The tragedy that is happening in Syria

Posted on March 19th, 2013

The following article was published by BASW on 18 March 2013:

One of the world’s most troubled zones, an estimated 60,000 people have died in Syria since the uprising of March 2011. Save the Children has warned of a “collapse in childhood” in the country, with one in three children having been hit, kicked or shot in the fighting. Sundus Saeed, a volunteer with Hand in Hand for Syria – one of the few aid organisations working in the country – describes the huge task of supporting a traumatised nation.

Sundus Saeed, Hand in Hand for Syria
Since the conflict began in Syria two years ago, families across the country have been torn apart. Children and women have been most affected, their vulnerability to attacks on residential communities perpetuated by the lack of psychiatric help and counselling, and the lack of a social care system.

Prior to the conflict in Syria, the role of social workers was beginning to develop. Largely operating in schools, social workers would liaise with teachers, families and students on non-educational matters and, wherever necessary, if any children were at risk of any kind, they would provide support and counselling.

However, since the uprising, a large number of children are now out of education. Particularly noticeable is a decrease in attendance by girls and a drop in the average days of attendance. Educational establishments are being used as places of refuge for internally displaced Syrians. According to the Ministry of Education/UNICEF, 1,960 schools and other public buildings are hosting IDPs (internally displaced persons) across Syria.  Other schools have been utilised for the purpose of establishing makeshift hospitals, while several have been completely destroyed in shelling. This has meant that the system, which heavily relied on the existence of co-ordination in schools between social workers and parents, has virtually collapsed.

Due to the large number of casualties involved in the current conflict, there are now significant numbers of orphaned and abandoned children roaming the streets, susceptible to ill-health and abuse. According to Human Rights Watch, children as young as 14 have been drafted into the armed conflict.

The absence of a breadwinner figure in families has led to a lack of reliable income. At the same time, little assistance and aid is reaching these broken families, and their basic needs are not being met. The 2 million internally displaced Syrians, of which children account for 46%, are in a dire and desperate situation.

Reports conducted by the UN have confirmed “increasing vulnerability of the populations inside communal shelters”, but in particular outside the shelters. The needs of women and children with regards to their protection and safety have increased; sexual harassment and abuse, domestic violence, early marriage, drop-out of schools, lack of access to basic services and psycho-social needs are prevalent.

Syrian security forces have used sexual violence as a tool of humiliation both inside and outside of detention centres. According to Human Rights Watch, women and girls have been raped and sexually assaulted during raids of their homes. Victims are hesitant to report such attacks because of the stigma attached to sexual violence, and because of limited access into Syria for humanitarian observers and journalists alike, documentation of such cases has been difficult.

Charities such as Hand in Hand for Syria are providing humanitarian and medical aid as best they can to the affected areas, but with the security situation still a significant hindrance, aid workers have to prioritise meeting people’s basic needs, such as medical treatment, food, shelter and warmth. This means counselling and psychological treatment remain a rarity in Syria.

Iman Mujahed, a trustee of the charity, has just returned from an aid trip and recalls the “dead” look in the eyes of children affected by the conflict. “They play as ‘normal’ children do, but they are reminded of the horrors of the conflict on an everyday basis, with scores of child refugees coming through the barbed wire entrances of the refugee camps, talking amongst themselves like little old men and women with stories of whom they have lost and how. It is tragic to witness their suffering.”

To deal with the large scale needs of children, Hand in Hand for Syria has opened a children’s hospital in the Atmeh border town in Idlib province, which hosts the largest number of refugees in Syria. There is also a new maternity unit nearby, established for an obstetrician previously delivering babies on her kitchen floor, highlighting the fortitude with which many women are dealing with the crisis.

Ms Mujahed added: “These stories are all too common. Stories of children bearing witness to things they should not; mothers bathing their children in what can only be described as orange sludge; small children walking around with no shoes during winter. This children’s hospital is but one small step towards helping young victims of the terrible events in Syria.”

