Inter Press Service, April 14, 1999

Rights -- Peru: Advocacy Groups Focus on Child Abuse

LIMA, (IPS) - The number of cases of child abuse being reported throughout Peru has increased at a steady annual rate of 15 percent over the past four years, according to children's rights organizations.

The groups were set up under the country's Child and Adolescent Rights Code and the Law for the Prevention of Family Violence as part of government efforts to enforce the rights of the child.

Actual rates of child abuse remain unknown, since an estimated 60 percent of the cases go unreported, according to sociologists. They figured, however, that in the last four years, more than 200,000 children have been victims of mistreatment or physical abuse.

Since 1995, the number of reported or discovered child abuse cases has grown by 15 percent each year.

"This does not necessarily imply that child abuse has increased, but that more people are turning to the institutions that deal with such cases," explained Pilar Dughi, national advisor for mental health for the United Nations Children's Fund (UNICEF).

"Many parents still think that the use of violence as a corrective method is acceptable, and in schools, some teachers resort to various methods of psychological mistreatment," she said.

"Despite the fact that education and parenting standards are changing, authoritarian models still exist in most families and schools. But the culture of children's rights is advancing and kids are exercising and demanding that their rights be respected."

There are now Child Abuse Treatment Units (MAMIS) in public hospitals in Peru and a police division has been set up which specializes in child protection. At the same time, Municipal Child Defense Offices (DEMUNAS) are opening throughout the country.

While the idea of children's rights was being promoted through the educational field, children continued to be frequent victims of mistreatment, medical statistics indicated.

Five percent of paediatric emergency services in Lima's public hospitals dealt with the physical abuse of young children with sexual abuse being among the most common, according to a report from the MAMIS unit at Cayetano Heredia Hospital.

Since 1995, 27 MAMIS units have been created in state hospitals throughout the country.

Cayetano Heredia Hospital is located in northern Lima in an extensive area of poor and marginal neighborhoods with a population of approximately two million.

According to physician Claudia Ugarte, MAMIS coordinator for the hospital, they have treated 4,826 abused children since 1995. The children were originally admitted as pediatric emergencies for accidents or for injuries from unknown causes.

In 37 percent of the cases, children showed serious psychological problems as a result of mistreatment, and 23 percent were victims of sexual abuse.

Similar rates were reported by the MAMIS unit of Lima's Children's Hospital, where the Children's Health Institute operates, according to Virginia Garaycochea, pediatrician and hospital department chief.

"The MAMIS teams are made up of psychiatrists, psychologists, social workers and doctors of various specializations," she said.

"Their creation was an important advance because now, as part of the admissions routine, we investigate emergency cases with an assumption of physical or psychological mistreatment."

According to reports, most cases of mistreatment or sexual abuse of children were committed by family members, including parents, grandparents, aunts, uncles, siblings or anyone in the family environment. They then took the children to hospital under the pretext of various types of accidents, according to Garaycochea.

"But we also see emergency pediatric cases brought in by specialized police where a neighbor has reported the abuse to the city's DEMUNAS, whose existence has become more known," she stressed.

Until a few years ago, it was difficult to detect mistreatment of children in medical exams, and more so for psychological mistreatment, "which is perhaps worse because it doesn't leave visible marks but can injure a child's personality and self- esteem, creating a depressed child," said Garaycochea.

Ugarte added that most abused children came from broken homes, where parents were separated or there was intra-family violence.

"Contrary to what one would think, fewer children are abused by alcoholic or drug-addicted parents. The majority of cases come from homes that appear normal but where family violence is usually hidden," she commented.

According to the doctor, statistics also disprove that fathers are more likely to inflict physical or psychological punishment.

Mothers were the primary agents of aggression against children, agreed Garaycochea, with the exception of sexual abuse cases.

The victims of sexual abuse are usually boys or girls between the ages of 5 and 7, and adolescents between the ages of 12 and 16.

"Sexual abuse is not just penetration, but also includes sexual touching and playing," observed Garaycochea.