Background:

The onset of sexual activity in the Caribbean typically occurs at younger ages than in other parts of the world (Kempadoo & Dunn, 2001), and early sexual debut is now recognized as child abuse. In 2003, The International Bank for Reconstruction / The World Bank concretized the scale of child sexual abuse in the Caribbean, reporting that in a CARICOM study of nine Caribbean islands, one in ten respondents reported being sexually abused, both boys and girls. Additionally, the report suggested that 48% of Caribbean girls receive their sexual initiation by force. In 2006, Hoot, Abella et al. drew linkages between poverty in the Caribbean and Latin America and an increase in sexual activity with children, while the ILO reported that in Belize, children who pass the “90lb test” (who weigh more than 90lbs) are seen to be ready for sexual encounters or sex for trade, despite their age (2006).

In Trinidad and Tobago, there is evidence of organized child prostitution networks (UNCRC, 2003). In 2009, a Haitian study reported 225,000 impoverished children traded into better-off families in an exchange of child labor for upbringing, with an unspoken understanding that sexual compliance is a part of the deal. In Trinidad’s 2016 Report on Child Abuse, the highest category of victims was boys in the age 4-6 category, and in January, 2018, the Office of the DPP in Grenada listed 15 cases of sexual abuse against children under the age of five, on their books at the current time.

Against this backdrop, the Caribbean has developed and enacted new legislation for dealing with perpetrators of sexual violence. Mandatory Reporting is in place, with guaranteed stiff penalties for those convicted. However, there are no psychological interventions in place for victims. The focus remains on apprehending and punishing perpetrators. Neither state nor community-based agencies have yet instituted, or even contemplated interventions to help child victims, once they are removed from physical harm. In Grenada for example, interviews with the Ministry of Social Development, the Child Protection Authority, and the NGO community including the Legal Aid and Counseling Clinic, and the GNCRC, confirm that there is no known available process for child victims (unless a parent has personal access to services).

Yet children remain the most vulnerable of all victims, with extremely debilitating mental, emotional and physical health consequences to bear without the correct psychosocial supports.

The list of disabilities as a result of rape trauma is long. They range from insomnia, anxiety and estrangement from other family members, through depression and suicidality, to more complex psychiatric disorders such as Borderline Personality Disorder, Schizophrenia and Dissociated Identity Disorder. (Kohut, 1985). Long-term physical health issues are also indicated, including chronic pulmonary disease, digestive malfunctioning, obesity, endocrine system dysfunction and cardiac disease. (Flaherty et al., 2006, Sachs-Ericsson, 2011, Thompson, 2004). Finally, considering impaired development of the limbic system, and of the cerebral cortex, it is clear that the impact of child sexual abuse upon the human resource element of our Caribbean is more devastating that any hurricane. Needless to say, this points to a complete failure to protect the basic human rights of a child victim, with crippling though often hidden long-term effects.

These issues can be addressed if victims are quickly and effectively mandated to standardized psychological systems of care, which is the objective of this study.