Monthly Archives: August 2016

Another incident of Child Abuse

17th August, 2016,

On my way back to Dhanbad from Kolkata, I happened to travel in general class, which was packed with people. The reason could be of Raksha Bandhan, a festival where the brother shows love for his sister and pledges to protect her. As the Durgapur station approached  I noticed something unusual.
A family with a mother and her four kids (3 boys and 1 girl) were on board. They somehow, caught my attention. The elder boy who was around 15-16 yrs of age was  was more inclined towards his younger sister and wasn’t paying attention towards other kids. Every move he made was to grab her face or to kiss her lips, sooner he started repeating it.  The girl child who was about 6-7 years old was trying to resist him, but failed to do so.

 

 

Most of the people ignored the act, and those who noticed considered it as child’s play.   This young boy made a possible reach to his genitals and was trying to seek pleasure irrespective of the resistance, which gave a gist of his intentions. I didn’t understand whether the mother was ignoring it or didn’t want to admit the act. Lately I realised that she possibly didn’t understand that it was an abuse.
I wanted to raise my voice against it but, was scared of the crowd. I wasn’t sure about the public’s reaction . This incident made me think of several questions. Was this happening for the first time? If yes, what would happen to that little girl in future getting abused by her own elder brother? What about the thought running at this tender age? How was he misled? How come no one from the family ever noticed such act? If this is just the case of one family, could be a similar cases of other families? Can such things encourage small underage boys to do heinous acts such as rape? What is the solution? I kept thinking, I should have raised my voice, told the mother, but I didn’t. I just didn’t. What you would have done in such situation?

One thing is for sure charity begins at home but crime too!!

 

By

Kevin Lodha, M.Tech-Petroleum Engg.

IIT (ISM) Dhanbad.

Sexuality Education in India

Dr.Shantanu Abhyankar MD OBGY graciously agreed to share his views on sexuality education in India.He talks about sexuality, menstruation and pornography. Our mate Dr. Jyoti Jagtap adds her insights like its not the length or the width but its the skill, have a look at this hilarious yet informative interview!

Precocious Puberty

What is puberty?

Puberty is the period during which the capability of sexual reproduction is attained.  Puberty includes rapid growth of bones and muscles, changes in body shape and size, and development of the sexual organs. This usually happens between ages 10 and 14 for girls and ages 12 and 16 for boys.

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Precocious puberty is development of the following characteristics before age 8 year in girls and before age 9 year in boys.

Signs and symptoms in girls include:

  • Growth of breasts.
  • First period (menarche)

Signs and symptoms in boys include:

  • Enlarged testicles and penis
  • Facial hair (usually grows first on the upper lip)
  • Deepening of voice

Signs and symptoms that can occur in boys and girls include:

  • Pubic or underarm hair
  • Rapid growth
  • Acne

Precocious puberty is classified as central and peripheral.

 In central, gonadotrophin dependent, when it results primarily from early hypothalamic-pituitary maturation. Central Precocious Puberty represents 80% of cases of Precocious Puberty and occurs more commonly in girls, with a female to male ratio of at least 3:1.

In peripheral, gonadotrophin-independent puberty, the primary event is increased secretion of adrenal or gonadal sex steroids or exposure to exogenous steroids. Some forms of peripheral Precocious Puberty occur in boys, such as chorionic gonadotrophin secreting tumors and familial gonadotrophin-independent peripheral Precocious Puberty resulting in constitutive activation of the LH receptor and hence testosterone production. [Symposium on Growth and Its Disorders-II, Growth in Precocious Puberty. Justin J. Brown and Garry L. Warne ]

Possible complications of precocious puberty include:

  • Short heightChildren with precocious puberty may grow quickly at first and be tall, compared with their peers. But, because their bones mature more quickly than normal, they often stop growing earlier than usual. This can cause them to be shorter than average in the long run.
  • Social and emotional problemsGirls and boys who begin puberty long before their peers may be extremely self-conscious about the changes occurring in their bodies. This may affect self-esteem, increased stress and increase the risk of depression.
  • Early menstruation can be very disturbing for girls who are of age 8 or younger who are not able to take care of themselves in those days. Parents can help by educating their child about what physical changes are occurring to them, how to take self care.
  • Decreased concentration, poor scholastic performance, bullying, teasing at school. Child may refuse to go to school.
  • Parents may have trouble dealing with child’s early development or worry regarding kids sexual interests but there’s no strong evidence that kids with early puberty are likelier to be sexually active at a younger age

Make an appointment with your child’s doctor if your child has any of the signs or symptoms of precocious puberty. Treatment of this is available. If you, your child are having difficulty coping, seek counseling. Psychological counseling can help your family better understand and handle the emotions, issues and challenges that accompany precocious puberty.

