Challenges in rehabilitation of child abuse survivors: A case series.

Abstract

Background: Child abuse (CA) in Sri Lanka remains a significant public health and social issue, often leading to long-term psychological and developmental consequences. Effective rehabilitation is crucial for the well-being of survivors and includes several aspects such as counselling & psychological support, cognitive & educational support, medical care, family & community support, and social reintegration & protection. In the local setup, multiple challenges are encountered that occasionally hinder this process. This case series mainly highlights the difficulties faced in ensuring a safe environment for CA survivors in Sri Lanka. Case study: Six cases involving child sexual abuse and physical abuse will be discussed. These cases address issues such as teenage pregnancy, special needs, psychiatric illness, re-admission while under probationary care and ethical & legal complexities in parenting. These cases aim to highlight gaps and grey areas in the local setup, particularly regarding the availability and adequacy of temporary and long-term safe placements for vulnerable children. Conclusions: Many children remain in unsafe or unstable living conditions, increasing their vulnerability to further abuse. A safe environment is a key factor in preventing such incidents, as children who continue to live in unsafe settings remain at high risk for re-victimization. Furthermore, limited availability of protective placements for children with special needs, as well as lack of interim care between medical treatment and discharge, remain gaps in the Sri Lankan system that require urgent attention. Without proper protective measures, other aspects of rehabilitation such as psychological support and educational interventions, are likely to fail. Therefore, ensuring secure protective placements and fostering a safe environment must be prioritized in the rehabilitation process.