violence against children WORLD REPORT ON - CRIN

“I am 8 years old and was raped when I was 6. My parents made a complaint to the police and he wassent to jail. But I cannot stay where I live anymore. You know what they call me here?They have nicknamed me the “tainted” (la déchirée)…even when I go to the well toget water the kids call me that. I want to run away from here”.Girl, 8, Eastern and Southern Africa, 2006 VIII3Table 3.1 – Global burden of mental disorder attributed to child sexual abuseMental disorderPercentage of global diseaseburden attributed to childsexual abuse (CSA)Females (%) males (%)Depression, alcohol and drug abuse 7–8 4–5Post-Traumatic Stress Disorder 33 21Further victimisationExperiencing violence as a young child alsoincreases the risk of further victimisation, andan accumulation of violent experiences. Thisreinforces the importance of recognising andpreventing violence against children as earlyas possible. Similarly, child sexual abuse hasbeen clearly established as a risk factor forsexual victimisation in adulthood, and the riskis compounded when it includes intercourseand other forms of violence. 110 The extent ofcontinued victimisation in the home has onlybeen assessed in a few countries where registersand databases are routinely updated. Inthe UK and the USA cases where violence tothe child has been referred to official childprotection agencies, rates of re-referral rangefrom between 5% and 24% within a 1–4 yearSuicide attempts 11 6Panic disorders 13 7Source: Andrews G et al. (2004). Child Sexual Abuse. In: Ezzati M et al. (2004). Comparative Quantificationof Health Risks: Global and Regional Burden of Disease Attributable to Selected Major Risk Factors, Vol 2.Geneva, World Health Organization, pp 1851–1940.follow-up. 111,112,113 In cases where a child hasbeen referred on at least two occasions, riskrises significantly.Family violence against children is believed tobe associated with increased risk of violence inother settings. A study in the UK found thatchildren witnessing domestic violence are alsomore likely to be victims of bullying, 114 andsimilarly a study of elementary and middleschool-aged children in Italy showed that beingbullied at school was associated with witnessingparents’ violence at home, especially for girls. 115Children who have been sexually abused, orextremely neglected, or who have experiencedviolence at home, may run away or drift intoa street life which exposes them to the risk ofsexual abuse or exploitation. This happens toboys as well as girls: according to a report from65Violence against children in the home and family