Child abuse: how to spot the signs

Using a series of shocking images, experts have lectured medical professionals on how to spot signs of child abuse and neglect.

ABU DHABI // Angry red welts criss-cross down a child’s back. Another cowering infant covers two black eyes with his tiny hands.

A shocking slideshow of images showing children who had been subjected to physical abuse drew gasps of horror on Tuesday, as experts lectured medical professionals on signs of child abuse and neglect.

“This is a hot topic,” said Dr Yasser Nakhlawi, chairman of the paediatric institute at Sheikh Khalifa Medical City (SKMC) in Abu Dhabi.

Dr Nakhlawi was speaking at the third Family Medical Conference on the last day of the Abu Dhabi Medical Congress.

“It is very important to prevent child abuse,” he said. “Abused children grow up to be abusers. We need to break the cycle.”

Dr Nakhlawi told of ways to differentiate between burns, cuts and bruises that have been inflicted on a child through abuse, and those caused accidentally. He also outlined the red flags of child abuse.

“What is the difference between accidental injury or so called abuse? It is very important to know,” he said.

More images showed children who had been whipped with a cord, a youngster with a cigarette burn on his knuckles, and another child whose feet were covered with blisters after being placed on a stove.

Padded areas such as the back of legs, thighs, buttocks and face tend to be where the abuser strikes, Dr Nakhlawi told the 100 audience members at the congress.

Bruises on poorly padded areas, such as knees and shoulders, are often accidental and common among active, playful youngsters.

Dr Nakhlawi spoke of a campaign run by SKMC, Abu Dhabi Police, social and judicial services and Abu Dhabi Health Service Company, among others, to educate on the signs of child abuse and what action should be taken to prevent further violence in the home.

“We can spot some of the signs of child abuse, but the big question is what next?” he asked. “We are really stepping up the effort on how to handle cases of child abuse.”

Risk factors include children who have mental or physical disabilities, a child who is “challenging”, dysfunctional or isolated families, substance abuse in the home or unrealistic parental expectations, said Dr Nakhlawi.

Neglect is the most common and the least diagnosed, he said. This was followed by physical, sexual and emotional abuse.

Alarm bells for child abuse include a delay in parents seeking medical care when their child has an injury, unwillingness to comfort a hurt child, or inadequately explaining the cause of bruising, burns, lacerations or fractures, Dr Nakhlawi said.

“Often the story does not fit the injury,” he said, recalling his first court case when he testified against a parent whose six-week-old had suffered a fractured femur.

“The story was that he was wiggling while they changed the diaper but it just didn’t fit.”

Some signs leave no doubt as to how an injury was inflicted, Dr Nakhlawi said.

“Usually a pinch mark leaves a double bruise. You can spot slap marks, while particular instruments, such as a stick, can leave an impact.”

Headline-grabbing cases have put a stronger focus on child abuse over the past year. In November last year a draft child-protection law was approved by the FNC.

Wadeema’s Law was named after an eight-year-old Emirati girl who was abused and tortured for months by her father Hamad Al Shirawee, 29, and his girlfriend Alanoud Al Amri, 27, until she died.

Her sister Mira, 7, was also tortured but survived.

This week Al Shirawee lost his final appeal against a life sentence. Al Amri received the same sentence.

Wadeema’s plight, which only came to light when her body was found abandoned in the desert, shocked the nation.

The child protection legislation in her name aims to limit violence against children by enforcing strict penalties and protecting children regarded as being at risk.

In Abu Dhabi, doctors can report child abuse cases to the police by calling 999.