Maternity Ward

She’s bagged a prized spot. A cot, right under the ancient ceiling fan that churns slowly, weighed down by decades of unmolested dust. A view from the window at whose edge sits a potted plant, struggling to breathe.

All around her, the steamy ward is buzzing. Patients sit fanning themselves with thick wads of cardboard, unselfconsciously scratching the sweaty spot where turgid belly meets bosom. Chattering, bantering, they alternately curse their fate and the authorities that run government hospitals. Nurses in harshly efficient uniforms, carrying trays and charts march around purposefully. The exhausted blades of the lonely fan noisily cleave the thick heat that permeates the room. Flat on her back, unmoving she lies, staring at the blades, hypnotized.

There had been a time, two weeks back, when she would probably have moved her head fractionally, every time someone entered the ward. Five weeks back, one could quite easily have spotted her walking around, begging the other inmates of the ward for a rupee coin to telephone her mother from the public booth down the corridor. And in the days when she’d been a fresh arrival at the hospital, she actually powdered her face and combed her hair every evening before visiting hours began.

But today, on her one hundred and eighty third day of existence in the ward, she lies still as a corpse. Since her arrival, thousands of visitors have passed through the ward but not a single one of them came for her. Only a letter came, two weeks ago, a brief, stark, unforgiving missive. “We are moving home. You don’t deserve to know the new address.” That was when she stopped moving or speaking or eating.

Today, as has been the case for a week now, the intravenous needle struggles to nourish the girl’s body, yet her sixteen-year old frame grows frailer and frailer. Only her bulging abdomen grows inexorably larger. Even the most hard-bitten inmates of the ward, veterans expectant with a third or fourth unwanted female child and left with no expectations from life, feel sorry for the girl. They speak to her, try to feed her, even stop envying her the cot under the fan. But the girl lies unresponsive, unblinking, barely breathing. The only sign of life is that swollen womb which sometimes stirs of its own volition.

The ritual round is in progress. Flanked by erect nurses in starchy white, the doctor has reached the cot under the fan. He studies the case paper tiredly. Unwed mother. Teenager. Attempted amateur abortion, failed. Admitted to the public hospital in the third month when abdomen started showing. Will stay in hospital, complete term. Will deliver and nurse the delivered baby for three months. 90 days after giving birth, will sign papers putting up the infant for adoption and leave the hospital. Will relinquish all rights to see the child ever again.

The facts are all there, succinct and common. Hardly an unusual case.

The nurses raise the girl’s hospital gown above her knees for the internal exam. All eyes in the room turn towards her – privacy and dignity are luxuries maternity wards in state hospitals can ill afford – but the girl does not seem to notice. Lifting her legs, the nurses bend them at the knees, opening up her body. The doctor’s fingers stab her painfully, but the girl does not flinch. Through the curtain of silence enveloping her mind, the girl can hear faint voices making meaningless noises. “Her bag has burst”. “She’s dilated”. “Labor is advanced, wheel her to the labor room”. Without warning, a sharp stab of pain wracks the girl. It is the first sensation she has felt in two weeks. It jangles her mind and body to life and she screams. A long, terrifying, animal like scream, “Ammaaaaaaaaaaaa…!”

Bludgeoned into silence the ward awaits the next scream or whimper, breathlessly. A sound a word or tear to mourn the childhood the girl has lost and herald the motherhood she will soon lose. But it does not come.

Within seconds, the girl is whisked off the cot under the fan and into the labor room. The bastard life in her fecund body will soon emerge. In her eyes, death has already burnt its indelible stamp.

Because I Care -- 3

FACTORS THAT INCREASE VULNERABILITY

There is no proto-typical victim of child sexual abuse. Any child may be victimized. However, abusers often target children with obvious vulnerabilities. A child who feels unloved and unpopular will soak up adult attention like a sponge. Children with family problems, who spend time alone and unsupervised, who lack confidence and self-esteem, and who are isolated from their peers are all likely targets.

Certain factors increase the vulnerability of children more at risk. Experts list these as being some of the key factors:

• A belief that "respect" means unquestioning obedience to authority
• Lack of appropriate sex education, either by way of vocabulary or boundaries
• Adult inability to teach children appropriate sexuality due to cultural norms and embarrassment
• Social norms giving children lower status than adults
• A child's predisposition to love unconditionally and trust implicitly
• Desire to please
• Values stressing family honour
• Disability
• Dysfunctional family
• Low self-esteem of the child
• Having few friends/ being isolated

PREPARING CHILDREN: KNOWLEDGE IS POWER

“I am filled with shame, disgust, guilt and low self-esteem. What I thought all along was affection, I realise now - after 12 years of sexual relationship with my uncle - was sexual abuse. AP, a 15 year old victim

There are no prototype sexual abusers of children. They could be anyone. Fathers, mothers, siblings, stepparents, grandparents, and other family members (uncles, aunts, cousins), neighbours, caregivers, religious leaders, teachers, coaches – in short, or anyone else who is in close contact with children. While we cannot teach children to suspect everyone around them, it is imperative to coach them on personal safety that can help prevent sexual abuse.

