Clinical Case

1. Clinical Case By Paul Wright Named Doctor Safeguarding Virgin Care Private and confidential

2. 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

3. 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

4. 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

5. 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

6. 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

7. 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

8. 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

9. 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

10. 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

11. 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

12. 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

13. 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

14. 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

15. 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

16. 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

17. 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

18. 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

19. 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

20. 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