RED CROSS CHILDREN'S HOSPITAL - CHILD AND FAMILY UNIT

REVIEW OF CURRENT FIREARM LEGISLATION:

SA is a violent society and it is necessary that we review the need for firearm legislation within this context. This matter will be approached by reviewing the incidence of violent crime and in particular gun violence statistically, the impact on individuals and in particular on children before discussing the need for urgent preventative strategies.

Just how violent we as a society have become is evident in the following statistics from the SAPS Crime Information Analysis Centre. Crime to minors will be highlighted

CRIMES REPORTED AGAINST CHILDREN AS REPORTED TO THE SAPS JANUARY TO JUNE 1999 (CIAC)

I mention as reported to the police, as it is common knowledge that not all crimes are reported, especially common assault, rape, indecent assault, incest and kidnapping for fear of reprisal or ignorance about procedures etc.

 

RSA

W. CAPE

Murder

0 – 11yrs

12 – 17yrs

485 365

23 69

Assault – Grievous Bodily Harm

0 – 11yrs

12 – 17yrs

1 762 5 357

257 951

Assault – Common

0 – 11yrs

12 – 17yrs

1 888 6 833

389 1 861

Rape

0 – 11yrs

12 – 17yrs

3 518 6 143

397 882

Indecent Assault – Girls

0 – 11yrs

12 – 17yrs

598 356

228 157

Indecent Assault – Boys

0 – 11yrs

12 – 17yrs

293 331

111 103

Incest

0 – 11yrs

12 – 17yrs

35 17

2 5

Kidnapping

0 – 11yrs

12 – 17yrs

450 385

48 50

CRIMES AGAINST ADULTS AND CHILDREN JAN – DEC 1998

Murder

0 - 17 yrs

Adults

Total

RSA

1 744

23 131

24 875

Attempted murder

0 - 17 yrs

Adults

Total

RSA

2 838

26 580

29 718

Assault with intent to inflict grievous bodily harm

0 - 17 yrs

Adults

Total

RSA

14 486

219 570

234 056

Common Assault

0 - 17 yrs

Adults

Total

RSA

16 741

182 572

199 313

Rape and attempted rape

0 - 17 yrs

Adults

Total

RSA

19 881

29 399

49 280

Statistics for individual provinces are not specified here, but it is worth mentioning that the Kwazulu-Natal, Gauteng, Western Cape and Eastern Cape had among the highest figures for different crimes.

Child abuse and neglect statistics are not reflected as no centralised facilities exist for recording all instances. Never the less, this is a problem of increasing magnitude, and often a predisposing factor in the development of violence in individuals.

FIREARM INJURIES

SAPS Statistics reflecting Murder with firearms as a percentage of all Murders

(Crime Information Analysis Centre, July 1999)

YEAR

1994

1995

1996

1997

1998

Murders with a firearm

11 134

11 065

11 394

11 215

12 267

Total Murders

26 832

26 637

25 782

24 588

24 875

Firearm Murders as a Percentage of all Murders

42%

42%

44%

46%

49%

An age breakdown of victims for gun-related murders and attempted murders in 1996 revealed that in the 12 and under age group there were 791 murders and 1 322 attempted murders and in the 18 - 49yr age group 8 762 murders and 18 912 attempted murders (Crime Information Management Centre, 1997).

According to a United Nations survey of 69 countries (1998), SA has one of the highest firearm related homicide rates in the world. Of note in their study is that in the UK with much stricter gun legislation and effective law reinforcement had only 72 homicides i.e. 0.13 per 100,000 people in the population. (1)

The USA has the highest rate of firearm-related deaths in the industrialised world - including homicide, suicide and unintentional deaths. The difference between the USA and other industrialised countries seem to be related to the easy availability of guns in the United States.

