Children increasingly targeted in shootings

CHILDREN with gunshot wounds used to be accidental victims caught in crossfire, but now they are the target of shootings, according to Red Cross War Memorial Children’s Hospital.

Professor Sebastian van As, head of Red Cross’s Trauma Unit, said more children are coming in with multiple gunshot wounds, and the victims are younger than ever.

“About a third are under the age of 5,” he said.

The hospital, which only treats patients 12 years and younger, has seen about 30 gunshot victims so far this year.

“The mechanism in which children are shot used to be stray bullets – like a gang fight between adults and then the child was accidentally shot. Now we see more and more that children are actually shot on purpose,” Van As said. “We know that these children were shot on purpose because we’ve seen an increasing number of children who were shot multiple times. With a stray bullet, it’s usually one.”

The violence is hitting the Western Cape’s trauma centres hard. Groote Schuur has seen its monthly case load of gunshot wound patients double over the past eight years. The latest monthly numbers suggest little or no relief since the deployment of the SA National Defence Force in the Cape Flats.

Tygerberg’s trauma unit is seeing around 200 gunshot patients per month, a radical increase in the past three years.

Meanwhile, community assault is becoming a massive burden on trauma resources.

Tygerberg’s head of surgery, Professor Elmin Steyn, said they see between five and 10 cases per day of patients who have been brutally assaulted by residents who are fed up with crime.

“They beat them up extensively and viciously,” Steyn said. “These patients spend a lot of time in hospital. It’s not being recognised as a major burden on the system.”

“IN 2007, we only saw five children who were shot in the whole year. This year we’ve already got 30.”

Professor Sebastian van As, head of trauma at Red Cross War Memorial Children’s Hospital, said children were being shot more than ever – and the victims were getting younger.

A disturbing trend is that children are intentional targets of shooting, instead of just being bystanders.

“Adults are usually shot on purpose, so we’re starting to see that in children as well,” Van As said.

“We’ve seen an increasing number of children shot multiple times. In the old times, children were usually shot only in crossfire. But if you get a child that’s been shot multiple times, you know that there was a connection.”

Van As said the intentional shootings were related to gang fights, and often happened because rival gangs couldn’t find the person they were targeting, so they hunted down his family instead.

“We’ve seen quite a number of these cases, which is very disconcerting,” he said.

“Another big problem is that the children are getting younger. About a third are under 5.”

A bullet can wreak havoc on a child’s small body.

“Children under 5 have relatively large heads,” Van As said. “We’ve seen quite a few gunshots to the head and central nervous system, and unfortunately, a number of the children have passed away and some of them have been paralysed permanently, which is a disaster for them.”

While injuries from interpersonal violence only account for around one in 20 children admitted to the trauma unit, these patients often end up spending long periods in hospital.

This is because the hospital doesn’t discharge them until they know it’s safe for the child to return home. “Half of the ward is full of children who have been abused either sexually or physically, or shot, just waiting for placement” he said.

“We cannot send them home if they’ve been abused or shot at home. We must first make sure the environment is safe.”

Often it’s difficult to know if the perpetrator of the violence is a family member, or somebody else close to the child. Then it becomes difficult to protect the child when family and friends visit them in hospital.

“Their families and visitors often cause trouble,” Van As said.

“You cannot be 100% sure if they were the perpetrators.

“We have to be very careful with that. It definitely does stress the staff,” he said.

Sometimes there is the fear that the perpetrator may seek out the child in hospital to finish the job.

“We often get children who are shot as part of a gang-related fight, and have to change names and hide, because (the shooter) may still come after them,” Van As said.

He also said the staff had noticed much younger children being recruited into gangs than before. “We recently had a few patients who were part of gangs,” he said.

In one recent shooting, two people were killed and a young child was taken into police custody for the murders. “He was 10 but definitely a gang member.”

The number of gunshot patients treated at Red Cross Children’s Hospital peaked in 2000, with 40 children seen that year.

When the Firearms Control Act was introduced in 2004, the annual number of gunshot patients dropped. However, in recent years the number has rocketed straight back to where it was before 2004.

DOCTORS assess the injuries of trauma patients. There has been an increase in the number of children treated for gunshot wounds.