Dr. Aprateem Mukherjee

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Puberty

What is puberty?

Puberty is the process of physical changes through which a child’s body matures into an adult body capable of sexual reproduction. It is initiated by hormonal signals from the brain to the gonads: the ovaries in a girl, the testes in a boy. (Wikipedia) The process lasts for around 4 years, and starts as early as 8 in girls and as early as 10 in boys. Puberty is one aspect of sex education that students generally learn in schools; hence parents don’t invest their time in telling their kids about puberty. However, the absence of sex education classes in India has left this task on the able shoulders of ‘that’mate.

What happens during puberty?

Both girls and boys go through a series of physical and emotional changes during this process. Many kids think whether the changes happening to them are normal. The onset of puberty varies among individuals. It could be dependent on both genetic and environmental factors are likely involved in the timing of puberty. The onset of the puberty also depends on the body fat or body composition of the individual. Some individuals go through an early onset of puberty which is termed as precocious puberty, it occurs both in boys and girls.

 

What are the physical stages of puberty in girls and boys?

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In girls the first sign of puberty is usually the growth of their breasts. Pubic hair and hair on legs and arms start to grow too. Around 18-20 months later girls usually have their first period. A few of girls have hair on the upper part of the lip and under arms. Many girls get acne . They also have a white vaginal discharge. This is completely normal.

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Most girls gain weight, they stop growing tall after around 4 years of puberty. Girls develop body fat along most of their body parts like their upper arms, thighs and upper back. Their hips grow rounder and waist gets narrower.

Menstruation is one of the major stages of puberty in girls. It’s the onset of womanhood in girls. It prepares a girl’s body so that she can bear a child. Many girls don’t completely understand the reason behind menstruation. They even don’t understand a women’s reproductive system completely. That can make the process seem even more mysterious and confusing for both girls and guys.

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What is menstruation?

Menstruation is a woman’s monthly bleeding. In menstruation body sheds the lining of the uterus (womb). Menstrual blood flows from the uterus through the small opening in the cervix and passes out of the body through the vagina. Menstrual periods last from 3 to 5 days. The average menstrual cycle is approximately 28 days long. Women undergo rise and fall of levels of hormones during the menstrual cycle.

What happens during the menstrual cycle?

Estrogen helps the lining of the uterus to grow and to thicken. This lining of helps nourish the embryo if a pregnancy occurs. At the same time the lining of the womb is growing, an egg, or ovum, in one of the ovaries starts to mature. At about day 14 of an average 28-day cycle ovulation occurs, the egg leaves the ovary.

The egg then travels through the fallopian tube to the uterus. Hormone levels change and thus preparing the lining for pregnancy. During these 3 days a woman is most likely to get pregnant if the egg is fertilized by a man’s sperm. If the egg is not fertilized, it will break apart. The hormonal level drops, and the thickened lining of the uterus is shed during the menstrual period.

 

In boys the first sign of puberty is that their testicles get bigger and the scrotum begins to thin and redden. Pubic hair also starts to appear at the base of the penis. Their voice breaks, they get wet dreams (involuntary ejaculation at night), they have hair growth at different body parts like under arms and pubic hair.

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Mood changes in puberty

Puberty may be an excruciating experience for some kids. They deal with a lot of physical changes like change in body odor, acne and weight issues. They may even go through depression, low self-esteem, aggression or unexplained mood swings

How to inform kids about puberty and the changes they are going through?

It never too early to start talking to your kids about puberty. It’s better to prepare children about the physical and emotional changes they will go through after the onset of puberty. Kids will have all sort of questions, however don’t wait for your child to come to you with questions, they may never come, because they don’t know its OK talk to you about this sensitive topic.

