Abused babies: protocols or networking?

The news of three babies hospitalized due to severe abuse has hit the media in recent days. It is said that “the protocols have failed” and I wonder if the public understands what this expression means when faced with such serious situations that undoubtedly strike us. The protocols are one of the main tools that we professionals in the fields of personal care –health, education, social care, gender-based violence, functional diversity, and many others– have equipped ourselves with to try to organize care and –supposedly– know what each person must do in the face of serious, diverse, and highly complex situations. Protocols are not activated nor do they fail like pressing a button on an assembly line where there is chain work. But it often sounds that way; and not only to the public, but also to the professionals themselves who are involved.

For more than 30 years I have seen protocols advance and recede, I have seen and participated in building new ones and also reviewing old ones; to address violence towards childhood (no euphemisms are needed, it is directly violence, not mistreatment) and for violence against women, for suicide risk and so many others. But unfortunately I have also noted that the work of building protocols never replaces deep knowledge about what happens to people and what can operate within families. Unfortunately, we have fragmented citizen care systems that respond to a logic of supposed professional specialization and that too often do not allow seeing the whole puzzle of everything that is happening, for example, in a family. If I work in a health center I attend to physical health, if I work in a school I dedicate myself to educating, etc. There are few real spaces for shared work where the different pieces of the puzzle can be put together that allow us to have a complete image. People are not fragments; we are a whole and to understand and attend to us, it is necessary that someone looks at us in all our dimensions.

It is very likely that these three cases—which are obviously now under investigation—were in contact with other public services or even community networks, it is very likely that they were already partially known to other professionals or environments; it is very likely that there was already some knowledge of worrying issues before the baby arrived at a hospital emergency room for the last time, but, as things stand, as the system is currently designed, it is very difficult to provide comprehensive support. Therefore, beyond the protocol and the specific tool, it is necessary for us to understand as a society and as a care system that the situations that erupt are not "mushrooms" that appear out of nowhere, but that addressing violence in all its forms requires knowing people's lives and life trajectories. It is at this point that we usually find the essential analytical elements that can allow us to identify situations of special vulnerability.

Knowing what lies behind this fragmented final image is essential. From this perspective, we cannot forget that when we speak of "fathers and mothers who mistreat children," in an overwhelming majority we are talking about fathers (men), and that behind these fathers who mistreat there is also, mostly, an aggressor man who exerts violence against the woman and mother of these children. Obviously, there are exceptions; obviously, there are filicidal women and women who can exert violence. But it has an exceptional character and, therefore, it is important to point out that, if we want to carry out prevention and detection, it will be necessary to understand that there are forms of violence against childhood that may remain hidden at first and that occur in contexts of sexist violence, because they are part of the same logic of exercising violence. As I was saying, it is necessary to know the complete stories.