Thursday, March 04, 2004

Save the children

Save the children
By Aviva Lori 
Haaretz Magazine -  March 4, 2004 (Adar 11, 5764)
Part I and II 

Pedophilia is a growing phenomenon in Israel, but the threat of punishment does not seem to deter most offenders. And with no therapy, no follow-up and no supervision, they go right back into the community after serving their prison terms.

M., a 3-year-old girl from Ashkelon, was attacked a month ago by a pedophile. The suspect, 23-year-old Tal Dorot of Ashkelon, was released for lack of evidence. The child failed to identify him in a lineup organized by police - which consisted of a series of photographs rather than suspects. Dorot was suspected and interrogated two months ago for a similar crime he committed in Eilat, and was kept under house arrest there. After his release, he returned to Ashkelon, to the home of his parents - a veteran, well-to-do family. Dorot was then hired as a maintenance man in the offices of the Conservative congregation Netzah Yisrael, which operates two kindergartens for children aged 3.5 to 5 on the same site. There are 70 children in all. Behind the dry facts lies the tragedy of a family, and a chain of foul-ups of the kind that are usually revealed only after a disaster has occurred.

But it's not only in Ashkelon. The whole country is experiencing an epidemic of pedophilia (from the Greek "pedo" - child - and "philia" - love). The pedophile from Herzliya was a sailing instructor.  The pedophile from Netanya was ultra-Orthodox; the pedophile from Eilat admitted committing sex crimes against 20 girls. The suspect from Tiberias was a soccer coach. The pedophile from Or Yehuda, a toy salesman. The pedophile from Jerusalem, a taxi driver. And this is only a partial list from recent weeks.

The police say that the increase is geometric. For every pedophile they manage to get their hands on, there are dozens and even hundreds of pedophiles who are not caught.

A law that's ignored

The first failure was the employment of a man suspected of sex crimes at a place where children were around. "Had they checked into the man's past," Chief Superintendent Eitan Gadassi, chief of the Ashkelon police station, said later, "they would have received answers and prevented him from getting to the children." In Ashkelon, the case is borderline. Dorot was not employed directly by the kindergarten. He was only there during the hours when it was open. "It's hard for me to believe that the story from Eilat didn't reach Ashkelon," says the mother of a 5-year-old boy in the kindergarten. "It can't be that the community didn't know that he was a suspected pedophile, and that he had been under house arrest because of it."

Since July 2003, there has been a law requiring every worker who comes into contact with children to show his employer - on the latter's request - a certificate from the police stating that he has no sex crimes on his record. "The law exists, but is not applied," says Chief Superintendent Suzy Ben Baruch, head of the Youth Section in the Criminal Investigations Department of the Israel Police. "Very few come to ask for these certificates. What does that mean? Either the employers don't ask for them, or these crimes are committed by veteran employees, because the law applies only to new workers."

Dr. Yitzhak Kadman, chair of the National Council for the Child, personally examined the police statistics two months after the law came into effect, a period that included September 1, a time when many people begin new jobs in educational institutions, and he was amazed when he was told that only 12 requests had been received by the police to check into employees' backgrounds. "We know that such people look for places of work around children, and there are tens of thousands of people to whom the law applies," says Kadman. "Transportation companies, sports associations, swimming pools, youth movements - and it's very clear that some of those to whom the law applies are not even aware of its existence. There was an embarrassing debate in the Knesset Committee for the Advancement of the Status of Children, as to which government ministry is responsible for publicizing the law. Every ministry said, `It's not us, it's them.' In the end we started to write letters and send them to all those involved. After the Ashkelon affair, I was interviewed on the radio, and then the head of a boarding school for children called me and asked where to get the forms."

The second failure is that of those responsible for running the kindergarten, in this case the Ashkelon municipality and the Conservative congregation. The kindergarten did not have its own bathrooms. The children used the bathrooms in the nearby congregation offices. Moshe Yanai, head of the education division in the Ashkelon municipality, says that in the morning, adults were not supposed to be in the area of the compound, and therefore they felt that the bathroom arrangement was satisfactory. They weren't supposed to be in the area, but the fact is that they were. M., according to all the signs, was attacked in the bathroom.

