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Sajid Javed and Shamima Begum: The courage to act with compassion

Over the past few days I have found myself increasingly troubled by the case of Shamima Begum – the young British mother wanting to return to the UK with her baby after fleeing the country as a teenager in 2015 to join Islamic State in Syria.

Yesterday the Home Secretary, Sajid Javed, ordered that she be deprived of British citizenship and barred from returning to the UK.

 

 

I am concerned that this decision has arisen from a background of fear. In taking this step, I feel that the Home Secretary is:

  • ignoring the nature of the grooming and exploitation process that underlies radicalisation;
  • trying to tackle an organisation that tramples on human rights by further abusing the rights of an individual; and that
  • rather than protecting the British public, this measure could ultimately escalate both fear and resentment.

In view of this, I have written this letter to the Home Secretary.

To act with compassion requires courage, but is the only way to tackle the hatred and violence that IS embodies.

Do you agree?

 

Rt Hon Sajid Javed MP

Secretary of State for the Home Department

 

Dear Mr Javed,

I am writing to express my concern over the decision you have made to deprive Ms Shamima Begum of her British Citizenship.

While I appreciate your responsibility, as Home Secretary, to protect all British citizens, I do not agree that this step is either necessary or appropriate to do so. Furthermore, by taking this step, you are potentially depriving Ms Begum and her baby of one of the most fundamental human rights, that of having a home and a country.

When Ms Begum left London in 2015, along with her friends Kadiza Sultana and Amira Abase, they were all three children and, as I am sure you will acknowledge, were victims of the grooming and exploitation that lies beneath any radicalisation. As a paediatrician and specialist in child protection, I have come across many cases of children and young people who have been subject to all forms of criminal exploitation, including radicalisation. What is clear from these is the very insidious nature of the grooming process and how many of these young people just do not recognise that they are victims of exploitation. These issues were clearly identified in the 2017 Serious Case Review on siblings W and X published by Brighton and Hove Local Safeguarding Children Board and in Mr Justice Hayden’s judgement in London Borough of Tower Hamlets v B [2016] EWHC 1707 (Fam).

The government’s own Prevent strategy and Channel guidance recognise that the process of radicalisation is a complex phenomenon with many similarities to child sexual exploitation and to criminal exploitation in gang membership and county lines. Whether or not Ms Begum recognised it, she was a victim of exploitation. I have no doubt that the processes of grooming and exploitation have continued over the years she has spent with Islamic State in Syria.

In revoking her citizenship and thus denying her the support and care of her family, I believe you are taking the step of punishing the victim, rather than addressing the deeper root causes of radicalisation which led to her taking that step in the first place. This step will do nothing to make the British public safer.

Rather than taking punitive action against a vulnerable young mother and her child, surely, as a free, democratic and humane society, we should respect her individual rights, recognise the reality of the exploitation to which she has been subjected, and offer the compassion due to a mother who has already suffered the loss of two of her children.

By allowing Ms Begum to return to the UK with her child, the way is then open for a full and fair investigation into both the nature of the exploitation to which she was subjected before leaving this country and into any crimes that she may have committed and any potential threat she may now pose to the British people, following due process of the law of our country. That way we also open the possibility for Ms Begum herself to change, to learn from her experience, and potentially to take more effective steps to prevent other young people being exploited in this way.

 

Yours sincerely

Peter Sidebotham

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Reflections on retirement 5. Child protection: the good, the bad, and the ugly

Child Protection

It is strange how one’s life journey doesn’t always take you on expected paths…

As a junior doctor and trainee paediatrician in the early 1990s, there were two career avenues I decided I really did not want to pursue: child protection and research. So I often wonder how it is, 28 years later, that I end up retiring from a career as an academic paediatrician specialising in child protection.

I suspect it was my time in Cambodia that set the compass leading me down this route. And perhaps, even more so, returning to this country – having seen the huge needs of children and families in such an impoverished and war-torn country – and wondering where the most vulnerable children and families in our country were, and what I could possibly do to make a difference.

I may puzzle over it, but I certainly don’t regret the career choices I have made. It has been an incredibly rewarding. Looking back, there is so much I can celebrate and feel positive about.

But it has also been a hard journey and it is perhaps only recently, with the prospect of retirement looming, that I have come to appreciate just how much of a toll it has taken. There are times when I feel tired and I look forward to no longer having to take responsibility for decision making and giving advice on individual cases – knowing that my advice can have such profound impacts on the lives of individual children and their families.