Firearm Injuries treated at the Red Cross Children’s Hospital

 

1995

1996

1997

1998

Severity

Minor

Moderate

Severe

Mortal

11

16

5

21

10

5

13

11

2

2

25

19

7

1

Total

32

35

28

52

Of note in the Red Cross Study, is that nearly 50% of all gunshot injuries occurred inside or outside the child's home, with a further one third of these injuries occurring on the streets. Also of note is that there was a dramatic increase in 1998 despite the fact that the new cases are increasingly referred to community units.

An epidemiological study of firearm related injuries among children and adolescents in Cape Town for the years 1992 - 1996 (2) reveals that: at least 1 736 children and adolescents were victims of firearm related incidents; 322 (i.e. 19%) died; that the incidence of firearm related injuries in this age group almost tripled during the period under review from 20.2 /100,000 in 1992 to 58.1/ 100,000 in 1996, as did the increase for deaths thereby demonstrating an escalation of almost epidemic proportions.

Approximately 60% of victims were male, with 860/0. between 13 and l8yrs of age.

Of the adolescent victims (aged 13 - 18yrs) who died, 21% had blood levels indicating that they were intoxicated at the time of death.

Where the site of injury was known, the most common places were on the roads or pavements (76%) or inside the children's own homes (15%).

What is of note is that this study cross referenced hospital, mortuary and police records, establishing many inconsistencies, incomplete or conflicting information. At least 20% of firearm related deaths involving persons under l8yrs of age were missing from police records.

NEED FOR STRICTER GUN CONTROL REGULATIONS

That the above and the Red Cross Hospital study report many firearm incidents as occurring inside children's own homes also endorses the need for stricter safety measures to be kept around the use of guns.

An American study (3) of parental perceptions about keeping firearms in the home revealed that the majority of unintentional shootings occur in the home. (4) Such incidents commonly result when children playing unsupervised discover a loaded handgun. Parental perceptions over-estimated their children's ability to be able to differentiate between toy and handguns in that three quarters of the gun owning parents believed that children between the ages of 4 -l2yrs could do so. Another 23% believed children in this age group could be trusted with a loaded gun.

All the above statistics reveal that we need to deal with this problem urgently if we are to work towards a safe future for ourselves as a nation and in particular for the children of this nation. One of the difficulties is that when society begins to degenerate into increasing numbers of persons with antisocial or criminal tendencies, it becomes virtually impossible to pull it back and the violence regenerates itself with increasing rapidity.

With no effective law enforcement people so violated, increasingly too take the law into their own hands in order to defend themselves.

It is of note that the United Kingdom with effective legislation and law enforcement has one of the lowest firearm homicide rates of the countries studied in the United Nations survey already referred to. (5)

EXAMPLES OF CHILDREN TRAUMATISED AS A RESULT OF FlREARM INCIDENTS IN RECENT YEARS

a) A three year old boy was referred to the Unit after witnessing his father shoot his mother before the boy was snatched away by relatives and father shot himself

This child was severely traumatised and for a long time afterwards, used to re-enact facets of this scene with a toy gun which he would point at every one in a room, before pointing the gun at himself and fire. He would then comment that his daddy has a gun.

This play which was distressing to watch, was a necessary part of assisting him to work through and gradually integrate this experience.

It was hard for him to grasp what had happened and when he heard ambulances, he would ask when "his daddy would come back from the sand". He was fearful of dying and would ask if he would die like his brother. He on one occasion when he accidentally scratched himself and bled, commented that he was "bleeding like his mommy". He would also scratch in the sand tray in an endeavour to "find his mommy". He would put dolls in a pram so that they could go to the cemetery to "visit his mother".

In these various ways he was endeavouring to hold on to his mother, as still too young to grasp that she could never come back.

What are the implications of the loss of so primary a caretaker at so young an age. Such things cannot be easily quantified, but the loss has immense future implications in terms of age. He initially too was very regressed and behaved in a baby-like fashion, drinking from a baby's bottle and wanting to sleep in his grandmother's bed.

