Keeping our children safe

New Zealanders have been horrified in recent years by several widely publicised accounts of children dying in gruesome circumstances that almost defy imagining. But the death of a four-year-old in 1999 was a catalyst for action…

James’ story.

Riri-o-te-Rangi (James) Whakaruru was born on June 13, 1994. He died on April 4, 1999. His mother’s partner had punched, kicked, and beaten him to death because he would not call the man “daddy”. This little boy’s death, says the Commissioner for Children, Roger McClay, highlighted several failures in New Zealand’s child protection set-up. The commissioner’s investigation – the first into the violent death of a child – found that information concerning James, his mother and her partner was fragmented and that people in various agencies didn’t act or share information with each other when they should have. The commissioner’s report of his investigation sparked a great deal of public comment about child abuse in New Zealand.

The commissioner told a family violence conference at Cyprus in November 2000 that the investigation was set up to examine how James died, despite the many agencies involved with the boy and his family, and to consider what needed to change so that family violence was effectively responded to. The investigation reviewed the circumstances of one child, and the response of agencies who had contact with him and who had an opportunity to notice and take steps to stop the harm being done to him. “. . . this investigation found that there were weaknesses at every point of community contact with James,” Mr McClay said.

James’s mother began a relationship with Ben Haerewa when the child was about a year old. James was seen by two general practitioners for facial injuries when aged 15 months (twice) and at 18 months. The Police had been called to a domestic violence incident about then, but James’s mother did not want to lay a complaint. “An effective intervention at this time could have altered the events which were to come later,” the commissioner said.

On July 18, 1996, aged 2, James was admitted to hospital with serious injuries when he and his mother were assaulted. The hospital reported the assault on James to the Police and Ben Haerewa was charged, convicted and eventually sentenced. On February 11, 1997, while Ben Haerewa was in prison and custody of James was being contested, James cut his chin in an alleged fall down steps. “The hospital emergency department did not access existing hospital records regarding the previous non-accidental injury.

They did not advise Child, Youth and Family of this incident,” the commissioner’s report says. Hospital records show that James was probably in his mother’s care, while Child, Youth and Family believed he was with his grandmother. “If this health information had been shared within the hospital and with CYF, a strong indicator of risk would have been apparent.” Ben Haerewa was released from prison on March 3, 1997. Conditions of his release were not passed to the Community Probation Service. The Family Court granted a temporary protection order for James under the Domestic Violence Act, 1995.

The court did not tell the Department of Corrections, who was supervising Ben Haerewa on his release from prison, that he had had a protection order granted against him. James, his mother, and Ben Haerewa were absent from view between April 1997–May 1998. No agency records show any contact with James. Between May 1998 and his death in April 1999, James suffered two significant injuries. Neither was reported to Child, Youth and Family or the Police. On May 9, 1998, James was in hospital for a tear to his penis, which required emergency surgery.

The hospital recorded two different explanations given by family and patient for this injury. “Neither the conflicting explanations, nor the medical history of non-accidental injury, seemed to alert any emergency or specialist staff to potential harm,” the commissioner said. 15 On March 20, 1999, James’s mother sought help from an emergency pharmacy for a deep laceration to James’s lip. She was taken to a GP who had had no previous family contact. She returned to the doctor again the next day, for no obvious reason, but did not return for the sutures to be removed. The doctor passed information about this incident to the practice where he believed the family was known, “but they said they had not seen James for ‘a very long time’.” James died shortly after arrival at the hospital emergency department on April 4, 1999.

He had extensive internal injuries and tissue damage consistent with one – or more likely several – prolonged beatings. James had been seen 40 times by health practitioners – four times at the hospital emergency department, two admissions and one outpatient clinic, three face-to-face Plunket contacts, and 30 visits to general practitioners at four practices.  “Collectively the health sector had available a telling picture of James’s circumstances,” the commissioner said. “This picture was never put together because of poor communication between practitioners.”

The commissioner went on to say: “James Whakaruru was badly let down by the state. “It is true that it was his mother’s partner who punched, kicked and bashed James to death during that Easter weekend [1999]. It is, however, also true, that the state did not protect him in the way that it should have during the five years of his life.” The commissioner made several recommendations to the Government, many of which have been implemented by the agencies concerned. Others are following.

