EIGHT in 10 Filipino children have experienced violence. Three out of five have been physically and emotionally abused, and bullied. One out of five has experienced sexual violence.
“Beyond the numbers, this is about the needless suffering of our children,” said Dr. Bernadette J. Madrid, a pediatrician, citing a 2016 national study on violence against children.
“It’s a moral disgrace and the consequences are borne by this generation and the next,” said Madrid, executive director the Child Protection Unit of the Philippine General Hospital (PGH), University of the Philippines Manila, and one this year’s recipients of the Ramon Magsaysay Award.
Madrid is recognized for “unassuming and steadfast commitment to a noble and demanding advocacy… that is admired in Asia.”
“We are the only Women and Children Protection Unit in the world,” Madrid said. “We have been one of the first among very few countries to call the attention of the world that boys are just equally at risk if not more so than girls for sexual abuse and other forms of exploitation.
“When we say services for children, that is for all children regardless of gender. More challenging is developing services for adult males and adult LGBTQI+.”
Early on, she and colleagues at UP Manila identified the Department of Health (DOH) as the best entry for a multidisciplinary team of doctors, social workers, and mental health providers working against child abuse.
“Health is the gateway for so many victims of violence,” Madrid explained. “It is a natural entry point for receiving care especially for those who are not ready to disclose abuse.” The DOH has the capacity for both intervention and prevention work and data collection is a routine part of its work.”
It led to a major achievement: the establishment of Women and Children Protection Units in all government hospitals and the DOH Women and Children Protection Program.
The next challenge was the placement of women and children protection in universal health care and convincing the DOH that violence against women and children is a public health problem.
Madrid was told many times, including by a health secretary, that violence against women and children was not a health problem. It took several resolutions of World Health Organization assemblies starting in 1996 before the perception changed.
It helped that a study Madrid conducted with colleagues in 2010 showed that most of the top 10 diseases in the Philippines could have been determined decades earlier by adverse experiences in childhood.
Today, with the United Nations Children’s Fund, Madrid is expanding women and child protection units at the barangay level.
Legal services are included in these initiatives. “Police and lawyers are not part of the health sector but access to justice is a need of the patients we serve,” Madrid said. Many times, having the police right there as part of the team decreases the re-traumatization of the victim, she added.
In 1998, a memorandum of agreement was signed with the Philippine National Police to have trained policemen as part of Women and Children Protection Units. The same agreement has been signed with the Integrated Bar of the Philippines, a lawyers group.
A study conducted at the PGH Child Protection Unit led the Supreme Court to require a competency enhancement training for judges and court personnel handling cases involving children.
One challenge is that most mental health providers are in Metro Manila, and only around 30 percent of the Women and Children Protection Units have mental health caregivers.
Expanding remote or tele-psychiatry is one coping strategy. Another temporary solution trains social workers to deliver trauma-informed psychosocial processing (TIPP), the Philippine adaptation of cognitive behavior therapy. It is done under supervision by a psychologist or psychiatrist trained in TIPP.
The PGH Child Protection Unit also presented evidence to lawmakers that most sexual abuse cases involved children aged 13-15 years old. It was one of the convincing arguments for lawmakers to increase the age of statutory rape from 12 to 16.
“From the start it was clear that violence against children and violence against women are closely related to each other,” Madrid said. “Children who are abused have mothers who were either a domestic violence victim or was abused as a child.”
It has been 25 years for Madrid. “We can have an impact if we are here for the long haul and we are persistent and focused.”
Madrid has devoted herself “to seeing that every abused child lives in a healing, safe and nurturing society,” her Magsaysay Award citation says.
