This year is already turning out to be grand, but I need to catch you up on some important events that happened in December. I was invited by the Forensics department of Chiang Mai University Medical School to present a series of workshops on child abuse and neglect (CAN) to their residents. Residents from Emergency Medicine also attended.
The four workshops were each 2.5 hours long (about 10x the amount of training on CAN that they normally get) and encompassed a general overview of CAN worldwide and the situation as we know it in Thailand (which isn’t much at all). I also covered physical, sexual, and psychological abuse and neglect. One session covered various “special topics” such as abuse of boys, forensic photography, medical child abuse (Munchhausen by Proxy), and a newly completed (but not yet published) report by a Thai colleague for UNICEF on physical punishment in Thai schools, government shelters, and juvenile justice centers. The last report was quite revealing to me and I think produced some discomfort among the doctors.
As usual, I learned a lot in the process. I learned about CAN but also more about Thai society, their attitude towards abuse and neglect. In fact, it is so pervasive that most people don’t realize that what most of the world considers abuse are acceptable forms of punishment here. When I asked the residents if they thought that child abuse was a big problem in Thailand, one or two said yes. Most thought it was a relatively minor problem. Furthermore, it is always a treat for me to be able to be involved with medical students and residents wherever I am.
While not a 100% given, child abuse is commonly a precursor to suffering other forms of abuse or for becoming a perpetrator. There is not space here to delineate what some spend a doctorate to study, but children who suffer from child abuse and neglect are at risk of developing maladaptive behaviors that make them vulnerable to a myriad of physical and mental ill effects immediately as well as into adulthood.
By training physicians in recognizing child abuse and addressing it appropriately, I can hope to prevent some kind of abuse, exploitation, or perhaps even trafficking from happening to a youngster. Perhaps, I hope, a champion for the cause may arise out of this group.
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