Child sexual abuse (CSA) and incest are brushed under the carpet by people, despite the fact that they are increasing rapidly, speakers said on Monday at the Pakistan Medical Association (PMA). The experts also spoke about their experiences as they discussed the limitations faced while dealing with victims of sexual abuse.

Before presenting any theories on the subject, however, all the participating doctors said that the data that they were going to present had mostly been compiled by researchers in the United States, “and though the statistics may vary, the basic physical and psychological conditions in both countries is the same,” Dr Shershah Syed, a gynaecologist, said.

Pakistan may not have a database to register victims, but the number of cases of incest and sexual abuse that come to doctors are too many to count, speakers said. Dr Syed said that he often known after examination that a patient has been sexually abused, but few people come forth and speak openly about it, because they fear isolation and mockery from people round them.

Dr Syed spoke about an incident that happened five years ago. “The case of a seven-year-old girl came to us. She had been raped by her brother-in-law, who forced a nail into her eyes so that she would not blame him,” he said, adding that the case later reached a wide audience, but the court, after hearing that the accused had confessed to his crime, let him loose after levying a fine.

Dr Syed said that the most prominent effects of sexual abuse, referred to as post-traumatic stress disorder (PTSD), can be seen by observing the behaviour of a child. Common symptoms include thumb-sucking, bed-wetting, losing skills that they had once learned, and acting younger than they are.

Street children, refugees, Hijras, and children going to religious and formal schools are at risk of getting abused, said Dr Nusrat Shah, an assistant professor at the Dow University of Health Sciences (DUHS). “Boys and girls are both victimised by CSA, and not necessarily by strangers.”

“Hospitals, on their part, have established Child Protection Committees which help the victims of sexual abuse and incest,” Dr Syed said. He added that the committee helps the child “for a long time — until everything he or she needs is provided.”

Dr Raza Ur Rehman, an assistant professor in the Dow Medical College (DMC) department of psychiatry, said that in case of incest, it becomes really difficult for the doctor to take any action or provide shelter for the victim. “We run the danger of being sued by the family of the victim,” he said.

Pakistan is one of the signatories to the Convention on the Rights of the Child (CRC), which was adopted in 1989 by the United Nations; the country, however, is at a standstill when it comes to doing something substantial about these crimes, Dr Shah said. “Annually, the US reports100,000 cases of incest. In Pakistan, 2 per cent of our general population experiences sexual abuse once in their lifetime,” she said.