violence against children WORLD REPORT ON - CRIN

5in both staff and resources, leading to increasedmortality rates among these children comparedto their peers in family environments.In Mexico, children in psychiatric facilitieshave been found lying on mats on the floor,some covered with urine and faeces. Lackingadequate staff supervision, some children wereseen eating their own faeces and physicallyabusing themselves. 67 In rehabilitation centresfor children with mental disabilities bedriddenchildren emaciated from starvation anddehydration have been found. Bottles of foodwere provided by staff, but children who wereunable to pick up the bottles due to their disabilitygot no nourishment. 68In many facilities for children with disabilities,the children have no access to education, recreation,rehabilitation or other programmes.They are often left in their beds or cribs forlong periods without human contact or stimulation.Such deprivation often leads to severenegative physical, mental and psychologicaldamage, and in many instances to death.Violence by other childrenChildren in residential care are vulnerable toviolence from their peers, particularly whenconditions and staff supervision are poor.Lack of privacy and respect for cultural identity,frustration, overcrowding, and a failure toseparate particularly vulnerable children fromolder, more aggressive children often lead topeer-on-peer violence. Staff may sanction orencourage peer abuse amongst children – eitherto maintain control or simply for amusement.While recent studies are not common onthis issue, studies from the 1990s in the UK,Russia, and elsewhere indicated that bullyingand sexual abuse by peers while children werein care widespread. 69 ‘High-impact’ physicalviolence was also reported widely, ranging fromknife attacks to kicks and punches, primarilyfrom peers. 70 In some cases, children reportedthat orphanage staff pitted them against eachother for their own entertainment. 71Impact of institutionalisationon children’s healthand developmentThe overuse of institutions for children exactsenormous costs on children, their families, andsociety. Extensive research in child developmenthas shown that the effects of institutionalisationcan include poor physical health, severe developmentaldelays, disability, and potentiallyirreversible psychological damage. The negativeeffects are more severe the longer a child remainsin an institution, and in instances where theconditions of the institution are poor.The risk of developmental and psychologicaldamage is particularly acute for young childrenunder the age of four, which is a critical periodfor children to bond to their parents or caregivers.72 Even in a well-staffed institution, it isunlikely that the attention they might receivefrom their own parents would be replaced bystaff. One study on institutions in Europefound that young children (0–3 years) placedin residential care institutions without parentswere at risk of harm in terms of attachmentdisorder, developmental delay and neural atro-189Violence against Children in care and justice institutions