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The Role of First Responders in Child Maltreatment Cases: Disaster and Nondisaster Situations
Office on Child Abuse and Neglect, Children's Bureau. Cage, Richard., Salus, Marsha K.|
|Year Published: 2010|
Common Folk-Medicine Practice Injuries That May Resemble Abuse1
|Circular burns, about 6-8cm in diameter; often multiple||Can result from "cupping," in which a cup of ignited alcohol is placed over a part of the body. As the heated area cools, the skin is sucked into the cup, producing redness and burns.||Mexico|
|Subdural hematomas (hemorrhages between the brain and its outer lining that are caused by ruptured blood vessels)||Remedies for caida de mollera, or "fallen fontanelle," can cause subdural hematomas. The fontanelle is one of two soft spots on an infant's skull, and some believe that it can become depressed if an infant is pulled away from a nipple (breast or bottle) too quickly. The most dangerous folk remedy for fallen fontanelle is hanging the child over a basin of hot water and tapping the child's feet.||Mexico|
|Light, linear bruising with petechiae (pinpoint-sized red spots on the skin), usually between the ribs on both the front and back; also may be seen on the neck, both sides of the spine, or along the inner arms||Although they resemble strap marks, these linear bruises may actually be the result of the folk-medicine practice of Cao Gio (coining). This practice is used to relieve symptoms such as fever, chills, headaches, and vomiting and includes massaging the skin with oil and stroking it with the edge of a coin until bruising occurs. It is believed that coining forces the "bad wind," or noxious substances, from the body. Normally, this practice should not cause undue concern about child abuse.||Vietnam
|Light bruising, petechiae (pinpoint-sized red spots on the skin), or abrasions on both sides of the spine, behind both knees, in the bend of both arms, and on the chest from just above the nipple to the clavicle||These bruises may be the result of the folk-medicine practice of Tzowsa (spooning). This employs a similar method to coining, but a spoon is used. If a raised area appears, cupping treatment has probably also been used. This treatment is believed to alleviate pain.||Hmong people|
|Intense, isolated, nonsymmetrical bruises anywhere on the body, but often found between the eyes on the forehead, along the trachea, in a necklace pattern around the base of the neck, bilaterally on the upper chest or arms, or along the spine||These bruises may be the result of the folk-medicine practice of Bat Gio (pinching) in which Pinching Tiger Balm, a mentholated ointment, may be massaged into the area before it is pinched. It is very commonly used to exude the "bad wind" for localized pain, lack of appetite, heat exhaustion, dizziness, fainting, blurred vision, cough, fever, or any other minor illness.||Southeast Asia|
|Second- and third-degree burns on the foot and ankle||In this practice, an analgesic balm, such as Icy Hot, may be applied to a child's foot, which is then held under running water. This home treatment is based on a hot-cold theory of disease that is held in many Latin American cultures, and it is performed in an effort to cure a child's sprained ankle. Because there is a clear line of demarcation, it may resemble an immersion burn.||Latin America|
|Burns or scars, usually 0.5-1cm in diameter (like cigarette burns), located randomly around the lower rib cage or in a definite pattern around the umbilicus (belly button)||These burns may be part of a folk medicine therapy in which pieces of burning string are lowered onto the child's skin in order to cure abdominal pain or fever.||Southeast Asia|
1Massachusetts Department of Social Services. (2002, March). Investigation training: Evidence and indicators of maltreatment. Boston, MA: Author.
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