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Susie’s Place to begin offering medical exams to child abuse victims

By Lauren Slavin, Herald Times:

There’s an immeasurable health benefit for children who have been abused to hear a doctor say, “You are OK.”

“It is good to be able to make sure that a child understands they are a healthy child,” said Dr. Richard Malone, a pediatrician with Riley Physicians at Indiana University Health’s Southern Indiana Physicians group. “It’s good for a child to understand they may require some psychological help to bring them back into good health, but that’s OK.”

But after Susie’s Place interviewers complete an investigation into a reported case of possible abuse or neglect, Malone estimates, more than half of the child victims don’t see a health professional for a follow-up medical exam.

The child advocacy center has locations in Bloomington and Avon, and its staff members conduct forensic interviews with children across the state. About 85 percent of cases involve possible sex crimes against children, according to Susie’s Place statistics. Last year, in Monroe County, the child advocacy center investigated 147 cases of possible sexual abuse and 21 cases of possible physical abuse.

“Many times with physical or sexual abuse, there’s not a lot of evidence to the plain observer that something has happened,” Malone said. “Many times when kids are abused, maltreated or neglected, there is no medical evidence, no injury that you see. But every child who is evaluated ought to get a medical exam to see if there is an injury.”

However, only two Indianapolis hospitals — Riley Hospital for Children’s Pediatric Center of Hope and Peyton Manning Children’s Hospital at St. Vincent — have pediatric sexual assault forensic medical programs close to where most Susie’s Place clients live.

Children living in poverty and facing barriers such as multiple working parents or guardians and limited access to transportation often don’t have the time or ability to go to multiple interviews and doctors’ appointments, Malone said.

Without medical intervention, Susie’s Place clients as young as 10 and 12 years old were pregnant and suffering from undiagnosed sexually transmitted infections, said Emily Perry, executive director of Susie’s Place Child Advocacy Centers.

“We had kids that were experiencing weeks, months, years of sexual abuse who were not getting appropriate medical attention because we could not get them to trained medical providers,” Perry said. “Not necessarily for evidence collection — just to make sure their bodies are healthy and normal, they don’t have STDs (sexually transmitted diseases), that they aren’t suffering from an injury that hasn’t been identified.”

Using an $11,000 grant from the city of Bloomington’s Jack Hopkins Social Services Fund, Susie’s Place will soon be able to provide nonacute medical exams at its Bloomington center for children suspected of being victims of abuse.

Starting Aug. 1, children who come to Susie’s Place for a forensic interview will immediately be able to get a medical exam, if investigators determine one is necessary. Exams are paid for by Indiana’s Violent Crime Victim Compensation Fund at no cost to the child’s family. From there, Malone, who will serve as medical director, and IU Health nurse practitioner Danielle Benedek, who will also be on staff, can determine if the child should also see a specialist.

“It just provides them an additional space to make sure they’re getting the treatment and care that they need,” Perry said. “Just to hear, ‘Your body is OK and healthy; you can have children. It doesn’t mean anything about your sexual orientation; your body responds a certain way during sexual assault,’ are things that are really important for children and youth to hear.”

Malone and Benedek also are receiving continual, specified training from Riley Hospital for Children at IU Health on conducting sexual assault exams for children. While general pediatricians provide holistic, long-term health care for children, Malone said, conducting forensic medical exams is difficult for health care professionals who haven’t been trained to do so “in the least intrusive way” possible for the patient. The exams must also be documented, and evidence must be collected or recorded to be turned in to law enforcement.

“It’s hard on people to do that. There are many health care providers who say, ‘I could never take care of a kid (victim of sexual assault),’” Malone said. “It takes somebody who really wants to serve a child in that way.”

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