TORONTO — Boys in poor urban areas around the world are suffering even more than girls from violence, abuse and neglect, groundbreaking international research published on Monday suggests.
The study in the Journal of Adolescent Health, along with similar new research, suggests an adequate focus on helping boys is critical to achieving gender equality in the longer term.
“This is the first global study to investigate how a cluster of traumatic childhood experiences known as ACEs, or adverse childhood experiences, work together to cause specific health issues in early adolescence, with terrible life-long consequences,” Dr. Robert Blum, the lead researcher for the global early adolescent study, said in a statement. “While we found young girls often suffer significantly, contrary to common belief, boys reported even greater exposure to violence and neglect, which makes them more likely to be violent in return.”
The study from Johns Hopkins Bloomberg School of Public Health looked at childhood traumas suffered by 1,284 adolescents aged 10 to 14 in more than a dozen low-income urban settings around the world such as the United States, China, the U.K., Egypt and Bolivia.
Overall, 46 per cent of young adolescents reported experiencing violence, 38 per cent said they suffered emotional neglect and 29 per cent experienced physical neglect. Boys, however, were more likely to report being victims of physical neglect, sexual abuse and violence.
While higher levels of trauma lead both boys and girls to engage in more violent behaviours, boys are more likely to become violent. Girls tend to show higher levels of depression.
Separately, a new report to be released next month at an international conference in Vancouver concludes that focusing on boys is critical to achieving gender parity. The report from the Bellagio Working Group on Gender Equality — a global coalition of adolescent health experts — finds boys and men are frequently overlooked in the equality equation.
“We cannot achieve a gender-equitable world by ignoring half of its occupants,” the report states. “It is crucial that boys and men be included in efforts to promote gender equality and empowerment.”
For the past six years, a consortium of 15 countries led by the Bloomberg School of Public Health and World Health Organization has been working on the global early adolescent study. The aim is to understand how gender norms are formed in early adolescence and how they predispose young people to sexual and other health risks.
Evidence gathered by the study indicates boys experience as much disadvantage as girls but are more likely to smoke, drink and suffer injury and death in the second decade of life than their female counterparts.
The key to achieving gender equality over the next decade or so — as the United Nations aims to do — involves addressing conditions and stereotypes that are harmful to both girls and boys, the researchers say. They also say it’s crucial to intervene as early as age 10. The norm is now age 15.
“Gender norms, attitudes and beliefs appear to solidify by age 15 or 16,” the working group says. “We must actively engage girls and boys at the onset of adolescence to increase total social inclusion and produce generational change.”
Leena Augimeri, a child mental-health expert with the Child Development Institute in Toronto, agreed with the need to focus on boys as well as girls. At the same time, she said, the genders do require different approaches.
“Boys are equally at risk,” said Augimeri, who was not involved in the studies. “When we look at the various issues that impact our children, we have to look at it from different perspectives and lenses and you can’t think there’s a one fit for all.”
Colin Perkel, The Canadian Press
Licence revoked for doc who used own sperm to artificially inseminate patients
TORONTO — An Ottawa fertility doctor who used his own sperm as well as that of the wrong donors to artificially inseminate several women caused “irreparable damage” that will span generations, a disciplinary panel with Ontario’s medical regulator said Tuesday as it revoked his medical licence.
Dr. Bernard Norman Barwin betrayed the trust of patients who turned to him for help in starting a family, the discipline committee for the College of Physicians and Surgeons of Ontario said.
The committee also expressed frustration that Barwin, 80, was not present to receive the reprimand, calling it unfair that he would not face the victims of his “disgraceful” conduct.
“It is unfortunate that at this time all we can do is revoke your licence to practise medicine and … deliver this reprimand,” said Dr. Steven Bodley, chair of the panel. “We do, however, take some solace in the fact that you are no longer in a position to cause further harm.”
The discipline committee had ruled earlier Tuesday that Barwin committed professional misconduct and failed to maintain the standards of the profession.
Lawyers for the college had then asked the committee to revoke Barwin’s licence, saying it was the only appropriate penalty for such a shocking abuse of trust. The college’s decision to do so means other medical regulators will be alerted should he apply to practise medicine elsewhere.
An uncontested statement of facts laid out the cases of more than a dozen patients who said they suffered irreparable harm as a result of Barwin’s actions, starting in the 1970s through the early 2000s.
Barwin pleaded no contest to the allegations through his lawyer.
A lawyer for the college said Barwin’s actions traumatized entire families.
“There is no precedent for the case you have before you,” Carolyn Silver told the disciplinary committee. “Dr. Barwin’s patients and their families were the unsuspecting victims of his incomprehensible deception.”
Some patients discovered their children were half-siblings, even though they had requested the same donor be used for both, the statement of facts said. Several men learned the children they had raised were not biologically theirs.
Rebecca Dixon, who waived a publication ban protecting her identity, said she discovered three years ago that Barwin — and not the man who raised her — was her biological father.
The committee heard Dixon and her family first became suspicious of her lineage after she was diagnosed with celiac disease, a hereditary condition that neither of her parents shares. Eventually a DNA test confirmed Barwin was her father.
“In that moment, my life changed forever,” she told the committee, adding she felt her entire identity was thrown into question.
The news made her feel ashamed and “contaminated,” and strained her family, she said.
Even now, Dixon said she continues to scan the crowds in Ottawa, looking for people who look like her and who may be her half-siblings. So far, Dixon said she has identified 15 half-siblings, though the case before the college involves only seven patients with children fathered by Barwin.
