Curbing child abuse in Mexico

What happens to child abuse victims in Mexico?

That was the question everyone asked after news broke that a young girl – initially believed to be 9 years old – gave birth in a Mexican hospital last month, raising international ire and dismay. Attention was suddenly trained on the failure of Mexican institutions to protect victims of abuse, especially children, highlighting how it can go undetected and unreported.

Adolescents and girls who are victims of sexual abuse in Mexico face a harrowing road to justice and recovery in a country where, although a federal law exists to protect them, in practice they are often left defenseless. Child rights advocates are pressing Mexico to reform arcane laws and a dysfunctional system of child protection. And at least one program is offering hope for a model of care.

The young mother known as Dafne was not nine but 12 or 13, as authorities later found (the girl's stepfather has been arrested in this case). But it was that misinformation that prompted her story to go viral and drove state authorities in Jalisco to investigate. Many say her case – like many others – may have otherwise gone ignored.

“It’s one of thousands [of similar] stories that unfortunately occur in our country,” says Araceli Borja, a child protection advocate with Mexico’s Save the Children.

Mexico knows it has work to do, and reform is on the legislative agenda. Meanwhile, civil organizations are pressuring the government to take action and are supporting small-scale efforts to improve the current system, including one in a Mexico City hospital that has had united agencies from health to family and legal services, and the police, to work together in defense of children.

"A key problem, which affects many countries, is a lack of clarity of roles and responsibilities between different institutions in child protection,” says Alison Sutton, chief of child protection for the Mexico office of the United Nations children's agency, UNICEF. “If everybody is responsible, nobody is.

"It is important to know who must act, when and how. Otherwise children fall between the cracks within and between institutions.”

Not an isolated case

Teen pregnancy in Mexico is rising, and some of those affected are very young. According to the 2012 national health survey, for every 1,000 women who give birth, 37 are adolescents between the ages of 12 and 19. That’s up from a rate of 30 in 2006.

Eleven thousand births were registered to girls between 12 and 14 in 2011.

What is worrisome about pregnancies at such a young age, particularly when the father is an adult, is that "the only explanation is sexual abuse,” says Juan Martín Pérez García, executive director of REDIM, the Network for the Rights of Children in Mexico.

Mothers who are particularly young face increased risks in pregnancy: Nearly 14 percent of maternal deaths in 2009 were girls aged 12 to 15, according to Save the Children, an international nonprofit that is among those leading the calls for change. Laws governing the age of consent or legal marriage vary widely across the country, from 18 to as young as 12 years old. (Jalisco state only recently raised its age of consent to 15 from 12.)

Complicating abuse cases, it’s often unclear which of numerous local, state, and federal agencies bear responsibility for investigating a crime and ensuring care for an abused child. Crime reporting in Mexico is dismally low, and that holds true for abuse cases. Fears that the government may take a child away also prevent many families from speaking up.

Dr. José Antonio Muñoz Serrano, secretary of the Jalisco health ministry which oversees the hospital where the young mother gave birth, says that too often girls and adolescents arrive at the hospital in similar conditions, having had no prenatal care, shrouded in suspicions of abuse.

“It’s reprehensible,” Mr. Serrano says. “It’s not possible that a nine-month pregnancy goes by in a minor and no one reports it. Someone is taking advantage of the fact that the minor can’t defend herself.”

A model for care

Dr. Bony Mendoza Huerta hears heart-wrenching cases of child abuse on a regular basis at her office at a pediatric hospital in Mexico City that is working to fill the gaps in child protection.

Two years ago, the hospital – which specializes in treating young victims – proposed to bring under one roof psychological counseling, an agency for family protective services, victims legal services, and, crucially, investigative authorities. Such close interagency cooperation is highly unusual in Mexico (although similar models can be found in the US, where state departments of children and families have clear authority to investigate child neglect and abuse and will participate in multidisciplinary teams).

In incorporating the team into the health system, “the idea was that it would be a friendlier place in which families could come and speak freely about what’s happening in their homes,” Dr. Mendoza says. “The intervention is much easier.”

Previously, if Mendoza detected a potential case of child abuse during an examination, she would treat the child but could do little more than urge a parent or caretaker to report the crime to the public ministry’s investigative police. Too often the case would never be reported or would soon be dropped for lack of follow-up by the family or the inefficiencies of the criminal justice system in Mexico.

Those involved say the pilot program initiated by Mendoza and backed by UNICEF has been nothing short of revolutionary for the hospital and Iztapalapa, Mexico City’s most populous – and marginalized – borough. The hospital detected just 12 cases of abuse in 2007 – largely due to underreporting, but that number rose to 316 last year, nearly one case per day.

A parent who brings in an abused child can access medical treatment and mental health counseling; consult with a pro bono lawyer specializing in abuse cases; and, if charges should be filed, visit a small office of the investigative police – all located within a few paces of each other. Both the lawyer and a caseworker from family protective services will follow up with the family through the entire process, even after a hospital stay has ended.

UNICEF, which has provided technical and financial assistance, is promoting the Iztapalapa program as one model for how a coordinated system could operate in Mexico.

“The aim is that you reduce impunity for crimes against children and you do so in a situation in which children are being given appropriate psychological and social support,” Ms. Sutton says.

Reforming the system

 The next step for Mexico, say advocates, is to reform its child protection laws.

A 2000 federal law incorporates many elements of the UN Convention on the Rights of the Child. But like many laws in Mexico, it is largely declaratory and lacks mechanisms that would make it functional.

A new law would attribute specific responsibilities across the three levels of government and dictate how agencies should coordinate child protection services, says Pérez García of REDIM.

He lauds the creation of a permanent commission on children in the lower house of congress and a special commission in the senate – signs that legislative advances may be on the horizon.

“Regrettably in our country, the laws haven’t changed,” Mr. Pérez García says. “Our laws are inefficient. They don’t properly define sexual abuse, and they cover up many instances of violence and abuse.”