Part II
Last week we went through the fable of the frog in the boiling water. We also discussed the details of two recent cases of failed children by the community and the state.
In the first case of Kimani Frančesku, for a two-year-old child to go outside freely would not be the first time the child had run away. That would probably be the furthest. And the last one. There may have been a culture of lax supervision and an overburdened family.
As for the neighbor who saw the child, in the past, a neighbor would accept the responsibility of the village and run after that child, catch him, return home, turn off the stove, take the child to the mother, advise. mother and return home to finish cooking. In the case of McKenzie Hope Rechier, there would be more community health follow-up of a depressed schizophrenic patient.
If neighbors overheard a mother with a history of mental illness talking about killing herself and her child, they said the neighbors would come down to the police station and force an answer. They called everyone, every day, until something was done. The grandmother held the child, while a nurse, a doctor, a priest, the police, the head of the community, the councilor, the ministry of something, someone, anyone would be informed by the neighbors, by the grandmother, forcing the state to get involved in this case . There would be no shifting of blame with the Child Protection Unit (CPU) and the Children’s Authority (CA) and, in fact, there would have been many of them involved in this case and they would have been stepping on each other.
Do not misunderstand me. I’m not saying that for sure, 100 percent, I would have done something better. I know these families and communities have been hurt. There may have been some guilt and blame and anxiety, and I don’t want to add it all up. I hope I would have taken more responsibility for the village if placed in a similar situation, as I’m sure most of us expect we would have done. But with crime, fear and silos, we are isolated in pockets. We are withdrawn. There is a sense of none of my business, none of my responsibility, let me stay in my corner and just take care of my family. There is a feeling that let me refer to the state and let it handle it as it is not my monkey or my circus.
People drive to work or commute, come straight home, give a little wave to their neighbors, watch Netflix and YouTube, send messages on WhatsApp, connect virtually and ignore the physical community. While this is happening and the village has abdicated its responsibility to raise and take ownership of the child, the state has not been able to pick up the slack and close the gap.
The police and the FIU are understaffed and do not have the capacity to cover all areas and respond urgently at all times. The Children’s Authority has, in my opinion, failed to make the impact it set out to make and its responses are still slow and pedantic.
Agencies and other related state agents have not recognized our faded social fabric and see responsibility as monochromatic. If it’s a child issue, it’s CA or CPU. But they are wrong. It is also the teacher, the health care worker, the community leader. This is not the Swiss cheese pattern where these kids have fallen through the cracks when the holes line up wrong. This is where no one has picked up the baton, leaving a big, bright void.
However, within the stories there was also the additional element of a lack of awareness of mental illness. Like diabetes and hypertension, mental illnesses require diagnosis, regular clinical follow-up, medication and psychosocial support. If there are signs that the person is decompensating, then he urgently needs medical help to reassess and treat. It’s not something to ignore and hope for the best.
I often talk to my emergency medicine students about visuals. To really see the patient when you listen to the story, you have to create the picture in your mind. I can see two-year-old Kimani, barefoot, walking along the track, walking in a diaper, sometimes unbalanced, happy to be away, looking for adventure, but suddenly alone. I can see seven-year-old Hope, in a shack with no electricity, with a withdrawn mother, talking to herself, not bathing or eating properly. I hope she is confused by her mother’s behavior, feeling alone and scared, choosing to stay quiet, in a corner, until things get better.
We would never really have the social financing that is readily available in developed countries or democratic socialist style countries. So the state would never have the capacity, staff or funding to care for all our children in need. Instead, we need to build in different layers of accountability and responsibility. If you see something, say something. If you are a government agency in charge of something, do something. If you are a leader in the community, in the nation, take ownership of something. I’m officially sounding the alarm. Wake up, wake up, the water is boiling.
– Dr Joanne F Paul is a lecturer in emergency medicine with the UWI and a member of the TEL institute
