We doctors are a cynical bunch. The novelty of the white coat expires after a short time treating drug addicts, combative schizophrenics and patients whose idea of "how-do-you-do" is threatening a lawsuit. This is to say nothing of conducting pelvic exams, bosses with God complexes and extracting a baseball bat that got stuck up someone's backside when he "fell on it."
Very few things shock us, but cruelty to children is one of them.
Behind closed doors, we even pontificate on the need for strict contraception laws. "Birth control should be sprayed into the air," we muse. "If people want children, they should pass drug tests and home evaluations." Another of our suggestions is that the government should lace fast food with trace amounts of contraceptives, so that people who eat it occasionally are unaffected, but those who exist on it are sterilized.
Bitter? Maybe. Harsh? Absolutely.
The inconceivable becomes plausible, however, after you see a nine-month-old boy test positive for mommy's crystal meth and Shaken Baby Syndrome render a six-month-old girl blind, or after treating the burns on a young girl who was dipped in boiling oil and the cigarette burns on her sister's back in the shape of a marijuana leaf. When a 13-year-old boy dies from heat stroke because he was chained to a tree overnight, "Proposition McSterilization" starts to make sense.
Three million reported cases of child abuse and neglect result in 2,000 deaths in the U.S. annually, according to the Department of Health and Human Services. Since 2001, 30,000 American children have been killed in their own homes, taken their own lives or been murdered in their own neighborhoods, according to Every Child Matters, a child advocacy organization.
Why does the U.S. lead the world's richest democracies in child abuse fatalities, with death rates that are three times higher than Canada's are and 11 times higher than Italy's? This doesn't even account for the fact that as much as 60 percent of child abuse goes unreported.
Now the nation's and the states' financial crises are leading to budget cuts of as much as $89 billion next year, cutting child services in more than 40 states. In Hawaii, Every Child Matters reports, funding for a child abuse reduction program was slashed so much that two years after serving 4,000 families, it can afford to serve only 100. In South Carolina, five state-run homes for children were closed. Child Protective Services is severely understaffed, with caseload ratios as high as 60 to one in some regions.
Nearly half of all the Texas children who are killed by abuse belonged to families that had been investigated by Child Protective Services. In order to keep families united, CPS attempts to place children with safe family members. While its motives are admirable, CPS should put a higher priority on protecting children from monsters and sexual predators than it does on keeping families together.
The blame doesn't lie with one organization, though.
In fact, the single best predictor of child abuse is poverty. Children raised in families with annual incomes of less than $15,000 are 22 times more likely to be abused. One in five American children, more than 14 million, live in poverty.
Budget cuts are taking a toll here, too. California Gov. Arnold Schwarzenegger has proposed discarding California's welfare-to-work program to tackle a $19 billion budget deficit, effectively eliminating aid for roughly a million children. Thousands of parents in the state would lose access to federally funded subsidized childcare, forcing them to give up their jobs and be thrust deeper into destitution.
If the most prosperous country in the world can afford to fight two wars, battle terrorism in far-off lands and bail out Wall Street by the billions, why can't it offer its most vulnerable and voiceless citizens anything but bureaucratic red tape? Children are the only investment with guaranteed dividends. Our refusal to make our childrens' well-being a priority foreshadows a terrifying future that perpetuates the miserable cycle of brutality, a future that's almost as terrifying as a girl dipped in hot oil, a boy tied to a tree or a child shaken to blindness.
ABOUT THE WRITER
Seema Jilani, M.D., is a Houston physician who specializes in pediatrics. She's worked in the Middle East and the Balkans, and is a freelance journalist. Her radio documentary, "Israel and Palestine: The Human Cost of The Occupation," was nominated for a Peabody Award. She can be reached by e-mail at firstname.lastname@example.org.
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