A medical article on child abuse has expressed its concern at the “worrying number” of abused children reported every year in Malta, stating that the increase in figures cannot be explained away by improved medical diagnosis or increased awareness.
The article was published in the June edition of the Malta Medical Journal and was written by pediatricians Dr Simon Attard Montalto and Dr Mariella Mangion.
The report noted that between 1993 and 2006, Agenzija Appogg received 6,442 reports of some form of child abuse – including multiple reports on the same case.
The cases came from all areas and both boys and girls were affected – even though there is a slightly higher ratio for girl to boy (1.5:1).
The majority of cases (55 per cent) were children aged between six and 15 while preschool children made up 12 per cent of the cases.
It added that while “heightened awareness, reportage and better diagnosis partly explain the figures, the increase remains real”.
The study gave several reasons for the increasing numbers including: “disintegration of social protective barriers, family fragmentation, increase in unwanted babies, pressures of parenting, daily stress, and crime – especially associated with illegal drug use.”
The researchers called on doctors to keep a “healthy but balanced suspicion” when speaking to parents and to make sure that the reason given for the accident is legitimate.
However, they admitted that “the situation is increasingly complicated in Malta by estranged couples fabricating claims of abuse on their offspring by their ex-partner, thereby using the children as battering ram to get at their opposite number”.
Physical abuse, the report said, makes up about 30 per cent of reported cases, while another 24 per cent are cases of neglect or abandonment. Cases of sexual abuse are 17 per cent, while six per cent are considered cases of emotional abuse.
However, the report warned that all types of non-accidental injury in children tend to be under-reported.
The most common types of physical abuse registered were scratches and bruises through beating. Between 28 to 92 per cent of children who were victims of physical abuse had bruises.
The report pointed out that bites, burns and immersion injuries are also common, adding that immersion injuries were often blamed on “a sibling turning on the hot water tap while the victim was in the tub”.
The study also spoke about the importance of listening to the child’s version where sexual abuse is concerned. Females had a higher ratio of sexual abuse compared to males: (5:1).
It noted that penetration is “unusual and that external physical signs are often absent – indeed physical abnormalities were found in just two out of 11 cases in one local review”.
The study said that sexual abuse, generally, seems to take the form of “inappropriate sexual exposure and/or fingering/touching by an adult who may well be known or related to the child.”