M.'s family came to Ashkelon about four years ago from Petah Tikva, a young couple with three young daughters who moved because of their work. "M. is an ordinary, happy child," says her father's cousin, "who suddenly, for two weeks, was behaving very strangely at home." She slept restlessly, she didn't communicate as usual, she was very scared, she wanted reassurance from the family and was deathly afraid to go to the bathroom. Her parents thought that she was going through a difficult period because she's a "sandwich" - she has a 1-year-old sister.

Then, on Shabbat three weeks ago, she had to go to the bathroom, and she sat and held her legs together tightly, and refused to go. Her mother asked her why she was holding herself in for such a long time, and M.said she was afraid. When her mother asked
her of what, at first she didn't want to say, she said it was a secret. Her mother said: `But we tell secrets to Mommy." And then she said that there's a big hand in the bathroom. At that moment her mother understood what had happened, and asked: `What did the hand do to you?' The child suddenly began to talk about a clown, and said that there's a clown in the bathroom who made a hole in her `peepee.' The next day, the mother, the child and the father's brother-in-law went to the kindergarten and tried to get the kindergarten teacher to talk. They asked her if she had seen someone walking around the kindergarten or in the area, and then she said, "No, you're mistaken, there's nobody here, the child is fine, and I don't know what you're talking about." The parents turned to the police the same day and filed a complaint. The next day, in the presence of a police investigator, the kindergarten teacher recalled a young man who had been seen in the area of the kindergarten for the past two to three weeks. Five days after the complaint was filed, the lineup was organized. There, a third failure took place.

G., the father, says: "I got up one fine day and heard the news that my daughter had been sexually abused. It's a black day when you need the state. I went to the police to complain, and hoped that all my problems would be solved, that they would embrace and support me, that they would reassure me. Instead, they abandoned us. The state is supposed to protect my little girl, but the state goofed up. They told us to come to the Ashdod police station for a lineup.

"When we arrived, they told us that they hadn't found people for a live lineup and that there would be a photo lineup. How can a 3-year-old child make a photo identification? Do they expect her to use her judgment? To look at all the photos first and only at the end point to the guilty party? I knew that it wasn't logical, but they told me they would prepare her. I expected them to play some game with her beforehand. But they took a huge table, placed the pictures on the table, lifted her onto a chair, and she stood in front and looked forward. She couldn't see the last two rows because they were too far away, and she could barely see the last pictures on each side, because the table was too wide. So two photos remained - computer images, which weren't clear. His attorney arranged the photos as he wished.

"The investigator prepared the child before the lineup. I told her that the child calls him `the  clown.' So the investigator said: `Point to the clown if you see him. And if you don't see him, don't point.' The child stood with a candy, she didn't understand a thing, she pointed to the first picture in front of her, and within a second it was all over. I told the investigator: `You're my mouthpiece, why didn't you put the pictures on the floor so she could walk around and see all the pictures?' But it was already too late."

Says Michal Haim, spokesperson for the Lachish area police: "The lineup was a failure for us. She couldn't do it, it was too difficult for a 3-year-old. It would be too hard even for a 12-year-old, and we are learning the lessons. We wanted to do a live lineup, but there were many difficulties involved."

After an attack
In cases of sexual attacks on children up to the age of 14, the investigations are not carried out by police. After the complaint is filed with police, child investigators from the Ministry of Social Affairs enter the picture. They are the only ones allowed to interrogate children. They are social workers with special training in the area of sex crimes and dealing with children.  There are 50 child investigators in Israel. "The decision as to whether to allow a child to testify is left to our judgment," says child investigator Michal Heimowitz-Hamudot. "In cases where we think the child cannot withstand an interrogation, the law  allows us to testify in court in their stead, in order to minimize the damage as much as possible. But not every child experiences an interrogation as hurtful. There are children who are comforted by an investigation, they no longer feel helpless as they did at the time of the attack. There are therapeutic theories that claim that the beginning of dealing with trauma is exposure."

What effect does such an incident have on the child?

"It depends on the severity of the attack and on whether or not the victim knew the suspect. It's easier for a child to deal with a stranger. In that way, he can distinguish between a good person and a bad one. When it happens in the family, it undermines something very basic in the child. There are immediate reactions, such as difficulty in falling asleep at night, fear of going outside, regression to behavior that they have already left behind, sexual behaviors that are inappropriate for their age. For example, one day we received a report from a kindergarten teacher about a 5-year-old boy who was undressing children in the kindergarten and sucking on their sexual organs. This is suspicious behavior that flashes a warning signal. In that case, there was a suspicion that someone in the family was abusing him sexually.

