Develop. Med. Child Neurol. 1979, 21, 699-700

EDITORIAL THE HAVES AND THE HAVE NOTS

INTERNATIONAL Year of the Child is all but gone; the consequences of such an appeal to the worlds consciences is hard to judge. Every meeting one has attended has been dedicated to IYC and there have been some extra meetings here and there to which distinguished child development specialists have commuted. One can cynically note that money has been spent on the experts, but wonder how much has percolated down to children and how many children will in the long run benefit from International Year of the Child.

One hears of a new children’s hospital being built in an Eastern European country: one reads of a new organisation-Defence for Children-founded in July in Geneva’, and one welcomes the concept, but doing something about maltreated children means having good services available in the places where the children are, and despite the organisers’ protestations it is arguable whether an international body can really play a significant part in protecting children. After describing some of the street-children of Bombay, Dada Shewak writes: ‘It is doubtful whether these children are aware that in public halls and open maidans, where entry to them is forbidden, the citizens of Bombay are dedicating 1979 to their welfare”.

At an international and a national level, people have still not learnt that reiteration of platitudes is negatively reinforcing: one does not want to read articles that contain recommendations that ‘sound educational methods and materials are used so that the educational objectives are attained’ or (and this sentence I really can’t understand) ‘The main emphasis at this stage is to improve the institutional capabilities for training workers at the community l e ~ e l ’ ~ . Of course I am being unfair in quoting out of context; nevertheless, wading through the flood of IYC articles that have come across an editor’s desk, one wonders if the year has done more harm to trees (paper) than good to children.

Alas, those children who are already best cared for may benefit most from the year. Perspectives of Child Health in Sweden4 is an exemplary look at ‘the present state of health of Swedish children’ and discusses attempts to deal with some of the most urgent health problems. Such careful assessment does provide a model of the

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way in which developed and developing countries could attack their problems. There are practical thoughts, too, for those who are developing services. In Sweden very few mentally handicapped children or adolescents are now in long-stay hospitals and the process of integration (mainstreaming) of these children is such that over 90 per cent of classes are now integrated. Present evidence suggests that this type of provision is the appropriate goal for services in those countries that lack them-there is no need to go through the historical process of institutionalisation which developed countries have followed.

On the other hand, the data on child abuse are less reassuring. Better reporting may largely account for the increased rates of child abuse recorded in Malmo between 1975 and 1978 as opposed to 1967 to 19745; nevertheless, an increase in the rate of severe lesions suggests that preventive measures, at best, are only containing the present level of abuse. Not a reassuring finding for those in other countries aiming to attain the sophistication of present-day Swedish culture. The final paper in Perspectives of Child Heallh in Sweden discusses some of the causes of these failings6, and ends on a timely note for those working in all countries-developed or developing. Collaboration between med- ical, health and social care may represent ‘one of the few possibilities of development in a time when the care resources are diminishing’. So forward into the 80s, with International Year for Disabled Persons in the offing. Let us hope that the opportunity will be used effectively.

MARTIN BAX

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REFERENCES International Child Welfare Review ( 1 979) ‘An international action initiative for . ,

maltreated children.’ 42, 19-20,

26. Shewak, D. (1 979) ’Rags and riches in Bombay.’ International Child Welfare Review, 42,

WHO Chronicle (1979) ‘Training in maternal and child health care.’ 33, 329-333. Aria Paediatrica Scandinavica (1 919) Perspectives of Child Health in Sweden. Suppl.

Bergstrand, C. G. , Forslund, M., Stibner, I.-B. (1979) ‘Child abuse in Malmo.’ Acta

Gustafsson, L. H. , Lagerberg, D., Larsson, B., Sundelin, C. (1979) ’Collaboration in

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Paediatrica Scandinavica, 68, Suppl. 275, 108-1 11.

practice.’ Acta Paediatrica Scandinavica, 68, Suppl. 275, 126-13 1.

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