Community training could protect children

People are embarrassed and ashamed about this stuff and they often don't ask for help. But with a health professional they can trust, they know they can share personal information and that they will be respectful and respond in a safe way.Russell Wills, Children's Commissioner STOP THE CYCLEKERRY Ratana pleaded guilty to manslaughter for the death of 5-year-old Sahara Baker-Koro in Napier on Tuesday.
Last week a nine-month-old Flaxmere girl lay in hospital in a serious condition following a violent incident between her parents.
Statistically, another Hawke's Bay child will have appeared in hospital with non-accidental injuries this week. And another the week after that.
Children's Commissioner Russell Wills said most weeks there were "substantial numbers" of non-accidental injuries presented at all district health boards.
It was a similar story when he worked locally as a paediatrician: "When I'm on call and working in the ward, we'd have a child protection case certainly once a week, sometimes three to four times a week."
There were 610 child-abuse cases from Napier and Hastings before Child, Youth and Family last year, and 122 children in its care.
Nationally, there were 125,000 cases reported to CYF, or 347 a day. Over 21,000 of these were confirmed cases of child abuse or neglect.
The grim figures were not altogether surprising in a country where communities all too regularly mourned the loss of children who died at the hands of those who should love them the most.
James Whakaruru, Nia Glassie, Chris and Cru Kahui had become nationally recognised names for all the wrong reasons.
National abuse prevention organisation Child Matters put out the call recently that professionals across various sectors needed specialist training to help combat what was becoming a national problem.
Spokeswoman Amanda Meynell said Child Matters delivered training to more than 20,000 people working with children, but their work had only "scratched the surface".
"There are numerous people throughout our communities that are in excellent positions to recognise when a child is being abused - not just in health but in education, early childhood, social services, community organisations and sport."
Dr Wills supported Child Matters' call and looked to the proven results of specialist training in the health sector, mandatory for all staff dealing with women and children.
Since the inception of the Family Violence Intervention programme at Hawke's Bay District Health Board in 2002, referrals to CYF had more than quadrupled, from 75 to more than 350 cases a year.
What's more, the quality of those referrals, the information they contained, had improved, giving CYF workers a much-needed head start.
About 1500 health professionals in Hawke's Bay had been trained in the programme to routinely ask most people in ED - that is, all women over 16, all mothers and pregnant women, and anyone of any age or sex presenting suspicious injuries - about their experiences with abuse.
Dr Wills said the frank questioning helped identify victims who might otherwise keep quiet.
"People are embarrassed and ashamed about this stuff and they often don't ask for help. But with a health professional they can trust, they know they can share personal information and that they will be respectful and respond in a safe way."
"They're deeply personal questions and people need to be trained well to ask these questions, and be respectful to the patients and respond to it safely.
"One of the striking findings is people don't mind being asked. They're delighted we're doing it. They think it's very appropriate," he said.
While training in the health sector had positive results, other sectors would need training specifically tailored for their individual situations.
Role plays were an integral component of the training where staff practised asking tough questions about abuse. The role plays were scripted according to professional groups, whether dentists or mental health workers, in order to give realistic and practical training.
Dr Wills said if the training was to be adopted by other sectors it would need to be geared towards their unique situations.
"You need to adapt your training. If you're going to train teachers [for example] you need to write the scenarios with the teachers," he said.
"We confirm from our research that that's the right way to do it."
However, prevention was always better than the cure and Mrs Meynell said key to that was community intervention.
"People in the general public don't know about the full extent of child abuse.
"But by making our community more aware in what they can personally do, we're going to get better results."
She said people could look for "red flags", risk factors such as a family history of violence or a violent home life, and offer their support.
"At the lower level, it's where you believe that you can step in to alleviate the situation. If you're worried a mum is stressed or under pressure, it's about you personally helping them out, providing a listening ear."
In more advanced situations, it could be putting the family in touch with a support agency, or contacting the police.
Either way it was up to us.
"Everyone in our community needs to take the responsibility for protecting our children," she said.