor: Child labor is considered as one of the worst forms of child exploitation around the world.13 Children are forcefully engaged in risky work including pushing rickshaws, as helpers at railway stations, launch ghat & bus terminals, breaking bricks at construction sites, carrying groceries for consumers in shops, peeling and packing in industries and large scale factories. The minimum age for employment according to Child Labor Code is 14yrs depending on the nature of the work, but this is not implemented in Bangladesh. Violence in the work place includes using abusive languages, low payment, long working hours, no leisure time or holidays and beatings. These children become mentally unhealthy and suffer from emotional stress and developmental problems. c. Violence on the streets: Children living on the streets are mostly vulnerable to abuse and exploitation according to report prepared by UNICEF in 2009.These children grow up without suitable accommodation, protection, education, health care, food, safe drinking water, security, supervision, recreation and guidance. Criminal networks engage these children in commercial sex work, smuggling, stealing and distribution of drugs and weapons.16 The early experience of child abuse can trigger changes in child’s behavior including discipline problems, insomnia, nightmares, anxiety, depression etc. This also causes problem with mental development of a child which interrupt his feelings, empathy, sympathy, reasoning, rational thinking and benevolence. Children who have been abused or neglected are more likely to be arrested as juvenile offenders & are more likely to be a sadist and involve in criminal activities as an adult.1 Measures to be taken to reduce child abuse   Child abuse is a silent epidemic. It is a social crime and is therefore a threat to our civilization. The intense media spotlight, often on particularly horrifying individual cases of violence against children suggests-greater prevalence. Children are probably the most neglected members of our society. As a result they are consistently becoming easy victims of all sorts of abuses. Violence against children must be stopped and the judiciary, law enforcing agents, parents and guardians of the children themselves must be sensitized to the provisions of the convention on the Rights of the child and the laws protecting children in Bangladesh. It is important for everyone to know the signs of child abuse and how to report it. We all share a responsibility to help keep our children safe. Children have the right to be children, to be loved, cherished, educated, nourished, clothed, pampered as children when they are children. Our vision should be to establish a healthy, child-rights enriched society, free of abuse, exploitation and discrimination for the disadvantaged children of Bangladesh. References 2.    Report of the consultation on child abuse prevention.  Geneva: World Health Organization; 1999. 4.    Amnesty International. Children in South Asia-securing their rights. London: Amnesty International; 1998. 6.    Shepherd R. Child abuse in Simpson’s Forensic Medicine.12th ed. London: Arnold; 2003. 8.    Mohiuddin H, Khatun A, Kamal MA. Corporal punishment in Bangladesh school system: an analytic appraisal of elimination strategy directions. ASA University Review 2012; 6(2). 10.  UNICEF. Ending child marriage: progress and prospects. UNICEF; 2014.  12.Breaking the Silence. Non-commercial sexual abuse of children in Bangladesh. Dhaka:Breaking the Silence; 1997. 14.  UNICEF. Daily lives of working children. Dhaka: UNICEF;1997. 16.  Aktar J. Health and living conditions of street children in Dhaka City. Dhaka, Bangladesh: ICDDRB; 2004. 2026 Ibrahim Medical College. All rights reserved.