Lost Lives. The Pandemic Violence Against Children



by Einar A Helander

Review by Anna Luise Kirkengen, MD, PhD

Spring 2012 - Volume 16 Number 2


Lost Lives is a book of great passion and meticulous documentation. It discusses the range and amount, locally, nationally, and globally, of childhood violation. It makes evident how violated children's health is impaired and plays out in subsequent everyday medical encounters. The book combines individual and global perspectives and integrates medical, psychological, and relational facts and data in a reflection about the origins and impacts of a global phenomenon: the violation of children, rightly defined as a pandemic.

The author, a cosmopolitical Swedish physician, has dedicated most of his professional life to collecting, exploring, and condensing a particular type of documentation: how and why the cutting of roses releases tornados. Einar A Helander, MD, former Chief Medical Officer for the World Health Organization (WHO) Disability Prevention and Rehabilitation Programme, uses this metaphor to make clear that if a rose is cut (a child is violated), an irreversible disruption takes place that represents a disturbance, the extent of which nobody can predict. Such "tornados" shake and destroy lives, they cause misery and transgenerational suffering and disease, and they fuel aggression, brutality, addiction, war, and crime. By means of figures, numbers, and reports from 185 of the 195 countries represented in the United Nations, Dr Helander makes obvious how far from real civilization the global society still stands.

Dr Helander also presents a calculation of the sociopolitical costs generated by the world's violated, abandoned, and abused children, and he documents that "in no less than 153 countries there were—in 2009—reports of non-war-related human rights abuses of children." Thereby he places the responsibility for an extended "legitimacy" of illegitimate crime against children at the highest sociopolitical level: childhood sexual abuse, child labor, child trafficking, and female sexual mutilation, although documented beyond doubt, are not responded to by means of adequate actions from the side of the rulers, some of whom have, according to Dr Helander, "been involved in this abuse."

The author's term "lost lives" refers to children who meet a premature death because of violation, who suffer from the long-term impact of having been traumatized, who live without a family, and who are exploited. In other words, he counts lives as lost not only in case of factual death, but also in the sense of present and future health being seriously impaired and their potentials for flourishing and unfolding decisively hampered or disrupted by abuse, deprivation, and neglect.

Child abuse occurs not only in a comfortable distance from affluent societies, in countries of the third world, among immigrant populations to developed countries, and in strata of populations that physicians in Western countries seldom encounter. Violated and abused children enter—either as molested children, troubled adolescents, or diseased adults—every clinical office, including Kaiser Permanente. This fact can be deduced from studies on population1 and individual levels.2 All physicians are confronted with the impact of the patients' violation experiences, whether they recognize or fail to understand the true origin of the health problems presented.

The book, introduced by a former Prime Minister of India, a former Director-General of WHO, and a clinical professor in pediatrics, ought to have a warning sign on its cover, a kind of BEWARE!, telling potential readers that the content is as far from comfortable reading as it can get. This is no book for physicians who don't want to know what children are exposed to, and how that plays out later in life in their offices.

People who not only want to appraise the theories of human rights' declarations in general, but who want to know how these are practiced in their own society in particular, to delineate how they themselves might contribute to improvements, will find a wealth of useful facts in the book's tables, boxes and lists. They will also find carefully selected photographs, none of which are speculative. It befits the message of this book to illustrate cultures of violence by an insight into an American gun shop or the pompous glory of a dictator along with a few photos of molested children. The guns and the glory are the other side of the coin of childhood misery worldwide. Dr Helander offers us knowledge that is highly relevant to successful clinical practice. Do we want to know?

1    Felitti VJ, Anda RF. The relationship of adverse childhood experiences to adult medical disease, psychiatric conditions, and sexual behavior: implications for healthcare. In: Lanius RA, Vermetten E, Pain C (eds.) The impact of early life trauma on health and disease: the hidden epidemic. Cambridge: Cambridge University Press, 2010.
2    Kirkengen AL. Inscribed bodies. Health impact of childhood sexual abuse. Dordrecht: Kluwer Academic Press, 2001.


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