Is it a reality in India? Is the girl child a welcome guest in every household? It is not in several families. Take the story of baby Pushpa (not the original name) who was born to a young couple six years ago. The mother suffered severe haemorrhage during the first delivery and had five blood transfusions. Five years after the birth of the first child, she was expecting the second baby. Her blood investigation revealed that she was HIV positive, but did not harbour the disease. Hence she went through the pregnancy.
A close relative of the father paid substantial sums of money to the midwife, who usually gives baby bath to do away with the child if it was a girl. Delivery took place at midnight and the newborn girl baby was immersed up to the waist in boiling hot water during baby bath. The child sustained deep third degree burns below the waist, developed shock and was brought to the neonatal Intensive Care Unit of a tertiary hospital.
The call came at 4 a.m. and the appearance of the baby was pitiable. But there was no time for thinking and we went into action. The child was treated for burns aggressively and after eight weeks was discharged with good wound healing and handed over to the parents.
The issues that we face are:
(a)Will we be able to honestly identify the perpetrator?
(b)Who will endorse the treatment expenses?
(c)If she develops complications like scars in later life, who will look after her?
For any good effort there is an answer and we succeeded in looking after Pushpa who is six years old now and attends regular school without scars. How can we inflict burn on this new born? There are no answers.
Child abuse by burning should be considered as the most likely explanation for inflicted burns of children between the ages of 0 – 18 years if they are non-accidental. Although general abuse is increasing, abuse by burning is often unrecognised. The hallmarks of intentional burning of children include a story which does not explain the wound, specific burn patterns and a peculiar evasive characteristic behaviour of the parents, caretakers and children.
We have analysed a group of 615 children during the years 1992 to 2009 and 9.33 per cent were proved cases of abuse due to burning. Most of the published literature quotes a higher incidence in younger children, our analysis has a higher incidence in older children and the causes reported are self-explanatory. When the injuries were carefully analysed, our investigation proved that non-accidental burns in children demand a thorough investigation of medical, social and emotional factors.
Unlike the cases of child abuse due to burning in the West, we have had more cases of contact burn with hot appliances or order or burning with chemicals particularly acid in older children. Fire-walking is a religious ritual practised in some countries of the East, particularly India. Usually adults practise fire-walking. But during the festive season, many toddlers, between the ages of 2-4, are made to walk on burning cinder by themselves; and sure enough, these kids fall and sustain flame burns and get admitted to hospital many times with serious burn injuries. Parents vanish from the scene to enjoy the festivities of the season.
In our group, there are older children employed as domestic help. They are abused by burning with hot metal sticks, and hot ladles are sometimes used to inflict strokes. When female children employed in households resist the sexual advances by their employers, they get punished by the slashing of acid on the perineum. These girls suffer deep burns. Sometimes burning cigarette butts are used to inflict burn injuries on teenage girls for the same reason.
(The writer is Chairperson, CTMRF, K.K. CHILDS Trust Hospital, Chennai. email: firstname.lastname@example.org)
Keywords: child abuse