violence against children WORLD REPORT ON - CRIN

326Violence against children in the communityServices for victims of violenceImproving pre-hospital care systems andemergency medical responses. In contrastto most of the other settings addressed inthis report, violence by and towards childrenin community settings includes a majority ofattacks involving firearms, knives and otherweapons. Such violence therefore gives rise tothe largest proportion of homicides across the0–18-year period of childhood, and accountsfor a significant proportion of long-term physicaland mental disabilities in children whosurvive severe violence-related injuries.Efforts to improve pre-hospital and emergencymedical responses are therefore likely to beparticularly valuable for reducing case-fatalityratios and disabilities due to violence in communitysettings. These should be connected toa range of services to support the physical andpsychological rehabilitation of children oncetheir immediate medical needs have been dealtwith (see box).Recovery, reintegration and rehabilitationservices. When children have been exposedto violent and traumatic events, a variety ofservices may be needed. These may includephysical rehabilitation, counselling services,and social worker follow-up to assist socialreintegration. Where domestic violence, traffickingor sex work is involved, ‘safe houses’or shelters may be necessary; however, it isimportant that these shelters provide for theneeds of the children as well for those of theirmother/caregiver. Making the access points forthese services widely known, especially to vulnerablegroups, is an important aspect of creatingcommunity confidence and also ensuringtimely access. The Thuthuzela Centres ofSouth Africa represent an emerging example ofthe importance of the integration of a range ofrelevant services in the interests of earlier andhigher-quality service to clients.Although it is frequently feared that childrenwho were used in armed groups and whocommitted acts of violence during a conflictmay continue this violence in their communitiesafter the conflict, research suggests thisis not necessarily so. A longitudinal study offormer child soldiers in Mozambique showsthat former child soldiers who are providedrehabilitative services, and are accepted backinto their families and communities, are ableto become productive, responsible and caringadults when they have received the requiredattention by child protection workers at thetime of demobilisation. Important componentsin successful rehabilitation included thecare and role modelling provided by trustedadults, traditional practices such as cleansingrituals, educational opportunities, apprenticeships,income generation projects, and the provisionof seeds and tools. 243