Cape Town - The December holiday is a dangerous time for children in the Western Cape as it brings a surge in serious injuries due to abuse and neglect.
Red Cross War Memorial Children’s Hospital saw an increase in children who had been abused over the festive season, which matches a trend that brings severely injured young victims of abuse to their trauma centre every year over the summer holidays.
Last month alone, Red Cross doctors referred 55 new cases of abuse to the hospital’s social work team.
Professor Sebastian van As, head of trauma at Red Cross, said festive season substance abuse could push perpetrators to strike.
“We see more children who are abused because of the lack of supervision, but also the perpetrators - if you’re inclined to harm a child and you’re intoxicated with drugs or alcohol, then you’re more likely to do it,” Van As said.
Nurse Sandra Swart, who is operations manager for the trauma unit, said all children under one year old who have a skull fracture due to “falling from a bed” warranted suspicion.
“We do an investigation into the circumstances, because sometimes the parents’ history and the injuries are not corresponding,” Swart said. “We do a full body X-ray, we do an eye test because some parents shake the children, and then we do a brain CT to see if there’s more pathology, bleeds or fractures. Sometimes it’s not the history the mother gave.”
Red Cross’s head of social work Carla Brown said that children who have suffered abuse often have to spend long periods in hospital after they’ve physically recovered, because it’s not safe to discharge them back into the hands of their families.
“We have unfortunately had cases which necessitated that children remain in hospital for extended periods - five weeks and more - due to safety risks for the children and awaiting safe discharge plans from the community-based social workers,” she said.
Aside from intentional harm in the form of abuse, parental neglect during the festive season leaves children at much higher risk of other injuries.
“There is less supervision because parents are distracted with their own activities - parties, food, shopping, drinking,” Van As said. “Children spend more time at home and in the streets. There’s more time to injure themselves instead of sitting peacefully in school.”
Dr Heloise Buys is the head of emergency services at Red Cross. She said the influx of children during the festive season is directly related to parents being irresponsible.
“The trauma unit sees an increase in injured children and that’s related to parental behaviour,” she said. “People drink and make merry and that leads to bad behaviour. It’s drinking and driving, no seatbelts, less supervision and that leads to a lot of paediatric injuries.”
Buys also drew a clear link between being under the influence of substances and being more likely to abuse a child.
“It’s not only driving while drunk, but behaviour within the home. Many of the child abuse cases are by people that the child and family know. It is rarely by someone unknown to the family.”
Aside from abuse, parents who are distracted and neglectful also leave room for accidents to happen. Buys said that being unsupervised can quickly lead to a small toddler drowning in a bucket of water used for washing up - even in the few minutes it takes for the parent to go to the bathroom. Parents also neglect to properly strap their children in car seats, which leaves them vulnerable to severe injury or death in a car accident.
Other common injuries Red Cross sees over the festive period stem directly from children being left to entertain themselves while enjoying the freedom of the summer holidays: fractured bones after falling from heights, or being hit by a car while playing in the street.
“The trauma unit does see a lot of poly trauma, pedestrian accidents, motor vehicle accidents. Many children will fall off walls, climb trees and fall out and there’s always an increase of that over the festive season,” Buys said.
She also sees children who have accidentally been poisoned while left unsupervised over the festive season. Last year alone, Red Cross dealt with over 12 000 calls about poisoned children, with 339 admitted for severe poisoning. Common culprits are paraffin kept in plastic drinks bottles and medications such as iron tablets, psychiatric medication and antihypertensives.