By Helen Altonn
Star-Bulletin
By Helen Altonn
Star-Bulletin
The case is a frightening example of a substance-abuse epidemic hurting and killing Hawaii's children, say workers in the CPS system.
Helen Mahuka, 21, holds 1-year-old daughter Claytona Auelua at
Women's Way, a Manoa drug treatment facility run by the
Salvation Army. Despite a waiting list, lack of funds has
kept beds at the center empty.
While the numbers of child abuse and neglect cases appear to be level, they don't present a true picture, says Dr. Cynthia Tinsley, who sees the grim reality in the pediatric intensive care unit at Kapiolani Medical Center for Women and Children.
"If you break them (cases) down, you find incidents of severe abuse increasing, and the number of children under 1 year of age is increasing."
Short of staff and resources, CPS workers can handle only critical cases, said Deborah Lee, an assistant program administrator for child welfare services.
Others are referred to community agencies. But with decreasing services, she said, "Our fear is they'll come back with more serious harm than when they initially reached out for help."
The Oahu CPS hot line receives 800 to 1,000 calls per month, said Johnny Papa, intake division supervisor at the state Department of Human Services. "There's no way we could assign that volume. We barely assign 20 percent. We network 40 percent."
Cases often involve multiple victims and types of abuse - physical, sexual and psychological, Papa said.
And most involve drugs, often by generations of drug users and abusers - one or both parents, grandparents and extended family members, she said.
Getting families into treatment is tough because the few programs available have up to six-month waits, said Ralph Aona, a investigative supervisor. He said workers are "just strapped" to find services to help people.
Dr. Steven Choy, clinical psychologist heading the Kapiolani Child Protection Center, is most distressed when he sees repeat drug-exposed infants. This usually happens because mothers abandon children, escape treatment and get pregnant again, he said.
Healing Art: Child abuse survivors use "healing art" as part of their recovery process and as a step toward breaking the cycle of violence. The artwork was recently exhibited at City Hall to remind citizens of the importance of preventing violence.
"We can encourage them to think about whether they're competent to raise a child," said state Human Services Director Susan Chandler. "We can't do anything to restrict someone from having babies." But family drug problems and the shortage of treatment programs are a big concern, she said.
CPS caseworker Elaine Chung said eight kids were removed from their mother in one of her cases last year, and five are already back because the mother responded to treatment.
Chung said the woman was so upset when CPS took her children that she worked to overcome her problems. "She was the key to it, not me, but it's possible."
Choy stressed the need for follow-up treatment for drug-addicted mothers.
Instead, he said, "We're going to cut 2,000 cases of drug addiction off the welfare payrolls and there will be more problems."
"Deaths are increasing, too. In our intensive care unit, it ranges from three to five children a year who die, where before we had none. Most are under 1.
"My unit is where the system fails," Tinsley added.
"If they wind up dead or with multiple injuries so severe that they're in an intensive care unit, that's a symptom of how our whole society is doing and how the system is working."
"One (death) is too many," Tinsley said. "I especially find it frustrating, as a physician, if we find a child is already in the system."
Papa "gets scared" when calls come into her 24-hour unit from homicide detectives and the coroner.
Not all of the victims are considered high-risk babies, she said. "We had an 11-year-old in a wheelchair . . ." Many cases involve "shaken baby syndrome," or as CPS workers call it, "impulse harm," Papa said. "Parents look like us. They're educated, financially stable, with careers. And these young babies show up with 38 fractures.
"As the case begins to unravel, people couldn't stand the (baby) crying and they snapped."
Shaken baby cases don't have red flags to warn workers the children are at risk, Papa said.
"That's what scares us. We lose our predictability capability.
"We had a lot of deaths the last few years."