 

The good

As I look back, though, there is so much I can appreciate. Like the little girl who took me by the hand and proudly showed me round her new primary school after I’d seen her for a follow up medical after the one that led to her being taken out of the awful home situation in which she was living. Or the stressed out mum who learned to praise the good she saw in her child…

I first saw this little boy as a toddler brought to my clinic with constipation and soiling. From the moment they entered the clinic room, his mother poured out a torrent of abuse, calling him a ‘little shithead’ and ‘the child from hell’. Over the following months, with appropriate treatment, his constipation gradually improved. Each time they came to clinic, I made a point of telling the little boy something positive about himself. I also, over time, started asking the mother what she liked about him. One of the last times I saw him, they both came in beaming and his mother (now calling him ‘my little angel’) prompted him to show me his latest star chart – a gold star on every day.

Or another family where a bit of joint agency detective work led to a positive outcome for everyone…

As a newly appointed consultant I was asked to see a baby girl with rib fractures discovered on a ‘routine’ chest x-ray. There were no other injuries, the girl looked healthy and thriving and both parents seemed to be devoted to her. And yet, she had serious and unexplained injuries. Further investigations, including a home visit, revealed that the family lived in a poorly maintained first floor flat. In order to reach their home, the father, who had a disabling muscle condition which left him unsteady on his feet, would climb a narrow, unlit stairway, holding his daughter under one arm, while he held onto the bannister with the other. It became apparent that at times he had stumbled and, in doing so, gripped his daughter tightly round the chest – the likely explanation for the fractures. With a multi-agency child protection plan, rehousing to somewhere more suitable, and some parent training and support, the family were able to stay together and protect their daughter from further harm.

 

The bad

Sadly, not all the cases had such good outcomes, or such readily apparent solutions. I am sure there have been times when I have missed cases of abuse, given unhelpful advice, or simply been unable to reach any clear conclusions. I know that there have been times when decisions I’ve made have resulted in children being left in abusive environments. Equally, there have been times when my advice has ended up with children being unnecessarily removed from families. That is the hard road we walk balancing child protection and family support, where far too often, we just don’t know what route to take.

And there have been other cases where the best solution has been apparent, but we just haven’t had the resources to see it through…

I was asked to assess the baby of a couple with learning difficulties. The baby had suffered sunburn after the mother had applied after-sun lotion, not realising that it wasn’t actually sun-block. The baby had signs of neglect with poor growth and developmental delay. Both parents clearly loved their child, wanted the best for him, and would never knowingly harm him. A psychologist had assessed the parents’ capacity to take on board instructions and to be able to parent their child safely. The advice of myself, the psychologist, and the social worker was that, given enough support, these parents could look after their child. However, the levels of support that would be needed to ensure the child’s safety and wellbeing, were well beyond the resources available in the local authority, and the child was placed in care.

 

And the ugly

One of the most disturbing cases I have dealt with in my career was as a young registrar, early in my training. I was called to the emergency department to see a 2 year old who had been brought in with some minor injuries. From the moment I walked into the cubicle, the young girl, sitting on the examination couch, watched me with an intent, watchful expression. Throughout my examination she didn’t react at all – neither smiling nor crying – while her father sat stony-faced on the other side of the cubicle. I concluded that her injuries were accidental in nature and didn’t need any treatment, and I sent her home with her father. What really upset me though – and has haunted me ever since – were five words written in biro on her arm: ‘I am a little bitch’.

I have often wondered what happened to that little girl. What kind of a home did I send her back to? What kind of person did she grow up to be? Did anyone else pick up on the emotional abuse she was experiencing and act where I had failed to act?

 

Child protection does have its ugly side. Fortunately they are rare, but there are parents and others who deliberately and maliciously harm their children – physically, emotionally, and sexually. In the course of my career, I have had to deal with that. It isn’t easy seeing the pain that some children have to live with. Nor is it easy seeing the pain of parents who have their children taken away from them; of families torn apart by abuse, domestic violence, addictions. Or seeing adults carrying the pain of abuse they have suffered – from parents or partners, and sometimes just not knowing how to deal with that pain, or the stresses of life that can be so overwhelming that children end up getting caught in the middle and hurt themselves.

It isn’t easy. But it is important.

