Protecting children from any kind of abuse, especially physical and sexual, is the motive behind the Child Protection Team -- a varied group of doctors, nurses, social workers and community agencies that have come together to educate and prevent such cases from happening.

And as April marks Child Abuse Prevention Month the team wanted to make the Bermudian community aware of the efforts being made to keep all children safe and educate hospital staff so all abuse cases can be detected or prevented.

The CPT was formed for two reasons -- the first being because of the perceived increase in the number of child abuse cases presented to the hospital (in 1988 15 cases, in 1989 32 cases) -- and the second being the concern with the uneven, inconsistent way in which cases of child abuse were being managed at the hospital.

This concern arose from former chief medical social worker Sharol Simmons during her assignment as a social worker to the Children's Ward, and it was shared by paediatrician and chairperson of CPT Dr. June Hill.

"As these cases presented themselves, there was always a dilemma concerning the proper management of the cases. It became clear that we needed to develop a coordinated team approach, a well-defined, well outlined step-by-step protocol for handling these situations in a smooth and professional manner, ensuring that nothing was overlooked and that no child `fell through the cracks','' the team stated.

It added: "Because of the overwhelming need for such a team and with the support of former medical director Dr. Ronald Lightbourne a multidisciplinary child abuse steering committee convened in June 1989.

"The objectives of the committee were to provide a policy and procedures manual, or protocol for handling all suspected child abuse cases, and to establish a hospital-based child protection team responsible for the management of all suspected cases of abuse seen at KEMH.'' In June 1990, selected members of the committee received on-site training in the management of child abuses at Children's Hospital of Eastern Ontario. In November 1990 the team was officially launched, with a series of workshops coordinated by Dr. Ron Ensom, coordinator of the Child Protection Team of Children's Hospital of eastern Ontario, and paediatrician, Dr. Angela Sirnick, from the same facility.

A medical social worker and Dr. Hill provides the initial assessment of all cases referred to the team by Emergency room, the Nursery, the Children's ward, private physicians or Health department.

Through out the management of these cases, there is active coordination between Family Services, the Police department, the Health Department and various hospital staff, according to the protocol outlined in the CPT manual.

All cases managed in the hospital are presented to the team for review and final disposition and a discharge plan is agreed upon by all team members. The CPT meets twice monthly in the Conference Room at KEMH.

Dr. Hill said paediatric and family doctors have an important role in the area of child abuse.

"The team looks at the detection and management of cases of child abuse and it had become perfectly clear to myself and the former chief medical officer Sharol Simmons that there were cases that were presenting themselves to King Edward but were going undetected or being managed in a less than ideal fashion,'' Dr. Hill said.

She added: "It is clear that the community does not know we exist and we felt that it was important to highlight our activities in the area of child abuse prevention, detection and management.'' Coordinator of the team and social worker Janel Swan said the team consists of paediatricians, two social workers from the children's ward and maternity, an on-call social worker that can review child abuse cases, secretary, four nurse representatives from maternity, the nursery, emergency and children's ward, plus a health visitor, child psychiatrist, Police officer, and a representative of Child Development.

"We meet every other week to discuss cases, referrals and what action will be taken. We also work with child based community agencies and health services.'' Dr. Hill added: "Our main goal is to manage child abuse cases that present themselves to the hospital through emergency, children's ward, and maternity and the nursery.

"We have kept a list of cases since our inception which is about 250, we also have a list of high risk children who are deemed to be at risk.

"With detection our aim is to educate, and heighten the awareness level of staff so they don't miss cases, often abuse can be masqueraded as something else.'' Ms Swan said the cases that present themselves are in the form of physical or sexual abuses and neglect. There are very little cases of mental or verbal abuse detected.

Medical Social Worker Nichole Whitter said upon a female's admission to King Edward if there is a history of alcohol, or mental abuse they get a referral to community services.

"When medical social workers are called in they have the right to go in and investigate what is going on once emergency staff feel they have seen something peculiar, or the story doesn't fit with the marks or abrasions left on the child. If there are general concerns then we (medical social workers) refer the case to Family Services,'' Miss Whitter said.

Dr. Hill added that the team has clearly set mechanisms in place and "we are confident that the hospital is doing a much better job. There is more physical abuse than anything else and sexual abuse. We monitor the at-risk mother, where the potential for abuse exists. Our main focus in this area is early intervention, before a baby is born, so families can be kept together.'' HELPING THE CHILDREN -- Child Protection Team members pictured back row from left are health visitor Arabelle Fubler, child psychiatrist Dr. Enid Melville, secretary for the team Lynelle Lightborne, P.c. Loucetta Beckles, assistant coordinator of the nursery Lisa Blyden, and medical social worker Nichole Whitter. Front row from left unit coordinator of the children ward Millisent Ardis, chief of paediatrics and chairperson of the team Dr. June Hill, coordinator of the team Jenal Swan, and assistant unit coordinator of the children's ward and team member Rochelle Christopher. Missing from the picture are Glenda Edwards of Family Services, Conchita Ming of Child Development Services, and Lynette Raynor of the Emergency Room Unit.