Kahui deaths tip of abuse iceberg

The Kahui twins died after being admitted to hospital with horrific head injuries.

New figures paint a grim picture of child abuse in New Zealand and show that the deaths of the Kahui twins were the tip of the iceberg.

Nearly one child a week is admitted to Auckland's Starship Hospital after being assaulted - many with head injuries similar to those that claimed the lives of the Kahui twins.

The startling findings are contained in Starship Hospital data on child abuse admissions, which has just been publicly released.

In the 12 months to July, Starship - New Zealand's largest paediatric hospital - admitted 48 children who were victims of "suspected or definite" child abuse.

Most cases involved children under a year old. Seven of those children did not survive, a figure Starship said was unusually high compared with previous years.

Overall, this equated to almost one hospital admission a week - with many of the cases "as horrific as the Kahuis", said Patrick Kelly, clinical director of the hospital's child abuse team.

"That [one case a week] is the case everyone knows about, but there are so many other cases that go unreported," he said.

Of the 48 children listed, 28 had head injuries, many of which were similar to the type of skull fractures and brain damage suffered by Chris and Cru Kahui, who are listed among the seven dead.

Adding to the horrific statistics, a further 13 children were admitted to Starship with "injuries definitely due to abuse but not involving a skull fracture or injury inside the skull".

In the remaining seven cases, the injuries suggested abuse.

More worrying was the suspected cases that were never referred for medical treatment, Kelly said.

"A lot of kids who suffer brain injury are never diagnosed," he said. "This contributes to ongoing problems later on."

Kelly said most of the child abuse cases came from the greater Auckland area and were a result of infants being shaken violently or being thrown against a hard object by a parent or caregiver who was "presumably in a fit of rage".

Kelly could not comment on the circumstances of the seven deaths as all had been referred to police for prosecution, but did say Maori were "grossly over-represented".

Kelly said those children who did survive were likely to have long-term brain damage, which would affect their intellectual and cognitive development.

He believed it was time more effort and resources were devoted to preventing child abuse.

"I think people forget how difficult it can be caring for infants ... and we do not put a lot of resources into helping families and parents through that.

"So we end up with stressed families with poor parenting skills and poor social networks.

"It doesn't take a lot to push them over the edge."