Which brings me back to the good, and one of the greatest privileges I have found through working in this field: the people. The very real and ordinary families who have shared with me some of their struggles, hopes and dreams; the amazing children, so many of whom show incredible resilience, joy and love, even in the face of such devastating adversity; and the professionals – social workers, police officers, nurses, teachers, doctors and others – all dedicated and committed to helping others, passionate about making this world a better place for children.

 

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Reflections on retirement 3: Longing for a world where children don’t die

Last week I received an email from one of our administrative team at the medical school, reminding me that I have just over two months to fully clear my office – to shred or archive all old research papers and data, get rid of the mountain of books and files, empty my filing cabinet, clear my hard drive, and hand back all my IT and other equipment.

Once I’d got over my initial shock and the reactive ‘I can’t possibly do that, there’s far too much, and what about all that academic stuff I want to keep on?’ I realised that perhaps it wasn’t such a bad thing after all. I do need to wake up to the fact that, come October, I will no longer be a paid employee of the University with all the benefits (and responsibilities and frustrations) that brings. It is also high time I had a good clear out of all the accretions of 13 years as an academic.

 

When was the last time I opened that file of research interviews I did back in the late 1990s?

 

So, taking the bull by the horns, I started work on one of my filing cabinet drawers. After filtering through each file, I think I ended up with just two or three papers worth keeping.

This particular drawer held all my case notes from the South West Infant Sleep Scene study I did with Peter Fleming in the early 2000s. As I started shredding the interviews from those early home visits to bereaved families, I reflected on the blessing it has been to meet with, and hopefully offer some support to, so many amazing families.

 

Longing for a world where children don’t die

The dramatic drop in SIDS rates in the 1990s has been one of the most impressive successes of epidemiological research this century. I have been immensely privileged to meet and work with many of the leading researchers from around the world who contributed to this work, and in my small way, to contribute to ongoing research, teaching and practice that has seen SIDS death rates continue to fall to this day.

At times it has been truly heart-breaking to meet with families in the horrendous trauma of their child’s death. But it has also been encouraging to know that the work we did in Bristol and elsewhere has contributed to more compassionate and thorough responses to unexpected child deaths. I have, over the years, had many expressions of thanks from bereaved families who have appreciated the care and support they have received from my colleagues in health, police, and social services.

And, even more encouragingly, over the course of my career, I have seen the numbers of children’s deaths decrease.

When I started my medical training in 1982, nearly 8,000 children in England and Wales died before their fifth birthday. By the time I started work as a consultant, that figure had fallen to less than 4,500. Now, as I retire, the figure is just over 3,000. Just looking at the past two decades, that suggests there are 15,000 children and young people alive today who might not have been if our mortality rates had stayed at the 1997 level.

Has my work contributed to that fall?

Perhaps I will never know, but I like to think that, in some small way, my research and teaching and the little steps I have taken to engage with individual parents and children might have made a difference to some. And perhaps, with so many others making their small contributions, we may just be moving towards a world where children don’t die.

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Child Sexual Abuse: Ethics and Evidence

‘Over the last 40 years, child sexual abuse (CSA) has become a regular, if discomforting, focus of public concern and attention. A constant stream of news items, investigations and arrests, public inquiries and statements from politicians and authorities can leave the impression that child sex offending is being countered by the full opposition of the state and community. This impression is deceptive. There have been, of course, meaningful advances in child protection and therapeutic responses to victimised children and adult survivors, and improvements in public awareness and understanding of CSA. Nonetheless, the challenges that CSA have always posed to child protection, health services, law enforcement and society at large – including the prevalence and secrecy of CSA, the complexities of prosecution and the multiple impacts on victims – remain with us today. Meanwhile, patterns of sexual offending against children continue to evolve with the development of new technologies and strategies for sexual exploitation.’

 

 Child Sexual Abuse: Ethics…

The latest issue of Child Abuse Review is a themed issue focusing on the ethics and evidence of child sexual abuse. In an accompanying editorial, freely available online, our Australian associate editor, Michael Salter, explores some of the issues raised by the papers.

We include a paper by David Pilgrim which provides a powerful check on impulses towards the minimisation of CSA. The tendency to minimise the abhorrence of child sexual abuse is thoughtfully challenged by Pilgrim, and is addressed later in the issue in a paper by Ethel Quayle and colleagues analysed material from the International Child Sexual Exploitation database. One of their disturbing findings was an increase in self-produced images (sexting), and the high levels of coercion involved in such activity. This adds a challenging new dimension to the ongoing effort to protect children from such abuse.

