Silent screams: listening to and making meaning from the voices of abused children

Background - Sexual violence against children is a major clinical, public health and human rights concern globally. Specifically, child sexual violence (CSV) is one of the world's leading causes of trauma in children. In extreme cases, victims of CSV grow up with a plethora of maladaptive behaviours, which may be salient in the course of growth but later present in adulthood as severe cases of comorbid psychopathologies. It is expected therefore that CSV cases be treated with urgency and policies/laws against perpetrators be translated into visible outcomes. However, many CSV cases go unreported; and where there are attempts at reporting, the manner and approach of handling these cases is discouraging and futile. In this study, we explored the lived experiences of CSV survivors in Nigeria who tried reporting and opening up their experiences.

Method - Using the hermeneutic phenomenological approach, responses from 11 girls aged 15 to 17 years at the time of the study and 8 to 16 years at onset of abuse were obtained. Data were gathered through interviews, and the victims' experiences were aggregated using content analysis.

Results - The major findings were summarized under the following themes: (a) silent screams, (b) trauma and the search for a therapeutic ear, (c) stigma and (d) withdrawal: our last resort. Respondents reported crying out and begging perpetrators to stop the act. They also reported experiencing trauma and related physical/mental health issues after the act. As they sought whom to disclose to, they reported feeling stigmatized and eventually having to withdraw and recoil.

Conclusions - Implications of the study cut across medical practice, social work, therapeutics and policy formation/implementation for the prevention of CSV and attending to CSV victims in hospitals, homes and schools. The importance of empathic therapeutic processes was discussed. The need for a multisectoral and multistakeholder approach in tackling CSV was also highlighted.