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Monday, September 1, 2014
- Joshua Kotouc, a doctor from the U.S., came with a group of missionaries to San Miguel Chicaj, a small town in the mountainous province of Baja Verapaz in northern Guatemalan, in 2006. “El Gringo”, as he is known in the community, decided to stay on out of “altruistic” motives.
But he ended up in jail for sexually abusing young boys.
Kotouc opened a health clinic in the village of San Gabriel, offering health care services for a token fee equivalent to just three cents of a dollar, to help the poor community. But he also started to invite young boys over to his house to play video games, watch movies and go on field trips to nearby towns and cities.
The local residents, who are Achí Maya Indians, were unaware of his real intentions, until one day the police raided his home and found more than 2,000 photos of local boys under 14 wearing only underpants.
However, the photos were only the tip of the iceberg.
The U.S. expatriate, who was 33 years old at the time, tried to commit suicide by stabbing himself in the neck with a scalpel. But he was rushed to the hospital and doctors managed to save his life. Last year he was sentenced to six years in prison after he was found guilty of sexually assaulting four 10 and 11-year-old boys. A number of other boys have also reported abuse at his hands.
Based on cases treated in all of the public hospitals and health centres around this Central American country of 14 million people, the National Commission against Child Mistreatment and Sexual Abuse reported that last year alone, 11,356 children were victims of sexual abuse and 7,002 of physical abuse, and 1,152 were injured as a result of neglect.
“We checked the records of the national hospitals, and this information helped us in our effort to get the country to gauge the scope of the problem of child abuse,” Miguel Ángel López, a member of the non-governmental Commission, told IPS.
Burns, open wounds, broken bones, and sexually transmitted infections are part of the long list of problems suffered by children treated in health facilities, whose abusers were generally people close to them, the expert said.
“In nine out of 10 cases, the culprits are family members, and in eight out of 10 cases, the abuse was committed in the minor’s house,” he said.
But the cases counted in the study were just a hint at the depth of the problem. “At the international level, where many studies have been carried out, it has been shown that for each case that is documented there are at least nine cases that have not been,” López said.
The problem is that such abuse is rarely reported. “In hospitals, for example, when one of these cases turns up, the doctors try to get out of it as soon as possible, to avoid becoming embroiled in a legal conflict,” he said.
According to the World Health Organisation (WHO), evidence shows that approximately 20 percent of women and between five and 10 percent of men suffered sexual abuse as children.
Nora Montoya, with the Survivors Foundation, a local NGO that offers social, psychological and legal support to abused women and children in Guatemala, told IPS that they deal with 25 to 40 cases of domestic violence a day, which often involve child victims.
In the town of Salamá, where Kotouc was in prison, the Survivors Foundation opened a clinic to provide psychological assistance to 32 boys who allegedly suffered abuse at the hands of the doctor.
“We have found that there were not just four boys, but 32, who were sexually abused,” said Montoya.
But the rise in the number of cases of child abuse that have come to light in recent years does not indicate an increase in the phenomenon.
Marco Antonio Garavito with the non-governmental Guatemalan Mental Health League told IPS that “the number of reported cases has increased and the problem has gained visibility thanks to the work of social movements.”
But he also said that the rise in the levels of violence in Guatemalan society “has generated a process of ‘dehumanisation’ and the loss of the sense of the value of others, a situation that gives rise to greater aggression and violence, which is taken out on those who can’t defend themselves.”
According to the United Nations Development Programme, Guatemala is one of the most violent countries in the world, with a murder rate of 48 per 100,000 population, compared to a global total of nine per 100,000.
In the case of sexual abuse, Garavito said two serious problems are the lack of formal sex education and the existence of strong taboos around the question of sexuality, which make it “extremely important” for families to discuss such issues. It is also important, he added, “because many children have already become victims of relatives even before they start school.”
Guatemala’s new family planning law, which is to usher sex education into primary school classrooms, went into effect in 2009. However, sex education has not yet been introduced in the curriculum, even though experts and social organisations say it will play an important role in combating child abuse and teen pregnancy.
In response to the high level of child abuse in the country, the Pediatric Association of Guatemala signed an agreement to implement a protocol for how such cases should be handled in hospitals.
“The protocol includes guidelines for identifying cases, treating the victims, and referring them to the proper care and authorities, given the large number of patients showing up at health centres,” Dr. Jorge Luis Ortiz, a member of the Association, explained to IPS.
The regulations also stipulate that victims of child abuse are to receive health care in their own language – not a trivial point in Guatemala, where 22 different Mayan languages, and Garifuna (the language of the descendants of escaped African slaves who mixed with indigenous Caribs), are spoken.
Many people in this country, where native organisations and NGOs say over 60 percent of the population is indigenous, speak little to no Spanish