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Maltrattamento ligure comune 2012

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Riunione per gruppo avuso comune

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Maltrattamento ligure comune 2012

  1. 1. CORSO PER DOCENTI ESPERTI/GARANTI UNICEF DEI DIRITTI DELL’INFANZIA E DELL’ADOLESCENZAconcertato tra Comitato UNICEF Genova, Di.R.E.- Dipartimento di ricerche europee eM.I.P. –Ufficio scolastico regionale della Liguria Rilevazioni di indicatori di disagio: semeiologia 16 febbraio 2012Dott. Alberto Ferrando•Pediatra di Famiglia•Vice PresidenteSocietà Italiana di Pediatria (SIP)•Vice Presidente Ass. Pediatri Extraospedalieri Liguri (APEL)•Presidente Federazione Regionale degli Ordini dei• Medici Chirurghi e Odontoiatri Liguri•Vice Presidente dell’Ordine dei Medici Chirurghi e Odontoiatri Liguri
  2. 2. Gli atti e le carenze di cure che turbano gravemente il bambino, attentano alla sua integrità corporea, al suo sviluppo fisico, affettivo, intellettivo e morale, le cui manifestazioni sono di: - trascuratezza e/o - lesioni di ordine fisico e/o - psichico e/o - sessuale da parte di un familiare o di altri che hanno cura del bambinoConsiglio dEuropa, Strasburgo, 1987
  3. 3. ”Ogni condizione che impedisce in terminipermanenti e gravi lo sviluppodelle potenzialità innate di crescita di unsoggetto in età evolutiva”I° Rapporto sulla Condizione dell’Infanzia edella Preadolescenza, EURISPES e TelefonoAzzurro, 2000
  4. 4. http://www.acf.hhs.gov/programs/cb/pubs/cm10/cm10.pdf
  5. 5. 7 gennaio 2005Periferia di BariBambina di 17 mesi MUORE DI FAME•Peso: 5,7 Kg•Altezza 76 cm•Capelli radi, fragili e facilmente asportabili•61 segni di lesioni violente o manifestazionimorbose o simili
  6. 6. 14 maggio 2009 - Imperia: muore bimbo di 17 mesi, sulsuo corpo numerosi lividi ed ecchimosiE’ giallo ad Imperia circa la morte di un bambino di soli17 mesi, deceduto ieri in circostante ancora da chiarire.
  7. 7. 3 dicembre 2009
  8. 8. Uccide il figlio e si suicida nelle sale dell AslRepubblica — 26 febbraio 2009 pagina 26 sezione: CRONACASAN DONATO MILANESE (MILANO) - «Andate via! Andate via o lo ammazzo!». Lascena a cui assiste uno dei primi testimoni che arrivano, poco dopo le 17, al primo pianodel Centro socio-sanitario di via Sergnano, a San Donato Milanese, già racconta latragedia che sta per compiersi. Un bambino di nove anni è a terra nel corridoio,sanguina dalla bocca, forse è stato già colpito da un colpo di pistola, unasemiautomatica calibro 22 che resta sul pavimento, poco distante dal corpo. Il padre,egiziano regolare, 52 anni, è lì con un coltello da cucina in mano, in forte stato diagitazione. Muove l arma in aria, poi la rivolge contro di sé e si ferisce ai polsi. Mentrearrivano infermieri e personale del centro che cercano di immobilizzarlo, inizia a urlare,si avvicina al figlio steso sul pavimento e lo colpisce per l ultima volta, poi si ferisce altorace e si uccide.
  9. 9. Tragedia a Venezia: madre uccideil figlio di 6 anni e si impiccaIl dramma è avvenuto in una casa di Ceggia verso lunaA scoprire i cadaveri il marito della donna al suo rientro
  10. 10. Dramma sfiorato in Val DAosta: padresi getta nel fiume con il figlio di due anniAOSTA (19 febbraio) - Mentre in Veneto si consumavail dramma della madre che a Ceggia ha ucciso il suobambino e poi si è impiccata, in Val DAosta, quasinelle stesse ore, se ne sfiorava un altro. Un 35ennetorinese, R.F., si è lanciato con il figlioletto di due annie mezzo da un ponte, a Donnas, dentro la DoraBaltea.
  11. 11. Ecc. ecc. vedi: http://pesanervi.diodati.org/pn/?a=126 La/le possibili soluzioni?? -Prendere coscienza dell’esistenza del problema -Prendere in considerazione che potrebbe capitare a persone a te vicine e a te stesso -Obbligo morale di considerarlo -Superare blocchi mentali e tendenze alle deleghe (ma io che c’entro? Spetta alla scuola, alla sanità ecc. ecc.) -Cercare alleanze con tutti: operatori della salute, del sociale, della scuola, delle forze pubbliche, del volontariato, delle conoscenze e delle amicizie