‘Two‐thirds of self‐produced images involved coercion, challenging the view that self‐produced images are less concerning than those taken by others. Manipulating or coercing a child to produce a nude or sexual image emerges in this study as a common and harmful strategy among online child sex offenders, casting debates on so‐called ‘sexting’ in a new light.’

 

… and Evidence

Two helpful reviews in the issue provide up-to-date research evidence on the causes of CSA (Estelle Clayton and colleagues) and structural brain abnormalities associated with it (Damyan Edwards). The themed issue also includes new research on multi-agency responses to CSA (Lindsay Voss and colleagues) and on the impact of sexual abuse on boys and men – typically an under-researched and overlooked group (Madelaine Ressel and colleagues).

‘The impact of sexual abuse on boys and men is a prominent and ongoing concern’’

 

Click on the link below to see the full table of contents, read Michael Salter’s editorial and for details of online access.

 

Child Abuse Review Volume 27, Issue 3

Table of Contents

Editorial: Child Sexual Abuse: Ethics and Evidence. Michael Salter.

Reviews

Academic Disputes about Adult‐Child Sexual Contact: A Critical Realist Appraisal. David Pilgrim.

The Aetiology of Child Sexual Abuse: A Critical Review of the Empirical Evidence. Estelle Clayton, Christine Jones, Jon Brown, Julie Taylor.

Childhood Sexual Abuse and Brain Development: A Discussion of Associated Structural Changes and Negative Psychological Outcomes. Damyan Edwards.

Original Research

Multiagency Response to Childhood Sexual Abuse: A Case Study that Explores the Role of a Specialist Centre. Lindsay Voss, Helen Rushforth, Catherine Powell.

Children in Identified Sexual Images – Who Are they? Self‐ and Non‐Self‐Taken Images in the International Child Sexual Exploitation Image Database 2006–2015. Ethel Quayle, Linda S Jonsson, Karen Cooper, James Traynor, Carl Göran Svedin.

Abuse Characteristics, Multiple Victimisation and Resilience among Young Adult Males with Histories of Childhood Sexual Abuse.  Madelaine Ressel, Jennifer Lyons, Elisa Romano.

Training Update: Eradicating Child Sexual Abuse (online toolkit) by the Lucy Faithfull Foundation, 2016. reviewed by Sarah Nelson

Book Review: Dark Secrets of Childhood: Media Power, Child Abuse and Public Scandals by Fred Powell and Margaret Scanlon, Policy Press, Bristol, 2015. reviewed by Marguerite L Donathy and Nicole Horton

 

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Child Abuse Review: Rising to new heights with our 2017 Impact Factor

I’m not usually one to boast, but as a co-editor of Child Abuse Review I’m feeling really pleased with the latest news from the journal.

2017 Thomson Reuters Journal Impact Factor

The 2017 Thomson Reuters Journal Impact Factors were released this week, and I’m really proud to report that our impact factor for Child Abuse Review has shot up from 1.543 to 2.253!

CAR Impact Factors 2011-17

This is particularly encouraging as we had set our target, in our 2014-19 business plan to increase it to 1.2 by 2017.

The result places the journal 4th out of 42 social work journals and 9th out of 46 in family studies.

 

Publishing high quality research that has an impact on practice

While journal impact factors have their limitations, I think this is a recognition of the fact that we are managing to publish really important, high-quality research in child protection, and that this research does have an impact on practice.

Artwork by Harry Venning
Artwork by Harry Venning

This was also reflected in the 2018 Wiley prizes for the best papers published in Child Abuse Review, which were announced at the BASPCAN congress in April:

 

  1. First Prize – Beyond the Physical Incident Model: How Children Living with Domestic Violence are Harmed By and Resist Regimes of Coercive Control by Emma Katz (Liverpool Hope University) – Published in Volume 25 Issue 1 (2016)

 

  1. Second Prize – The Prevalence of Child Maltreatment across the Globe: Review of a Series of Meta‐Analyses by Marije Stoltenborgh, Marian J. Bakermans‐Kranenburg, Lenneke R.A. Alink and Marinus H. van IJzendoorn (Leiden University) – Published in Volume 24 Issue 1 (2015)

 

  1. Third Prize – Risk and Protective Factors for Physical and Emotional Abuse Victimisation amongst Vulnerable Children in South Africa by Franziska Meinck (University of Oxford), Lucie D. Cluver (University of Oxford, and University of Cape Town), Mark E. Boyes (University of Oxford), Lodrick D. Ndhlovu (Tintswalo Hospital) – Published in Volume 24 Issue 3 (2015).

