A field work report from a seminar at the Department of Social Welfare, Kogakkan University, organised by Professor Toyoko Yasui
Introduction: Toyoko Yasui, Associate Professor, Kogakkan University
The number of instances of child abuse in Japan has been drastically increasing and cases range from physical and mental damage to fatalities. They are ranked from physical abuse, the largest in number, on to neglect, mental abuse, and cases of sexual abuse, which are the smallest in number. Factors leading to these abuses in Japan are classified into the following four reasons:
- first, parents’ anxiety about bringing up children, caused by single parenthood set against a background of the change in family size and urbanization;
- secondly, child care abandonment owing to poverty;
- thirdly, unhealthy abused relationships between children and their stepfathers after the mother’s remarriage;
- fourthly generational chain reactions following experiences of abuse in the care-takers’ childhood.
Under these circumstances, the Child Abuse Prevention Act was enacted, which has been reinforced and revised year by year. Centering on the child counseling office, various measures for prevention, early detection measures, treatment, and aftercare have been actively introduced and implemented, but they are only a drop in the ocean.
The following case work papers which I am introducing are reported by my seminar students at the Social Welfare Department of Kogakkan University. In this seminar, most of the students chose child care as their research project. We have been investigating child abuse problems through reading previous academic documents (mainly books) and through field work throughout the academic year of 2006. In this report, I am introducing some of my students’ reports.
We visited the ward in a local child medical center, where a staff medical doctor showed them three cases of abused children – a ‘shaken baby’, a patient whose brain was damaged by being thrown down a staircase, and a neglect case of a seriously psychosomatically disabled child. The Doctor explained these children’s treatment processes together with appalling photos of abused children. In witnessing this serious process of treatment, the students no doubt realized the inhuman cruelty of the crime called child abuse.
After this experimental field work, students began to investigate how to eradicate child abuse through policies; how they can find effective measures for each case; how to develop collaboration between medical, social work, and educational organizations. They were able to reconfirm their research points of view and had precious opportunities to gain new incentives toward their research.
The following reports are only part of our education and research projects concerning the actual circumstances of child abuse in Japan.
Report 1 (Ms. Mayu Noro) : A hearing at a Child Medical Center
We had a hearing session about the abuse of babies and infants with a medical doctor at the child medical center. I was able to develop my research on child abuse with this field work session, having more realistic knowledge and deeper understanding than reading data, which obviously increased my interest in it.
First of all, abuse starts at a very early stage of one’s life, with new-born babies. How can parents abuse such a baby when it cannot even hold up its own head? X-ray photographs showed its brain was deformed and there was bleeding in the skull, at which I became lost for words. Another case was of a baby who had serious damage in its brain owing to ‘shaken baby’ syndrome. I also felt deep sorrow imagining the baby’s reality and its future life. I strongly insist we have to eradicate this kind of abuse.
According to the doctor, medical staff can only treat children who are brought to the hospital and have contact with infant nursery home specialists. Hospitals cannot be involved in children’s individual situations. Infant nursery homes have the important role of supporting victims, judging cases properly, caring for abused children, caring and intervening with abusers and others.
I also realized that it was the same in every case, that family environments were abnormal or at least special. Although the abusers’ actions should not be forgiven, they do not bear the sole responsibility for these cruelties. Social factors should be taken into consideration. Abuse does communicate from generation to generation under hardships such as raising two disabled children, having no partner to raise them with, and other factors. It is not the matter of family alone but also that of society.
The role of social work is to try to understand and accept sufferers’ feelings and predicaments and give them good assistance. I realized social workers’ responsibility toward society and my own mission to work for them, by seeing the photos of a baby who had died from undernourishment and abuse.
Report 2 (Ms. Miwa Kawamori) : A visit to a Child Medical Center
We had a precious time and experience visiting the child medical center, in which we witnessed various cases of child abuse. Above all, the case of the death of a three-year-old male infant who suffered from hydrocephalus had a strong impact on me, and gave rise to some questions as to why parents did not take him to the hospital at a point when he could have recovered through medical treatment and why people around him, neighbors and caretakers, did not realize the seriousness of the situation. If administrators and municipal officials had investigated the case beforehand, he could have been saved.
In Japan endless cases like this occur, owing to the lack of investigation. I felt offended by the present child protection/ custody system. In spite of good counseling organizations for abuse, hospital and social support organizations are still somewhat special facilities and hard to access for help. There is a need for a means of communication between hospitals and patients. We need more social workers and more active and effective networks among medical institutes, child counseling facilities, and social welfare institutes in order to treat patients’ mental care and solve social problems so that we can cope with these cases much more speedily. The number of abuse cases known at present is only the tip of the iceberg. After sending children back to their homes, we also need to keep watching them and avoid repetition of their abuse.
Our field work and session at Special Ward in Osaka gave me a better understanding of the present situation of child abuse. Making much of what I learned there, I would like to investigate what we, social workers-to-be, can do for the wellbeing of children.
Report 3 (Mr. Masaki Inagaki): About the actual conditions of child abuse
The first abuse case was a child suffering chronic subdural hematoma. The child’s mother insisted that the three-month-old infant tumbled down and hit his head, but it was impossible. This baby’s illness brought her to a child counseling office and a social worker interviewed her. The counselor generally decides whether the abused child should be sent to an infant home or not. But in this case, problems considered included the mother’s inability to understand the situation, the possibility of continued abuse happening, and what would happen after sending the child back. I found that social workers would be needed when parents declined to go to counseling at the hospital, although hospitals have their own counseling systems for parents who have child care problems.
The second case was abuse by the mother’s partner. This child was suffering from serious convulsions and consciousness disturbance. The child turned out to be suffering from ‘shaken baby’ syndrome, whose main symptoms were weak crying, weak sucking, and snoring. Shaken-baby syndrome is an illness of the child’s brain blood vessels being cut because of being swung back and forth and right and left. I cannot understand the mother’s attitude, because she seemed to love the child at first. Why did she overlook her partner’s cruelty toward her baby? I learned that counselors can give permission for her to take the baby home, depending upon the outcome of interviews with her and family conditions, but it is clear the child will be abused as long as she lives with her partner.
The last case was a child suffering from congenital hydrocephalus. The patients were brothers. The child suffering from this illness had raised intracranial pressure which caused developmental defects and leg paralysis. They had to undertake a ‘shunt operation’ to remove cerebrospinal fluid by a tube. Their mother was advised to take him to the hospital to avoid blockage of the shunt tube.
After a while counselors had to acknowledge that the children had been neglected by their mother, becoming very thin. The mother stopped coming to the hospital without knowing of this seriousness, and thus the younger brother was seriously damaged. The hospital team and counselors immediately took action to save the elder child and he was safely hospitalized.
I have a question about this treatment and disposition. Could the children not have been protected or removed from their mother compulsorily? If it was not possible under the present legal system, I think child counseling offices should be given authority to take its emergency action.
We are indebted to Professor Hisayo Ikeda, Kogakkan University for translating this article from Japanese into English.