Another initiative of Hand in Hand for Syria has been the distribution of 3,000 children’s books to refugees and schools inside Syria. ‘Books for Syria’ aims to assist children directly affected by the Syrian crisis, educating them with socially and culturally relevant content, and inspiring them with a new found hope and confidence for the future.

Ms Mujahed said: “On receiving the beautifully illustrated books, the children instantly starting reading them, in awe of the precious gift they had received.

“Despite the ongoing conflict, these initiatives are one step on the road to recovery for the thousands of families and children who have witnessed unimaginable levels of atrocities.”

Ruth Stark, Convenor for the Human Rights Commission of the International Federation of Social Workers (IFSW), said: “Through our connections in IFSW we were aware that social work was beginning to get established in Syria before the collapse of society in the last two years. We are concerned, along with many agencies, about the loss of childhood.

“Social work as a profession was first recognised by the UN as an important contributor to social recovery following the disasters that had befallen people after the Second World War and was awarded NGO status with the UN precisely to advocate and work with others in these situations.

“While this task has fallen primarily to third sector organisations, some UK authorities have loaned staff to countries re-structuring, for example after the fall of the Berlin Wall or civil war in the Balkan countries. All this forms part of the work we are trying to do internationally for social work and social development, as well as to work towards what will be put in place by the UN when the Millennium Goals are reviewed in 2015.”

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Safeguarding children with disabilities

Posted on March 4th, 2013

Article in Community Care 04.03.13

Practitioners must take time to find out disabled children’s perception of events, understand their wishes and feelings, and support them to participate.

It is cause for concern that there is so little research in both the UK and further afield about safeguarding disabled children. Nonetheless, consistent findings emerge throughout the available evidence.
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Key messages from recent research

Stalker et al (2010), in a scoping study, found disabled children were significantly more likely to experience abuse than their peers and were subject to lower levels of reporting and registration. The study highlighted the risk of practitioners applying higher thresholds to disabled children because they saw abuse as attributable to the stress and difficulties of caring for a disabled child.

Guide for social workers

Many practitioners said it was a challenge to communicate with disabled children, leading to difficulties in ascertaining the child’s perception of events and understanding their wishes and feelings. Disabled children were seldom involved in case conferences and assumptions were made about their inability to give credible evidence or withstand the rigours of court processes.

In a study of lessons learned from serious case reviews, Brandon et al (2011) found practitioners paid insufficient attention to the abuse of disabled children. They allowed parents’ voices to dominate; they didn’t communicate with the child; they saw the disability, not the child; they accepted a different or lower standard of parenting than would be tolerated for a non-disabled child.

Explanations for bruising were accepted by practitioners without sufficient scrutiny, and bruising was somehow (but implausibly) connected with a child’s disability. The researchers noted some professionals had difficulty believing disabled children could be deliberately harmed or neglected. In reviews concerning disabled children, researchers found the onus seemed to be on the child’s capacity to communicate well enough, rather than the professional’s responsibility to find ways of communicating.

An Ofsted thematic inspection on protecting disabled children (2012) found evidence that low-level risks were managed effectively through timely multi-agency early support. But it found children in receipt of children-in-need services too often had child protection needs that went unidentified. In some cases, decisions and assessments were not consistently well informed by previous concerns and cases were closed too early before risks were fully assessed.

Inspectors found many child protection plans were not sufficiently focused on outcomes, and it was therefore difficult to hold agencies and parents to account and to measure progress. The extent to which the views, wishes and feelings of disabled children were captured and recorded varied. Children were not always spoken to directly about the concerns for their welfare, even when they could communicate well.

The impact on practice

Social workers must recognise that disabled children are not only vulnerable to the same types of abuse as their able-bodied peers, they are also more vulnerable to abuse.

The impairment with which a child presents should not detract from early assessments of need, which consider possible underlying causes for concern. To protect disabled children, assessments must cover the ability and capacity of parents/carers to cope with the demands being placed on them.

