Child abuse in Kuwait: problems in management.

OBJECTIVES To explore the extent of child abuse in Kuwait and examine the difficulties associated with its management. SUBJECTS AND METHODS A retrospective analysis of the 60,640 medical records of children admitted to Al-Amiri and Mubarak Al-Kabeer Hospitals, Kuwait, between 1991 and 1998 was done. RESULTS Of the 60,640 records, 16 children showed evidence of abuse. Of these, the perpetrator was a parent in 75% of the cases, which involved the following abuses: physical, 13; sexual, 2; and Munchausen syndrome by proxy in 1. Children with physical abuse had more than one type that included bruises (77%), burns (38%), intracranial haemorrhage (38%), fractures (23%) and cut wounds (15%). Seven of the children were returned to their biological parents, 7 were lost to follow-up and 2 died. CONCLUSION Child abuse exists in Kuwait and is probably underreported. Management proceedings are not ideal and guidelines as well as legislation are needed.