By Rob Moodie
First Posted Wednesday, 9 July 2008 at On Line Opinion

Over many months we have witnessed the surfacing of truly saddening and horrifying stories of child abuse, neglect and death. As The Age editorial (June 26, 2008) pointed out, these are only the tip of the iceberg. We have been forced to acknowledge that this is a problem with no boundaries. It is happening in all sorts of suburbs - comfortable and poor, remote and urban, non-indigenous and indigenous. It is happening in single-parent families and in families with two parents. It could be happening in our community, on our street, right next door.

Child abuse and neglect is not just a family problem and something to be solved by social workers, police and the courts. It is a whole-of-nation problem. Although we do not have a national study to show its prevalence, we know reported cases are on the rise and that our "treatment systems" are straining to cope.

Cost estimates of providing services to ameliorate the damaging consequences of this problem are enormous. A conservative estimate puts the figure at about $5 billion. The cost is more than the price of direct intervention - the social workers, police, doctors, nurses, foster families, psychologists, court workers. It includes the provision of long-term services to address the consequences of abuse - the health, welfare and justice services later in life. And it includes the cost of opportunities lost when an adult survivor is unable to contribute positively and creatively to society.

The damage of child abuse and neglect goes well beyond the physical manifestations of bruises and tears. Neuroscientists tell us that early abuse acts as a severe stressor that can produce lasting alterations in patterns of brain development, which, in turn, can adversely affect personal functioning later in life. It can shape the brain to be more irritable, impulsive and hyper-vigilant - and it can reduce the capacity of the child to learn.

Mental health problems often have their origin in abuse or neglect in childhood, as do addictions - including hazardous drinking, poor school attendance and crime. All of these increase the risk of an adult life of poverty, failed relationships, homelessness and isolation. Child abuse is not something you "get over".

How can we as a nation truly claim to value and love our children when we pay our car-park attendants more than we remunerate child-care workers, when pet shows get more airing than parenting shows, and the teachers who care for our children and have the responsibility for the learning that sets them up for life are paid less than most other professionals?

Adults plan and run cities from adult perspectives. Consequently, children have been driven off our streets as parents fear for their safety. Yet we replace one risk with the potentially much greater risks of inactivity and social isolation.

No reasonable adult would accept a boss hitting an employee, no matter how slight the hit or how poor the behaviour of the employee. Nor do we tolerate adults hitting each other in the streets or in the home. Our laws say no one has the right to hit another person, but when it comes to children we overlook this law. Corporal punishment of children in schools is outlawed, but a parent may physically chastise a child.

Given these anomalies, it is hardly surprising that we design and run our child protection systems from organisational, adult, perspectives.

Integrating existing services and programs will provide some solutions, but a more integrated response requires that the central and first question be "what is in the best interests of this child?" rather than "what can we do for this child within our area of responsibility?"

We need to fundamentally shift our thinking and doing to be much more focused on our children than, dare I say, on ourselves. To quote Josh, aged nine, from the Australian Childhood Foundation's 2004 report Play Your Part: "Child abuse will only stop when children like me become important to everyone."

Some very exciting ideas about enhancing social inclusion and minimising poverty emerged from the recent 2020 Summit. These included a national action plan on social inclusion, the establishment of a national housing foundation, with a small percentage from the sale of every property in Australia to go to public housing and homelessness, and a National Development Index underpinned by specific measurable indicators of social inclusion.

These are consistent with the best evidence from countries that most successfully improve child wellbeing and minimise child abuse and neglect.

We need a universal system of home visits and assessments by nurses in the first instance and other professionals in the follow-up phase, if required.

We need greater public awareness about the long-term consequences of child abuse and neglect.

Local governments need federal and state support to build child-friendly communities that include safe play areas and areas for young people to meet and socialise, libraries, child-care centres and early childhood education centres. Just like roads and rubbish collection, these are essential elements of local infrastructure. They are vital for developing healthy children.

UNICEF's report in 2007 Child poverty in perspective: An overview of child wellbeing in rich countries (PDF 1.52MB) says that "the true measure of a nation's standing is how well it attends to its children - their health and safety, their material security, their education and socialisation, and their sense of being loved, valued and included in the families and societies into which they are born".

In Australia this means revaluing our children, something that must be done for humanitarian and compassionate reasons as much as for economic reasons.

First published in The Age on June 30, 2008.

Rob Moodie is Professor of Global Health at the Nossal Institute for Global Health at the University of Melbourne. Between 1998 and 2007 he was the CEO of VicHealth. He is co-editor of three books, including Hands on Health Promotion. He is currently writing a book called Recipes for a Great Life with Gabriel Gate. 

This work is licensed under a Creative Commons License.

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