According to a Government report, the commissioner found: · A fragmented approach to the rights of the child, lacking a “global” policy or plan of action concerning children and their rights. · The approach to care and protection was fragmented. Agencies did not collaborate and share information with one another, and they didn’t follow the rules. The agencies failed to engage with families and communities, nor engage culturally appropriate services, despite the Government’s commitment to the Treaty of Waitangi. Families, communities and professionals did not recognise and report incidents of child abuse and neglect. Assessments of risk factors were incomplete or flawed, and some people were confused over thresholds for statutory intervention. Professionals were hindered by a lack of information bases, including a central database for recording health information.

Flaws in legislation or its use to help children. This little boy’s death prompted an investigation by the Commissioner for Children at the time, Roger McClay. Mr McClay found that information concerning James, his mother and her partner was fragmented and that people in various agencies didn’t act or share information with each other when they should have. His report sparked a great deal of public comment about child abuse in New Zealand. He made several recommendations to the Government, many of which have been implemented.

Reporting guidelines for doctors.

In May 2001 the Ministry of Health issued a set of protocols, or guidelines, for general practitioners to follow if they encountered abuse, or suspected it, in their child patients. The guidelines were developed by the Ministry of Health and the Department of Child, Youth and Family Services, with input from a group of Royal New Zealand College of General Practitioners. The main guiding principles are that the child’s safety is paramount; that an early referral to the appropriate authority is essential; and that the Department of Child, Youth and Family Services and/or the Police investigate and interview the child and family – that’s not the GP’s job. There are no legal barriers to referring a child to the proper authority. Key points for GPs are:

  • keep an open mind to the possibility of child abuse;
  • look for signs of abuse and neglect and adequately document;
  • refer to an appropriate authority;
  • seek feedback about the child’s progress from the agency the doctor made the referral to;
  • keep up the relationship with the child and family, where possible;
  • get support for themselves.

Doctors should note and keep evidence of child abuse. The guidelines include child diagrams on which doctors can note injuries that might be the result of abuse. Children who have been abused, or show signs of possibly having been, should be referred to specialists such as paediatricians or Child, Youth and Family workers. The history and clinical signs of injury should be adequately documented. Where sexual abuse is a possibility, Doctors for Sexual Abuse Care will be contacted by Child, Youth and Family or the Police. If in doubt, doctors should tell someone such as an experienced colleague, paediatrician, Youth Health Services or Child, Youth and Family, or some other agency for social support. Doctors are urged to look for signs that might be consistent with a child’s being abused.

These include:

  • history inconsistent with the injury presented;
  • delay in seeking help;
  • past abuse or family violence;
  • disclosure by the child;
  • exposure to family violence, pornography, alcohol or drug abuse;
  • parents abused as child (or children);
  • inappropriate or inconsistent discipline (especially thrashings or any physical punishment of babies);
  • terrorising, humiliating or oppressing;
  • neglecting the child;
  • actively avoiding care or shopping around for care (frequent changes of address).

Physical signs could include:

  • multiple injuries of different ages, including welts, cuts bruises;
  • scalds and burns;
  • pregnancy;
  • poor hygiene;
  • fractures.

Behavioural and developmental signs include:

  • aggression;
  • anxiety and regression;
  • self-mutilation;
  • suicidal thoughts/plans;
  • overly responsible behaviour;
  • fear, sadness, defiance.

James Whakaruru, in his four years of life, was seen 40 times by health practitioners – hospital emergency departments four times, two admissions and one outpatient clinic, three face-to-face Plunket contacts, and 30 visits to GPs in four practices.

Reporting child abuse.

Anyone can report suspected child abuse in this country and people who call Child, Youth and Family can ask to remain anonymous. Even if an investigation results in no abuse being found the law will protect you if you disclosed or supplied information in good faith. Fear of being wrong is the single most common reason people might decide not to act. People feel this way because they might be afraid of:

  • repercussions;
  • being thought insensitive;
  • breaking a confidence;
  • being disloyal.

