It is impossible to describe the blood-boiling anger I feel every time I read a horrific story about a child being a victim of abuse. Every day, everywhere, no matter what community, what race or social status, children continue to be the victims of adults who, without mercy, beat, torture, starve and kill these defenseless angels. Why? I do not know and I do not care for any explanations.

One of the most sadistic tales of child abuse has been the recent story of 7-year-old Nixzmary Brown. Her stepfather, Cesar Rodriguez (read the NY Post article), beat her to death after she took some yogurt without permission. New York City officials say the girl's mother, Nixzaliz Santiago, did nothing to help or stop this abuse. What is even more shocking about this story is that the poor girl was ignored by everyone. According to reports, there were at least TWELVE opportunities where authorities could have intervened to save this girl’s life. Both parents had systematically beaten, tortured, tied up, bound, and deprived this 7-year-old of food. Twelve chances missed!

Did the system fail? No! It was not the system. People failed. The people who set up the system, who run the system, and who check the system should be held accountable. Child welfare workers say that the parents were not cooperating and were not responsive or receptive to their inquiries. C'mon! You call, they hang up on you. You knock on the door, and they slam it in your face. Is it just me, or shouldn’t that kind of consistently hostile behavior raise a red flag or two? Wouldn't a normal and responsible child welfare worker wonder if these people were hiding something? Did they talk to the neighbors? Since Nixzmary's death, some have come forward saying things were just not right in that household. Sooner or later somebody will come out with another excuse and say, "well, we have so many cases and not enough child welfare workers." Unacceptable!

I am sure there are many professionals who would like to explain to me and others why some parents behave this way. You know what? I DON'T CARE! I am tired of listening to the words: tolerance, understanding, accidents, and the ever famous phrase, ‘the system failed the child.”

Although there were many documented opportunities to do something, two specific events were quite alarming. First, the failure of a doctor, who examined the child with a cut and swollen eye back in December. Although a report of suspected child abuse already existed, the physician didn't bother to question her condition, to ask the child what happened, or question the mother's story. Second, was the failure of the caseworker not pushing to obtain the legal recourse necessary to visit the child after the father refused to open the door.

Miscalculations, mistakes, indifference, etc. America, our children need help! As I try to learn more, I contacted someone who knows a lot about child abuse. Colleen F. Kearney is one of the heads of the Pediatric Ambulatory Medical/Surgical Services at the Joseph M. Sanzari Children's Hospital (Hackensack University Medical Center). The Audrey Hepburn Children's House is a department of the Joseph M. Sanzari Children's Hospital.


DR. MANNY: Why do we see more and more child abuse?

MS. KEARNEY: National and state statistics over the last several years have really stayed somewhat consistent suggesting that there is no increase in child maltreatment. However, the awareness and perhaps the difficulties child protective agencies are having in appropriately managing cases of child maltreatment is more likely the reason why we feel there is an increase.

DR. MANNY: What signs do we need to look out for?

MS. KEARNEY: There are many signs of child maltreatment so it is difficult to just identify a few. The most important thing is to be open to the possibility of abuse. Considering abuse as a possible differential diagnosis and screening appropriately is essential to identification. Children present with injuries that aren't consistent with the history, when explored, will usually provide information that will help in determining how the injury occurred. Another sign: physical injuries present on areas of the body that are less likely caused accidentally, or may reflect an object. Sex abuse victims have their own physical and behavioral indicators. However, the most reliable indicator is the child's history of the abuse. Stress is the only common dominator in the perpetrator therefore anyone can be an abuser. Maltreatment knows no social, educational, or economic barriers.

DR. MANNY: How do we engage a child in talking about child abuse?

MS. KEARNEY: First, we provide an environment that is warm and kid-friendly. We let them know verbally and with our body language that they are not in trouble and that our job is to help children. We use developmentally appropriate protocols that are used in an objective manner that will elicit credible information. We are try to be honest with the children and are careful not to re-victimize them.

So how do we save our children? I can tell you one thing: we'd better stop looking for what went wrong and start focusing more on the victims. Or we'll hear more and more of... "Your Honor, my client pleads..."

Well, you know the rest.

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Dr. Manny Alvarez serves as Fox News Channel's senior managing health editor. He also serves as chairman of the department of obstetrics/gynecology and reproductive science at Hackensack University Medical Center in New Jersey. Click here for more information on Dr. Manny's work with Hackensack University Medical Center. Visit AskDrManny.com for more.