Injuries and violence in the Caribbean: how big is the problem?

OBJECTIVE: To quantify and characterize deaths from injuries and violence in the English- and Dutch-speaking Caribbean. DESIGN AND METHODS: The most recent year of available national cause-of-death data for each country for the period 2007-2013 was selected from the CARPHA regional mortality database. An analysis of regional causes of deaths by age and gender was completed. The crude injury death rate for each country, by gender, was also calculated followed by a descriptive analysis of the type of injuries contributing to death in each country. RESULTS: In the English- and Dutch-speaking Caribbean, annual deaths from injuries accounted for 11.5% of all deaths and four times as many men as women died from an injury. Among persons aged 15-44 years, 116,931 person-years of life was lost due to injuries. More males aged 1-44 years died from violence (one in four) than from any other cause. The injury death rate and the related causes varied substantially across countries within the region. CONCLUSIONS: Understanding the current mortality profile of injury and violence in the region is critical to the development of effective and efficient interventions to address this problem. Variability of these profiles across the region suggests that more research is needed to inform development of age, gender and country-specific programmes.

Gender-based violence: don’t ask, don’t tell, don’t care

OBJECTIVE: Our goal was to highlight the ongoing disparity, promote discussion, and advocate for further funding to examine the factors associated with sexual violence to target prevention rather than intervention. DESIGN AND METHODS: We compared prevalence, incidence, and economic burden of sexual violence to other major public health issues in the US: cardiovascular disease, cancer, and diabetes. We compared the public funding allocated to an issue as a proxy of the social priority of addressing the issue. Finally, we calculated the ratio of public funding to economic disease burden. RESULTS: [Table]. CONCLUSION: Public funds allocated to sexual violence were a fraction of those allocated to other major public health issues such as cardiovascular disease, cancer, and diabetes despite similar incidence, prevalence, and economic burden between them. While sexual violence was similarly prevalent and costly to these other major public health issues, it received a fraction of public funds.

Experiences of mental health professionals counseling young survivors of sexual abuse in the Cayman Islands

OBJECTIVE: To explore the experiences of mental health professionals counseling young survivors of sexual abuse in the Cayman Islands; how they navigated challenges in their experiences and sustained themselves through their work with young survivors of sexual abuse. DESIGN AND METHODS: The present study incorporated a qualitative approach using a phenomenological design to elicit a description of the experiences of mental health professionals who counseled young survivors of sexual abuse in the Cayman Islands. Five mental health professionals were recruited using purposive sampling methods. Semi-structured interviews were facilitated to answer the research questions centered on describing their experiences in counseling young survivors of sexual abuse in the Cayman Islands. Data analysis resulted in four core themes that described their lived experiences as notably punctuated with both significant systemic challenges and significant posttraumatic growth. RESULTS: The findings indicated that mental health professionals compensated for the systemic influences such as patriarchal belief systems and oppressive and complicit attitudes objectifying children by diversifying and expanding their interventions. CONCLUSION: The present study supported recent literature from the Caribbean region that described the embedded oppressive belief systems and traditional patriarchal attitudes that have perpetuated abusive treatment of children. Furthermore, the study provided a greater understanding of mental health professionals’ experiences in the Cayman Islands that also supported expanding the scope of the mental health professions to include social justice and advocacy efforts.

Knowledge attitude and practice of professionals who investigate child sexual abuse Kingston and St. Andrew, Jamaica

Child sexual abuse is a significant public health problem. Health care and social welfare professionals play a crucial role in the care and protection of children who have been abused. However several factors influence the professionals knowledge, attitude and practice in their attempts to carry out their duty. The aim of this study was to investigate the influence of personal experiences of childhood, training and job experiences and demographic factors on the knowledge, attitude and practice of professionals who investigate cases of child sexual abuse. It consisted of a cross-sectional comparative study, designed to describe and to compare three groups of professionals within the Corporate Area of Kingston and St. Andrew who are attached to public institutions that offer immediate and long-term services to sexually abused children. The results showed that there were significant relationships between personal experiences of childhood, training and job experience and the knowledge level of the professionals. The professionals who were victims of childhood sexual abuse themselves demonstrated superior behavior in all three parameters of knowledge, attitude and practice. Furthermore, those who acknowledged these experiences had superior scores compared to those who minimized their experiences. Although the medical doctors demonstrated superior knowledge scores the social workers had better attitude scores and the police officers the best practice scores. The high prevalence (68 percent) of childhood sexual abuse among this group of professionals further supports the social importance of this problem. These findings are interesting as they represent a positive outcome from an extremely negative situation. It allows public health authorities an opportunity to develop and implement services that not only attempt to treat acute situations but recognize and promote optimum health in care-givers. This study sheds light on the need for an integrated approach encompassing not only knowledge but also attitude and practice in the training of health care and social welfare professionals. It can be concluded also that further interaction among the various groups of professionals should have a positive influence on behavior (AU)

Sexual abuse of children in Kingston & St. Andrew, Jamaica

A descriptive study of 29 cases of alleged sexual abuse involving 33 children (in 4 cases one adult abused two children) observed at the Community Health Centre, Department of Social and Preventive Medicine, U.W.I. Mona, Jamaica, and the Family Court, Jamaica, is reported. A similar incidence was found when compared with studies conducted elsewhere and females were abused more than males. Children of all ages were affected and fell mainly into one of two groups, 3 to 6 years old and 11 to 13 years old. Clinical manifestations included hymenal rupture, vaginal bruising, pregnancy, vaginal discharge and sexually transmitted diseases. A belief in the child's version of the incident, a careful detailed social inquiry, a medical and gynaecological examination and laboratory studies are needed to substantiate the allegation of sexual abuse. (AU)