"We do not realise the amount of devastation abuse can unleash in a child until it happens to someone we know," says Zoone Hasan Sultan, who, in 2018, initiated Tahaffuz - a child protection initiative by a non-profit organisation, Thali. "In Pakistan, efforts to tackle child abuse have often been taken as a reactionary - rather than preventative - approach. When something as catastrophic as Zainab case takes place, it causes us to momentarily sit up and take notice. But with time we forget everything since the storm never really reached our own turf," she says.

Sultan is referring to the case that shook the country in 2018 when a girl child was abducted, raped and murdered by a serial killer in Kasur. Last Tuesday, police recovered remains of three children - raped and murdered - from sand dunes near Chunian Bypass. This unfortunate event has brought the issue of child abuse to the fore, once again. It has shown that these incidents are not one-off. They point towards an underlying issue that has remained unaddressed for long. According to a report by Sahil, a local NGO working for child rights, over 1,304 children were sexually assaulted in Pakistan within the first six months of 2019.

With the number of sexual abuse cases growing throughout the country, it is imperative for parents and caregivers to try to identify and address the warning signs of abuse before the situation escalates into something utterly disastrous.

"Most commonly associated signs with child abuse are bed wetting, promiscuous behaviour and profanity," says Saira Aziz Khan, a licensed psychotherapist from California who has been working as a psychologist in Pakistan for a few years now. "Keep a close check on how children communicate with friends, whether or not they are using words or expressions not commonly used in your household."

Khan says that if the presence of any adult is causing a marked difference in their behaviour, it might be an indicator of abuse. Among other signs are a sudden drop in grades, increasing temper tantrums, having trouble sitting, bruising around genital areas or the presence of UTIs. "In all such cases, there is a sudden development of self-esteem and anxiety issues in the child."

She says that in most cases the abused child will know that there’s something wrong, but may not be able to understand or express it properly. "In this case, children will often try to replicate the abuse scenario with their peers."

"Children who are being abused will quite often unknowingly threaten other children at school with the same kind of abusive behaviour," says Aleesha [name has been changed upon request], owner of a private school. "Older kids will handle it by describing their own experience as something that’s happening to a friend or someone they know." She says that abused kids portray the trauma they’re facing in different ways at school. "Sometimes they draw what they’re feeling. Other times, they would write something that depicts their emotions. Or they will be overly aggressive."

The list is not exhaustive. All children are unique and hence react differently to a thing as severe as abuse. Parents need to be vigilant, look out for the telltale signs of abuse and take necessary steps to tackle the situation as soon as they feel something is off about their children’s behaviour.

Parents need to develop a safety net for their children, says Khan. "Children should be confident that parents won’t reprimand them if they talk to them about their experience." Khan says that parents should ask open-ended questions instead of jumping straight to the topic of sexual abuse. "It might confuse the children. We must remember that a number of times, these changing behaviours are not even related to child abuse and point towards some other issue, like bullying."

She asserts that kids should never be shamed - explicitly or inexplicitly - when they come out with their experience. "Or else that shame will be internalised forever. They need empathy at moments like these." Khan maintains that the primary responsibility to detect abuse lies with parents and teachers. "Lines of communication between parents and children should remain open at all times. Children should feel that they can talk to their parents about every thing."

Sultan thinks that in a country as conservative as Pakistan, storytelling could be used to help children understand what child abuse entails. "Without being too explicit you can say it all out. Like we did in case of Chuchu ki Kahaani (A story she’s written for children on the topic of child abuse).

This all sounds doable on paper. Children experience abuse, they talk to their parents about it, parents take care of the issue. Problem solved. But the reality is far from perfect. In Pakistan, matters like child abuse are often brushed under the carpet. Parents face a number of social challenges in tackling child abuse.

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A lot of times, children show aversion to being in the company of certain relatives. According to Khan, in these cases, the child should not be pressured into meeting such family members. "They should know that their parents have their back. When it comes to dealing with abuse, your child’s interest is paramount. Parents need to have the courage to stand up to the relative in question or else they will ruin their child’s mental state forever," says Sultan.

According to Aleesha, school counsellors need to maintain strict confidentiality with children instead of spilling the beans to their parents. "The child needs to be able to trust the counsellors in order for them to be able to help the child. There is not a lot of training about confidentiality around these matters." She also says that parents should also be more open in such cases. "Oftentimes, it becomes impossible to convince parents about their child being abused, as the major source of abuse often lies at home."

She also says that in order to effectively create awareness about child abuse, the initiative needs to come from the top. "It is difficult to create awareness in an environment where private schools have to tear out chapters on reproduction from science books." She says that private schools are not allowed to discuss sexual health with students or use words such as ‘puberty’ in class. "How can we educate children about sexual health and abuse in this manner?" she asks.

All this presents a gloomy picture of the situation. But does it also mean things will never change? Not necessarily, argues Sultan. "Deeply ingrained social behaviours take a considerable amount of time to change." She says that both parents and kids should continue to take part in abuse awareness workshops and trust activities conducted by child psychologists, as these can bring about results sooner than later.

"We need to keep at it. Trying but not witnessing any concrete results can get frustrating at times, but it’s our children who are at stake. We just can’t afford to give up," she says.