Such events can precipitate the tendency towards an anxious disposition in life.

b) An eight year old girl, who had witnessed a gang related shooting outside her house, when a neighbours child was shot in cross fire. She and other children had been fleeing to safety when this occurred. This was on a council housing estate. The consequences for this child, who had been previously traumatised was to make her very tense, vigilant, unable to concentrate and unable to sleep as the area frequently resounded with gunshot at night, a complaint we get from many families who live on such housing estates.

A 9yr old girl whose mother was shot by a neighbour, a police reservist, who had been fooling around with his gun, boasting to those in the neighbourhood. He suddenly began to shoot randomly across the street as this child's mother walked past and was hit. She died as a result of the injuries sustained. Again another child was left motherless with resultant implications for her ongoing care, not to mention the emotional trauma and loss sustained.

d) Two children aged 5 and 8yrs, have very recently been referred to us, having witnessed both mother and father shot dead in their presence. Again one cannot underestimate the consequences of such a trauma for children so violently deprived of good parents at so young an age. This is a very significant loss for any child, but even more so where children have a close and loving relationship with their parents.

In terms of staff:

e) medical technologist was shot dead in the grounds of Red Cross Hospital in 1999.

f) a medical student was hi-jacked at gun point a few months ago as she arrived at our unit.

What are the implications of such traumas, not only for the victims, but the secondary traumatisation of those with whom they work and the community at large?

Many children so severely traumatised suffer from Post-Traumatic Stress Disorder some of the symptoms being frequent re-experiencing of the event, persistent avoidance or numbing, nightmares, intrusive thoughts about what happened and persistent symptoms of hyper-arousal when reminded of traumatic experiences.

Those repeatedly traumatised may present with an absence of feeling, a sense of rage or unremitting sadness (6)

Those that respond with aggression tend to anticipate aggression and so attack first in order to survive and achieve ends. Such children may lack empathy and the capacity to perceive matters from another perspective. Guns in their hands would simply increase their danger to others.

The oppositional and conduct problems that such children who are inconsistently parented commonly present, chrystalise into established patterns of antisocial criminal personalities by mid to late adolescence.

Those with ‘’flight'' type personalities often are more inclined to dependence on substance e.g. drugs and alcohol. However, substance abuse can also compound aggressive tendencies.

Children from lower socio-economic communities are particularly vulnerable, as many have family environments that are violent and/or that are inconsistently responsive to their needs from early infancy. The most vulnerable are those that are unwanted and bond poorly with parents who are immature, pre-occupied with own needs, inconsistently responsive and unable to provide consistent care with clear expectations and guidelines for behaviour on a day to day basis. As a result children are often untrusting, anxious and insecure or irritable and demanding and as they become older gravitate to whoever will respond to them at some level, thereby facilitating a process by which they are susceptible to negative influences as some attention is better than none.

At school too they are often inattentive hyperactive and distractive of others, which becomes an increasingly unrewarding experience as they perform poorly and incur the wrath of teachers and fellow pupils alike. It is therefore common for such children to drop out of school and to join gangs.

GUNS AS SYMBOLS OF MASCULINE STRENGTH AND POWER

Guns can with time take on meaning for boys who lack power in their lives, and who through negative and aggressive behaviours conclude that aggression is a successful way to negotiate life's problems.

For many boys guns are therefore exciting and arousing. They make them feel powerful and strong and they therefore believe it acceptable to respond violently to perceived dishonour. Guns therefore become symbols of "strength and manhood and also protective agents to assist against fear of assault and death". (7)

The fact that their use is also advocates in many countries today, reinforces this image of power and success when used by strong men

GAMES SHOPS AND GUNS ON TV

I question the wisdom of almost rightly advertising of TV movies etc. with a few scenes of gun wielding men achieving their ends. For many in lower socio-economic communities TV is the only entertainment and so this image of needing a gun to achieve success is reinforced.

Games arcades too encourage the development of gun use through many of their programmes. James Gabarino who spoke at the SA Child Psychiatry Congress in Cape Town last year and who has written on "socially toxic environment", mentioned how a 10yr old boy who had spent many hours playing at shooting games at a games shop, walked into a school classroom in the USA one day and shot 12 children, killing 9 of them, a result that even skilled and practiced police or army officers reportedly would find difficult to achieve in a live situation.