When preparing children, it is very important to:

Teach them to trust their feelings. Tell them it is OK to say “no” when someone they know and care about does something they do not like.

Instruct them about the difference between good touch and bad touch and that secrets about touching are not OK. Tell them that a touch that makes them uncomfortable or upset in any way must be reported at once. Children also need to understand that people they know could be capable of doing hurtful things.

Get yourself and the child comfortable discussing sexual abuse and referring to body parts by their proper names. A very important factor that keeps children from disclosing abuse is their lack of vocabulary of their private parts and therefore the resulting inability to describe acts of sexual abuse. Children are usually not taught the correct names for the private parts, and are told that "nice girls/boys" don't use those words that refer to private body parts or sexual behaviour. Debunk this.

Give the child a sense of self-esteem and confidence.

Involve your child in setting up a safety plan that is easy to remember. The plan must include a list of people the child can call for advice, information, and help.

Because I Care -- 2

WHAT IS SEXUAL ABUSE?

“Sexual abuse of children is a very real problem in India, and the situation is aided by the absence of effective legislation and the silence that surrounds the offence.” Asha Krishnakumar, child rights activist

The basics begin with understanding what constitutes sexual abuse and what its dynamics are, preparing children to recognize and deal with it, creating an open environment in which children can express themselves freely, learning to notice and react to sexually inappropriate behaviors towards children and responding when we think a child is being sexually abused.

A clear understanding of sexual abuse is critical in recognizing and dealing with it.

Experts explain child sexual abuse as the use of a child for sexual gratification by an older or more powerful person. The offender is usually an adult, but could also be a more powerful child. Both girls and boys are vulnerable. Besides being a public health concern, it is a crime punishable by law.”

The types of abuse include Touching and Non-Touching Acts such as these:

Touching

Fondling a child's body for sexual pleasure

Kissing a child with sexual undertones/inclinations.

Rubbing genitals against a child's body.

Sexually touching a child's body, and specifically private parts (breasts and genitals) and/or encouraging or forcing a child to

do likewise.

Making a child touch someone else's genitals, or playing sexual ("pants-down") games.

Encouraging or forcing a child to masturbate, with the child as either a participant or observer.

Encouraging or forcing a child to perform oral sex (mouth-to-genital contact on or by the child)

Inserting objects or body parts (like fingers, tongue or penis) inside the vagina, mouth, or anus of a child; includes attempts of these acts.

Non-touching

Encouraging a child to watch or hear sexual acts either in person or lowering the bars of privacy

Looking at a child sexually

Exposing one's private body parts to a child (exhibitionism)

Watching a child in a state of nudity, such as while undressing, using the bathroom, with or without the child's knowledge (voyeurism)

An adult making suggestive comments to the child that are sexual in nature. Commenting on the sexual development of a child

Encouraging or forcing a child to read/watch pornography, giving pornographic material or using the child in pornography

Quarter-life is the new Mid-life

"Who am I?" "What have I achieved?" "Is life meaningful?" "What have I got to live for?" The typical menopausal-andropausal questions are no longer the exclusive preserve of the 45+. Gen next is ridden with this nature of angst in its twenties. Yes, quarter-life is the new mid-life. And I am surrounded by sufferers! What on earth is driving them there so soon? Any guesses anyone?

Because I care

As part of a team creating a series of self-help books on various topics for children in the eight to twelve age group I had an experience that is imprinted in memory forever. I’d written a book on child sexual abuse by relatives – a fictional story about a little girl who had suffered sexual abuse at the hands of her maternal uncle. It was being tested with a group of twenty girls in Karnataka. The facilitator read out the story. There was pin drop silence in the room. The story concluded and suddenly on of the girls burst into tears and then another. Slowly they began to speak of their own experiences with sexual abuse and how they had been able to tell no one about it all these years. What echoed most resoundingly was the plea: “Please help us. We have no one to turn to.”