She said after the hearing that more victims may yet emerge as others discover their parentage or that of their children is not what they believed.
Dixon also said she was glad that Barwin’s licence was revoked, adding the case raises questions about how the fertility industry is monitored and regulated.
A woman who can only be identified as Patient M told the committee she learned recently that her teenage daughter was conceived using an unknown donor’s sperm rather than her husband’s. She has not yet broken the news to her daughter, worried the shock would be debilitating, she said.
Patient M said Barwin went out of his way during the procedure to show her the vial of sperm with her husband’s name on it, knowing it contained material from another man.
“I still felt so violated, I felt dirty, almost as if I’d been raped,” she said.
In a written statement submitted to the committee, a man who learned his daughter was biologically Barwin’s child said he was devastated by the discovery.
Barwin was cavalier in his dealings with them, even after the truth was uncovered, claiming he didn’t know what had happened but saw a family resemblance with his newly found biological daughter, the man said.
According to the statement of facts, an expert retained by the college to review Barwin’s case found it unlikely the doctor’s use of his own sperm was accidental. Barwin’s explanation that contamination must have occurred when he used his own sperm to calibrate a sperm counter is neither plausible nor believable, Dr. Edward Hughes said.
Barwin had previously been disciplined for artificially inseminating several women with the wrong sperm, admitting to professional misconduct when he appeared before committee in 2013. At the time, Barwin said errors in his practice had left a few patients with children whose biological fathers were not the ones they intended.
The committee then suspended him from practising medicine for two months, but Barwin gave up his licence the following year.
There was no evidence in that case that Barwin was the biological father of any of his patients’ children, said Silver, the college’s lawyer. Barwin intentionally concealed what he was doing, she said.
Tuesday’s hearing dealt with fresh allegations against Barwin of incompetence, failing to maintain the standard of practice of the profession and of engaging in dishonourable or unprofessional conduct.
As part of his penalty, Barwin will have to pay the college more than $10,000.
He is also facing a proposed class-action lawsuit launched by several patients. It alleges more than 50 children were conceived after their mothers were inseminated with the wrong sperm, including 11 with Barwin’s.
Paola Loriggio, The Canadian Press
‘Clients fall off:’ Calgary program helps recently released prisoners with hep C
CALGARY — Imagine adjusting to life after serving prison time, then add mental- health struggles, addiction or homelessness.
Now, throw in hepatitis C, a blood-borne virus that can cause serious liver problems and is several times more prevalent in federal prisons than the general population.
A specialist in addictions and internal medicine who focuses on vulnerable populations has launched a pilot program in Calgary to ensure recently released inmates with a history of injection drug use are screened and treated for the virus.
“It takes a lot of willpower and effort on their end to come out of this. And if we don’t provide them with enough support, they’re not going to be able to,” says Monty Ghosh, a University of Alberta professor who splits his time between Edmonton and Calgary.
The program connects newly released prisoners with so-called peer navigators who have lived through similar experiences. The navigators accompany the former inmates to medical, legal and social services appointments — interactions that many avoid for fear of judgment or because more pressing issues are at hand.
“Clients often tell me that they’re confused about resources in the community. They don’t know where to go or how to get there sometimes. They have very little money to take a bus to get to where they need to be,” says Ghosh.
“Sometimes they have to decide between food and lining up to get into the shelter versus actually making their medical appointment.”
In a best-case scenario, Gosh says, it can take five months to clear the body of the hepatitis C virus. Usually, it’s more like nine or 10 months. There are numerous blood tests and followups a patient must go through over that time.
“We find that every time we add another step, clients fall off. But if you add a peer navigator, they make it to each and every one of those steps at a high, high rate.”
The program, which began in April, aims to reach 120 clients in its first year and have 80 per cent of them follow through with their treatment to the end. Ghosh says about 40 per cent of incarcerated people usually complete the treatment.
The initiative is funded with $46,000 through what pharmaceutical company Gilead Sciences Canada calls a “micro-elimination” grant. The grants are meant to help organizations combat hepatitis C in the most affected groups.
“We recognize that it will take more than just science to eliminate the burden of (hepatitis C) on patients, our health system and Canadian society as a whole,” says Gilead general manager Kennet Brysting.
The Correctional Service of Canada says hepatitis C rates in federal prisons dropped to just under eight per cent in 2017 from 32 per cent in 2007. In the general population, the decrease is less than one per cent.
Spokeswoman Stephanie Stevenson says 80 per cent of federal inmates with the virus are diagnosed before incarceration or at intake. The rates are higher than the general population because there is often a history of high-risk behaviour, such as injection drug use or unprotected sex, she says. The virus can also be spread through snorting drugs or getting a tattoo.
In addition to medical treatment, Corrections also offers educational, counselling, peer support and harm reduction programs, including needle exchanges.
“Prior to release, (Corrections) health-care professionals liaise with community health-care providers, including infectious disease specialists, to facilitate effective transition and followup in the community,” Stevenson says. “Once in the community, provinces and territories are responsible for offenders health-care needs.”
The head of the John Howard Society of Canada, a group that advocates for an “effective, just and humane” criminal justice system, says inmates are sometimes released without a provincial health-care card and only a few weeks worth of medication.
“If they’re going into a halfway house or going into a parole situation, those with whom they’re staying will go to great lengths to try and make sure that their health-care needs are being met,” Catherine Latimer says.
“But it’s often challenging.”
Lauren Krugel, The Canadian Press
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