"Basically, it hard to define symptoms among children that testify to a sexual attack, because most of the symptoms can also characterize other problems. For example, bedwetting. Many children start bedwetting again when there is a sexual attack, but not every child who wets himself has suffered a sexual attack. One of the only symptoms that indicates a sexual attack is sexual behavior in children that is not appropriate for their age. That means that they were in some way exposed to sexuality."

One gets impression from media reports that you have been very busy recently.

"We have work all the time, but it has begun to make waves; it's a terrible thing. The reasons are that there really is more abuse of children, and also that there is greater awareness that leads to exposure, both among the public and among children. Since the law that requires reporting was passed, professional people are afraid not to report, because that exposes them to lawsuits," says Heimowitz-Hamudot.

The law was passed in 1989 and has been expanded over the years. Today it applies to all those responsible for children, like parents, guardians, teachers, kindergarten teachers, counselors and even babysitters over the age of 18. "The law was copied from Europe and from America," says Ben Baruch, "and it means that when a child is exposed to emotional or physical abuse, including sexual abuse, those around him are required to report this to the police. The punishment is six months in prison for professionals and family members who know that a child is a victim and don't report it, and three months in prison for any other citizen."

Cognitive distortion
A pedophile, according to the Diagnostic and Statistical Manual of Mental Disorders of the American Psychiatric Association (DSM), is someone who suffers from recurrent, intense sexual urges and sexually arousing fantasies, of at least six months duration, involving sexual activity with a prepubescent child. The fantasies cause clinically significant distress or impairment in social, occupational or other important areas of functioning. As soon as the child exhibits clear signs of sexual maturity, the pedophile usually loses interest. In the literature, the maximum age of victims of pedophilia is 13, and the minimum age of the pedophile is 16, with at least five years' age difference between the attacker and his victim. "Most pedophiles suffer from cognitive distortion," says Dr. Moshe Birger, of the division of forensic psychiatry in the Ministry of Health and the Be'er Yaakov Psychiatric Hospital, and director of the psychiatric division of the Prison Service. "They believe that children are sexual creatures and are as interested in sex as they are, and that it is their job to instruct the child. Many suffer from problems with couple relationships, lack of confidence in their masculine identity. Some have children, but they know how to distinguish between their own children and those of others, and are able, superficially, to conduct a double life; to be normative during the day and to turn into pedophiles at night. Some hurt their own children. Some have high intelligence, and some borderline intelligence. There are pedophiles who have sexual relations with children exclusively, and there are pedophiles who have sexual relations with adults as well."

All the experts in the field are aware that the dimensions of the problem are much greater than the statistics. The data in Israel are a mystery. No official body wants to commit itself on the extent of the phenomenon, because no official body really knows. The statistics in the United States speak of at least half a million new pedophile attacks every year.

Here we know only about pedophiles who reach the attention of the police and are tried. "In 2002, there were reports of 2,340 incidents of sex crimes against minors within the family and outside of it, and 2,247 such cases were reported in 2003," says Ben Baruch. "Among the 1,000 sex offenders serving sentences at present, 300 are pedophiles."

Kadman says that the police statistics are dozens of percentage points below the reality. Statistics from the National Council for the Child reveal that every year about 2,500 children up to the age of 14 are sexually abused. "We estimate," says Kadman, "that the real number is 10 times as great, in other words, about 25,000 children."

As a rule, psychiatrists have difficulty explaining clearly what motivates pedophiles. The assumption is that the phenomenon is a combination of some biological complication and emotional, behavioral and social disorders, and that every pedophile suffers to some extent from each of these. Is pedophilia addictive, like drugs or cigarettes? Some professionals say it is, others claimit isn't.

Incest is pedophilia
Whatever the case, most pedophiles behave like addicts. They commit a large number of crimes despite the risks, and despite the threat of prison. "Most of them have been arrested repeatedly, and in spite of that they are not deterred," says Birger, "because committing the crime gives them a high, like taking a drug. When they can't commit crimes for long periods, they suffer from a type of withdrawal syndrome that is expressed in restlessness, tension, anxiety, depression - it's like addictive behavior."

