From mud to chaos, from chaos to life

EDITORIAL

From mud to chaos, from chaos to life

Elizabeth Cordeiro Fernandes

Professor of Faculdade de Medicina da Universidade Federal de Pernambuco (UFPE)

In this issue we publish three articles on violence in childhood that focus on distinct, but no less important, aspects of this highly serious social problem that is difficult to solve. The focus on different facets of the problem is interesting, because the articles deal with specific aspects—and experiences in different countries—as if they were two sides of the same coin. Both, meanwhile, seek to identify the underlying reality and to point out the difficulties that need to be overcome.

The Canadian article, which is a Review, addresses the issue of the impact of affection on the quality of relations between mother and child, while the original Brazilian article examine the lack of support and difficulties confronted by public health services in a developing country. This Editorial will highlight the latter.

Of the many tragedies that beset the world, violence and hunger are the ones that cause the most suffering to the greatest number of people. Were he alive today, the eminent Pernambucan doctor and politician, Josué de Castro, who wrote "The Geography of Hunger," would probably be stunned to know that there has been a surge in another kind of hunger: hunger for affection.

Both lack of food and lack of love produce a look of sadness in the eyes, corrode the soul, and dash hopes of a better future. Both are killers, in real or symbolic terms, and contravene divine and man-made laws alike; they wear down personal dignity, leaving an invisible but indelible tattoo. The lack of food may harden the heart and lead to a lack of love and vice versa, trapping in its finely-spun web thousands of children and adolescents, who are brutalized on a daily basis by social, domestic, sexual, and urban violence.

I once held a group therapy session with adolescents where I asked them to define violence. One thirteenyear-old girl responded "Anything that hurts us". This was twenty years ago, but her words come back to me on occasions such as the one I am about to describe.

Amora was fifteen when I met her. She came to the consultation with her mother, complaining of stomach pains and nausea. She was a quiet girl, who did nothing but stay home and go to school. She responded to my attempts to strike up a conversation with monosyllables or silence. When I examined her, I saw that her uterus was swollen and an ultrasound confirmed that she was pregnant. Amora tried to deny it but, when she saw the blurred image of a beating heart, she bowed her head and wept.

Her story is repeated like an echo in the lives of hundreds of adolescents in Brazil and around the world. The eldest of four children, her parents were semi-literate and had separated before she completed her first year. Months later, her mother had a new partner. She was a woman who was devoted to her family, who would leave home at the crack of dawn to work as a housemaid. Her partner looked after the kids and worked as a night watchman for a shop. When he noticed that his step-daughter was already developing the body of a grown woman, he was aroused by her and gave into the temptation. He threatened her with a kitchen knife as she was preparing lunch and this was the beginning of almost daily torture sessions, which eventually led to her becoming pregnant.

Now the conspiracy of silence had been broken, I found myself confronted with a dumbfounded mother, furious at her partner, whom her daughter called Dad. In mother and daughter alike, I could see tears of disappointment, tears of shame, tears of fear and disgust.

Some time later, I went to visit them in the maternity hospital. Amora was breast-feeding a baby girl, with the proud new grand-mother at her side. The latter told me that she had reported her partner and he had been sent to jail. She also revealed that the situation had repeated itself from one generation to the next. She too had been raped by her step-father, but her mother, Amora's grandmother, had refused to believe her and kicked her out of the house. When I asked the young girl how she was doing, she replied brightly, "Fine now. Everything's peachy."

According to the response of the girl who took part in the group therapy, Amora was carrying a heavy burden of incalculable pain. In technical terms, she had suffered a whole string of different kinds of violence, from physical to sexual, not forgetting that this case would also be considered an act of gender violence. Born in a poor ghetto in the Northeast of Brazil, she had inherited a life of social exclusion, been abandoned by her father at a tender age, and threatened and abused by her step-father.

Amora is not the girl's real name, but this is a true story and reflects that of other young girls, many of whom never recover from the experience. Hundreds flee onto the streets to escape the clutches of their abuser, falling into a life drugs, prostitution, and crime, which only adds to the violence. Many of them develop post-traumatic stress syndrome or depression, and, for some, the pain is so great that they attempt—sometimes successfully—to commit suicide. Many of them are not lucky enough to have a mother like Amora's, who was prepared to break the transmission from one generation to the next of soul-destroying and physically destructive violence and incest.

Were he still with us, Josué de Castro would have some hope: science recognizes a phenomenon known as resilience, which is an individual's capacity to sustain and overcome adversity or extreme—physical or psychological—pain. There is biological resilience, which is the capacity of organs to recover from damage, including the impact of everyday stress; but there is also social, psychological resilience. All of these resources flow into the same sea, which is the renovation of life, the recovery of the future, the possibility of being happy again.

Resilience is a process, not a permanent trait. It is a facet of one's personality, sometimes a genetic inheritance, which is linked to the ecological and socio-cultural context in which one lives.

These positive forces are freed up and allowed to develop by a caring family environment, by a network of affection and social relations, by public policy that targets families at risk, by an effective legal system, and by laws that ensure that offenders do not go unpunished, regardless of their gender, profession, social standing, or the color of their skin.

This concept of resilience sheds new light on the invisibility of those who live on the margins of society; it reawakens hope in those who have lived through unimaginable horrors. Resilience can bring us from mud to chaos and, from chaos, back to life.

Publication Dates

• Publication in this collection
  19 Apr 2011
• Date of issue
  Mar 2011