* Covid-19 has a victim who has largely gone under the radar

* The closure of schools has led to children locked up inside homes — which are not always safe havens

Doctors couldn’t quite fathom what was wrong with the nine-year-old girl. She wouldn’t eat, was nauseous and often breathless, her mother said. Investigations were carried out, medicines prescribed, but nothing seemed to help. Then the mother revealed that the child had shown similar symptoms a year ago. Then, as now, the girl’s father happened to be cooped up at home in a city in North Bengal.

The lockdown, imposed on March 25 in view of the Covid-19 pandemic, meant that the father was not going out for work. Last year, he was at home on leave because of an injury. “After talking to the child, we found that she was being abused by the father,” the paediatrician treating her says.

Covid-19 has a victim who has largely gone under the radar. While it is known that the elderly and those with co-morbidities are more vulnerable to the novel coronavirus, few realise that hundreds of thousands of children across the world are equally in danger — not from the virus but from violence and abuse.

Every year, nearly a billion children suffer physical, sexual and psychological violence that leads to injuries, disabilities and even death, says a global report released last week by the World Health Organization (WHO), along with others such as Unicef and Unesco.

But it has come to the notice of the global bodies that the situation has worsened in the pandemic period. “During the Covid-19 pandemic, and the related school closures, we have seen a rise in violence and hate online — and this includes bullying,” notes Audrey Azoulay, director-general, Unesco.

The closure of schools has led to children locked up inside homes — which are not always safe havens. “Lockdowns, school closures and movement restrictions have left far too many children stuck with their abusers, without the safe space that school would normally offer,” holds Henrietta Fore, executive director, Unicef.

The report underscores the increase in violence against children during the pandemic across the world, and the reality is not any different in India. According to media reports, tens of thousands of children in India have been calling violence-related helplines daily. Nearly 40 million poor children were affected due to the lockdowns enforced to combat Covid-19, say media reports.

A recent Unicef report makes this observation on children in India: “In the current context of lockdown and restriction of movements, children have constrained access to socialization, play, and even physical contact, critical for their psychosocial wellbeing and development.”

Spiralling tensions at home — there are reports of a rise in domestic violence during lockdown — make children vulnerable to violence, too. For children exposed to verbal altercations at home, the school was a safe space, which is now lost to them owing to the pandemic.

“For many children, going to school is an emotional safety valve,” says Anirudh Kala, psychiatrist and author and clinical director of Ludhiana-based psychiatric hospital Mind Plus. “The longer the schools are shut, the worse the violence against children becomes,” Kala adds.

Agnimita Giri Sarkar, consultant paediatrician at the Institute of Child Health in Kolkata, agrees. “The pandemic along with the lockdown is bound to affect the parent-child relationship and give rise to violence against children,” she says.

Multiple factors may together have resulted in a spike in child abuse during the lockdown, adds Debaroopa Bhattacharyya Panja, a Kolkata-based child welfare specialist and founder-director of social organisation Tribe Tomorrow. Among the factors she cites are poor mental health of parents, trying economic conditions, unemployment, massive pay-cuts and the absence of avenues for recreation.

And the one at the receiving end is the child at home. Soumitra Datta, consultant psychiatrist and honorary senior research fellow at MRC clinical trials unit, London, UK, points out that there is poor awareness among Indians on what constitutes unacceptable behaviour — physical, sexual, and emotional — towards a child. Existing legislation, he points out, is focused on sexual abuse, thereby missing out on other forms of violence.

“Increased conflicts between couples, substance withdrawal-related problems in adults in the family, domestic violence, economic hardships resulting in young children being left unattended and unsupervised while parents become desperate for work, and lack of routine health-related follow-up (such as immunisation visits) may uncover signs of violence,” Datta says.

Adults should refrain from verbally abusing their children or the spouse. “Even unintentional words of abuse can demoralise children and push them towards depression and low self-esteem,” Bhattacharyya Panja points out.

According to Datta, village elders and health workers should be trained to identify signs of violence towards children. If schools remain closed for long, outdoor interactions between teachers and students should be organised with time slots for physical exercise followed by midday meals.

“This will give an opportunity for children to talk to adults outside the family,” he says. “Health staff conducting home visits or telephone-based health surveillance of parents with suspected Covid-19 symptoms should be encouraged to ask about the well-being of dependent children,” he suggests. “[They should also be] trained to identify early warning signs of abuse or violence towards children,” he adds.

Giri Sarkar concurs. “Improving the mental health of the parents is an important step to combat violence against children,” she says. Parents need to focus on adolescent children, involving them in decision-making, getting them to participate in creative ventures together, and reducing virtual screen time by involving children in family activities.

“Only happy and (mentally) healthy parents can raise happy and healthy kids,” Bhattacharyya Panja adds.

Sanjeet Bagcchi is a physician and an independent writer based in Kolkata