Child sexual abuse in KwaZulu-Natal, South Africa.

This paper discusses child sexual abuse in a hospital serving a largely rural population in Eshowe, KwaZulu-Natal, South Africa during a period of 9 years and 2 months. Child sexual abuse was a significant problem. The incidence of sexually transmitted diseases at presentation was high (65.9%). The abuser, when identified, was more commonly an acquaintance or stranger than a family member. The shortage of resources in 'third world' countries means that medical personnel must take the lead in identifying and managing children with sexual abuse. Frequently they must assume additional roles, such as that of social worker, if management is to be successful. However, high patient case loads in these situations make this difficult and therefore child sexual abuse may not be adequately dealt with. A possible solution to this problem is the use of outside agencies to research the problem and the establishment of regional special units to manage child abuse.