Medicine

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Child sex abuse-a global problem
(Sri Lanka College of Obstetricians and Gynaecologists, 2008) Padumadasa, G.S.
There has been increased awareness globally of child sexual abuse and harassment. In Sri Lanka too, the National Child Protection Authority has probed many incidents of child'sexual abuse and highlighted them via the media, thereby increasing the public awareness. Although worldwide, girls have a higher prevalence of sexual abuse, according to studies in Sri Lanka, more boys are abused than girls. The incidence increases with age. Anumber of psychological and medical consequences have been described as associated with child sex abuse. Psychological disorders are reported as having an increased incidence in those who have been abused sexually and include depression, eating disorders, anxiety disorders, substance abuse, somatization, post traumatic stress disorder, dissociative disorders, psychosexual dysfunction in adulthood and a number of interpersonal problems including difficulties with issues of control of anger, shame, trust, dependency and vulnerability. Furthermore there are physical effects such as bruising, abrasions, lacerations and these children are more likely to be infected with sexually transmitted diseases. Majority of cases of child sexual abuse go unreported due to fear and shame. Most cases of child sex abuse occur within the privacy of the family and this adds to the difficulties of diagnosis and management.