Despite the gravity and prevalence of child sexual abuse, and the nuanced handling required in such cases, most hospitals in the city don’t seem to have a protocol in place for examining victims.
Unlike adult sexual assault crimes, most such cases against children go unreported and are only detected by doctors when the victims come to the hospital complaining of unexplainable pain or injury, said experts. This means that the responsibility on doctors to detect and then report such cases is higher.
A forensic doctor from JJ Hospital, Byculla, said most cases are handled either by paediatricians or gynaecologists. “We are only called if the child has sustained an injury,” the doctor said.
Doctors expressed the need to sensitise the medical fraternity so that they can raise an alarm when children come for treatment of suspicious injuries, on their genitals, for instance, of sexually transmitted diseases (STD).
“Once it is ruled that the child did not contract the STD through the mother, it is important to report the matter to the police. There should also be a protocol to provide psychiatric counselling to the child,” said Dr Indrajit Khandekar, assistant professor, Forensic Medicine, Mahatma Gandhi Institute of Medical Sciences, Wardha.
Experts also cautioned that cases pertaining to sexual violence against children needs to be handled with greater sensitivity, as the child rarely understands the crime s/he has suffered.
Keeping in mind the rise in cases of assault against children, the civic run Nair Hospital’s forensic department has instituted a ‘Multi Disciplinary Child Protection Centre’, a first-of-its kind facility that exclusively looks into cases of child abuse.
“If a department receives a suspected case of child sexual abuse, a team of forensics, psychiatrists and doctors treating the patient examine the child together. If each doctor in turn asks the same questions to the family and the victim, it will only add to their agony,” said Dr Shailesh Mohite, head of the hospital’s forensic department, adding that the doctor should develop a rapport with the victim.
Under the law, any private doctor is permitted to collect evidence, said Dr Duru Shah, member, Federation of Obstetric and Gynaecological Societies of India. “In case of child abuse, doctors need to be very sensitive when collecting evidence,” he cautioned.
“We even get false cases, where children lie about abuse. Other times, children may lie about the accused, as they are afraid. We had a case where a girl kept insisting that she was raped by an outsider, but later confided in me that her elder brother was raping her,” said Dr Mohite.