EULALEE THOMPSON
There was an estimated 57,000 deaths attributed to homicide among children under 15 years of age in 2000 - World Health Organisation.
VIOLENCE IS described by the 'World Report on Violence and Health' as a global public health concern. The report refers to different types of violence: youth violence, violence by intimate partners, abuse of the elderly, sexual violence, self-directed violence, child abuse and neglect by parents or caregivers.
On the issue of child abuse and neglect, the World Health Organisations state that the risk of fatal abuse for children varies with the income level of a country. In high-income countries, for example, the rate of child homicide is 2.2 per 100,000 for boys and 1.8 for girls, while in low-to middle-income countries, the rate is three times high 6.1 for boys and 5.1 for girls.
'The World Report on Violence and Health' states that head trauma as a result of abuse is the most common cause of death in young children. Children under two years old are the most vulnerable to this form of battery. Patterns of injury to the child's skin, the report states, is an important "red flag" of possible child abuse "because force applied to the body passes through the skin."
There are also skeletal manifestations of abuse, according to the report, such as "multiple fractures at different stages of healing, fractures of bones that are very rarely broken under normal circumstances, and characteristic fractures of the ribs and long bones."
The report refers to some other "red flags" of child abuse:
The shaken child
Most of the children who are victims of shaking are young, often younger than nine months old, according to the report; and, most of the perpetrators of shaking are male caregivers. The report states that the shaken child may show up with intracranial haemorrhages, retinal haemorrhages and very rapid shaking and/or hitting the head against a hard surface may result in small "chip" fractures at the major joints of the child's extremities. The worldwide data on the shaken child shows that about one-third of shaken infants die and most of the children who survive this ordeal suffer long-term illness, such as mental retardation, cerebral palsy or blindness, according to the report.
The battered child
Repeated injuries to skin, skeletal system or nervous system are some telltale signs of the battered child. These abused children may also have multiple fractures, head and visceral trauma, according to the report.
Sexual abuse
The child victim of sexual abuse may attract attention in school because of his behavioural problems. The report advises that to be able to neglect abuse, the teacher or others in contact with the child should have a "high index of suspicion and familiarity with the verbal, behavioural and physical indicators of abuse." It is also not uncommon, according to the report, for sexually-abused children to show symptoms of infection, genital injury, abdominal pain, constipation and chronic or recurrent urinary tract infections.
Neglect
The report highlights many forms of the neglected child such as caregivers not protecting their child from the various environmental dangers, abandonment, inadequate supervision, poor hygiene, depriving one's child of an education, not taking one's child for appropriate health care, not feeding one's child resulting in hunger and failure to thrive and exposing one's child to drugs.
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