Text: Chris Bateman. Article from the March 2015 issue of Noseweek Magazine.
Huge numbers of children growing up without parents or parental care pose a major threat to SA’s future.
OF THE 18.5 MILLION CHILDREN under the age of 18 in South Af¬rica, 21% are orphans, 25% do not live with their parents and 60% live in poverty – frighten¬ing figures which, top local epidemiolo¬gists and clinicians agree, help to ex¬plain why the risk of a child dying here is ten times higher than in Europe.
These figures emerged with the re-cent release of the annual South African Child Gauge report by the Children’s In¬stitute at the University of Cape Town and from a Noseweek interview with Professor Sebastian van As, Chief Paedi- atric Surgeon at the city’s Red Cross War Memorial Children’s Hospital, the only dedicated children’s specialist hospital in the country. Since 1991, the hospital has built up the world’s single largest data base on child trauma.
The experts at both institutions agree that poverty along with the widespread, absence of the most effective risk-miti¬gating factor possible – a child’s biologi¬cal parents – render the 80% of South Africa’s children living in informal set¬tlements highly vulnerable as they roam dangerous environments, often border¬ing highways, train routes or bodies of water.
HIV/Aids in the pre-antiretroviral era has left the country with one of the world’s largest orphan populations. Even those children who have working parents or guardians are often left unsupervised as their primary minders spend long hours away from home eking out a living.
Van As told Noseweek that children younger than six years old were insuf-ficiently developed neurologically to properly assess immediate dangers. The paucity of child-minding facilities and creches in the townships is a major prob-lem.
The ten-times-greater risk of a South African child dying as opposed to a Euro¬pean one, Van As pointed out, came from a World Health Organisation (WHO) country-by-country child mortality com¬parison.
He said that three years ago his unit had compared the relative risk of a child ending up in a Cape Town hospital ver-sus a British child being admitted to Bir¬mingham Hospital and the data showed a 25-times-greater chance locally.
South Africa was “anything but a child- centred society,” he said. The media focus on violence against children disguised the “true numbers” which showed that ten times as many children died from ac¬cidental injuries as were violated. Just 5% (or 500) of the 10,000 children seen at the Red Cross Children’s War Memo¬rial Hospital annually were physically or sexually abused.
The Red Cross Children’s hospital admits children aged 13 and younger. Van As and his team (two trauma and three orthopaedic consultants, backed by an average of 10 paediatric registrars), ad¬mit 3,000 children annually; 1,000 suf¬fering from burns and 2,000 from a range of other injuries, with road accidents be¬ing the biggest overall killer.
Half of the 45,000 contact crimes reported were sexual offences – an average of 62 cases daily
Malnutrition impeded neurological development, further hampering less-privÂileged children from reaching their full potential. The country’s violent past and the generational passing on of violent behaviour, aggravated by widespread poverty, meant that, “we are world chamÂpions at killing children,” the professor observed.
In the hour that Noseweek spent interÂviewing him, Van As attended to a child with 32 fractures resulting from domesÂtic violence between adults, in which the child was used as a shield – a common cause of severe trauma. And he watched another die after the upper part of her torso had been kept alive for two days. Hit by a heavy duty truck while walkÂing on a township road, she had literally been “torn in two”.
The Child Gauge 2014 report, PreÂventing violence against children; breakÂing the inter-generational cycle, found that over half of South Africa’s children frequently experience some form of vioÂlence from a very early age.
While there was a paucity of systemÂatic research on the extent and range of violent experiences, population-based prevalence studies showed that over half of children experience physical vioÂlence by a caregiver, teacher or relative.
Incidents of sexual violence were under-reported – “a disturbing reality,” when considering that half of the 45,230 “contact crimes” against children reÂported in the 2013/2014 crime statistics were sexual offences (an average of 62 cases per day).
A two-province study found that one- third of participating children experiÂenced emotional abuse. Emotional vioÂlence, neglect, corporal punishment and humiliating censure of children were “common in the home”, where abuse and neglect of especially young children could result in death. Physical punishÂment at schools was still pervasive in spite of being banned for the past 20 years.
Shanaaz Mathews, Director of the Children’s Institute and the lead editor of the Child Gauge 2014 report, said such experiences hampered development, learning ability, self-esteem and emotionÂal security and had negative long-term consequences for employment prospects and life expectancy.
The United Nations International Children’s Emergency Fund (Unicefs) SA representative Herve Ludovic de Lys, said the current epidemic of violence “unÂdermines the fabric of society, affects proÂductivity, well-being and prosperity.
