Broken by sexual abuse

She lay supine on the examination bed, devoid of all articles of clothing, but covered by a clean white sheet, which draped her trembling body between her neck and her ankles. Tears welled up in her eyes, on the brink of breaching her lower eyelids and overflowing onto her well-applied eyeliner, and the mortified look on her face was indicative of the extreme level of fear being experienced.

Examination of her upper body was uneventful, but when asked to drift downward, place her heels in the stirrups, and abduct her thighs in readiness for a pelvic examination, it was as if her world was about to be struck by a meteor of epic proportions.

It usually takes a few seconds to do a Pap smear, but in this case more than 10 minutes elapsed before I could even gain access to the entrance of her vagina, with much of the time spent negotiating and reassuring.

In an effort to placate her, I asked her what type of music she liked, and responded by playing some R&B from the iTunes library on my laptop, amplified by the mini sound system in my office. Subsequently, I visited the pharmacy on the premises and returned with a bar of Nestle Crunch, which I handed to her, and she graciously accepted, nervously tearing open its bright blue wrapper.

Following this I sat on the wooden stool to her right and spoke calmly to her, as standing over her would likely heighten her anxiety and feeling of vulnerability. I assured her that the examination would not be painful, that I would use a small speculum, about the size of my middle finger, and that I would lubricate and warm the instrument prior to insertion.

Despite the sincerity of my pledges, several attempts were made to perform the test, and on each occasion, as the instrument was advanced toward her pelvis, she recoiled, while hyperventilating, firmly uniting her thighs and placing both hands over her external genitalia, as if to protect them from an unwelcome invasion. This was becoming an exercise in futility, with both parties experiencing frustration and growing weary. She then asked if she could speak with her mother on her cell phone, as this would soothe and distract her. I obliged, and was finally able to complete the task, but not without her crying, screaming and writhing in agony.

The woman’s behaviour described in the abovementioned scenario was not unlike that of a captive in a torture chamber. But in this case, the ‘captive’ was a willing, yet reluctant patient, presenting herself for a gynaecological check-up. What is a regular routine for many women is an exercise in heroic bravery for her. The reason for the unbridled apprehension was simple – she had been the victim of sexual molestation as a child. The perpetrator in this case, the gardener, had used his fingers to violate her, and the experiences had so traumatized her that even the thought of being touched between her legs would induce a reaction of sheer panic.

This is just one of the many women who have presented themselves to me for care, living with histories and memories of child molestation, and the stories are all disturbing, evoking visceral reactions of disgust.

My profession affords me the opportunity to hear the sordid tales of  unfortunate victims, some events unknown by their parents or partners, and my findings and observations have confirmed that the scars of sexual abuse run astonishingly deep, often giving rise to psychopathology persisting way into adulthood, with depression, anxiety and sexual dysfunction being common sequelae. These not uncommonly contribute to dysfunctional relationships with spouses, which affect the children of these unions, who in turn grow up with their resulting maladaptations, and the cycle of psychological disturbance is perpetuated. The sexual abuse of our youth does not just affect them; it has repercussions on our society.

The perpetrators of child sexual molestation are sometimes strangers, but are often familiar to their victims and families, and more importantly, trusted by them, and include family friends, neighbours, relatives, spouses of parents and even parents themselves. Sometimes it is the very persons in occupations charged with guiding and protecting children, such as teachers, clergy or the police, who betray their trust.

And there is also one other common finding – reports are rarely made in a timely manner and guilty parties hardly ever brought to justice. After almost two decades in private practice, as a gynaecologist, I can literally count on one hand the number of cases that I am aware of, where convictions occurred. The miscreants involved in most of the incidents related to me are probably still roaming freely today, carving more notches in their belts, after they pull back up their trousers following their nefarious acts.

It is incumbent on us to protect our children. We must be aware that any adult in contact with a child is a potential abuser. Careful thought must be given to those who we leave our children with, and those we allow into their spaces and lives.

Conversations must be had about ‘good touch’ versus ‘bad touch’. Their stories must be keenly listened to and changes in behaviour noted and investigated. Many wounded women, and men, walk among us, often suffering in silence. Unfortunately, many of us witness in silence too, and in doing so enable the injustice. It is time to break the silence, and do all that we can to fight the rape and sexual abuse and exploitation of the most vulnerable among us.

- Michael Abrahams is a gynaecologist and obstetrician, comedian and poet. Email feedback to columns@gleanerjm.com and michabe_1999@hotmail.com, or tweet @mikeyabrahams.