On the other hand, pedophilia is not motivated by an irresistible urge. Pedophiles are well aware of their actions. They plan them, conduct observations of the kindergarten or the school, often become friendly with their victims, and only when possible do they go on to the stage of seduction and implementation. The victim will always be a rejected, quiet, introverted child, who won't resist or run to tell the others. One can see this in Clint Eastwood's latest film, "Mystic River." A pedophile will never attack a child when there is an adult around.

"A pedophile has control, although it is minimal, because he has very strong sexual urges. But it isn't something that isn't in his hands, like mental illness, for example," says Dr. Yael
Idisis, a clinical criminologist who is head of the forensic psychiatry division in the Ministry of Health. Dr. Idisis explains that because a pedophile doesn't suffer from his addiction, he
isn't interested in being cured of it. "As long as they haven't caught him, he had no problem; as soon as he is caught, when he has already been sentenced for the sixth time, after hundreds of victims, he says that he needs help."

Imprisonment, say the experts who were interviewed for this article, doesn't "cure" a pedophile of his behavior. "According to worldwide statistics," says Birger, "the arrest itself causes about 50 percent not to repeat their offense within five years." Receiving
treatment in prison, it should be noted, depends on the pedophile's consent.

Kadman claims that recidivism among sex offenders is extremely common. "A month ago, they caught a Jerusalem taxi driver who attacked two 14-year-olds while driving, in two separate incidents, and when he was arrested it turned out that a month earlier he had been released from prison after serving a sentence, not for the first time, for sex crimes. And that's what happens in case after case. One of the prison heads once said to me, `Sex offenders return here as through a revolving door. I know that after they leave, it's only a question of how long it will take and how many more children [they'll abuse] until they're back again."

The definition of pedophilia includes incest, most of which is committed against children aged 5 to 11, which is why it is difficult to estimate the dimensions of the phenomenon. Young children are not always aware that they are being sexually abused, and if it's a matter of incest, it's usually covered up and concealed behind walls of silence. "We will never know the extent of this problem," says Prof. Sarah Ben David, a clinical criminologist and head of the Department of Criminology at Bar-Ilan University, who treated sex offenders for many years in various prisons in Israel.

"Many of the victims don't even know that there's anything wrong.  The most recent cases, where pain was involved, are not common.  Most pedophiles don't cause pain, so the child doesn't know that they've done something bad to him. Sometimes it's not unpleasant for the child, and if it is somewhat unpleasant - many things are unpleasant for children, even brushing their teeth and going to kindergarten are often seen as something unpleasant. But they don't understand the significance, and therefore they don't tell, and when they don't tell, we don't know. There are many, many cases of pedophilia where the parents know, but they don't complain because someone close is involved. Very often they call me and tell me, and when I tell them to complain, they say they feel uncomfortable about it. They're more concerned about the adult than about the child. A child is forgiving, or so we believe."

Does a 3-year-old child remember anything?
"It depends. If the pedophile gives him attention, love and warmth, and takes him to all kinds of places, and the child enjoys it, then he won't remember. But if it's something unpleasant, then he'll remember. It's possible that at that moment he won't interpret it that way, and will understand only many years later that he was abused. Sex offenders were asked if they were victims as children. They said no, and then when they were asked when they had their first sexual experience, they said at the age of 11-12, with an older woman, and spoke of it with great pride. For children who do remember - later it leads to lots of problems. Some of the victims become sex offenders themselves."

Ben Baruch says that the police's working assumption - on the basis of studies conducted worldwide - is that 60 percent of the pedophiles were themselves victims. Kadman has reservations about the overuse of the word "pedophile." "Not all sex offenders who harm children are pedophiles by definition, but for the child it makes no difference. There are many sex offenders who harm children because it's convenient and easy, and the chance of being discovered is smaller."

A backward attitude
The fourth failure is the attitude of the state toward the victims.  Kadman says that in terms of protecting children, Israel is backward.  Even more, the state absolves itself of responsibility. In principle, victims of sexual abuse must look out for themselves. "The treatment of children who have been sexually abused," says Kadman, "is a scandal. When a child falls and breaks her leg, there's no question, she's taken to the emergency room, her leg is placed in a cast, she's given medication, examinations and physiotherapy.  But when a child's soul is broken, everyone avoids responsibility for her. The welfare services say it's not our field of expertise, the health services give something in the context of the Health Ministry's mental health stations. But they aren't available everywhere in the country, and there are waiting lists that turn the issue into a joke." Kadman calculated the annual cost of treatment for the hard cases of all the children up to the age of 14 (about 1,000 a year, in his estimation) who are in need of therapy, and reached the figure of NIS 6 million.

