No country for children

IT IS a slow-motion catastrophe: we are killing our kids.

Homicide is the second-biggest cause of death among children whose bodies end up at a morgue, a pilot study has found.

Among the alarming findings in this study and an earlier one are that:

Three children are murdered every day;

Nearly half of child homicides are linked to abuse and neglect;

Physical punishment under the guise of discipline is a contributing factor;

Nearly half of murdered children have single moms;

Over a third are killed by an acquaintance and a third are killed by their mothers; and

Murder is the biggest cause of death among 15- to 17-year-olds.

The new study, reported in the South African Medical Journal, was based on the international “child death review” model, where every death deemed “unnatural” is discussed by a team of experts including a senior state advocate, medical specialists, pathologists, social workers and police.

These include murders, suicides, accidents, sudden and unexplained deaths and cases where someone may be liable.

Another alarming finding was that among babies who die, 70% do so at home, mainly from respiratory tract infections like pneumonia, with parents unaware that something is wrong.

“People don’t realise the enormity of what is happening,” said Professor Lorna Martin, head of forensics and toxicology at the University of Cape Town and Salt River mortuary.

A MAJOR concern emerging from the child death review is that nearly 70% of newborns who die — mainly from lower respiratory tract infections such as pneumonia — die at home, with parents and caregivers unaware the babies need urgent medical attention.

Health Minister Aaron Motsoaledi sees an increase in the number of trained community health workers as the answer to these tragedies, and was in New York this week at the UN General Assembly lobbying for just that.

He said: “The idea that most newborn babies who die, die at home, means we have no control. That is why I believe the new approach to healthcare should be about strengthening the primary healthcare system.

“Community health workers can pick up problems and it is an affordable system. We can’t just rely on clinics and hospitals — it is not viable.

“These community health workers are not medical professionals, but they are trained to pick up problems early in ways that parents aren’t. They are the NO CONTROL: Health Minister Aaron Motsoaledi ones who can really reduce the mortality rate. If the science proves it — all the better for us.”

The review also corroborated earlier research that South Africa has one of the highest global rates of neonaticide — the killing or abandonment of a baby under six days old.

Of all child homicides, 16% were due to abandonment in the first week of life.

According to the researchers, this was “shown to be a period of increased risk of deaths resulting from abandonment and injury”.

Also of concern is infanticide, the killing of a child — deliberately or through abandonment — before their first birthday.

A worrying gender component is that girls were much more likely to be abandoned than boys.

Neonaticide and infanticide are “far more common than the child death review pilot suggests”, say the researchers, “as many infants are ‘dumped’ in sewers, refuse dumps and dirt bins, and the pilot only identified remains brought to a mortuary”.

They say that despite liberal legislation on the termination of pregnancy and the availability of community-based contraception services, “it would appear that we are not meeting the needs of large numbers of women. We need to examine maternal and mental health services for pregnant women and determine the appropriate support services required by women in communities to decrease infanticide.”