Child maltreatment: "No animal can be as cruel as humans"
Most children are from baby to elementary age
Finally, when she has lifted the children off the examination table and praised them for their patience, Dragana Seifert pulls up the cupboard under the changing table every time. "This is a magic cabinet," she tells the children: Pixi books are lying there, lollipops, granola packs, cuddly toys, picture books with Ferdinand, the elephant. The children, whose body she has just searched for signs of beatings, burns, bites, may then choose something; Most of them take crayons and a coloring book, some of them cereal bars, out of hunger, because nobody in their family cares about them eating regularly.
They take the pencils, the bolt and the book and leave the world they do not really belong to, because it is not made for people who are at the very beginning of their lives: the Forensic Medicine of the Hamburg University Hospital Eppendorf, UKE.
Dragana Seifert is a forensic doctor, she investigates maltreated, neglected children; Children who bring her the youth welfare office. Actually, the investigations are not their job, but a pediatrician. But because it takes legal expertise to recognize that a hematoma is not the result of a fall from a baby's dresser, but fist blows, and that a little boy's lipstick injury suggests she was brutally fed, she had taken UKE eight years ago The Children's Competence Center is launched. "No animal can be as cruel as humans, I've learned that," she says.
Seifert has the resoluteness of a woman accustomed to making herself heard. She has to do this in court, where she presents her report on injuries to victims of abuse and violence, both adults and children. She speaks loud and straightforward, in a hard, rattling staccato. There is an urgency in her tone. Children in distress need help quickly, and Seifert only has this brief moment in an ambulance after an examination to make it clear to parents or youth workers that they must act immediately.
She examined 800 children in 2016, 100 more than the year before, most between the baby and elementary age. In about 15 cases, she then filed a complaint with the director of the institute, Klaus Püschel - especially critical cases for which she is allowed to break her medical confidentiality because the life of a child is in danger.
When a life is in danger, it breaks its secrecy
The lawyer Dragana Seifert founded the Children's Competence Center in Hamburg in 2008.
© Julia KnopOne must not accompany them in this work, it protects their little patients. It is hard enough for them alone to gain their trust. So you meet for a chat in one of their two study rooms, several times, because they can only interrupt their work for an hour or so.
Sometimes she squats on the edge of the examination couch during the whole conversation because she forgets to make herself comfortable while telling. Another time she sits at her desk, a small, plain table with a file hanging on it, in front of it two orange chairs, financed by donations, as well as the baby changing table with a huge plush teddy on it.
The conversation interrupts her only for a WhatsApp her adult son, she answered smiling. She is always in the right place because it's her thing. "The Competence Center," she says, "that's what my son, of course, does for what I burn."
At that time we asked ourselves: "Who actually cares about the children?"
She realized just how urgently the children need their help when, together with Klaus Püschel, she set up a contact point for adult victims of violence in 1999 at the UKE, where they worked as volunteers for the first two years. "Many of the women we studied told us that their husband also beat their children, so we asked ourselves," Where are all these children, who cares about them? "
Supported by a foundation, they founded the Children's Competence Center in 2008. The Hamburg Social Security Agency is also supporting the project. "The authorities are sensitized, you can tell," she says. Between 2013 and 2015 alone, the number of children examined in the competence center doubled. However, the subsidies from the agency are not enough to finance the investigative body, Seifert and her colleagues continue to depend on donations.
The center is a special feature in Germany. For a long time, there was no special advice center for youth welfare workers who discovered suspicious wounds on a child, and certainly no job that produced a report that could be used in court.It is also particularly important that the center is officially a partner of the city: a cooperation agreement concluded in 2014 with the social security authority stipulates that youth welfare office employees should present children and adolescents to the center staff in cases of physical injury or neglect.
Although pediatricians can detect maltreatment. "But in practice, they often lack the time to deal with the background of the injuries," says Seifert. And sometimes the distance to the parents is missing. "As a forensic doctor, I approach the matter neutrally, without the thought: That can not really be done." It can do it, she knows that. "Maltreatment is happening across all layers."
The death of three-year-old Yagmur was like a failure of her own
Dragana Seifert is a native Croatian, at 23 she went to Switzerland, her "adopted home", as she emphasizes. She made her specialist and got to know the principle of clinical legal medicine, which she then brought to Germany. Because with us victims of violence were then only then examined by legal medicine, if there was a criminal complaint. It was not the victims, but the police or prosecutor's office that initiated the assessment. "But many victims do not report for fear because it was a relative," says Seifert. "If they later want to sue in court, they lack the legal medical report." The injuries are then no longer provable in court.
Seifert and her colleague Püschel were the ones who in the case of Yagmur - the three-year-old girl who was killed by his mother at the end of 2013 in Hamburg after the youth welfare office had returned it from his foster home - were charged with ill-treatment Child had been introduced to her. It took a long time for her to accept that she could not prevent Yagmur's death, that her criminal charges had no consequences. "Suddenly the child lay in the cellar with us, which sounds pathetic, I know, but for me it was like a failure of its own, and I kept wondering: what more could you have done?"
This is the worst thing for them: to accept something as unavoidable, to accept. Dragana Seifert wrote her doctoral thesis in radiology and worked in Switzerland for several years as a radiologist; many of the patients she was dealing with were suffering from cancer. "It was extremely hard for me to say goodbye to patients I had taken care of for months, and to hear that feeling someone had died made it easier to know people in forensic medicine as dead."
