Cape Town - Professor Shanaaz Mathews is on a mission: to prevent South Africa’s children from dying and to get justice for children who are killed.
Mathews is the director of The Children’s Institute at the University of Cape Town and the woman behind the Child Death Review (CDR) project.
“The Child Death Review is a project that has been running since 2014, initially as a pilot project based on the work I was doing with the South African Medical Research Council looking at the size of the problem of child murders in South Africa,” Mathews explains.
“The work I did with the council was the first study to quantify the numbers of children murdered in South Africa and being able to work out the proportion of children killed because of child abuse. That piece of research showed us that in South Africa we have more than a thousand children murdered yearly, half of them in the context of fatal child abuse. But what was alarming from that piece of research was that very few of our child murder cases went to court and when it did go to court it had really poor outcomes. That made me particularly concerned because what it meant was that children didn’t get justice.”
So Mathews went to work to find a way to improve this, looking at best practices around the world and what other countries were doing. She came across child death reviews.
“It was used mainly in high-income countries, in fact, there were no child death reviews in a lower to middle-income country.”
Despite this, the CDR pilot project was launched in Cape Town at Salt River Mortuary and in KwaZulu-Natal at Phoenix Mortuary “to see whether in fact, it could work in very different settings where there are different levels of support.”
Following the success of the pilot, the CDR process is being extended to all mortuaries in the Western Cape, with the aim of having complete coverage by the end of 2019. The team have also been awarded the Western Cape Government Boundary Spanning Leadership Award “which recognises leaders and leadership teams who achieve breakthrough results through collaboration across boundaries”.
But what does the project actually do?
“What we do is we identify all children that have died in a particular month and then lead by the forensic pathologist discuss the cause of death. We bring together a multi-disciplinary team, so the forensic pathologist is really key because they bring the information on the cause of death.
"We have a South African Police Services official who brings the police investigation information. We’ve got senior-level National Prosecuting Authority prosecutor attending because we want a real-time response. We also have the Department of Social Development, which is really crucial because what we are trying to achieve is look at child deaths not just from a biomedical point of view but bring together both the social context and the biomedical factors to start thinking about how do we prevent children from dying.”
Mathews says while gang violence is a pivotal problem in the Western Cape, it can be eradicated.
“If you look at violent countries like Colombia, they have introduced approaches to reduce gang violence. One of the things is getting guns off the streets. We’ve seen increases in the murder rate because we’ve seen increases of guns in the communities again.”
Mathews also explains that the patterns of child murders in the Western Cape and KwaZulu-Natal, where the CDR project operates, are very different.
“In the Western Cape, we see the murder of children linked to rape, homicide and gang violence, in KZN it’s more cultural forms.
“In KwaZulu-Natal, the positions of women and children, their place in society, is very contested. It’s important to understand that levels of gender-based violence and violence against children are incredibly linked and the social position that children and women hold in society mirrors where you see levels of violence highest against women and children.”
While she admits it’s all very gloomy she says: “I feel that if I can change the life of one child and one family at a time, I am making a difference.”