Despite multiple warnings about the compromised routes to the hospital due to Fiba, individuals still chose to attend the medical conference. These attendees had just come from a productive multistakeholder meeting focused on health and prevention, which explains their sustained excitement to rush to the venue. Dr. Bernadette Madrid, after being properly introduced, confidently asked the audience about the amount of time they had. Her firm yet soothing tone and engaging smile captured everyone’s attention. A friend sitting beside me jokingly whispered that she could take the whole afternoon. Her response resonated with all of us, as both the speaker and the topic held immeasurable value.
The next question posed by Dr. Madrid was thought-provoking. She asked whether asthma or child abuse was more common. Some of us in the room were uncertain about the answer, considering that asthma is a frequently diagnosed condition during clinic visits. Before diving into statistics and potentially confusing us, she provided a clear definition of child abuse, also known as child maltreatment. Referring to the World Health Organization’s website, she explained that child abuse encompasses various forms of abuse and neglect experienced by children under the age of 18. This includes physical and/or emotional ill-treatment, sexual abuse, neglect, negligence, and exploitation that harm a child’s health, development, survival, or dignity within the context of a responsible, trust-based, or power-based relationship.
A nationwide study conducted in 2015 aimed to determine the prevalence of violence against children and youth. Out of 3,866 respondents aged 13-24 from 172 barangays, the study found that 80% of them experienced some form of violence in their homes, schools, workplaces, or communities. More than three in five individuals suffered from physical, psychological, or peer violence, while 22.4% were victims of sexual abuse. Additionally, 10% experienced physical neglect, and a significant number felt psychologically neglected by their caregivers. The study also revealed that LGBTQ+ individuals had a higher prevalence of violence compared to heterosexual males and females. Surprisingly, less than 10% of the respondents disclosed their experiences of abuse, primarily confiding in friends and parents. Only one in ten sought professional help.
Dr. Madrid then discussed the signs of child abuse, emphasizing that bruises are often overlooked, especially during the precruising stage when a child is not yet able to walk. She introduced the TEN-4 acronym, which helps clinicians recognize potential child abuse cases and distinguish them from accidents. The acronym stands for bruising in the Trunk, Ear, Neck, and includes infants less than four months old. Any abdominal injury also requires further investigation. While physical examination findings are important, Dr. Madrid stressed that they only scratch the surface. The true impact of child abuse lies in the deep psychological and emotional scars it leaves behind.
During my early years of training, I encountered a case of a physically battered child whose mother initially refused to reveal that the father was the perpetrator. Her reason was that he was the family’s breadwinner. Unfortunately, there was no child protection unit at that time, so we referred them to a government hospital where they could file a medicolegal report. However, before doing so, we warned the father about the consequences he would face if there were any repeat incidents.
Thankfully, there are now laws and policies in place to address child abuse. As healthcare professionals, it is crucial for us to record, document, report, and refer cases to relevant agencies such as the Department of Social Welfare and Development, local government units, the National Bureau of Investigation, the Philippine National Police, and the Commission on Human Rights. For the general public, the Children Protection Network Foundation offers free online courses for those interested in championing the cause. We should treat child abuse as we would a disease, working together to protect children’s human rights. After all, it takes a community to raise a child.
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