Back in Mumbai, when I shared this heart-rending experience with my college going daughter, her response was equally wrenching. “Ma,” she said, “this kind of abuse is everywhere. I have a friend who was abused regularly for four years by a caretaker. She’s so distraught I feel terrible. The abuse stopped many years ago, but she hasn’t got over it. It haunts her every day. She feels very helpless. And there are many cases like this.”

Statistics on recent sexual abuse cases against children tell a horrifying tale. A 1999 World Health Organization report stated that 1 in 10 children is sexually abused. But Lois J. Engelbrecht, a researcher working on the problems of child sexual abuse, quotes studies showing that over 50 per cent of children in India are sexually abused, a rate that is higher than in any other country. Huma Khan of the Kanpur-based Centre for the Study of Human Rights terms child sexual abuse as one of the least documented violations. But studies made across India, documented in Grace Poore's resource book The Children We Sacrifice show the wide prevalence of the problem.

A survey with 350 schoolgirls in New Delhi by Sakshi (an NGO) in 1997, showed that 63% had experienced sexual abuse by family members; 25% of the girls had either been raped, made to masturbate the perpetrator or perform oral sex. Another 1997 study on middle and upper class women from Chennai, Mumbai, Kolkata, Delhi and Goa by the NGO, RAHI revealed that 76% of respondents had been sexually abused as children, with 71% been abused either by relatives or by someone they knew and trusted.

Samvada's 1996 study on students in Bangalore stated that 47% of the respondents had been sexually abused with 62% having been raped once and 38% having been repeatedly violated.

Tulir-CPHCSA`s study in 2006,conducted among 2211 school going children in Chennai, indicates a prevalence rate of 42%. Children of all socio-economic groups were found equally vulnerable. While 48% of boys reported abuse the prevalence rate among girls was 39%.

Yes. It is a reality that sexual abuse of kids is rampant. As adults, we need to be acutely aware of the fact that any child we know is vulnerable to sexual abuse. As it is not always possible for us to ensure a child's safety, it is critical that we teach children how to protect themselves.

Struggle ends

Today I grasped the difference between overcoming and transcending. What a critical difference it is!

People who find life full of struggles tend to become "overcoming" specialists; warriors against obstacles and impediments so to speak. I kind of always put myself in this category without being aware of the fact. And I have used it as a weapon even when it came to impediments and obstacles within myself, internal to me...with very little success.

Then today a penny dropped. I was reading Osho's Secrets of Yoga where he says, "Overcoming is a repression: it is a conquering over. You fight, you force it down, you jump on the chest of it and you sit there, you wrestle with it; then it is overcoming. But it is always there and you are caught in a trap; now you cannot leave it because the moment you get off, it will get up. Overcoming is not the same as transcending...Overcoming comes through struggle. Transcending comes through understanding."

The passage spoke to me. Almost as if it was written just for me. It shed instant and blinding light on several areas of and incidents in my life.

I will try now not to overcome. Perhaps I might then transcend.

Finale

Death.

Ultimate. Embrace.

Holding. Tending. Mending.

Forever more.

Slumber.

Roje ki baat

Wet and weary night. Slightly frustrating auto ride looking for an address I can't find. The auto driver, a 50 something north Indian, hard of hearing can barely follow my instructions. Finally, after some texting and calling, I manage to obtain detailed directions. Relief. My mind turns to other important things -- like buying something for my hosts; a task I have left, as always, to the very last moment!@#$%^&!

I spot a wayside flower shop. Eureka. "Rokiye, rokiye" I shout practically into my auto driver's ear. He, somewhat reluctantly, halts the vehicle. In deference to my leg in plaster and crutches, the young boy manning the flower shop comes up to me. A couple of quick questions, some nifty bargaining in Bengali (I cannily latch on to the boy's accent) and he returns to make my bouquet. A moment passes and then the auto driver turns to me, points to a bunch of vivid purple orchids in the shop display and asks, "Madam, woh roje hai kya?" "Nahi, usko orchid boltey hain," I reply, not surprised that he doesn't recognise a videsi phool. Right then comes his googly, "Phir roje kaunsa hai, Madam? Humney kabhi deykha nahi."

Now my eyes pop! I'm trying to figure if this guy really means what he's saying. Realise he is for real. So I point out a bucketful of red roses to him. The guy steps out of his auto, walks up to the shop, picks a rose and actually buries his nose in it. Then he walks right back. My bouquet is ready. I pay. The auto driver revs up the engine, and before shooting off Schumi style, turns to me and grins, "Pehli baar roje sunkhaa Madam. Bahot khoobsurat hai."