Guidance counselor Shosh Zimmerman heads a special unit in the Ministry of Education that specializes in crisis intervention and in developing prevention programs to deal with sexual abuse of children and adolescents. The unit has trained professionals, advisers, kindergarten teachers for 3- and 4-year-olds, and trains educational psychologists. Zimmerman emphasizes the cultural climate in the country and all over the world, where child sexuality is greatly emphasized in the cinema, in advertising, in the media.

For example: "It's natural not to control yourself," says a reassuring voice in a commercial being broadcast these days on television.  It is referring to potato chips that a little girl is eating on a train, while making eyes at a man sitting opposite her.

The punishments
Police say the punishments are too light, and judges say the punishments are too severe, but a punishment alone does not lead to rehabilitation. "At the trial, he is accused only of acts for which there is clear evidence," says Birger. "And often in a plea bargain some of the accusations are erased, because it's hard to bring the victims to testify."

Justice Ezra Kama, of the Jerusalem District Court, sat on many different panels that tried pedophiles, before he retired last year. He calls them sick people. "It's a broad subject," says Kama, "and includes not only the sick people who abuse children, but incest in the family as well. A sick man grabs a child in the street, so you say to yourself, `I'll make sure my child doesn't go outside.' But within the family, the child is helpless.  A child will complain about a stranger. In the family, he is  threatened and had nobody to turn to. That's why the punishment is greater for crimes within the family, because the very person who is supposed to protect him, is harming him."

Kama recalls a 2001 decision that sentenced a pedophile, the father of five children who had committed incest, to 20 years' imprisonment, while a sexton in a synagogue who sexually abused children got nine years.

"Should there only be stiffer punishments? Unless there are also therapy programs, there will be no deterrence. I'm not afraid of medical treatment that will even cut off certain things if necessary, it's right and has to be done. There are cases where nothing helps, so it may be that with certain legal arrangements this has to be allowed."

Is there an increase in the phenomenon?

"There's more willingness to expose the incidents. More children are willing to expose relatives. I have encountered cases where it was less important to a child what they had done to her; the main thing was for people to believe she had told the truth.  Legal decisions today emphasize the fact that we believe the children, because in the majority of cases they are telling the truth. There are only isolated incidents of fabrications." In  Israel the period of imprisonment or the punishment are not determined by the degree of danger presented by the pedophile, but by the severity of the deed, as the judges see it, says Ben David. "Everyone wants a stiffer punishment, but the punishment is worthless, because when he gets out, if he hasn't undergone therapy, he immediately attacks again. Prison only increases frustration.  It's a shame that we don't have a real period of suspended sentence, like elsewhere in the world, which means keeping tabs on criminals, and that there is no civil arrest, where, if a person has committed several serious crimes, he enters a closed therapeutic institution, not a prison. It's a shame because we're paying a great deal of tax money so that these people will sit in prison, but it's worthless."

The law
Ben David points to the fifth failure in handling of pedophilia, which is the absence of legislation. A pedophile enters prison, serves his sentence and goes free. Nobody in the country takes an interest in his actions until the next time he is caught.  In the prisons there are therapeutic rehabilitation programs, but pedophiles cannot be forced into them. In the summer of 1996, the deputy attorney general, Yehudit Karp, attended an international congress in Stockholm on the sexual exploitation of minors. Afterward, she initiated the establishment of an interministerial committee in the Ministry of Justice, in which representatives of volunteer organizations participated, to examine the extent of sex crimes in Israel, and attempted to propose methods of intervention on the level of legislation, enforcement, education, prevention and treatment. In 1998, a detailed memo was written by the National Council for the Child. MK Tamar Gozansky (Hadash) and two MKs from her party proposed private members' bills that passed a preliminary reading.

In 1999, after the elections, the government wanted to turn the private bill into a government bill, and it passed the first reading in the Knesset. But since then, nothing has happened.  The law is stuck in the Ministry of Justice. Kadman, who fought to promote the bill and encountered delays daily, says: "Israel is the only Western country without any legislation that arranges for follow-up, supervision and monitoring of sex offenders."

