Broken babies - Study reveals pattern of hidden toddler abuse
Published:Sunday | March 20, 2011 | 12:00 AM
Tyrone Reid, Sunday Gleaner Reporter
A review of 238 cases of paediatric thigh bone fractures in children, 12 years and under, treated at the nation's only paediatric hospital - the Bustamante Hospital for Children (BHC) - over an eight-year period, is pointing to a significant pattern of toddler abuse.
The review, covering the years 2002-2010, conducted by Dr Dayanand Sawh, head of the orthopaedics unit at the Bustamante Hospital for Children, and a colleague from the University of the West Indies, Dr A.K. Crichlow, showed that a high percentage of the femoral fracture cases at the BHC occurred in infants who were less than three years old at the time of the incident.
Babies, less than one year old, represented the largest number - 60 - of the broken thigh bone cases that were used in the analysis. Infants, who had passed their first birthday but were not yet two years old, came in a close second, with 59 cases.
Another 23 cases of femoral fractures in children who were older than two but not yet three years old pushed the number of infants, under three years old, who suffered a fracture of the femur, to well over half of the total cases under review. Yet nobody has been imprisoned, as far as he knows, lamented Sawh.
The consultant orthopaedic surgeon argued that all of these suspected cases of abuse have gone unpunished, save one, which is currently being prosecuted, because the hospital's overwhelmed social work department is not able to investigate all of them. The social work team consists of two persons - a nurse and a social worker. The hospital treats hundreds of various fractures annually.
Frightening statistic
International statistics reveal that approximately 60 per cent of femoral fractures in children under two years old are caused by some form of abuse, and Dr Sawh does not believe that Jamaica defies the data. "Half of the patients in the study are under two years old. That's a frightening statistic," said Sawh.
"I'm yet to be asked to write a medical report or to attend court for any case of suspected child abuse," lamented Sawh, who has been practising at Bustamante for a decade. "Either our parents are better than the world literature suggests, or we are missing them (cases of abuse) all," he added.
He also explained that not all injuries would be physical abuse; in some cases it would be the result of neglect leading to injury. However, the femur is the largest bone in the body and is listed among the hardest to break. Only certain bones in the skull are harder to break than the femur, which is more popularly known as the thigh bone.
"We have a problem. We know it exists, but we lack the capacity to put forward a decent investigation. (Currently), we are unable to do more than an interview. I know that the abuse is being missed," Sawh told The Sunday Gleaner.
The hospital's skeleton staff in the social work unit is kept busy helping parents with the needs of their children and hardly finds the time to pursue prosecution, Sawh said.
The orthopaedic surgeon is calling on the relevant arms of the State to "empower the social services" and "enforce the laws with teeth".
Sawh pointed out that every case of suspected abuse is reported to the hospital's social worker who reports it to the Child Development Agency (CDA). "What happens after that is anybody's guess," said Sawh.
In response to the claims made by Sawh, Rashida St Juste, public relations and communications manager at the CDA, told The Sunday Gleaner that she would look into the matter. However, she pointed out that the complaints should be filed with the Office of the Children's Registry (OCR), which started in January 2007. The OCR would then pass on the information to the Office of the Children's Advocate and or the CDA for further investigation.
Prior to the establishment of the OCR, suspected cases of child abuse were reported to the police and the CDA, she said.
"The CDA has a responsibility, under the Child Care and Protection Act, to investigate cases that are reported to us, and then we have an obligation to report to the registry on the progress of these investigations," St Juste explained.