LSP IP

Twenty years ago, Hong Kong awakened to the occurrence of child abuse, mainly external injuries, being a problem in our society. Active cases managed by both government and non-governmental agencies remained around 450 each year with physical abuse, approximately 350 cases, being the majority. In 1997, reported cases of sexual abuse had escalated from 2%, prior to 1991, to 29% (242) of 833 active cases while physical abuse (424 cases or 51%) increased much less and dropped proportionately. There are still much difficulties in defining neglect and psychological abuse which accounted for 6 and 4% respectively. Multiple abuse (10%) is increasingly recognized. Awareness of specific conditions like Shaken Impact Syndrome and Munchausen Syndrome by Proxy is only beginning.

A multidisciplinary approach to reports of abuse has developed over the years. It has become much more organized in the last few years in response to legislative changes to the investigation and prosecution of child sexual abuse. Specialised units are in place in different disciplines including the Child Protective Services Unit of the Social Welfare Department, the Child Abuse Investigation Units of the Police and designated Medical Coordinators on Child Abuse in all Paediatric Units of public hospitals. Guidelines to the management of child abuse first published in 1981 have been revised again recently defining clearly the role of different professionals who may be in contact with children suspected of being abused. Systems of referral, procedures for assessment, investigation, support and aftercare are laid down with the emphasis of "working together, trusting each other, for the welfare of the child". These admirable objectives still need much professional training supported by resource provision before they can be achieved.

To truly protect our children from abuses, equal if not more effort than that devoted to its investigation is required. Apart from publicity in the community, special programmes to empower children, to teach them self-protection, to assist new parents to give their children a healthy start and mothers to network with each other to avoid social isolation are in progress.