  12. 12. - Ogni 10 secondi una denuncia di abuso- Ogni giorno muoiono più di 5 bambini per conseguenzedi abuso-l’80% dei bambini morti hanno un’età inferiore ai 4 anni- Oltre il 90% delle vittime di abuso sessuale conoscevail molestatore- L’abuso avviene ad ogni livello socioeconomico, sociale,etico, culturale, religioso- Il 30% dei bambini abusati e maltrattati commetteràabuso sui propri figli- Il 80% degli abusati a 21 anni avrà problemi psicologici- Il costo dell’abuso e maltrattamento è stimato, negliUSA, essere di 124 miliardihttp://www.childhelp.org/pages/statistics#gen-stats
  13. 13. Injury Deaths Compared to Other Leading Causes of Death for Persons Ages 1-44, United States, 2007*•Injury FactsMore than 180,000 deaths from injury each year — 1 person every 3 minutes•Leading cause of death for people ages 1-44 in the US1•More than 2.8 million people hospitalized with injury each year•More than 29 million people treated in Emergency Department for injury each year•More than $406 billion annually in medical costs and lost productivity
  14. 14. ANCHE NOI POSSIAMO ESSERERESPONSABILI DIMaltrattamento per omissione di:-Diagnosi (vedi quanto esposto)-Informazione ed educazione-Prevenzione
  15. 15. Superamento del concetto “paternalistico”del Medico e sostituzione della “cultura dellamalattia” con la “cultura della salute” To cure To care
  16. 16. Ruolo e uso del pediatra•Pediatria “passiva”(ovvero orientata per vari motivi , soprattutto di demagogia, alla customersatisfaction e alla soddisfazione di tutte le richieste del singolo, della societàe della burocrazia)•Pediatria “intercettiva”(miglior organizzazione dell’attività e attivazione di filtri che permettono diintervenire in modo più efficace quando una famiglia si reca in studio: es:tosse e si verifica stato delle vaccinazioni, rendimento scolastico ecc.)•Pediatria “attiva” (o “di iniziativa”)(massima organizzazione dell’ambulatorio con cartella clinica informatizzatae richiamo delle famiglie che non si recano in studio. L’ambulatorio èintegrato con i servizi del distretto sociosanitario e con la scuola)
  17. 17. I luoghi delle violenze (alcuni dati italiani- Fonte CISMAI ) extradomestico 9% Il maltrattamento infantile è presente nella quasi totalità dei casi in “AMBIENTE DOMESTICO”domestico Fonte CISMAI 2001 91%
  18. 18. Chi è l’abusante? Dalla letteratura emerge: Il padre (prevalentemente nelle situazioni di abuso sessuale); Entrambi i genitori (in situazioni di trascuratezza, di maltrattamento psicologico, di maltrattamento fisico ed infine nelle situazioni a rischio); La madre (prevalentemente nelle situazioni di trascuratezza, di abuso psicologico e di ipercuria); Altri, quali nonni, fratelli, altri parenti, conviventi del padre o della madre, persone sconosciute (scarsamente presenti in tutte le forme di violenza ad eccezione dell’abuso sessuale).
  19. 19. Cosa fare per interrompere il ciclo ripetitivo del maltrattamento? Promuovere azioni finalizzate alla prevenzione primaria> diffusione di una Interventi dicultura dell’infanzia prevenzione in ambito scolasticoInformazione e Formazione permanentesensibilizzazione operatori Campagne di sostegno alla genitorialità
  20. 20. Percorsi di intervento di prevenzione secondaria e terziaria nei casi di “abuso all’infanzia” Rilevamento Diagnosi di accertamento, di esclusione o di rischio di maltrattamento attraverso una valutazione congiunta interdisciplinare Analisi del bambino e dei suoi bisogni Presa in carico Formulazione di un progetto integrato in “équipe” Attivazione di un intervento integrato e strutturato di ampio respiro (coordinamento tra ambiti sanitario, sociale e giudiziario)
  21. 21. Attori di un lavoro integrato• Forze dell’ordine e servizi di pubblico soccorso (polizia, carabinieri, vigili urbani, vigili del fuoco)• Servizi sociali (psicologi, psichiatri, assistenti sociali, educatori)• Scuola (insegnanti, dirigenti scolastici)• Uffici giudiziari (polizia giudiziaria, avvocati, magistrati, giudici)• Area sanitaria (medici, pediatri, infermieri, puericultori)
  22. 22. Cosa fare operativamente? Realizzare un collegamento istituzionale e formalmente riconosciuto con i Servizi Competenti ed eventualmente con le Strutture Giudiziarie
  23. 23. Abuso eMaltrattamentoinfantile

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