PREVENTION

Risks for violence include: childhood and adolescent exposure to family violence from early childhood; inconsistent parenting and care in childhood and adolescence; poor school performance; exposure to antisocial behaviours; depression, low self-esteem, substance abuse, withdrawal and poor peer relationships. It is important therefore to focus on factors that will enhance family functioning, ability to cope with different emotions, ability to develop normal relationships and integrate at school. Prevention also needs to look at protecting the wider community through adequate laws and law enforcement.

In order to therefore reduce the incidence of violence and the need for guns we need a multifaceted approach.

This begins as early as the adequate prenatal care of individuals through to providing adequate facilities to meet their needs as they progress from infancy.

One needs to reduce the number of unwanted births greatly by making sure adolescents know about the responsibilities of safe sex and are not caught resentful with unwanted babies who are likely to receive inadequate care and be dumped etc. Parents need encouragement to bond and to respond to children’s needs for adequate and consistent care that takes cognisance of physical emotional social intellectual and educational development. The intellectual so that they can benefit from education and not have to drop out early.

Classrooms need to be of manageable sizes as frequently these days in lower socio-economic communities classrooms are huge and those children with educational and emotional needs are unable to cope and drop out early. This leads to more disillusioned children on the streets on the lookout for negative peers with whom to associate and get up to mischief especially if the home environment is not supportive or attentive, as parents and caretakers are pre-occupied with other issues.

However, most important of all if we are to reduce the incidence of firearm injuries and deaths we need an adequate legal framework - good laws and law enforcement when laws are broken. Both seem to be lacking in this land, for the status quo to be as it is. Laws needs to control where guns are kept and if loaded or not, how they should be carried and sizes of guns allowed. Many accidents are caused by handguns. Gun control should also be considered about the shapes and makes of toy guns, so that children clearly differentiate between fantasy and the real, as there can easily be a carry over so that if real guns are found at home children can fire them thinking they're not real.

It may even be beneficial to consider banning toy guns that are too real looking. It is often too the immature that apply fantasy to real life situations and later act them out to resolve problems as adults.

That this situation is urgent needs to be appreciated if the loss of life as well as injuries and resultant long-term needs for rehabilitation, care etc. of those who will never regain their former capacities is to be addressed. The monies saved from not having to manage these problems can then be diverted to development programs aimed at improving the standard of living of all and decreasing the need for guns.

If the only means to achieve these ends is to ban guns altogether, the government needs to give this thought. Whichever way, the situation cannot continue as it is. In recent months we hear of increasing incidents impacting on children and yesterday I received a call from a grandmother enquiring where she could get help for her 8yr old grandchild who was very distressed as his mother had been shot dead as she walked to a shop in Mitchell's Plain a week ago.

These situations are increasingly painful to hear and to deal with, so please do what you, the persons that govern this nation can do as soon as possible to ensure the safety and protection of all, and to ensure that the children of the new South Africa have a better future.

1. United Nations International Study on Firearms Regulations 1998 - as given out by the Gun Control Alliance, Mowbray, CT.

2. Wigton, A. Firearm-related injuries and Deaths among Children and Adolescents in Cape Town, 1992 - 1996. SAMJ, April 1999, Vol. 89, No. 4

3. Farah, MM.; Simon, HK.; Kellerman, AL. Firearms in the home Parental Perceptions. Paediatrics, Vol.104, No.5, 11 1999.

4. United Nations: International Study on Firearms Regulations 1998

5. Group for the Advancement of Psychiatry, Committee on Preventive Psychiatry. Violent Behaviour in Children and Youth : Preventive Intervention from a Psychiatric Perspective (1999). J. Am. Acad. Child and Adolescent Psychiatry, 38, 3, 1999.

6. Terr, L. Childhood Traumas: An Outline and Overview. Am. J. Psychiatry 148: 1,January l99l.