Child deaths related to abuse and neglect are especially common in children under five, highlighting the vulnerability of young children to violence and neglect in the home. Children under five are most likely to be killed in the first six days of life, largely as a result of abandonment.
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The year 2019 was a year of outrage about violence against women and children. It was also a year of concerted effort by child protection activists to prevent abuse and abandonment-related child deaths. Yet in the battle to minimise violence and stop child deaths, the annual 16 Days of Activism for No Violence against Women and Children brought no substantial policy amendments. The reasons are simple: while the causes of child deaths are easily identifiable, fixing them is a lot more challenging. What the government does next will determine what the child violence and death statistics will look like this time next year.
Preventing child deaths is one of the many challenges South Africa faces. The 2009 Child Death Review, which focused on natural and unnatural deaths, found that child deaths related to abuse and neglect were especially common in children under five, highlighting the vulnerability of young children to violence and neglect in the home, and that children under five were most likely to be killed in the first six days of life, largely as a result of abandonment. Given that both abuse and abandonment are preventable, the country should be making every effort to minimise them.
It is what prompted a 2013 strategy, created by the Department of Social Development (DSD) for shifting child protection from a predominantly reactive approach (often too late to be effective), to an emphasis on early intervention, to an eventual focus on prevention. Six years later though, it is hard to see how anything has changed.
Daniel* and Ayanda* were both three when they died, both beaten to death by a family member. Their stories are testament to how broken the system designed to protect them really is.
When Daniel died at the hands of his mother’s boyfriend, the second-degree burns to his tiny body, broken elbow, broken femur, injured ribs, multiple bruises and 15 applications of blunt force trauma were so horrific that even seasoned child protection activists were traumatised by the autopsy photographs.
But, only three months before his death, he was flagged as a possible abuse victim by a hospital paediatrician who treated him for a broken leg. She rejected the family’s story that he had “fallen from a tree” and passed his file on to the hospital social worker to investigate. The Department of Health social worker had no authority to intervene, so passed it on to a Department of Social Development social worker, who in turn handed it to a delegated authority.
It took almost two months before the file reached the SAPS and a social worker who had authority to investigate. The police apparently spoke to Daniel’s abuser through a locked gate, and the social worker, who did not meet Daniel or present his file to the courts, enquired about his health telephonically. Both she and the police accepted assurances that the child was fine, overruling the expert paediatrician on the word of Daniel’s abuser. Seven weeks later he was brutally murdered.
The authorities weren’t the only ones who let Daniel down. His mother’s family tried to stage an intervention shortly before the child died. But attempts to have Daniel and his two siblings removed from the home of his abuser were blocked by his mother and his maternal grandmother who allegedly said, “people struggle sometimes as a part of life”.
Daniel’s murderer was found guilty and sentenced to life imprisonment and his mother to 20 years for failing to save his life. The social work agency that failed to properly investigate his abuse was never sanctioned. Instead, it was tasked with placing his two younger siblings in care following his mother’s sentencing. They elected to give custody to the grandmother who failed to report Daniel’s abuse, or to intervene and save his life.
Ayanda was just two when a teacher at her Early Childhood Development Centre noticed a change in her behaviour. The once bubbly little toddler shrank away from contact and began soiling herself. The teacher alerted her local DSD office when she found bruises and lacerations on the child’s arms and torso (hidden under the long sleeves she wore despite sweltering December heat).
It was February before a social worker followed up. She decided to remove Ayanda from her mother and place her in care. Weeks later, Ayanda was moved to a foster family without legal documentation or a home visit. Ayanda’s foster mother was told not to worry, and months of follow-up calls and emails remained unanswered. It was April before she was informed that Ayanda’s social worker had left.
Ten months later, a new social worker opened Ayanda’s file and, noticing that there was no paperwork, chose to remove Ayanda from the foster family and return her to her mother. It was December, and she was about to go on leave, so reunification happened without a home visit. Ayanda’s mother had received no therapeutic intervention while Ayanda was away. Angry about the humiliation of having her child removed publicly from her home, she began beating her again.
On 24 December, just two weeks after Ayanda came home, a neighbour found her on the doorstep of her family home bleeding from a head wound after her mother had hit her with a brick. She was rushed to hospital but did not regain consciousness. Ayanda died on Christmas Day.
Stories like these make the problem seem overwhelming. And in many ways it is, especially since the 2013 plan is designed to move social workers from reaction to the proactive prevention of abuse: when abuse is alleged, social workers should be responsive and agile, investigating quickly, removing children from harm’s way if they are at risk, and placing them with properly screened families with appropriate documentation. They are then required to monitor the child’s progress and ensure that the abuser is rehabilitated, and receives suitable interventions. The goal is for reunification to occur if the abuser is no longer a danger to the child. Where reunification is impossible, children should be given permanency options.