These days, kids are exposed to so much information about sex either from TV or from Internet, that they generally know things forehand. Yet, talking about the issues of puberty remains an important job for parents because everything on the Internet is not reliable.

You can start talking to your kids as early as they are 3 years old. You can inform them about good touch and bad touch. You can ask your kids following questions and then try answering them if they struggle:

Why are the differences between a girls’ and a boys’ body?

What do we call the different parts of girls’ and boys’ bodies?

Where do babies come from?

How are your friends similar or different to you?

Which parts of my body are private?

What is a safe zone?

Who all are in the safe zone?

Whom to tell when somebody touches your private parts?

How can I say ‘no’ if someone wants to touch me?

Whom should I tell if someone touches or wants to touch my private parts?

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‘Having Period is not a problem, Missing it is’

As a usual habit, the nurse started sending Medical Representatives inside my cabin once the patients were done. The afternoon was about to get over. With mobile & Facebook, I was trying my best to ignore all the things they were saying. Anyway, they don’t have anything new to talk. But that day, one of his sentences grabbed my attention. He said. “Now the festive season is about to start, so women will rush to get their periods postponed. Don’t forget to give them our medicines. Please sir, the company has set higher targets for the festive season. Without your help, it won’t be possible for me.” He kept one pack of his medicines on the table while leaving. I was stunned.

It was convenient for him to convince a small town doctor, so this business of altering period is very profitable you see! I knew that pharmaceutical companies can go to any levels to increase their sales, but I never knew they would go so low on this. Understanding the nerve of Indians, they had brought the product up right in time. I just admired the company for that.

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Actually this is usual habit followed during Pooja, festivals and pilgrimage. Sometimes travel or exams might be the reason but not usually. This is so simple, women come to us, answer 2-3 questions and get the medicines to postpone their periods. I just think how silly these women are. They are still clinging to primitive concepts.

When time comes, the hypocrite inside me starts talking. Usually I give out prescriptions whenever someone asks for it, but whenever a lady comes upfront I ask her ‘What about your education?’

‘X’

The value of X can be anything, from an illiterate to a doctorate.

‘If the period comes, you should not participate in the function, you know that right?’

They have typical answer like ‘We have a function at home…’.’My family doesn’t allow this…’. Whatever be the ‘X’, in my entire career of 20 years I never got the answer ’I do not believe this. I have to do it against my will’.

I visit schools a few times to deliver lecture on puberty. Girls always regard period as a “problem”. On a funny note I always say, ‘Having Period is not a problem, Missing it is the real problem’. I tell girls not to refer period as a problem, just say you got your period. If you are ashamed to speak in Marathi, then use M.C. or if you just want to show off your English use Chums, but don’t refer it as a problem. Referring it as a problem, the natural body process seems so negative, doesn’t it? The use of problem doesn’t make it negative, but the negativity inside you makes you use the word problem. Anyhow I feel this word should not be used. This makes the negativity inside you grow further. On top of that people agree with it also.

This leads to further misunderstanding. If any trouble occurrs due to the periods, doctors wash/clean the uterus. However, the scientific meaning is the layer inside the uterus is scraped out to stop the bleeding, get a part of the layer for inspection and to make the newly forming layer uniform. Curetin is a English word used generally, but no one knows this process behind it. They use uterus washing/cleaning without any concerns.

Once period is a problem is decided then the rest comes eventually. Then we quickly understand that, period is a process to throw out all the waste that’s accumulated in the body. There’s no surprise that people have correlated period and impurity. Sewage is a regular excretion process. A process to regularly throw waste out of the body. Due to unawareness people have labeled period in the same way. In reality, body cells keep on dying and reforming regularly. Our skin sheds and new one grows, hair sheds and new one grows, the lifespan of red cells is 120 days; in the same way period also works. The layer of uterus can support pregnancy only for a specific time, after that it becomes useless. So the body throws it out, this is how period comes. The new layer starts developing again (Monthly routine). The main point is period is not an excretion process. But many people think that all the waste in the body, accumulates in the uterus and is thrown out of the body at month end.

