Island children one step closer to safety, as VIHA response team gets new lease on life
Island children who have experienced sexual and physical abuse will have an extra helping hand from a newly forming specialized Vancouver Island Health Authority (VIHA) abuse-response team.Thanks to the pediatric expertise of Dr. Wilma Arruda, VIHA has been able to reopen its specialized abuse assessment unit, also known as Health Assessment and Resources for Children (HARC). The unit — which is comprised of a leading specialist and child psychologists, nurses, social workers and more — has been closed for nearly two years due to funding restrictions after the previous doctor stepped away from the position. Now, Arruda will be selecting her team of child specialists to complete the HARC roster, which will be based out of Nanaimo as early as late spring. “As a pediatrician, I do see children from all walks of life, and seeing child abuse is something we face in our jobs,” Arruda says. She adds that while all general pediatricians do what they can to best assess situations of child abuse, teams like HARC are essential to medical care. “After the basics, like making sure a child is safe, abuse can be a very complex issue, and it really is up to a specialized team to deal with the findings.” Arruda is currently the advocacy chair of the B.C. Pediatric Society, and had close ties with the Ministry of Child and Youth Development. She has worked in Nanaimo since 1997, and says she’s had the opportunity to view a spectrum of at-risk youth in the north Island region.“We’re phenomenally lucky to have her,” Elaine Halsall, VIHA’s manager of child and youth family mental health, told media. “She’s an incredibly well-respected, experienced pediatrician. It’s beyond what we’d hoped for. It’s been a long time coming, but it certainly was worth the wait.”VIHA is still negotiating finances with the Ministry of Children and Family Development, which covered the $300,000 cost of the previous HARC unit.When it comes to child abuse in the region, the stats do seem grim. HARC receives about 200 referrals annually from around the Island, even since its closure, though most of these cases have been handled by emergency room doctors or physicians without specialized support. Meanwhile, the Island sees about 30 cases a year of seriously injured children who, until now, have had to travel with a social worker to Vancouver for expert assessment at the B.C. Children’s Hospital.It’s easy to picture these cases as young toddlers unable to help themselves, but Arruda says it’s important to remember that abused youth are seen well into their teens, and are just as badly in need of support. She also points out that abuse doesn’t always come from direct family members.“That’s the age-old question: at what age do you become an adult? For our purposes, we usually see youth until they are 18 or 19, though there can be a blurring of those lines,” she says. “When it comes to child abuse, the question really is, do we have good stats? There are, potentially, many cases that go unreported. For as much as we’re seeing, what aren’t we seeing?” Arruda’s team will not act as a 24-hour, seven-days-a-week service, and she points out that HARC will always depend on pediatricians to do initial assessment plans. But in terms of how the unit will operate, Arruda says she will have to see who the members are first. “What we have [for care] right now hasn’t yet covered all the needs,” she says. “There are so many factors to consider when calculating abuse — the emotional, psychological and physical wellbeing of a child, for example — that we can really only start to skim the top of an issue until we bring in that high level of knowledge.” Arruda says she will be reducing her time in her own practice in order to serve the needs of HARC, something she’s been interested in taking on for some time now. According to VIHA’s stats, as much as 40 per cent of the referrals come from the northern part of the Island, and travel is one of the largest deterrents to accessing help.“For many survivors of abuse and their families, the process of accessing help can almost be like one more level of abuse — you have to relive and often retell the situation,” says Arruda. “We don’t push children aggressively to be assessed. They have to want help, and to be a part of the team, part of the process. But you can imagine how adding two days of travel to that situation just layers on extra complications.” Arruda attended an international conference on child maltreatment in San Diego in January to update her skills, and plans to spend some time with Dr. Jean Hlady, a child abuse expert at B.C. Children’s Hospital. While she says she’s excited to be leading the team, she adds that finding a balance in her own life — as with any doctor — will be a key component of her success. “We do see a lot of happy and healthy children come through our doors, but we also see children with stories that are quite unbearable to hear,” she says. “There is a need for people to understand that this is out there and that we, as a society, have so often hid these dark secrets under the carpet. Can we find and help every case? No. But the more educated we are, the better we all can do.” M