Every day, in the flood of emergency room visits, doctors ask themselves this painful question: has such and such a child really had a bad fall or has he, in fact, been beaten? Is he in danger at home and should I report it? More often than not, they give up making such a heavy decision for the future of children that they are only crossing paths with.
Result, “Only 5% of reports of mistreatment are made by doctors, while they see, at one time or another, all the child victims”, deplores Dr Céline Gréco, responsible for pediatric palliative care at Necker hospital, in Paris. At the end of the day, the damage is considerable: “Without being rescued in time, abused children lose twenty years of life expectancy. “
In order to remedy this, Céline Gréco has been carrying out a project for several years which has been successful these days: the creation of specialized mobile teams in hospitals. Seven are emerging (read the benchmarks). Composed of specialists – doctor, psychologist and social worker – they intervene at the request of their colleagues, in the hospital and in town, in order to support them.
Changing the trajectory of victims
This device could fundamentally change the trajectory of children, hopes this doctor, who is highly respected in child protection circles. Under the name of Céline Raphaël, she had recounted her own childhood in a book, Excess, published in 2013. We read there the abuse she had suffered as a child, in general indifference, from her father who was determined to make her a piano virtuoso.
→ TO (RE) READ. Céline Raphaël promotes the cause of children
Spotted at the time by the Minister for Families, Laurence Rossignol, she is now actively supported by Brigitte Macron, president of the Hospitals Foundation, which is funding the project to the tune of 1.5 million euros. It will then be perpetuated and extended to the whole of France.
“In two days, I have already been approached ten times”
Because the first results show the extent of the needs. “In two days, I have already been approached ten times”, testifies Dr. Tania Ikowsky, head of the mobile unit of the Robert-Debré hospital in Paris, which has just opened. She discovers the deep distress of her colleagues. “In pediatrics and emergencies, everyone realizes that, too often, the hospital remains a place of passage which cannot assess the overall suffering of the child and does not know how to decipher the latent signs of abuse” , she believes. The examination of the child finished, he goes home, and everyone remains with his doubts.
Conversely, the mobile team “Makes it possible to break the solitude of the doctors, to support them in the detection, but also to reassure them about the future of the child after a possible report. In such a case, I myself make the link with the juvenile judge, social services, etc. to find out what is happening and coordinate his care path. “
A comprehensive approach to care
This rapprochement with the judicial world has already started, testifies for her part Dr. Solène Loschi, referring doctor in child protection at Trousseau hospital in Paris, a function created in 2016. According to her, it is now to go further in this direction.
“In Trousseau, since we meet social workers, police and justice representatives, we know better how to hear the child or write reports. These steps are essential in saving lives, but they are actually very little taught in medical school. It is essential to remedy this lack ”, notes Solène Loschi.
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Ensuring that no more children fall through the cracks is also the hope shared by Professor Yann Mikaeloff. On May 5, the unit of the Kremlin-Bicêtre hospital (Val-de-Marne) will also open its doors with the same concern for a global approach to care. “We can then take care of the whole family for an assessment but also in the prevention of recidivism, in order to prevent a disaster from occurring”, explains the neuropsychiatrist. And do so before it is too late.
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Children’s pact
This federation brings together the seven hospitals who are to deploy a mobile child protection team by September. These are three Parisian pediatric hospitals (Necker, Trousseau, Robert-Debré), one establishment in Seine-Saint-Denis (Jean-Verdier in Bondy), another in Val-de-Marne (Kremlin -Bicêtre) and the University Hospital of Brest and Grenoble.
Their mobile teams will intervene in all establishments and private medical practices in the sector.
The aim of the federation is to better identify child abuse, but also to develop appropriate care for child victims, including after their eventual placement in foster care or foster care.
The needs are real: only 30% of children in care today benefit from a health check-up and 10% from medical follow-up.
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