Positive Prevention and Intervention Strategies

For Child Abuse

The Right to happiness project started before the Stockholm World Congress against Child Abuse. It was part of the process of preparation during which large gaps of our knowledge had been identified. These gaps were not just about the incidence, the numbers of children who were being abused, but also covered a lack of aware­ness about what was currently being done to try to address the problem, and which of these were most effective.

The Right to Happiness project was implemented by the NGO Group for the Convention on the Rights of the Child. It was established to try to identify some of the responses that were hap­pening around the world to try to address the problem of child abuse. The project wished to pres­ent information about what was happening to the World Congress, to inform about positive actions that were already being taken. The Con­gress wanted to raise awareness about this is­sue around the world. The Right to Happiness proj­ect sought to ensure that included in this aware­ness was some knowledge about interventions that were being effective about prevention and re­covery.

As to the World Congress itself that took place in Stockholm in August 1996. The Stockholm meeting was the direct result of an almost unique degree of cooperation between different groups and sectors. It combined and utilized the talents, strengths and resources of governments, notably the government of Sweden, intergovernmental bodies and the world-wide NGO community.

What did it do? It achieved a great deal. 122 governments were represented. Hundreds of NGOs, academic institutions and concerned in­dividuals attended and contributed. Many of the constituent parts of the UN family were represented.

It involved policy makers, legislators, practitioners, and advocates, and most notably children who were able to demonstrate their understanding, competence and positive ideas for addressing the issue. It focused world attention on child abuse. It acknowledged it as an almost universal phenomenon. It commented upon the scale of abuse.

A Declaration and Agenda for Action were unanimously agreed. The Declaration affirmed the commitment to global partnership against child abuse which was recognized as an absolute and fundamental violation of the rights of the child. It restated that all the signatories to the Con­vention were required to protect children from abuse and promote physical and psychological recovery of those already victimized. It affirmed the need for strong laws, and the need for re­sources and political commitment to enforce them. It confirmed the need to build and pro­mote partnership between all levels of society to counter this form of violence. It called for the highest priority to be given to action against child abuse, to develop and implement comprehen­sive planning and programs that address the issue through a diverse but complementary range of strategies.

TEXT 10

Balkans after Milosevic: Still Perilous Waters

The removal of Slobodan Milosevic in Serbia has opened new opportunities for peace in the Balkan region, but also created a fluid situation where treacherous problems abound.

For some time, Western strategic thinking on the area has involved the notion that if Mr. Milosevic could be ousted, other problems would fall away. But for a variety of reasons including the depth of anti-Serbian feeling engendered by nine years of war and the record of Mr. Milosevic’s suc­cessor little soothing balm has immediately been felt.

Vojislav Kostunica, the new Yugoslav president, has made clear conciliatory signals toward Croatia, which has long battled Belgrade for independ­ence, and Montenegro, where secessionist currents are strong. Yet his gestures have not convinced a skeptical region.

"There has been tremendous positive change in Serbia, but it has not had the immediate positive impact on the region that we would have hoped," said William D. Montgomery, the Buda­pest-based United States ambassador with re­sponsibility for Yugoslavia.

A new era in the Balkans has opened Mr. Milosevic, who propelled Yugoslavia into war nine years ago, is gone; Franjo Tudjman, the Croa­tian president who fanned Mr. Milosevic's flames, is dead; Alija Izetbegovic, the outgunned and stubborn Bosnian president, quit last week­end. It is not surprising that expectations are high.

But it is not yet clear that Mr. Kostunica is able, or willing, to deliver what America wants. His past nationalism makes some neighbors skeptical, his popularity in the West makes other neighbors envious, and his arrival has come so late in the process of Yugoslav disintegration that it is far from clear that the process can be arrested.

“The tremors continue from what has been a very strong political shock, and there is some am­bivalence in the region," said Zarko Korac, an ally of Mr. Kostunica who visited Croatia last week. "Some people feel that Serbia will now get off the hook too quickly, and there is concern we will get the lion's share of money and attention."

There are, however, encouraging signs. Lead­ers from Bosnia, Croatia, Macedonia and other Balkan states are to meet Mr. Kostunica in Skopje, the Macedonian capital, next week, the first such gathering for many years and an indication of the hope engendered by the Yugoslav president.

But the meeting also illustrates a central point: the problems of the Balkans remain deeply in­terlinked. Change a border here in Montenegro or Kosovo, for example, and Bosnia's Serbs may feel justified in demanding union with Serbia or a state of their own. Support Serbia with a lifting of sanctions and Croatia may feel slighted or enraged.

The question now is how sensitive Mr. Kos­tunica will be to this regional volatility. Up to now, the signals have been mixed.

"We would have liked to hear Mr. Kostunica address the Serbs of Bosnia and tell them that while they will always have a special relation­ship with Belgrade, their future lies unambigu­ously in Bosnia-Herzegovina," said Jacques Klein, the American who is the chief United Nations repre­sentative in Sarajevo. "But it has not happened."

Rather, Mr. Kostunica has said he respects the 1995 Dayton accords while setting the Bosnian government's nerves on edge by indicating that he may travel this weekend to the Serbian part of Bosnia to attend the emotional reburial of a poet, Jovan Ducic.

TEXT 11

Physician Violence - Who Is Involved?

Liederbach, et al, appear to define physician violence as violent crimes committed by physicians in the course of medical practice. However, perhaps the group should be expanded beyond physicians to include most health care practitioners. For example, the National Practitioner Data Bank receives reports of judgments, complaints, and actions taken from state medical boards, DEA, FDA, and various federal medical organizations such as the Veterans Administration and the Bureau of Indian Affairs. This data bank lists twenty seven categories of health care practitioners for which it records data. Of the approximately 192,000 reports filed in 2002, 133,000 were for physicians - the next largest groups were dentists, chiropractors, and nurses. However, the data bank also includes such diverse categories as acupuncturists and social workers.

To be complete, a definition of physician violence should be expanded to cover health care professionals and include at least those professional categories listed in Table 1 of the National Practitioner Data Bank. It may be useful to re-label physician violence and call it violent medical crime. After all, dentists and nurses have been convicted of crimes committed in the course of medical practice or in a medical setting. And, it appears from the data that acupuncturists and social workers are also involved in medical care and generate reportable activity.