CHILD-ABUSE SERVICES AT A CHILDRENS-HOSPITAL IN CAPE-TOWN, SOUTH-AFRICA

Since the establishment of a Child Abuse Management Service at the Red Cross War Memorial Children's Hospital in the early 1980s, there has been a steady increase in patient numbers. In order to assess the prof ile of patients, and also the allocation of staff to the service, all child abuse related patients seen at the Red Cross War Memorial Childr en's Hospital in Cape Town over the period of June 1989 through July 1 990 were reviewed. Five hundred and three children with a median age o f less than 7 years were seen. Abuse was confirmed in 389 (160 physica l abuse and 229 sexual abuse). Abuse was suspected and not confirmed i n 114 (41 physical and 73 sexual). Half of the patients presented to t he hospital outside of normal working hours. Eighty-one percent of chi ldren less than 5 years of age were seen in the Trauma Unit by surgica l residents with minimal pediatric training. One hundred and thirty fo ur of the patients were Xhosa speaking while only one social worker an d no medical staff could speak Xhosa. Pediatric residents were involve d in the care of less than 2% of cases. Conclusion: Management of chil d abuse constitutes a significant commitment and appropriate staff all ocation is essential. Although it is not possible for each child in wh om abuse is suspected to be seen by a specialist, they should be seen by those staff with the most expertise. Staff allocation must take int o account the needs for education, training, and audit as well as serv ice provision.