This Iqaluit group is changing how abused children are heard
‘You tell your story once and you don't tell your story again,' pediatrician says
This is part one of a three-part CBC North series, The Small Abused. The series looks into reporting, prevention and support services available to children in Nunavut who are victims of abuse.
There are soft lights at the house, comfy blankets and toys. There are doctors, and police officers, but they dress in regular clothes. Then there are people like Emma Akulukjuk-Hackett, a 25-year-old child and family advocate whose main job is to always be there.
The Umingmak Child and Youth Support Centre opened last October in Iqaluit.
It's a place for helping hurt children and youth.
Akulukjuk-Hackett remembers spending many hours with one of those children who had suffered abuse, while they met with the doctors and police, and waited.
The centre's Inuit advocates help children and families navigate the government system. They're a stable and familiar face when clients are meeting with different professionals.
"We're not here to assess them, we're not here to interview them. We're here to hold space for them so that they feel comfortable and supported," she said.
Sometimes that work is as simple as playing with a child, or bringing their caregiver a snack.
A social worker told her afterwards that the child felt helped and supported through an otherwise terrible experience, because they had the centre to go to.
"That's what I hope we bring to each child that comes here. I hope we give them a positive experience," said Akulukjuk-Hackett.
She means, safe treatment that doesn't re-traumatize victims of abuse.
Repeating their story harms children, pediatrician says
In Nunavut, a territory where nearly half the population is under the age of 24, children and youth suffer abuse at a rate that is 10 times the national average. Nunavut also has the highest rates of child sexual abuse in Canada.
Those figures, reported by Statistics Canada, are cited by the Umingmak Centre in its 2014 funding pitch that lead the $1.8-million, three-year pilot project to open its doors last fall.
It's a space for social services, health workers and law enforcement, as well as family, to come after an abuse has been disclosed.
Health staff can access the centre at any time to do physical exams, so children don't have to wait in the emergency ward, where they aren't always the patient in most urgent need of care.
"Our emergency department, it's great for emergencies. It's not really great for children who have been through a terrible thing," says Nunavut pediatrician and founding member of the Umingmak Centre, Dr. Amber Miners.
Oftentimes, children who have been through trauma have to wait their turn to see a doctor, she said, while heart attack or car accident patients are seen first.
Seeing violence hurts too
The coordination of front-line service at the Umingmak Centre hasn't always been available to hurt children who are navigating the social, health and justice systems in Nunavut.
Before, a child might explain their story to a teacher or relative and later to a social worker, then to a nurse, the police, and maybe to a lawyer.
That's too many people for a child to talk to, Miners said.
"One of our big mandates is, you tell your story once — in a child friendly, culturally appropriate environment — and you don't tell your story again," says Miners.
Types of abuse can range from neglect, to verbal and physical violence, to sexual harm or trafficking. But children can also experience trauma when they witness abuse.
Watching a parent be violent toward another parent can be as traumatic to a child's mental health as being abused themselves, says Miners. In Canada, rates of family violence are highest in the territories.
A lot of the times for our children the person that has harmed them is someone that people in their family love or depend on.- Sarah Clark, Umingmak Centre executive director
And when children don't have physical injuries, they still benefit from meeting with a physician, Miners said.
The "reassurance exam" helps with mental health and trauma healing, Miners said. Children have questions for her like, "will people be able to know that I've been assaulted?" or "does this mean I'm not a virgin anymore?" and "can I have babies after this?"
Around 95 per cent of the time, children who were sexually assaulted will have normal physical exams, she said.
Abuse unreported due to fear, shame, family ties
In 2016 in Nunavut, 475 children aged 18 and under were victims of police-reported violent crime causing death or bodily harm, according to Statistics Canada.
The highest number of those crimes were for general assault, sexual offences and sexual violations that are specific to children, such as sexual interference, invitation to sexual touching and sexual exploitation.
Last August, an RCMP special forensic unit opened to investigate child maltreatment in the territory.
Disclosures of abuse that happen during police interviews can sometimes implicate multiple other children as victims, said Sarah Clark, executive director of the Arctic Children and Youth Foundation, the not-for-profit that runs the Umingmak Centre.
Because much abuse goes unreported, and not all reports result in formal charges, the centre says the actual number of children being abused, and the communities where abuse is happening most, isn't known.
"It is really difficult to get a good picture of what's happening [in Iqaluit]," said Clark. "I just know anecdotally, the number is extremely high," and no cases are simple, she said.
Marginalization, language barriers and intergenerational trauma that Inuit children in Nunavut communities experience make that even more true, she said.
"A lot of the times for our children, the person that has harmed them is someone that people in their family love or depend on," Clark said. "There can be extreme shame and guilt that comes along with disclosing something about someone you love or someone that your family loves."
And when social services and RCMP become involved, the child doesn't get to decide if they are taken from their home, or if charges are laid.
The Umingmak Centre is helping front-line workers learn to give children more agency. That could be as simple as letting a child choose which arm they use when their blood pressure is being taken, says Clark.
Abuse damages long-term health
The territory's action plan against suicide, Inuusivut Anninaqtuq, says investing in the safety and wellness of children is one way to prevent suicide in Nunavut.
Miners says there's medical evidence to prove childhood trauma can lead to negative health outcomes for adults.
Living with a person addicted to alcohol or a person who is suicidal, being abused physically or sexually, or witnessing that violence are all experiences that leave children in a constant state of stress while their brain is still developing, Miners said.
These experiences lead to higher rates of depression, low self-esteem, substance abuse, and can increase the likelihood of suicide attempts, she said.
The good news is that the harm is reversible with treatment, Miners said. The Umingmak Centre is one place to start that healing.
"We should be screaming this from the rooftops," Miners said. "This is how we help our kids."
It's a success story, the Umingmak Centre. But it's also only in Iqaluit, and there are 25 communities in Nunavut.
One young person, surveyed by the centre, wrote that while abuse happens to them, their siblings and their friends, they don't trust the justice or social service systems enough to report.
"Abuse has become normalized, so why bother? I am also afraid of retaliation," the youth wrote.
Laura Pia Churchill is another child and family advocate at the centre. She says over the last year, she's been watching that trust be rebuilt in Iqaluit.
Providing a culturally relevant environment to children and their caregivers is part of that, she said.
"Walking into the centre and being able to be fully comfortable and fully yourself, your Inuk self, is really important. It's something that doesn't require a lot of talking," she said.
But outside of the centre, she does see many clients struggling with basic needs like food, or finding a safe place to do their homework or even sleep. It makes healing harder, she said.
A report is being developed now to show what the centre has learned since opening last fall.
Nunavut youth who need to talk can call the Kamatsiaqtut Nunavut Helpline at 1-800-265-3333 and visit http://nunavuthelpline.ca.
Families and children can also call the child welfare line, at 1-844-392-4453 (FW CHILD).
To report an abuse in your community, contact the RCMP or a community social service worker.