Why our children are dying

RESPIRATORY tract infections, murder and road accidents were the three leading causes of death in children, according to a pilot study to review child deaths in the country.

The study was conducted in 2014 at two mortuaries: one in Phoenix, Durban – which also covers the areas of KwaMashu, Inanda, Ndwedwe and Ntuzuma – and Salt River in Cape Town, which covers several suburbs including Mitchell’s Plain.

It reviewed 711 deaths – 163 at Phoenix and 548 at Salt River – and found that 53.3% of the deaths were natural, 42.2% were unnatural and 4.5% were undetermined.

The review was carried out by a multidisciplinary team consisting of representatives from law enforcement, social welfare, forensic pathology and prosecutors who reviewed the circumstances of the deaths.

In this month’s issue of the South African Medical Journal, researchers delved into key issues that the study had uncovered, including that children under the age of 5 continued to die of preventable illnesses such as respiratory tract infections and that there was a risk of fatal child abuse at home.

The deaths owing to infections appeared to be caused by several factors including poor living conditions, limited support for mothers and inadequate community-based services.

The study said while deaths involving severe child abuse were easier to identify, deaths related to neglect, drowning and abandonment remained difficult to detect and 33 cases of neglect were identified as a result of the review.

Joan van Niekerk, the president of the International Society for the Prevention of Child Abuse and Neglect, said it was not surprising that neglect had not been initially uncovered in some of the cases. Social workers, both in government and NGOs, had extremely heavy caseloads.

Cracks

“A caseload of 300 families for a social worker means that it is easy for children to slip through the cracks.”

Van Niekerk said that parenting programmes should start as early as high school but the life skills subject was not given adequate attention at schools.

“Young people need to be educated about parenting, what constitutes child abuse as well as about the choices they make with regards to sexual partners. We have such a high number of teenage pregnancies because children are not being educated about the choices they make,” said Van Niekerk.

She said there should be a system where mothers met social workers after they gave birth so that they could be advised about the assistance that was available. The challenges of parents in low-income, highpoverty areas were particularly high and there were also external risks.

Van Niekerk said that a particular challenge in the greater Durban area was the number of children who died a year owing to illegal electricity connections.

“There are about 20-30 deaths a year which could be prevented by interventions by the municipality,” she said.