One of the best ways to overcome this fear is to equip ourselves with good knowledge and to discuss concerns early with an appropriate person. You can use the Child, Youth and Family freephone – 0508 326 459 – to sound out your concerns. If you are concerned that a child or young person is being abused, remember that their safety and wellbeing comes first. If you suspect abuse:

  • Look for signs that abuse has occurred – these can be as obvious as a child or young person telling you that something has occurred, or physical signs of bruising or discomfort. Some signs are less obvious, and if you would like more information contact your local Child, Youth and Family office.
  • Make and keep notes. What are you seeing and hearing? What are the times, dates and places? Notes will help you clarify your concerns and be a ready reference for you to talk with a social worker.
  • Contact a social worker at the national call centre for Child, Youth and Family.

They are available on freephone 0508 326 459. Call into your local Child, Youth and Family office if you do not have a phone. When you are reporting a concern, Child, Youth and Family will need to know as much as possible about the situation. Useful details include the name, age and ethnicity of the child or young person, the address where the child or young person can be found, and as much about the abuse or your concerns as possible.

If you witness an incident, or have immediate serious concerns that a child is being abused, you can contact the Police immediately. Dial 111, and remember to give the operator exact address details of where you are or where the abuse is occurring – your locality might not be the only one with a “King Street”, for example. Such precise details could be crucial in saving a life. You can expect to be informed of the outcome of the notification, unless it is clearly impractical or undesirable to do so. Everyone has a duty to help keep our children safe. There are many ways to help children and families. You can offer support, offer to mind the children, share time over a cup of coffee, or suggest community services that might be of help.

The frightened little witnesses.

Children and babies are often invisible to adults in violent situations, and to adults who come to help. Every year, thousands of New Zealand children are seriously affected by domestic violence. Adults often hope that children don’t realise that their mothers are being abused – “the children were asleep”, “they were outside playing”, “too little to understand” . . .

Children who are frightened and traumatised suffer from health, development and emotional problems. Trauma interferes with their ability to learn. Studies show that children can often give detailed descriptions of the abuse. Men and women abuse children. Women abused by their male partner might in turn abuse their children. Children who are frightened and traumatised suffer from health, development, and emotional problems. Trauma affects children’s brain development greatly.

Chronic anxiety creates chemicals in their brains that interfere with their ability to learn. Children’s intellectual, emotional and psychological ability is shaped by what they see, hear, and how they make sense of it. Being abused, listening to it or hearing it prevents children from realising their potential as adults. A New Zealand study found that 75 percent of children in women’s refuges who had witnessed the abuse of their mother showed behavioural problems severe enough to require specialist help.

If a woman is beaten when she is pregnant, then the risk to the child of being beaten after it is born is greatly increased. Children and youth who have been abused or neglected at home are more vulnerable to other types of abuse, especially sexual abuse. Psychological and verbal abuse also damage children. Effects include acute feelings of loss, anger, sadness, confusion, guilt, shock, fear, insecurity and risk of self-mutilation. Some experts say that children will cope in one of four ways:

  • Living in secret, withdrawing into a fantasy world, apparently unaware of what’s going on around them. Maybe overly compliant, quiet, or high achieving at school.
  • Conflict of loyalties – they feel they have to choose which parent to support or that they can love only one parent.
  • Living in terror and fear with no stability or certainty, chronic long-term anxiety, depression, bed wetting, going back to younger behaviour.
  • Aggressive and bullying, behaviour problems and failure at school, sometimes diagnosed with attention deficit hyperactivity disorder (ADHD).

Boys who witness their mother being beaten frequently go on to abuse their women partners. Some girls assume that male violence is a normal part of a relationship.

What we can do to help children

If the violence is serious or imminent, report it to the Police or Child Youth and Family immediately. Also:

  • Make sure the child’s primary caregiver is safe from violence and abuse.
  • Consider the needs of children when responding to domestic violence.
  • When violence is present, assume that it is affecting children and whanau nearby.
  • Assure children that violence used by adults is not the child’s fault.
  • Recognise that domestic violence abuse and neglect are often accompanied by sexual abuse, which also requires a specialist response.
  • Find out about the specialised children’s services available in your area.
  • Learn about the effects of trauma on children.
  • Listen carefully to children’s experience – recognise that it is real for them.
  • Recognise that with careful, consistent and skilled help, children can recover from the effects of abuse.