She carries her mobile phone with her around the clock, she can always be reached. In addition to the 800 or so examinations a year, there are still 300 to 400 counseling sessions, often with worried grandparents or teachers who have noticed something about a child, for example, because it has come to school with bruises. It also goes on public holidays or a weekend in Advent for examinations in the clinic. The Circle of Friends has become accustomed to getting up in the middle of dinner when the phone rings and saying, "Continue eating without me." "Not everyone understands that," she says. "But my work can only be done if you really stand behind it, but I do not want to pretend heroic deeds, I rarely wake up at night, the main time is between seven o'clock in the morning and 11 o'clock, when youth workers or worried teachers or kindergarten staff call."
If the calls start at night at the institute, the phone is manned by a medical student who decides whether to contact Seifert or another doctor. A mailbox is out of the question for her. "Anyone who cares about a child and has the courage to call, he also needs someone to talk to him at night," she says.
She does not ask the child, she listens and looks
More than 80 percent of the children are brought by a youth worker. Mostly Seifert does the examination himself, and there are also some colleagues in forensic medicine who support their work. In at least two thirds of cases, the initial suspicion is confirmed. If the parents do not consent to the investigation, the office temporarily treats the child.
Seifert picks up the child and youth workers at the entrance of the institute, she has set up the waiting area herself, furniture in the 70s style, the chairs in white and apple green, a modern break from the purpose-gray of the building. She talks briefly to the bureaucrat to find out why he came. Then she brings the child to the examination room, paints with him first or plays ball or puts the teddy on the couch and shows him how to make it up and shut down again.
She does not ask what a child has experienced, she only accepts what she tells her. An examination is a careful approach to the body. Seifert takes the time to win over a child; sometimes the children twitch at a touch. The most common physical abuse she sees is the marks of a hand, a shoe or the welts of an electric cable. "Shaped injuries?" She calls it. "I always follow the tempo the child gives me," she says.
The trickiest point is undressing."You look at your upper body, put your child back on, look at your legs, the underpants are always on, but I look in, because it's often a region where it gets hit, if it says no, it will not convinced with a lollipop, so I would do the same to him the offender did to him. " The investigation takes about an hour. Often she seeks advice from colleagues - surgeons, radiologists, psychologists. "Child maltreatment is medical teamwork," she says.
Although the cooperation agreement with the city provides that all children with suspicions are presented in the center. But the youth welfare office can only react to cases of which it learns; Since benefits such as family help are often outsourced to free-lancers, who in turn employ honorary staff, a number of cases slip through the loop, especially those in which there is a lack of health care. Because most children bring with them a whole bunch of problems. Therefore, in three out of four examinations, there is a pediatrician who looks at where the child is in its development. Recently, the competence center has its own pediatrician with a full-time job.
When parents lie to her, she does not get angry. But she wants them to get help
The doctors then prepare a written statement, recommend further treatment at the orthopedist or ophthalmologist or in the adolescent psychiatry. "I'm not only concerned with bruises and scars, but with everything a child brings," says Seifert. "If we want to give these children a chance in life, it is very important that they are not only forensic, but also pediatricians are examined." Many parents do not go to the regular examinations 'The children have asthma and allergies, that only turns out to be here.'
She talks about a girl of elementary age, who brought the youth welfare office on suspicion of assault. The child was diabetic, and it was all his own fault with his insulin control, which he was not capable of. "That's life threatening," says Seifert. "And the youth welfare office did not even mention that."
Often, parents try to talk themselves out, saying that a bone fracture comes from a fall. A child who can not walk can not break their bones in a fall, then makes them clear. She is not mad at these parents; She gets angry when a child is brought to her too late by the youth welfare office or when her recommendations are not met.
She wants the parents to deal with what they do to their children, to seek help. Sometimes she sees remorse in the course of a court case in which she acts as an appraiser? most recently with his father, who shook his three-month-old son in Hamburg in April 2015, that he is now severely disabled in the clinic. At first the father denied? an alcoholic who caught his aggressive behavior at birth at the hospital? "" maybe even to himself, "she says. The man admitted in his statement that he had beaten the child. She reminded the court that the baby's head must have jerked back and forth like a whip for minutes. "After that I got the impression that he realized what he had done."
Sometimes she experiences a child clinging to her after the examination and crying because she does not want to go back to her parents. That, she says, are the hardest moments.
In the evening, around 7:20 pm, she drives for three quarters of an hour to the outskirts of the city, where she lives with her husband, who is also at UKE. She listens to classical music or French chansons in the car, eats with the family, checks her mails, she has no time at the institute, sits on her fitness bike, cycles for three quarters of an hour and watches TV. It is important for her to meet with her good friends, "that grounds me, even if I can not talk about my cases, it helps me to forget what I experienced." At the weekend she and her husband go to the concert or to the theater. Or they are watching a love movie, with a happy ending. In a tragic movie, she says, nobody gets her.
Child Maltreatment: The sad numbers
- In 2015, youth welfare offices rated the well-being of a child at risk as acute or latent. In the acute cases this was an increase of 11.7 percent compared to the previous year, with the deferred ones rising by 7.9 percent.
- 23.1 percent of these children showed signs of physical abuse, and 63.7 percent showed signs of neglect.
- 77645 children and adolescents have taken care of the youth welfare offices in 2015. In 2014 there were 48,059.
- 130 children were killed in Germany. 80 percent were younger than six years.
