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This clinical case details the life of Child BA, a 13-year-old girl who faced severe physical abuse in her adoptive home. Referred to Social Care and Police after disclosing her experiences, BA's history reveals a troubling past that includes the loss of both parents to AIDS-related illness and a pattern of mistreatment by her current caregivers. Despite being an exemplary student, BA's home life was marked by punishment and domestic chores, leading to continued disclosures of abuse. This case highlights the challenges in safeguarding children and the importance of appropriate intervention.
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Clinical Case By Paul Wright Named Doctor Safeguarding Virgin Care Private and confidential
Introduction • Child BA • Referred in May 2010 – Aged 13 years 6 months • BA had disclosed to a teacher that she had been beaten over a long period at home • School referred to Social Care and Police • They visited her but although had been happening for over a year – no acute injuries • 2 days later was kicked in the morning and medical requested Private and confidential
History of Presenting Problem • BA recalls many incidents of physical beating and injury • 2 years previously she had been hit with a metal mop which had caused her to break the middle finger of right hand • Present Carers have hit her many times • Sometimes has to kneel on the floor with her hands above her head; if they drop she is beaten Private and confidential
History of Presenting Problem • She has to do a lot of chores at home including looking after the other 2 children (they are natural children of the carers) • She runs their baths, sweeps the floor, does the food shopping and cooking for the family • She has to eat different food from the rest of the family Private and confidential
History of Presenting Problem • On the previous evening she had had little sleep and had not got up to do her chores • Carer had woken her up and kicked repeatedly on her legs Private and confidential
Past History • Born and spent early childhood in Nigeria • Family ethnically Yoruba • Father was Muslim and Mother Christian • Father died when BA 3 years of age, and Mother died when BA 8 years of age • BA told that father had died in a car accident, and mother following robbery and rape • However both died of AIDS related illnesses Private and confidential
Past History • BA has two older siblings in Nigeria • When her Mother died all went to live with different relatives • BA’s current carers are her Paternal Grandfather’s Brother’s son and his wife • Mr SA (adoptive father) was granted temporary residence in UK under the Highly Skilled Migration Programme Private and confidential
Past History • In March 2009 BA arrived in the UK with her adoptive parents and their 2 children • Papers prepared for immigration state BA born in 1997, whereas BA stated she was born in 1996 • As part of adoption BA’s name was completely changed • September 1999 started at Secondary School Private and confidential
Medical History in UK • Taken to see GP within 2 weeks of arriving in the UK • History of bedwetting every night • 2 older siblings described as “bedwetters” • Referred to Enuresis Clinic • No appointments were kept Private and confidential
School Progress • Adoptive parents refer to major behaviour problems • These are not substantiated by her school • Form tutor states BA an exemplary student, her only problem being her persistent late arrival • Academic progress has been excellent but adoptive mother has never congratulated her, and has hidden her good reports from adoptive father Private and confidential
School Progress • April 2010 – Adoptive Father contacted School Pastoral Care Coordinator about comments BA had been writing in her diary • He said he would punish her with a cane • Told that an inappropriate method of punishment and reported to Social Care • BA later disclosed to Social worker that had been punched on back, legs and arms Private and confidential
School Progress • May 2010 – BA disclosed to school that she was being punished at home and do housework in the mornings • Had been hit across back with a stick and had to hold her hands up to protect her head • Disclosed that she was adopted and fearful of reprisals • School contacted Social Care Private and confidential
School Progress • Next Day – Interviewed by Social Worker and Police • 2 Days Later – BA arrived at school very distressed as mother had reportedly kicked her 7 times that morning • BA kicked on thighs and legs and noted to be unable to sit down comfortably • Social Care informed and Medical arranged Private and confidential
Medical • Numerous old scars noted • Back at least 6 • Right leg at least 12 including a large one which was reported to be a burn from a motorbike accident • Left leg at least 5 • Left Elbow 2 • All injuries consistent with being hit by a hard object over a prolonged period of time • 2 injuries consistent with accidental burns Private and confidential
Follow up from Medical • Following Medical, Police took out an Police Protection Order and BA placed in Foster Care • Following day – Meeting between Foster Mother and Social Care • Foster Mother informed that LA seeking to take out an Emergency Protection Order in respect of BA • Section 47 Investigation to be conducted into 2 other children Private and confidential
Follow up from Medical • EPO obtained that day • 3 days later Home Visit – Foster Mother very distressed and pleading that BA returned to her care • 2 days later – Final strategy discussion and decision that an Initial Child Protection Conference be convened on 2 younger children • LA obtained an Interim Care Order Private and confidential
ABE Interview • Domestic Chores worse when adoptive father away • Persistently verbally denigrated by adoptive mother to visitors to house and to family in Nigeria • Beaten by cane anywhere on her body • Palms a common site as did not show marks • Hand beaten by a metal mop by adoptive father which had led to a fracture and resultant trigger finger Private and confidential
Investigation into 2 other Children • No concerns raised re physical abuse other than emotional impact of what they had witnessed • Both made subject to CP Plans under Emotional Abuse Private and confidential
Further History • BA remains in Foster Care • BA made an allegation that she was raped aged 9 years in Nigeria • HIV and STD screening negative • Seen in Enuresis clinic – Secondary Enuresis following Mother’s Death • On Desmopressin for a year – Now stopped Private and confidential
Points • Cultural Differences – Safeguarding follows UK law and is Culturally blind • Falsification of Age • Children brought to UK by “Family Members” and placed in servitude Private and confidential