Heather Roy's Diary – 8 July 2008
I had many responses to last week's Diary discussing the sad fate of the Kahui twins and child abuse in general. Many
comments were informative and some spoke of painful personal memories. Some people asked what ACT would do about the
problem - a fair question and one I intend to address today. A good place to start is to examine the risk factors for
child abuse.
Most of the risks relate to the parents and some to the child. I emphasise that these factors are just statistical
probabilities and being in one category does not, in itself, necessarily mean anything. It is important to remember that
risk is about the increased likelihood of an outcome - not about a direct correlation. Risk factors give us some clues
about who might be affected.
Below are the risk factors in the parents:
* Teenage parents
* Alcoholism in a parent
* Illegal drug use in a parent
* Social isolation
* Single parent
* Parent themselves victims of abuse
* Children and a parent who are not biological relatives
* Poverty
* Depression in a parent
Here are the risks in the child:
* Handicap * Long term illness * Male sex
There is an element of controversy about these factors and some are too complicated to be addressed in a list. One
chilling factor is the age of the victims. The textbook "Practical Paediatrics" comments that the highest death rates
are amongst boys from newborns to age 4, followed by girls of the same age. I once asked a salty old paediatrician I
knew why these figures indicated that it was the youngest who were at greatest risk. He replied that by the age of five
most children can run pretty fast.
There are also many social factors to be considered. When society as a whole is violent some sociologists suggest that
domestic violence is increased.
A quick glance at the list of risk factors shows that it is possible to draw widely varying conclusions from them.
Socialist politicians find another reason to tax more and to spend on benefits, so as to combat poverty. Other
politicians point out that the traditional lifestyle where children live with their natural parents with Dad working and
Mum staying at home provides the safest environment for children.
Finally there is the controversial question of race. Again quoting from "Practical Paediatrics" there is a chapter on
the "Maori view of child health and illness" written by Lower Hutt paediatrician Leo Buchanan. He makes the following
observation :
"Compared with non-Maori children, tamariki [Maori children] are four times more likely to be hospitalised for injuries
sustained as a result of deliberately inflicted physical injuries. Notifications to the statutory authority for
investigating child abuse in New Zealand have likewise been found to be higher for Maori"
Why Maori? I think it is safe to say that it is nothing genetic because when scanning the list of child homicides since
1990 I was struck by how seldom Pacific Islanders were mentioned.
Amongst the large number of commentaries in the media this week was an informative article in the Sunday Star Times by
Michael Laws. He asked if the Kahui family are symptomatic of an underclass within Maori who are resistant to both
mainstream and Maori assistance.
Time for Action
The first thing that needs to change is that people must have realistic expectations. The thought that Child, Youth and
Family Service (CYF) should be responsible for all cases including ones not on its caseload is unreasonable and simply
drives good people out of the service. There must be a differentiation between preventing problems and dealing with
problems that have arisen already. A two-pronged approach is needed. It is not enough just to try and deal with problems
as they arise - that is just treating the symptoms of the problem. If any progress is to be made in preventing further
deaths like the Kahui twins the actual causes of the problem must be tackled. I'm not just talking here about domestic
violence, but also the burgeoning problem of welfare dependency.
We have to align CYF powers with its responsibilities and CYF workers need access to better facilities for children
requiring placement. Some type of institutional placement (for want of a better term) is essential for emergency cases.
Safe houses for children are not a long term solution but social workers need to be able to make emergency placements to
ensure a safe temporary environment.
Most importantly, CYF must have the obligation to place children with whanau removed. Children in danger and at risk
must be placed in a safe environment. Sometimes this will be with family but we have seen too many cases where, because
of the law, children have been taken from one unsafe situation and placed in another equally unsafe family situation,
leading to tragic results. This simple change would make a big difference and I am puzzled as to why the current law was
introduced in the first place. As the television advertisements remind us, domestic violence is often an
inter-generational phenomenon.
Finally CYF should be changed into a Child Protection Service with police, social workers and doctors working together
on a full time basis.
This model is functioning well at Auckland Hospital. Because of the passion and drive of a select few a service now
operates to serve children with suspected abuse who live in Auckland. It wasn't easy and it won't surprise many to know
that one of the biggest obstacles was a protracted argument about how the participating government departments - health,
welfare and police - would divide the costs of floor space! Unfortunately this model hasn't been replicated elsewhere.
This service would better reflect the needs children and would help overcome the conflict that currently exists between
the policing and helping roles of CYF Social Workers.
Prevention, as always, is a much tougher area and one that warrants an article of its own - that's next weeks diary.
ENDS