All disabled children receiving children-in-need services, or subject to child protection plans, should have clear, outcome-focused plans, which are robustly reviewed and not allowed to drift.

Special attention should be paid to every child’s communication support needs. The necessary time should be taken to ascertain the child’s perception of events, understand their wishes and feelings and support them to participate. Practitioners should be aware of non-verbal communication systems, when they might be useful, and how to access them.

Questions for social workers to reflect on

Why are disabled children more vulnerable to abuse and neglect and what role can social workers play in reducing this added vulnerability?

What responsibilities do social workers have in ensuring that all disabled children know how to raise concerns?

What additional time and resources are required for disabled children if their account of abuse or neglect is to be made possible and their wishes and feelings heard?

Suggestions for further reading

Brandon, M., Sidebotham, P., Ellis, C., Bailey, S., and Belderson, P. (2011), Child and family practitioners understanding of child development: Lessons learnt from a small sample of serious case reviews, Department for Education, Research Report DFE-RR110

Department for Children, Schools and Families (2009), Safeguarding disabled children: a resource for local safeguarding childrens boards

Ofsted (2012), Protecting disabled children: thematic inspection

Stalker, K., Green Lister, P., Lerpiniere, J., and McArthur, K. (2010), Child protection and the needs and rights of disabled children and young people: A scoping study, University of Strathclyde

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Kaiya Blake Serious Case Review

Posted on March 1st, 2013

Report in Community Care 01.03.13 by Judy Cooper

The death of a four-year-old girl suffocated by her mentally ill mother could not have been predicted, but there were serious failings by numerous agencies, including social workers.

That was the conclusion of a serious case review, published today, into the death of Kaiya Blake in September 2011. Kaiya was known to Manchester social care and was the subject of a child protection plan for the 10 months leading up to her death.  Her mother, Chantelle Blake, pleaded guilty to manslaughter on the grounds of diminished responsibility at Manchester Crown Court last November. It was accepted she suffers from paranoid schizophrenia.

‘Insufficient focus on risk to the child’

The serious case review (SCR) found serious failings by mental health agencies after repeated mental health assessments concluded there no concerns. However, it also found social workers – who received many referrals about Kaiya – had focused too much on obtaining a medical diagnosis and not enough on the presenting evidence of risk to the child.

“The fact that assessments concluded that no mental illness was present was treated as an outcome to the concerns rather than an indicator as part of a more holistic assessment. [Social workers] appeared to remain simply puzzled by the lack of any formal diagnosis and how they could continue from that point,” the report stated.

Hostile and aggressive behaviour

Blake was a heavy cannabis user who behaved in a hostile and aggressive manner to all professionals, her own family and other parents and children at the children’s centre she attended. She also sometimes reported hallucinations and severe paranoia.  She was obsessed with the risk of sexual harm to her daughter, twice stripping her daughter after she returned from emergency foster care to look for signs of sexual abuse.  The SCR said no investigation was made of whether this behaviour stemmed from sexual abuse in the mother’s own childhood.

Despite reports and referrals detailing incidents of physical and emotional abuse, social workers returned Kaiya to her mother the next day, subject to a child protection plan due to “neglect”.

Mother left confused by professionals’ concerns

This meant the mother was confused by professionals’ concerns, because it appeared clear that her daughter was physically well-cared for and meeting developmental milestones.

There were also 10 scheduled case conferences, but six were cancelled and others had poor attendance. The report criticised the child protection plan as suffering from a lack of focus. It also highlighted that the child had not been seen on her own at any time in the process.

Many of the problems stemmed from inadequate social care assessments that lacked rigour, or any investigation into what life was like for the child, the SCR concluded. As a result, social care closed the case numerous times with little justification.

Recommendations for social workers

The review recommended the case be used as an instructive case scenario against which to test out the developing single assessment used in Manchester following the Munro Review.

It also recommended that social workers should be prepared to challenge other professionals, including those in the medical profession, and an analysis be carried out into why Manchester has a lower than average number of child protection plans focusing on risk of sexual abuse.

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