P Ip, PSK Lui Tsang

The above theme of the ISPCAN 5th Asian Conference on Child Protection held in Hong Kong in l999 highlights the fact that we have moved quite some way from the diagnosis of physical illness to the recognition of the importance of total fitness. We have also moved from adopting a micro approach of treating an individual to the awareness of the significance of a macro approach of looking at the family and the society as a system. Furthermore, the community has moved from the recognition of physical abuse 20 years ago to the protection of children by the creation of an environment conducive to their optimum growth and development.

The four articles of the keynote speakers J Thoburn,¹ P Chu,² D Glaser³ and YW Choi⁴ share many common concerns and each own a unique focus. All parties adopted a holistic approach in the early and strategic assessment of the needs of children and family. All parties stressed the importance to work with parents and children as partners but not to hastily intrude into individual and family privacy. In view of scarce resources and increasing societal demands, proper resourcing for early intervention and prevention is preferred to mere ''ambulance'' services. It is essential to invest in measuring what works and in actively implementing family (parents and children) participation. D Glaser discussed extensively the prevalence of psychological abuse and how the community neglected this particular arena in the past decades. She defined it not as a single interaction but as a parent-child relationship and the harm done as often subtle, detrimental, long lasting and hard to detect. YW Choi focused on adolescents at risk and thought that it was costly to provide services to everyone and thus a screening instrument to identify the at risk youth in schools would help. He suggested acquiring a conceptual framework of ''resilience'' to work out a preventive program by building inner strengths and promoting protective factors. However the suggestion to identify at risk youth in schools aroused much current debate in the community as to whether a label was adversely attached to the group identified.

PSK Lui Tsang⁵ related the societal changes in Hong Kong over the last two decades and Hong Kong's response in the area of child protection both in the government and non-government sectors. She stressed the need to create inner peace and to turn, if not prevent, threats into challenges. The need of a child perspective in policy and practices in the community is essential. ACW Lee^6,7 on behalf of the Medical Co-ordinators on Child Abuse presented the pattern of abuse seen in public hospitals in Hong Kong. He drew attention to the occurrence of Shaken Baby Syndrome locally, a condition surfacing recently but not recorded in the government Child Protection Registry which does not include children who died of abuse. He pointed out succinctly that the handling of child abuse requires special expertise in recognition, treatment and advocacy. He urged for child abuse to receive priority in resources and attention. LKY Lee⁸ presented her experience in treating children sexually abused and demonstrated as in overseas, the importance of the support of the non-offending parent. Treatment of perpetrators in child sexual abuse is a relatively new service in Hong Kong. CC Lu Chan⁹ shared her valuable experience in treating sex offenders in the Correctional Services Department.

AC Leung¹⁰ explored the constructivist approach to child rearing which is empowering both to the parent and the child, while J Ho¹¹ in the Against Child Abuse's "Let the Dolphin Lead" project illustrated an effective child participation and empowerment project. Children are provided opportunities and guided to voice their wishes to policy makers in improving their family, their schools, their media and their government.

As BS Chua and HO Abdul¹² found, no ethnic origin is spared of child abuse which arises from complex, multi-factorial factors. We need to learn from different countries and share our successes and failures.

Protecting children in the 21st Century is therefore no longer solely the responsibility of the family or even that of a single discipline. It has become a communal and global concern, requiring the dedication, and collective wisdom of the entire mankind. The articles covered in this journal should stimulate us to step back and think whether we are indeed heading towards total fitness, creating peace and stability and ensuring optimal growth and development of our children.

References

1. Thoburn J. Building a caring community for the protection of children. HK J Paediatr (new series) 20001;6:3-9.

2. Chu P. Promoting family well-being - future direction on family and child welfare services. HK J Paediatr (new series) 2001;6:9-13.

3. Glaser D. Awareness of psychological abuse and promoting mental health in families. HK J Paediatr (new series) 2001;6:13-6.

4. Choi YW. Working through adolescence crisis for family stability: a targeted, systemic, integrated approach. HK J Paediatr (new series) 2001;6:17-24.

5. Lui Tsang PSK. In peace and stability we develop out total fitness. HK J Paediatr (new series) 2001;6:25-9.

6. Lee ACW. Suspected child abuse cases in public hospital: an interim analysis of 494 cases. HK J Paediatr (new series) 2001;6:52-6.

7. Lee ACW. Shaken baby syndrome: the local perspective. HK J Paediatr (new series) 2001;6:30-3.

8. Lee LKY. Intra-familial child sexual abuse in Hong Kong: a descriptive study of 23 cases referred for psychological treatment. HK J Paediatr (new series) 2001;6:35-9.

9. Lu Chan CC. Psychological intervention for sex offenders in the correctional services department. HK J Paediatr (new series) 2001;6:33-5.

10. Leung AC. The child rearing approach in an era of change. HK J Paediatr (new series) 2001;6:46-51.

11. Ho J. Youth empowerment - ''Let the Dolphin Lead''. HK J Paediatr (new series) 2001;6:44-6.

12. Chua BS, Abdul HO. The influence of ethnicity, gender, personality, life satisfaction, and number of children in the family on child abuse potential. HK J Paediatr (new series) 2001;6:40-3.