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Charlotte Amalie
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HomeNewsArchivesCHILD ABUSE AND NEGLECT: TRIAGE IS NOT ENOUGH

CHILD ABUSE AND NEGLECT: TRIAGE IS NOT ENOUGH

First of two parts
May 5, 2002 – Say there was a little clinic somewhere in the Virgin Islands, and one day a school bus pulls up. Inside the bus there's a hundred kids, and they're all hurt.
Some of them have broken bones and cuts, others have bruises and burns. The skin is peeling off of some of the burn victims. Then you get a bunch of kids who had accidental falls and black eyes from running into doors.
Then in come the serious cases. A girl who tried to hang herself, some drug o.d.'s, a boy who's half dead because his father went wild on him with a baseball bat. Another boy who got shot defending his mother from her boyfriend. A girl who was set upon by five men who raped her. There's also kids who got stabbed by some other kids.
They come in all at once, so the doctors and nurses get to work.
They accomplish a lot, but a couple of kids don't make it. A rape counselor arrives to take charge of the little girl. Doctors call a psychologist for the attempted suicide and patch the bruises. The o.d.'s ride out the night and get a good talking to in the morning.
But by the time they get down to the kids with the burns and broken bones, all that's left at the clinic is some gauze, a bottle of alcohol and a couple of Band-Aids.
Then another school bus pulls up …
If such a medical emergency were to occur, society would start shouting and keep on shouting until something was done. But this scenario is playing out every day in the lives of battered, abused and neglected children in the Virgin Islands. And sometimes it seems as if society doesn't want to know, at best, or doesn't care.
In 1992, on the day of the V.I. Carnival Children's Parade, a 2-year-old girl was beaten, burned and suffocated to death. Although her budding life was stamped out, Shaquanna Arnette left a legacy that protects the battered children of the Virgin Islands. In her name, the Legislature made child abuse a major crime, which it had not been before — which is why her abuser walked free after six months in jail.
In passing Shaquanna's law, the Legislature said "it is the policy of the government of the Virgin Islands to protect children from assault, abuse and neglect …"
Ten years later, protecting children is more of a challenge than ever before. Reports of child abuse and neglect to the Human Services Department are on the rise — with beatings and battering outpacing other kinds of abuse last year.
Reports to Human Services of child battering territorywide rose sharply in the year 2000, to 117 from 86 the year before. They increased again last year, when there were 133 recorded cases, the highest number since the department started keeping child-abuse statistics, in 1995. Last year, the V.I. Justice Department went to court to remove 47 children from their homes for their own protection. That, however, was a decrease from 2000, when 57 were removed.
In one of the most shocking case since Shaquanna's death, another 2-year-old, Rasheem Todman, died in December of repeated blows to the abdomen. A 32-year-old man who had been baby-sitting the child and four others at the time has been charged with second-degree murder in the case.
The professionals whose job is it to help battered children — from the legal, medical and social service fields — say those two horrific deaths are extreme examples. However, one local expert on child abuse says as many as 35 children have died in the Virgin Islands from abuse or neglect since the 1970s.
There is no question that widespread child abuse in the territory is real. What else is real for many social workers is an unending stream of abused children being added to already-staggering case loads.
"Sometimes they come in every day," Ferrynecia Benjamin, assistant Human Services commissioner, said. "We're being stretched to the limit."
For Assistant Attorney General Douglas Dick, head of the Justice Department's Division of Family and Special Victims Unit, rising reports of child abuse signal rising public concern. "We've seen an increase over the years," Dick said. "I think it's mainly more reporting, more attention by the community."
Like other government agencies, Human Services is operating under budget cuts put in place to cope with the Virgin Islands' fiscal deficit. Benjamin said the cutbacks have left about eight social workers on St. Croix, each juggling up to 40 cases per month. On St. Thomas, there is half that number in the department's Office of Intake and Emergency Placement, each dealing with up to 20 case a month, she said.
Sources familiar with intervention services say in spite of larger numbers of social workers, St. Croix is carrying higher caseloads because it takes longer to get to the bottom of things. Social workers face cultural and language barriers from large Hispanic populations, they say, and supervisors are reluctant to send social workers into some residential areas by themselves.
"We never have enough resources," Benjamin said. Yet the cry for help grows louder each year. From 1995 to 1997, the incidence of battered child cases territorywide skyrocketed, from 59 to 95. Over the next four years, battering reports increased by a third. And in spite of the Justice Department's commitment to prosecuting accused sexual offenders, reports of child sexual abuse rose from 43 in 1995 to a peak of 78 in 2000. Last year, the figure was 72.
A hierarchy of care
The result, Benjamin said, is a system which parcels out services in triage fashion — attending to the children with the most immediate needs and creating a hierarchy of crisis care.
"We're dealing with a chronic situation where we get new cases with children who need early intervention, but they don't get it," Benjamin said.
And as a result of that, she said, some children whose situations are not life-threatening lose their best chance at recovery — and also lose hope of getting better. Instead, they become depressed, act out their anger, get into fights, drop out of school, run away from home and/or turn to legal and illegal drugs for escape.
One child advocate says the situation is especially bad for older male children who have been abused but are in effect shut out of the foster-care system because of a lack of households willing to take them in. This, according to the advocate, may be one of the greatest factors in crimes committed by boys 14, 15 and 16 years old.
"There are no foster homes for teen males, or very few at best," children's court advocate Gail Shearer said. "These boys get sent home to the same environment that they were removed from — or become homeless and often quit school. I believe there is a correlation between crime in the islands and the number of kids who are quitting school without an education or a skill."
Shearer is the founder of the Virgin Islands chapter of CASA, an acronym which stands for Court Appointed Special Advocates. CASA is a national organization of trained volunteers who keep tabs on children making their way through the justice system.
Some advocates for child abuse victims say the hierarchy of care becomes most apparent in cases of child neglect, defined by law as failing to provide children with proper food, shelter, clothes, medicine and/or education — and also leaving children in the care of those who can't care for or may harm them.
Most reported, least addressed
Until 2001, Human Services records showed child neglect cases exceeding those of child abuse — with 161 cases in 2000, 163 in 1999 and 199 in 2000. Last year, unexpectedly, neglect reports dropped by half. Benjamin said she cannot account for this.
"Perhaps people are not reporting," she said. "Some of the multi-problem families could have relocated." She added, "A lot of children are neglected. It's not just children that are poor. We have a lot of single heads of household who
are having a tough time trying to make ends meet."
At KidsCope Inc. on St. Thomas, founder and director Dilsa Capdeville has developed a specialized service to aid children in crisis. There are sophisticated care models being used today to help rape and molestation victims, she said, but neglect victims deserve specialized care, too. She said children who are victims of neglect suffer much longer because their symptoms are harder to recognize.
"With physical abuse, you can see the scars," Capdeville said. "But with neglect, the scars are inside. We have a lot of children in our community who are being neglected on a daily basis — children who are left alone, verbally abused, left to fend for themselves too often, inappropriately supervised. Those are forms of neglect that we tend to bypass," she said — because the triage system demands that attention be focused on children in crisis from physical abuse.
But once the symptoms of neglect are recognized, authorities can find themselves facing situations where the remedies are often as bad as the problem.
Tuesday: What intervention can do, and what else must be done.

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