There has been increasing awareness that sexual abuse of children is a problem in Malaysia. Existing data is based on notification of cases. Population based studies are required to plan services for sexually abused children. This study utilized trainee paramedical staff as a community population to determine the prevalence of childhood sexual abuse. An anonymous, self-administered questionnaire was given to student nurses and trainee medical assistants at the Ipoh School of Nursing and Hospital Bahagia Medical Assistant Training School. Questionnaires were distributed directly to all students in a classroom setting and retrieved after a 30-minute interval. Information collected included questions on personal experiences of sexual abuse. Sexual abuse was defined as rape, sodomy, molestation, or exhibitionism occurring to a child less than 18 years of age. Six hundred and sixteen students participated in the study; 6.8% of the students admitted to having been sexually abused in their childhood, 2.1% of males and 8.3% of females. Of those abused, 69% reported sexual abuse involving physical contact, 9.5% of whom experienced sexual intercourse. The age at first abuse was < 10 years in 38.1% of the cases; 59.5% were repeatedly abused and 33.3% had more than one abuser. Of the abusers, 71.4% were known to the respondent, 14.2% of whom were brothers, 24.5% relatives, and 24.5% a family friend. Further, 28.9% of all students knew of an individual who had been sexually abused as a child. While this population may not be entirely reflective of the community, this study does provide an indication of the prevalence of sexual abuse in Malaysian children. The prevalence figures in this study are lower than those reported in industrialized countries and this may reflect local sociocultural limitations in reporting abuse.
This paper describes a case note and interview study of a cross sectional sample comprised of all children seen and confirmed as being sexually abused between June 1985 and December 1990 by the Suspected Child Abuse and Neglect (SCAN) Team of Kuala Lumpur General Hospital. A total of 101 cases, which represented 18.2% of all child abuse cases, were seen together with their accompanying adults. Information about ethnicity, socioeconomic status, family constellation relationship of perpetrator to the child, and reported psychosocial factors that could have contributed towards the abuse were recorded. The Indian ethnicity group was found to be overrepresented. The mean age of children was 6-8 years, SD 4.1, with age ranging 1.5-16 years. Forty-one and one-half percent were in the age range 5-9 years. Among the important associated psychosocial factors found were the absence of another adult at home, unemployment, and history of drug abuse among the perpetrators.
Child maltreatment is a substantial public health problem worldwide. Although extensively studied in Western countries, until recently little systematic research had been published about the situation in the world's most populous nation and ethnic diaspora. In this review, we examine trends from community-based research with Chinese young people and parents in mainland China, Hong Kong SAR, Taiwan, Singapore, and Malaysia. It is clear that many Chinese adolescents experience a substantial burden from various forms of maltreatment and the psychological and behavioral correlates are similar to those found in other cultures. However, the research reveals a large gap between this reality and Chinese adults' perceptions about emotional, physical, and sexual abuse. Comprehensive awareness programs are needed to close this information gap and thereby mobilize support for prevention and care initiatives.
This paper gives a detailed account of 30 cases of childhood deaths caused by physical abuse, detected by the Suspected Child Abuse and Neglect (SCAN) team, General Hospital, Kuala Lumpur. They consisted of 12 Malays, 6 Chinese, 9 Indian, and 1 Indonesian child. Three cases could not be ascertained as to their ethnic origin. There were 13 male and 17 female children. The average age of the abused children was 2 years 5 months. The most frequent causes of death were intracranial hemorrhage and intraabdominal trauma. Of the 17 cases of intracranial hemorrhage, only four had X-ray evidence of skull fracture. This suggests the possibility of whiplash injuries with/without the abuser suspecting that he/she had injured the child. Of the 22 abusers who could be identified, there was no sex differentiation. Fathers formed the largest group of perpetrators, followed by mothers and childminders. Fifteen of the natural parents of the abused children were married, four were divorced and four were never married. Five of the abusers had aggressive personalities and three were drug addicts. Only one abuser was found to be an alcoholic even though a few were also under suspicion. For most cases, trigger factors could not be identified.