In practice, however, both Daniel and Ayanda’s story show that investigations are often tardy or incomplete, interventions come too late (if at all), and the foster-care system is so overburdened that children are frequently placed in foster families without proper screening or paperwork. The rehabilitation of abusers seldom occurs, which means that when children are reunified (a frequent outcome), it can cost them their life.
As hopeless as it may seem, civil society has important strategies that government can implement immediately to reduce child violence and deaths. These include addressing budget constraints, increasing the number of social workers employed by the department and NGOs, ensuring that social workers have time and capacity to focus on preventative care and early responses when a crisis arises (this involves managing their workloads and removing other burdens including the ongoing crisis in foster care), changing the Children’s Act to make reporting of physical abuse mandatory, holding those tasked with protecting children accountable if they fail to act, facilitating better communication across departments, managing the policing and prosecution of child abuse, and introducing safe-haven laws to minimise unsafe abandonment.
Increase the budget for prevention of child violence
Lucy Jamieson, senior researcher from the Children’s Institute, contends that if government really had the political will to prevent child violence, it would budget accordingly. Yet, its own diagnostic review determined that only 1% of the combined national and provincial DSD budget is spent on reducing violence.
In addition, a pre-Children’s Act costing specified how much it would cost to run the social services envisaged by the act. Significantly, the DSD is only contributing about 50% of this amount. It’s no wonder that cases are improperly investigated and critical parts of the child protection process are omitted when budget constraints are so substantial.
This is true for both government and NGOs that have traditionally carried out much of South Africa’s child protection work. The department admitted to insufficient funds for NGOs in a 4 September 2019 presentation to the Portfolio Committee for Social Development: “Inadequate budget allocation for NGOs rendering child protection services; this resulted to NGOs scaling down their services and some closing down, transferring their cases to DSD, leading to increased workload for DSD.”
Insufficient budget has made child protection services reactive, inconsistent, and in the worst cases, almost non-existent. It’s far from the ideal of preventative child protection that the country is trying to achieve.
Employ more social workers
Inadequate funding has also resulted in a scarcity of human resources available to protect children. In her budget presentation to Parliament in July 2019, the Minister of Social Development, Lindiwe Zulu, confirmed that the National Development Plan (NDP’s) conservative estimate is that by 2030, 55,000 social workers will be required to effectively respond to social development needs. Even that may be insufficient though. In an interview with SABC news during the 2019 Child Protection Week, Deputy Minister Hendrietta Bogopane-Zulu explained that the Children’s Act alone calls for 65,000 social workers.
The department isn’t even close to meeting this human resource requirement. A 2017 study, Out of Harm’s Way, revealed that there were only 9,289 social workers employed by the DSD and non-profit organisations (NPOs), and only a portion of these social workers work with children and families. The number equates to 17% of the social workers required by the NDP, and an even smaller percentage of the resources needed to apply the Children’s Act. It is therefore not surprising that government social workers are reported to have caseloads of between 100 and 300 cases, and, in some rural provinces, to have ratios of one social worker for every 10,000 residents.
The government, which declared social work a critical skill in 2001, has been offering scholarships to social work students to try to increase this capacity. But, frustratingly, budgetary constraints have resulted in 5,000 government-funded social work graduates being unemployed (adding to 7,000 others). And while 12,000 additional social workers would still not meet the NDP requirements, the additional resources would make a huge impact.
In its defence, it’s a challenge the department is trying to address, using creative means like asking Treasury to convert a portion of the scholarship fund into a conditional grant to employ more social workers. Treasury has allocating R846-million to the project over a period of three years, and since 2017, the scheme has resulted in the appointment of 566 new social workers. In addition, although multiple SOE bailouts make the prospect of those extra budgets unlikely, the minister has committed to petitioning Treasury to obtain additional funds to employ more social workers.
Fix foster care and rethink the proposed new strategy for adoptions
Whether or not the department obtains additional resources, it must use the ones it has more effectively. Its failure to fix foster care through a comprehensive legal solution has resulted in an unmanageable additional workload. During presentations to the Portfolio Committee on Social Development this year, many provinces confessed that they either had two full days a week allocated to foster care, or in some cases, all of their resources deployed to try to renew orders.
Now that the High Court has granted the department a further 12-month extension to legally solve foster care, resource constraints have temporarily lifted. But given that there are 416,000 children in the foster care system, and the Children’s Amendment Bill does not solve foster care, the DSD may be in the same position at the end of 2020 if it does not rework the Bill.
Equally, given the department’s resource constraints, its commitment to redeploy 889 department social workers to work on adoptions seems inexplicable. Rather than adding to their load, it would be far wiser to allow private social workers and Child Protection Organisations (CPOs) to continue processing adoptions and to allocate a portion of those departmental social workers’ time to the development of skills and mentorship programmes with experienced adoption social worker practitioners.
