Child abuse in Turkey: an experience in overcoming denial and a description of 50 cases.

OBJECTIVE: To share the experiences of the first clinical multidisciplinary child abuse and neglect (CAN) team in Turkey with international child abuse community. METHODS: The authors established the first Turkish CAN follow-up team at Dr. Behcet Uz Children's Hospital. Following a training program in five teaching hospitals in Izmir, the authors kept a record of every case diagnosed with CAN from these hospitals between 1996 and 1998. The demographic, epidemiologic, and medical features of this case series are summarized. RESULTS: Fifty cases were diagnosed and followed-up. Seventy-six percent of patients were reported from Dr. Behcet Uz Children's Hospital. Age and sex distribution was 9.2 +/- 6.7 years and 46% male, 54% female, respectively. The offenders were only father in 38%, only mother in 28%, and multiple in 34%. More than three CAN risk factors were present in 94%. Of the children reported 44% survived, 14% died, and 42% were lost to follow-up. Sixteen percent were free of reabuse, and 42% survived with handicaps. CONCLUSIONS: Child abuse and neglect is a reality in Turkey. The team's work increased pediatricians' awareness of CAN. Reporting these cases to Social Affairs Bureau was established for the first time in Turkey. Physicians in Turkey need training to diagnose and properly report CAN. The implemen tation of a national CAN prevention program is an urgent need for Turkey.

A multicenter child maltreatment study: twenty-eight cases followed-up on a multidisciplinary basis.

Twenty-eight maltreated cases were presented in this multicenter study. Hospital distribution was as follows: Dr. Behçet Uz Children's Hospital, 54 percent; Dokuz Eylül University Hospital, 21 percent; Ege University Hospital, 14 percent; Tepecik Social Security Hospital, 7 percent; Atatürk State Hospital, 4 percent. Age and sex distribution was two months to 25 years and 43 percent male, 57 percent female. The offender was the father in 71 percent, the mother in 32 percent and multiple in 25 percent of the cases. More than three child maltreatment risk factors were present in 93 percent. Nineteen patients (68%), nine of which were effectively followed-up were reported to the Social Affairs Bureau. Sixty-four percent gained acceptable health with the support of our team, 14 percent died, and 21 percent failed to comply with follow-up. A multidisciplinary group may interfere both medically and socially with these cases to interrupt the course of maltreatment. Every children's hospital needs such a team to increase diagnosis establishment necessary to initiate social support.