Imagine that you woke up this morning and the newspaper headlines said that scientists had discovered a new disease. The scientists went on to report that over 1 billion children throughout the world were exposed to this disease each and every year. Furthermore the scientists reported that those exposed to this disease were at greater risk for mental illnesses like depression and anxiety disorders for the rest of their lives; also at greater risk for chronic diseases such as diabetes, heart disease, and cancer; even at greater risk of infectious diseases like HIV, that are still often fatal in parts of the world; and, if that wasn’t enough, at greater risk for involvement in social problems such as crime and drug abuse over the course of their lifetimes.
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Courtesy of Nadia Todres, used with permission. www.nadiatodres.com
If we had such a disease, that was entirely preventable, what do you think we’d do? The truth is we do have such a disease — it’s called violence against children. And one of the first things we would do is measure it and use those measurements to propel effective and sustainable action.
A Question for the Hero
Shortly before my former neighbor Stan Foster retired at age 80 to spend time with his wife, he took me and several others working in the area of global child health out to lunch. For those who don’t recognize the name, Stan Foster is a public health hero famous for helping lead the global smallpox eradication campaign. In his typical hippo bowtie, smiling ear to ear, he listened attentively to our question, posed after relating the scenario above about the newspaper headlines.
“Stan, if you wanted to eradicate violence against children around the world and replace it with safe, stable and nurturing relationships, what would you do?”
“Well,” he said, “This type of problem has to be solved from the bottom up. So I would work on community transformation and use exceptional video technology – like that being used by Kate Winskell (Assistant Professor in Global Health at Emory) in her work on Global Dialogues over at Rollins School of Public Health. With video we can influence and impact many more people these days. I would admit my mistakes and learn from them – people do not find that easy – particularly scientists. We made a lot of them trying to eradicate smallpox, you know. Of course the backbone has to be both surveillance and case finding. To do all this, I would convince donors to pay for people to go all around the world to work on it until it was done.”
Then, leaning in, Stan asks Jim Mercy (Strategic Advisor for Global Health, Division of Violence Prevention) a question, ”How did you get started with all this work anyway?”
Jim begins, “Well, you see, one day I received a phone call from Jama Gulaid, the UNICEF representative from Swaziland whom I had met when he was training at CDC.”
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Courtesy of Nadia Todres, used with permission. www.nadiatodres.com
Stan interjects over laughter that comes tumbling out, “I know Jama! I introduced him to his wife!” With a personal connection to extend the professional one, the dialogue takes off.
Getting back to the Swaziland story, Jim continues. “Jama explained to me that Swaziland had the highest HIV seroprevalence in the world, and that the newspapers were constantly reporting stories of sexual abuse of young girls. Jama, thinking the two might be related, asks me if CDC can help him conduct a nationally representative Violence Against Children Survey (VACS) to measure exposure to sexual, physical and emotional violence among girls. We were in fact able to collaborate on this national survey, under Jama’s leadership, and found the results disturbing: 3 out of 10 girls had experienced sexual violence during childhood. That was 2006; since then we have gone on to provide technical assistance for conducting these VACS – that is, the Violence Against Children Surveys — among both girls and boys in Zimbabwe, Kenya, Haiti, Tanzania, and Cambodia. The good news is that in countries around the world, governmental Ministries of Health, Gender and Family, Labor, Justice, Education, and Finance are joining with multilateral donors and civil society to use national VACS data to drive evidence-informed, effective, and sustainable changes that make are effective in reducing violence against children.”