Dr Nandita de Souza of Sangath, which works with children and their families in Goa, says, ‘I cannot overstate the importance of sex education in homes and schools. I always stress that if parents want to keep their children sexually safe then they must educate them, either themselves or through the school; parents have begun understanding this now. It is also vital that sex education in schools addresses the issue of Child Sexual Abuse beginning with the younger children.’ Sangath has conducted three workshops for the parents, staff of an orphanage and teachers, ‘We focussed on the development of a child’s sexuality, which behaviours are normal and what could be a cause for concern. We also teach parents how to talk to their kids about sexual abuse. The most important task for parents is to create an atmosphere of trust and openness at home which would encourage children to ask questions and share information about whatever concerns they may have.’

To correctly understand the signs of Child Sexual Abuse in a child it is primarily important to know the stages of sexual development in a child so that the parent can be in a position to assist the child more efficiently. Just as children learn that various body parts have diverse functions and produce different sensations, they become aware of the feelings that arise from the manipulation of their genitals. Anything that is pleasurable is likely to be repeated. This is normal self-exploration as children learn more about their own bodies. Child psychologists say that children develop their own sexuality in distinctly different ways—a little girl may like the idea of constantly sliding down banisters or swooping into the sky on a swing; a little boy may feel turned on during his first motor-cycle ride or even when watching fire engines. Almost all children by the age of five are playing games of ‘house house’ or ‘doctor doctor’.

A stray thought. The child is playing ‘house house’ with other children, any one of them could have been sexually abused by their father or close male relative in their own house; what kind of twist can this game take even as the children play it?

Another thought. The number of ‘doctor sets’ available in toy shops are testimony to the number of parents who want their children to become doctors when they grow up, no matter if the child displays piffling aptitude for the field of medical healing. The child has yet to grow up, parents have already started collecting money for the huge donations they will readily pay so that their child can become a doctor. They proceed to the toy shop and promptly pick up a ‘doctor set’ to present to their child as a play apparatus. The child is at the sexually explorative age, it has been sexually abused by the family doctor, it has some plastic instruments in its hand which its parents insist are part of its ‘doctor doctor’ game. Playing ‘doctor doctor’ can turn serious; and what about child and adolescent patients when this child grows as an adult, practising doctor?