Presidential Proclamation – April 2014 is child abuse prevention month

I spent this morning lecturing at Dell Children’s Medical Center talking about Paediatric Emergency Medicine work in the UK as well as some of the child protection cases we see through our Emergency Departments.

I particularly focussed on issues to do with substance abuse, alcohol, deliberate self harm and mental health presentations and the association is crucial to recognise – that is that some children present in this way because of previous, or on-going, abuse.

We discussed the Rochdale Child Sexual Exploitation cases (YP1-6 and YP7) and talked about the failures which allowed these cases to go on, unrecognised and unstopped, for far too long (http://www.rbscb.org/professionals/serious-case-reviews/default.aspx).

It is clear to me that, whilst there are a number of different methods of responding to alleged cases of child abuse between our different countries and there are significant differences in the way that legal cases may be handled, there are a huge number of similarities in the way that the clinical aspects of these cases present to Emergency Departments (and other facilities) and the importance of peer review of cases, shared learning from system failures and multi-professional education cannot be underestimated.

There is some great research going on here looking at very detailed analysis of children who have been through child protective services and I’m hopeful that in the future we might be able to start doing some collaborative work, at least on a small scale to begin with, that will provide a fascinating insight into the similarities and differences between two distinct geographical settings.

I was pleased to be able to attend the educational Journal club at lunchtime today – I say pleased as my experience of such events in the NHS is that they are often hurriedly put together, poorly attended and held over lunch in a seminar room or office somewhere. Not so with the event I attended today which was fully funded by the hospital and held at a local golf club. Stereotypical, I know, and the irony was not lost on me but I have to say that with a very tasty lunch inside me and a few swings of a 7 iron in between discussions of papers, I was impressed that the discussions managed to stay focussed, that the event was properly educational and that it also had a clear team-building element to it as well. And, of course, I’m now (again) very full of Tex-Mex food. I may just turn into a Taco or Slider by the time I return home!

On a more serious note, I’ve come to the USA at the right time – April 2014 is National Child Abuse Prevention Month as proclaimed by Barack Obama himself:

NATIONAL CHILD ABUSE PREVENTION MONTH, 2014

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BY THE PRESIDENT OF THE UNITED STATES OF AMERICA

A PROCLAMATION

In the United States of America, every child should have every chance in life, every chance at happiness, and every chance at success. Yet tragically, hundreds of thousands of young Americans shoulder the burden of abuse or neglect. As a Nation, we must do better. During National Child Abuse Prevention Month, we strengthen our resolve to give every young person the security, opportunity, and bright future they deserve.

We all have a role to play in preventing child abuse and neglect and in helping young victims recover. From parents and guardians to educators and community leaders, each of us can help carve out safe places for young people to build their confidence and pursue their dreams. I also encourage Americans to be aware of warning signs of child abuse and neglect, including sudden changes in behavior or school performance, untreated physical or medical issues, lack of adult supervision, and constant alertness, as though preparing for something bad to happen. To learn more about how you can prevent child abuse, visit www.ChildWelfare.gov/Preventing.

Raising a healthy next generation is both a moral obligation and a national imperative. That is why my Administration is building awareness, strengthening responses to child abuse, and translating science and research — what we know works for kids and families — into practice. I also signed legislation to create the Commission to Eliminate Child Abuse and Neglect Fatalities, and we are providing additional resources and training to State and local governments and supporting extensive research into the causes and long-term consequences of abuse and neglect.

Our Nation thrives when we recognize that we all have a stake in each other. This month and throughout the year, let us come together — as families, communities, and Americans — to ensure every child can pursue their dreams in a safe and loving home.

NOW, THEREFORE, I, BARACK OBAMA, President of the United States of America, by virtue of the authority vested in me by the Constitution and the laws of the United States, do hereby proclaim April 2014 as National Child Abuse Prevention Month. I call upon all Americans to observe this month with programs and activities that help prevent child abuse and provide for children’s physical, emotional, and developmental needs.

IN WITNESS WHEREOF, I have hereunto set my hand this  thirty-first day of March, in the year of our Lord two thousand fourteen, and of the Independence of the United States of America the two hundred and thirty-eighth.

BARACK OBAMA

The President says that in the USA every child should have every chance in life, every chance at happiness, and every chance at success. Of course that is true, but it really ought to be the case that wherever they live, whatever their background and whatever culture they are being brought up in, children, who are the future of our global society in its most general terms, receive the safeguarding that they deserve, the support and chances that they need and the full and unwavering protection of the State when things go wrong. It is not just in the USA that children deserve this protection but it is a tall order trying to achieve that across the board and we have to start somewhere. Why not here (https://www.childwelfare.gov/Preventing/)?

I’ve never known there to be a Government supported Child Abuse Prevention month in the UK – supported at the highest level in line with the clear public message such as that given out by the President in the USA and I can’t help but wonder what the reaction would be if we held such a similar event in the UK? I know from speaking to people outside of medicine who often want to know what it is like to be a doctor working with children that they want to hear about children getting beads stuck in their noses or ears, children who have amusing stories to explain their injuries, children who have become mobile money-boxes from swallowing coins and children who our teams have managed to grasp from the very limits of existence and who are now leading normal lives when the alternative outcome could have been a very sad one indeed. But what people don’t want to hear about is when those cases are interspersed with a potential, or actual, case of child abuse. It simply isn’t a pleasant subject to hear about and I’m sure that many metaphorical hands are put over ears at that moment.

One of the things that I have thought for quite some time is the reason that child protection and child abuse work is still, I believe, considered in many places to be a socially unacceptable thing to discuss is because it is not talked about enough. Cancer used to be the same thing many years ago – but now with really great information campaigns and public awareness, cancer is a word that is acceptable to use. I hope, in time, that child abuse will be an acceptable thing to talk about as it is only by raising awareness and getting people to think about its existence that we will have any real hope of combatting it, so that we won’t need to talk about it in such a way in the future. For combatting it is only something that society can do. We as health professionals can recognise it when it happens, we might be able to pick up warning signs which, if unaddressed, may put a child at risk of significant harm but, fundamentally, it is only society itself, through support for each other and earlier recognition of families and communities approaching crisis points, that we can really deal with the issue.

So, what would be the impact of having a Child Abuse Prevention month or event in the UK – targeted not just at professionals but on everyone in every community? An interesting idea, I think.