ACW Lee, D Ling, KT So

Background Child abuse has been an increasing problem of child health in the northwestern New Territories.

Patients and methods A retrospective review was conducted to examine all cases of suspected child abuse handled by the Tuen Mun Hospital from January to December 1994. All suspected victims were managed according to the guideline issued by the Social Welfare Department.

Results Fifty-four children, including 29 boys and 25 girls, of mean age 7.8 (range 0.2-17.6) were suspected to be victims of child abuse. They were managed by the paediatric (n=47), medical (n=2), surgical (n=3), and accident and emergency (n=2) units respectively. The average duration of hospitalization was 15.4 (range 1-64) days. Eight children were discharged when initial investigation failed to substantiate an abuse case. Multidisciplinary conferences were held for the remaining 46 children. Twenty-nine (63%) children were concluded to be victims of child abuse. They were classified as physical abuse (n=17), sexual abuse (n=1), psychological abuse (n= 1), gross neglect (n=5), and multiple abuse (n=5) respectively. In addition to superficial injuries, 4 children had skeletal fractures. Three infants were found to have intracranial haemorrhages of which 1 died. Associated factors, often multiple, include conjugal conflict, parental unemployment, early parent-child separation, and restoration of filial piety for unwanted behaviours or undesirable school performance. Care and Protection Order was applied for 20 victims, and 19 children were placed in institutions, small group or foster homes, or taken care by relatives. All children at risk were followed up medically or socially. With a follow-up of 13.2 (range 8.3-19.7) months, two children (7%) were re-admitted for recurrence of non-accidental injury.

Conclusion Child abuse is a common and serious child health problem in the northwestern New Territories. Increased public awareness and better co-ordination of the various professionals is necessary to facilitate early identification and successful management of children at risk.