Social workers yesterday expressed concern over child abuse in Taiwan, saying many cases have gone unnoticed.

Parents and families seldom send their abused children to doctors until their conditions become too serious, the social workers said.

They warned that when such children's ordeals are exposed, these children are usually already either dead or seriously injured, particularly those 6 years of age and younger.

Of the 77 major child abuse cases that made headlines last year, 58 involved children were aged 6 or under. Of those, 75 per cent were dead or seriously injured when their stories were reported in the news.

The social workers said these pre-school kids usually stay home without outside contact, making it difficult for outsiders to find out about abuse. They also asked doctors to pay more attention to young patients to uncover abuse cases.

Chang Gung Memorial Hospital in Linkou has recently set up a child protection unit to assess possible abuse cases and report them to police and social workers as soon as possible.

Hung Ching-lung, vice chief of the hospital, said pediatricians have often found it difficult to determine whether their patients are victims of child abuse.

They are often caught in a difficult situation: overreacting to minor cases may incur parent's anger, but failing to report these may risk the children's lives.

The new Chang Gung unit brings together doctors from various departments with social workers. Their standard procedure includes diagnosing the children, treating them, collecting evidence and filming the process as evidence.

Doctors said sometimes their own safety may be at stake while handling child abuse cases.

They said some parents will threaten medical practitioners or even resort to violence when learning that their child abuse cases will be reported to police.

Hung Chia-hsiu, chief of a children's hospital in Taipei, noted that the law requires medical practitioners to report suspected child abuse within 24 hours of receiving the patients.

He said he would try to avoid direct clashes with parents. Children will be hospitalized first and then their cases will be reported to the police at a proper time.

Lo Fu-sung, head of the Chang Gung child protection unit, said all of the hospital's staff have been advised to look out carefully for signs of abuse. If they find anything wrong or suspicious, they should first send the children to the intensive care unit (ICU), he said.

Lo added that Chang Gung's ICU has both a front door and a back door. When angry parents wait outside the front door, doctors and nurses are able to use the back door to avoid potential clashes.