In the context of this law, "The Sex Offenders Bill (Protectionof the Public) 2002," the Ministry of Justice recommends three steps. The two main ones are preventive intervention, follow-up and supervision. The third is an assessment of the degree of danger presented by the offender, which is a tool for operating programs for intervention, supervision and follow-up. Preventive follow-up means that the convicted sex offender will be obliged to participate in therapeutic preventive programs, inside the prison or in the community, including pharmacological treatment - on condition that a medical specialist determines that the offender is suited for treatment. Supervision and follow-up refers to the framework called "parole" in other countries, whose purpose is to supervise every sex offender in the community, whether after serving a sentence, or instead of a sentence. A criminal under supervision and follow-up will be required to appear periodically before a parole officer and report on his life and his activities, as well as any change of residence. The supervisory body will determine the rules of behavior that apply to the offender during the period of supervision.

According to the proposed law, specially trained professionals will decide on the degree of danger presented by the criminal, and their decision will determine the intensity of supervision and follow-up.

What is envisioned by Kadman and others who are in favor of the law? They all give the example of the Netherlands, where sex offenders are very carefully watched. Before they are released from prison, they are diagnosed, and according to the degree of danger they present, are sent to therapeutic institutions.  The most dangerous are sent to a closed hostel, while the less dangerous must wear an electronic handcuff, so a parole officer knows where the pedophile is at any given moment. They are required to report daily to a police station and report any change of address. Not only in Holland, but in most Western countries, pedophiles are under supervision. The United States has a law requiring convicted pedophiles to post a warning notice about their past on the door. In Israel, this idea was raised while the law was being formulated, but the majority was opposed. In any case, in most countries pedophiles don't go straight home from prison.

At present, there is no law, nor will there be one in the near future. The Justice Ministry is aware that the law is stuck there. Rachel Gershuni, a prosecutor in the legislative advice department, who is responsible for the bill, was just making the final amendments when the Finance Ministry informed her that it was a waste of time, because in any case there was no budget for it. Meanwhile, the Ministry of Social Affairs is developing a pilot program
of its own, hoping to prove to the treasury that something can be done, even with a low budget.

In recent years, an innovative treatment for pedophiles, using Decapeptyl, has been introduced into Israel's health care system.  This is an injection containing a substance called Triptorelin, which lowers the level of testosterone to zero, and is widely used in the treatment of prostate cancer, for IVF, and in certain birth control pills. Birger: "The injection suppresses the sexual urge, and it has relatively fewer side effects than other drugs.  We recently received approval from the Prison Service to treat five men. Even that is done willingly and with consent."

Two people are responsible for developing the new treatment: Prof. Ariel Ressler, an endocrinologist from Hadassah University Medical Center in Jerusalem, and Prof. Eliezer Witztum, a psychiatrist on the Faculty of Health Sciences at Ben-Gurion University of
the Negev.

"It began over 10 years ago," says Ressler. "My friend Eli Witztum told me that he had many patients who were pedophiles, and that the drugs that were in use were not effective and had severe side effects. He asked me if I had any ideas. I deal with hormones and glands, and I did some thinking and had the idea of using this substance, Decapeptyl. The brain produces GnRH (gonadotropin-releasing hormone) that activates the pituitary gland, which monitors a series of glands in the body. These include the woman's ovaries,
which produce the ova, and the man's testicles, which produce the sperm. It is known that if there is a constant secretion of this substance, let's say artificially, an opposite effect is achieved. Within a few hours, the hormonal system is temporarily paralyzed. That's how they had the idea of producing GnRH synthetically.  When I stop him the drug, everything returns to normal."

Is that chemical castration?
"It's a mistake to call it chemical castration. We say that it suppresses the reproductive system, and stops thoughts about sex and sexual performance."

In 1993, Ressler and Witztum turned to the Swedish and Danish drug company Ferring through the Israeli importer Lapidot, and the company gave permission and funding to carry out a clinical trial on 30 people. At the same time, they received permission from the Helsinki Committee. In 1998, an article was published in the New England Journal of Medicine about the new use of the injection, and since then, says Ressler, there has been a worldwide revolution. Today, many countries have followed in the footsteps of the Israeli researchers, and have introduced this new use for the drug. A year and a half ago, the treatment received approval from Israel's Ministry of Health. Decapeptyl has been on the Israeli market since 1978, and is included in the health basket for all uses, except for pedophiles. They may buy it in private pharmacies for NIS 800 per month. The drug costs the Ministry of Health NIS 260.