For ladies, secluded place, different food, staying away from others, refraining from pooja & avoiding temples, having a bath on fifth day are all the products of these thoughts. Whichever be the cast, whatever be the religion, they all have same set of rules for these things. There is a part of society which says, a woman should get rest during periods, etc. That means, generally they should be so occupied with the work that they don’t get time for themselves. This one has come out to cover up old thoughts and not as a sympathy. It isn’t because of the respect or because of the empathy. It is apathy. Say NO to such rest. It bleeds monthly like the moon rises. It’s nothing like a scar. When you get puberty, it starts bleeding. It stops when you get old.It stops when you are pregnant. This is so simple. But it is wrong to follow what our elders taught.

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The Science behind menstrual cycle is now understood. Even the pills to alter them have been invented. We will use this technology just to cover for the old school rituals. But, Why!?

Is it necessary that if people call it desecrated, we shall still continue it? Who has decided that the periods started naturally are not okay and it is okay to alter them with medicines? Should not we say NO to these things?

The defense has two answers for this. First is, in the men dominated society, women have to follow what men say. The other is, What’s wrong in it? The answer for the first question is that we should look at it as a stand against the old school mediocre rituals. The thing is pretty simple. It is agreeable if told authoritatively. If you agree it, you can tell it. If you don’t, there is no question.

 ‘What’s wrong in it?’ comes with the answer that mom does so does the daughter. Elder sister does so does the younger. No one uses their own brain and it goes on.

This must be stopped somewhere. Men and women should be able to differentiate each other infallibly. Someone should start it now. Will YOU?

QQ

Dr. Shantanu Abhyankar

MD Obstetrics and Gynecology

Chairperson Sexual Medicine Committee 2011-2013

Was awarded Dr. Anandibai Joshi Gaurav Puraskar by Government of Maharashtra

Secretary Federation of Obstetrics and Gynecology Society of India

 

POCSO – Protection of Children from Sexual Offences.

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Child sexual abuse has been a hidden problem in India, largely ignored by the people and also the criminal justice system. It was not until recently that child sexual abuse has been acknowledged as a criminal offence. Crimes against children such as child sexual assault (not accounting to rape), exploitation and harassment for pornography were never legally sanctioned.

The Ministry of Women and Child Development started a campaign which led to the enactment of a new legislation called the Protection of Children from Sexual Offences (POCSO) in 2012. Till 2012 the only sexual offences which were recognized by the law were rape, outraging modesty of women and anal sex, homosexuality or bestiality.

According to this act definition of child sexual abuse includes the following: penetrative sexual assault, aggravated penetrative sexual assault, sexual assault, aggravated sexual assault, sexual harassment, using child for pornographic purpose and trafficking of children for sexual purposes. This Act also addresses attempts to commit a sexual offence, and the abetment of sexual offences against children.

POCSO does not confine to penetrative sex to penile penetration and rape. Instead, it broadens the offence termed ‘penetrative sexual assault’ and also includes oral sex and insertion of any object into anus, mouth or vagina. This includes sexual assault committed by persons in authority or position of power with respect to a child, committed by persons in a shared household with the child. POCSO is quite modern with respect to many issues, such as, the definition also includes sexual harassment with repeated following, watching or contacting a child either directly, electronically or through other means, covering incidents of child harassment via sexting or sexual cyber bullying.

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This act protects children (defined as those below 18 years) from these offences. Setting up of special court, child friendly atmosphere through all stages of the judicial process, from reporting, recording of evidence, investigation, trial in-camera and without revealing the identity of the child.

The punishment prescribed in this act may include a fine, as well as payment of compensation to the child for trauma suffered and for rehabilitation, as necessary; imprisonment for a variable term and can extend up to a maximum of life imprisonment, depending on the gravity of the offence. However, controversial thing is it contains an extraordinary clause (Chapter VII, Clause 29) which states that the accused person is guilty unless proven innocent.

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The number of child sexual abuse cases have been increasing rapidly, it is of utmost importance that these laws are taken seriously. Government has made a substantial contribution in educating the people, sensitizing the criminal justice system, and making the reporting of child sexual abuse compulsory. POCSO 2012 has been a positive step and has made a significant contribution to tackling the problem of child sexual abuse in India. It has identified and criminalized a range of unacceptable sexual behaviors that pose a threat to children.

Shruti

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