 

All three of these papers are freely available online for the next year, as are all our editorials and many other papers, so do take a look.

All this could only have been achieved through the hard work of our editorial team, Diane Heath, our editorial manager, the publishing team at Wiley, and, of course, our authors, reviewers and readers. Thank you all.

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That’s how the light gets in

And so the 10th BASPCAN child protection congress is over. The banners have come down, the delegates have gone their various ways, and the PowerPoint slides deleted from the desktops.

It has been an incredible four days: a time of inspiration and challenge, of hard grind and relaxed friendship, of shared laughter and shared tears.

I have been inspired by meaningful research, emerging ideas, and examples of innovative practice. I have had some of my own perspectives challenged. I have been encouraged equally by young and enthusiastic researchers, and by committed practitioners who have walked many years. I have been overwhelmed by the generosity, commitment and hard work of all those who have contributed to the congress, and the feedback and encouragement of so many participants. And I have been amazed at the vigour and resilience of children, young people and adults – survivors in the fullest sense of the word.

For me, though, the essence of this congress was captured in the fragile, vulnerable daffodils that decorated our plenary lecture hall. In spite of all our efforts, they kept flopping over and looking muddled. And yet, they continued to bloom, bringing their bright colour and life into that hall.

Perhaps we are all a bit like that – fragile, vulnerable children; wounded, hurting survivors; struggling practitioners and academics – dependent on each other for encouragement and support; and yet, in spite of all our limitations, bringing hope and life. And united in our longing for a world in which no child ever has to experience the terror and pain of abuse or neglect, and where each of us is valued as a unique, wonderful and beloved person.

Ring the bells that still can ring

Forget your perfect offering

There’s a crack, a crack in everything

That’s how the light gets in

– Leonard Cohen

 

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The Impact of Neglect on the Developing Brain

Clare Shaw, Poet in Residence for the BASPCAN 10th International Child Protection Congress considers the impact of neglect on the developing brain.

With just 3 weeks to go, it’s not too late to register for the congress and what promises to be an exciting and stimulating programme combining cutting edge science, evidence-informed practice, and reflective creative space.

You can read all of Clare’s poems and find out more about the congress here.

The Impact of Neglect on the Developing Brain 

 

Dreams:  

you can’t find your mother. 

 

A series of rooms  

one after another  

 

each smelling of urine  

and dust.  

 

And of course   

there are ghosts –  

 

you fear them like murder.  

By night, there are spiders and mice.  

 

Then sleep is a space  

with no air.   

 

It’s too hot.  

All of your words have been sucked out.  

 

The books on the shelves  

are rotten. You read them.  

 

You almost forgot that door 

and the corridor leads to outside.  

 

In the yard,  

how small you are  

 

in this rain  

you will never own.  

 

It’s all falling around your ears.  

The rabbits are still in their hutches 

 

and no-one has fed them 

for years.  

 

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International Women’s Day

International Women’s Day is a great opportunity to celebrate so many amazing women who have made a difference to our world. And, for me, to remember with gratitude the many incredible women I have had the privilege to know.

It is also an opportunity to recognise the ongoing violence and abuse that affects so many women and girls across the world.

The statistics are horrific.

But even more salutary are the individual stories that lie behind those statistics – salutary not just because of the appalling circumstances so many women and girls have to live with, but also because of the amazing courage, resilience and hope that they embody.

 

Today also marks one month till our 2018 BASPCAN international child protection congress. And, as it approaches, I am looking forward to it more and more. And not least because of some of the incredible women whom we have lined up as speakers.

People like:

Elaine Storkey, former president of Tearfund, and long-standing campaigner for women’s rights, who has powerfully documented the reality of violence against women and girls in her book, Scars across Humanity

Clare Shaw, our poet in residence, whose poems reflect the depth of expertise held by someone who has walked with trauma

Siobhan Beckwith, whose talk, Hearts in the Goldfish Bowl, draws on her experience coming alongside mothers who have had to live apart from their children

Kish Bhatti-Sinclair, a reader in social policy and social work, who will be challenging us to rethink our own prejudices, discrimination and unconscious bias

Anne Fine, the celebrated author, whose novels capture, in a very human way, the reality of many children’s lives

 

There are so many more I could mention. And I’m really looking forward to meeting them and hearing what they have to say.

It is not too late to book, so do take a look at the programme on our congress website:

BASPCAN Congress 2018