------------------------------------------------------------------------------------------------------------------ January 2008| Volume I Issue I
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What is the CJC?
The room is a soothing baby blue with one wall painted like a chalkboard. A small table and chairs perfect for a toddler is underneath.  Across the room are building blocks painted like bricks. A plush sofa that’s cradled more than one child as he napped is against the back wall.
           
There’s no television, no music blaring. The room is designed to be peaceful, a respite from the traumatic experiences endured by children who come to the Batson Hospital CARE (Child Abuse Referral and Examination) Clinic at the Children’s Justice Center.
           
Physical and sexual abuse and neglect are what brings these children – ranging from teens to infants – to the clinic in the Jackson Medical Mall. When they leave, the hope is they feel better.
           
“I don’t think many of the kids leave here feeling badly about themselves,” said Dr. Kathryn Kolar, pediatric nurse practitioner at the clinic. “We deal with a very sober subject, but it is a delight to take care of these children.”
           
The clinic, designed to provide noninvasive medical examinations and treatment for abused and neglected children, is part of the Blair E. Batson Hospital for Children. It provides expert medical assessments to determine the presence of injury or infection. Staff also document findings indicating abuse or neglect and work in conjunction with Children’s Advocacy Centers, which interview children that have disclosed sexual abuse.

Elizabeth Hocker, executive director of the Children’s Justice Center, said children are referred to the clinic by the Mississippi Department of Human Services (DHS), child advocacy centers around the state, health care providers  or law enforcement. In 2007 over 200 children have been to the clinic from as far north as Tallahatchie County to as far south as George County.
           
Kolar said before their 18th birthdays, one out of four girls and one out of seven boys will be abused.
           
DHS statistics show more than 19,000 cases of abuse were reported in 2006, impacting over 30,000 children across the state. Kolar said research shows that only half of all abuse is reported.
           
Eight Mississippi children died in 2006 from either abuse and/or neglect, according to DHS.
           
“Child abuse is a public health issue,” Hocker said.
 That’s part of the reason why she met with Dr. Owen B. Evans, chair of the Department of Pediatrics, in 2001 to discuss ways to meet the needs of abused and neglected children.
“None of this would have been possible without the support of Dr. Evans, the Mississippi State Department of Health and DHS,” Hocker said.
           
Evans said child maltreatment is an unfortunate fact of life, occurring in every layer of society and in every geographic region of the globe. That’s why it is a health problem.
           
“It goes to a child’s emotional development, and depending on the type of maltreatment, it can affect a child’s physical development,” he said. “And it should be addressed in a tertiary care facility like the Medical Center. We have the research, education and programs to manage significant illness, which can translate into better care and better treatment in the future.”

Evans said prior to 2001, most of these patients were managed on an ad hoc basis, usually within hospital emergency rooms by people who have had some training but not in-depth training to conduct the specialized examinations needed in these types of cases. Law enforcement relies heavily on the medical evaluation when investigating allegations of abuse and neglect.
           
In some cases at hospitals, evidence wasn’t handled properly, and in other cases, not obtained at all. Evans said the CARE clinic establishes a standard for care.
           
“With this, we hope that we can expand our education not only to our physicians in training so that they can be better able to recognize the signs and symptoms of maltreatment, but also extend this to our nursing students and our psychology students. They will learn the same policies and procedures and proper ways to evaluate children,” he said.
           
Kolar said typically no more than two children are seen each day because the staff spends between 90 minutes and two hours with each child. That time is spent trying to make the children comfortable by engaging them in light-hearted conversation and by explaining what they can expect during the examination.
           
Stacee Naylor, clinic manager, checks vitals, such as weight and blood pressure and assists with the examinations. Kolar performs the examination and documents any findings, and she refers children to physicians for other health problems she may find.
           
A picture is taken of each child because sometimes it may take years before cases are heard in court.
           
“I want the jury to know this is what this children looked like when they were abused,” said Hocker, a lawyer and former prosecutor.
           
Upon completion of the visit, children can pick from an array of donated stuffed animals, toys and books to take with them.
           
Recently, the clinic received funding to connect to the University of Mississippi Medical Center’s TelEmergency System, which allows emergency room physicians to assist nurse practitioners in rural counties. The clinic uses  the system to consult on suspected abuse and neglect cases.

In 2007 two satellite clinics were opened to provide care to children residing in the coastal counties and in six counties bordering Alabama. The CARE Clinic at Rush and the CARE Clinic at Singing River Hospital provide forensic medical assessments one half day per week clinic. (Return to front page)

http://cjc.umc.edu/