Make the reporting of physical abuse mandatory
During the 2019 Child Protection Week, Women and Men Against Child Abuse (WMACA) argued that the law should be changed to make the reporting of physical abuse mandatory (as it is with sexual abuse). According to child protection activist Luke Lamprecht, the government needs to amend Section 110 of the Children’s Act because although it is mandatory for anyone aware of sexual abuse to report it, only professionals (such as medical practitioners, religious leaders, social workers and teachers) are obligated to report physical abuse. The list of mandatory reporters is extensive. But, the people who are most often aware of abuse (including family members) aren’t legally required to report it.
In Daniel’s case, if mandatory reporting of abuse had been obligatory, his extended family may have been able to save his life, and his grandmother who knew about his abuse but failed to act would probably not have been granted custody of two of her surviving grandchildren after their mother’s sentencing.
Hold those who fail our children accountable
Talia-Jade Magnes, co-director of the Shaken and Abused Babies Initiative argues that although social workers are overburdened and often unsupported, there is sometimes an element of “willful negligence” in their conduct. She describes a case where a hospital social worker was notified at 3.15pm about a six-month-old baby caught between her parents’ domestic violence, and thrown across a bedroom floor. Her response was that she would be “knocking off”, and couldn’t see the case as priority.
Daniel’s story, which is not isolated, shows how the improper, delayed or incomplete investigation of abuse can cost a child his life. Yet none of the authorities involved in his case was held accountable for their role in his death, and the agency that failed to save his life was tasked with the placement of his surviving siblings.
Magnes recommends that legal action be taken against professionals whose neglect results in child deaths. She contends that we should apply the criminal “law of causation” in these cases, showing the causal relationship between an act of omission or commission, and the resulting harm, injury, or death of an individual. In cases of child abuse and neglect, this would mean not only holding those who directly inflicted harm on a child accountable for their actions, but also those whose lack of action allowed the harm to continue, and in severe cases, resulted in death.
Improve systems (especially across the police and government departments) and enforce protocols
Across civil society, one of the most common causes of abuse-related child deaths is improper investigation and a lack of inter-sectoral cooperation. Jamieson says that most children don’t even enter the child protection system, they are turned away by the SAPS when they report abuse. She also says many of the professionals involved choose not to follow the abuse protocols when a case is reported.
The Children’s Institute’s study Out of Harm’s Way, designed to track child abuse cases through the child protection system found that only 44% of the DSD’s cases had paperwork, and that 71% of social services files were never referred to the SAPS for investigation (or from the SAPS to the DSD). Both Ayanda and Daniel’s lives may have been saved if there had been proper paperwork, and communication between authorities had been better.
Magnes cites the shocking example of a man convicted of 107 counts of possession, producing, and distributing child pornography. At no point during the eight-year criminal investigation and trial did anyone notify authorities that he had a son in his care. It was only at sentencing when he tried to use the boy as a factor to minimise his sentence that authorities removed the child and placed him into child protection.
Even fewer cases make it to prosecution. To quote the Shukumisa Coalition, referring to abuse cases involving women and children: “While the [National Prosecuting Authority] NPA claims a 74% conviction rate, most people do not realise that it is only 74% of those cases that actually make it to courts, which on average is less than 10% of all reported cases. And because we do this work every day, we know that only between one in nine and one in 25 cases are ever reported.”
It’s a concern reiterated by the head of the NPA, advocate Shamila Batohi: “We dare not applaud ourselves for the high conviction rate while the prosecution rate is so low”.
Legalise safe abandonment and introduce safe-haven laws
Despite the challenges of curtailing or preventing abuse-related deaths, the government could still avert a large number of child deaths if it minimised unsafe abandonment. The 2009 study of unnatural death in children under the age of five showed that of the 454 children who were killed that year, more than half were early neonates (only eight were over six days old), and 74% were infants under the age of one.
The creation of safe-haven or anonymous-birth laws, allowing women to safely abandon their child at designated places if they cannot parent, and decriminalising safe abandonment, could therefore save the lives of large numbers of infants. Yet, the government currently has no plan to manage or minimise abandonment, or to stop abandoned children dying.
Truthfully, South Africa is no closer to preventing child deaths than it was in 2013. But we know what needs to be done to move from a reactive to a preventative model: Treasury must allocate more money to social welfare, DSD must deploy those additional resources in preventing and intervening in abuse, government must fix foster care and adoption, authorities must facilitate more effective cooperation and communication across the child protection process and ensure that professionals are sanctioned if they don’t act in the best interests of children, and legislation must be amended to make reporting of abuse mandatory. Finally, government must tackle the scourge of abandonment and make it easier for abandoning mothers to save their children’s lives.
But does government have the political will to make the changes? For the sake of the most vulnerable, we have to hope that it does. DM
*Not their real names.
First published in the Daily Maverick: 13.12.2019
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