Why isn't Decapeptyl included in the health basket? The ministry spokesman said: "The committee for expanding the health basket decided, based on its present budget and order of priorities, not to include Decapeptyl for the purpose of suppressing the sexual urge in the health basket."

The National Council for the Child made a calculation, using the statistics provided by the deputy director general of the ministry, Dr. Yitzhak Berlowitz, that the annual cost of Decapeptyl per patient is NIS 3,120, whereas psychiatric treatment will cost NIS 12,876 annually. The cost of maintaining a prisoner, according to the Prison Service, is NIS 98,550 annually. This is the sixth failure.

The injection is administered once a month. To date, Ressler and Witztum have treated about 65 pedophiles, and they report success.

What are the side effects of the injection?

Ressler: "Over time they become impotent. There are hot flashes, like those of menopausal women, a tendency to gain weight, a loss of calcium from the bones. Such people sometimes need treatment all their lives. The classic pedophile needs treatment for many years. We administer a combined drug treatment that reduces the sexual urge itself, and we suggest that they receive psychiatric treatment."

For whom is the injection unsuitable?
Witztum: It should be pointed out that the treatment by injection must be accompanied by psychological therapy. I'm talking about three groups of pedophiles: Simple pedophiles, pedophiles with another psychiatric illness, and pedophiles with severe personality disorders. The first and second groups are suited to receiving injections. The third group is not, because I need the cooperation of the patients, and one can't depend on that. If there is a law, it will be possible to treat more pedophiles."

In addition to the injection, there are pills on the market, Provera and Androcor, that are in the health basket. But they have severe side effects, including psychological disorders, weakness, dizziness, problems with liver function and an increase in tissue cancers. One of the pills causes the growth of breasts in 20 percent of men.

Pedophiles and their punishment

Seven pedophiles of the past seven years

- Shalom Twito, 36, was sentenced in December 1997 in the Tel Aviv District Court to seven years in prison for indecent acts he committed on a boy from Bnei Brak when he was on leave from prison, where he was serving a seven-year sentence for sex crimes against children. Twito said in court that he was aware of being a pedophile, but he refused to undergo chemical castration, as the Prison Service suggested.

- Moshe Mordof, 20, of Bnei Brak, was convicted on his own confession, in May 2000 in the Tel Aviv District Court, for sexual offenses against 13 minors aged 6 to 11. He was called "the rapist of the shelters," because he carried out some of the crimes in bomb shelters, to which he dragged his victims. The court sentenced him to 15 years in prison. The accused committed the crimes over a period of seven months, while on leave during his military service. The indictment stated that all the crimes were committed by applying pressure, causing physical suffering, use of force and without consent.

- Aryeh Goldman, "the Ramle pedophile," was convicted in 2001 in the Tel Aviv District Court, and sentenced to 16 years in prison and a two-year suspended sentence. He was convicted on his own confession for committing acts of sodomy against two minors, and indecent acts against three minors; the five victims were aged 9 to 13. In explaining the punishment, the judges wrote that had the accused not confessed, they would have meted out a stiffer punishment.

- Alon Koren, 31, of Tel Aviv, was convicted in the Tel Aviv District Court in May 2002, and was sentenced to 18 years in prison and a two-year suspended sentence for rape and sodomy of a 10-year-old girl. Koren was a delivery man for Supersol.  He convinced the minor to come with him to the park behind her parents' home, claiming that there was an injured man there who needed help, and there he raped her.

- Faiz Abu Kerinah, 32, "the pedophile from the south," was tried in December 2002 in the Be'er Sheva District Court and sentenced to 30 years in prison. During the course of the trial he confessed to three acts of rape of small girls in Be'er Sheva and Ashdod.  One girl was 7 years old; the other two were 9.

- Yosef Ovadia, 32, of Tel Aviv, was convicted in November 2003 in the Tel Aviv District Court, and sentenced to 22 years in prison for indecent acts, rape and sodomy of three girls aged 6, 9 and 12.

- Itay Leibowitz, 24, was convicted in January of this year in the Tel Aviv District Court and sentenced to 24 years in prison for sex crimes, including two acts of rape, on seven girls aged 4 to 11. He was convicted on his own confession. He followed the same behavior pattern in all the acts. He followed the girls on their way to school and chose places of work in the vicinity of children. (A.L.)

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