Living on a railway line. Turning the tide of child abuse and exploitation in the UK and overseas

Published: 20 Oct 2014

Author: Andrew Rowland
Living on a railway line. Turning the tide of child abuse and exploitation in the UK and overseas

New report says, 'we need to recognise that the majority of child abuse and neglect occurs within homes, families and communities'. Today, Monday 20 October, sees the launch of a new report into how different countries tackle child abuse, in particular sexual exploitation, and how the UK can benefit from this learning.

‘Living on a railway line. Turning the tide of child abuse and exploitation in the UK and overseas: international lessons and evidence-based recommendations’ is a work by The Pennine Acute Hospitals NHS Trust’s Professor Andrew Rowland, in association with The Winston Churchill Memorial Trust and University of Salford.

There are 10 key recommendations for the UK together with 25 associated and enabling recommendations and seven international recommendations. All of the recommendations are designed to build strong and healthy communities with children at their hearts.

There are five major themes that run throughout the report:

Mandatory reporting of child abuse occurring within organisations exercising care, supervision or authority over children.

Better training to recognise and respond to cases of potential child sexual exploitation.

The launch of a children’s advocacy centre pilot and advocating on behalf of children.

Prohibition of physical punishment of children.

The need for further research surrounding child protection in the UK, including ascertaining the views of society to help develop preventative strategies.

The launch coincides with the 25th anniversary of the signing of the UN Convention on the Rights of the Child. According to Professor Rowland’s report, a quarter of a century later there are still laws, policies and procedures in the UK and internationally which fall way short of properly protecting children.

Professor Rowland gathered evidence from USA (Texas, Arizona, Pennsylvania, Colorado), Singapore, Malaysia (Kuala Lumpur, Ipoh) and Cambodia (Sihanoukville). He investigated the impact of mandatory reporting of child abuse, the work of children’s advocacy centres and learned about strategies used to identify children at risk of child sexual exploitation and trafficking. He uses his international experiences to make recommendations for the UK and the international community. The work contains over 300 scientific and other references.

Professor Rowland said

It is of the utmost importance that we recognise that the majority of child abuse and neglect occurs within homes, families and communities. We must not be distracted by a media frenzy of high-profile cases related to public figures and celebrities - disturbing though they are, they do not reflect the majority of abuse cases that occur within our communities. However, it is time for the UK to take an unequivocal stand against child abuse cases occurring in association with positions of power or responsibility, and the law in the UK should be changed to introduce mandatory reporting of them. We need much better research to understand, in more detail, society’s views about child abuse. There needs to be a standardised educational programme delivered to all professionals working with children and families, not just a competency framework. Professionals working with children need to advocate much more on behalf of children and empower them to participate more fully in decisions relating to the communities in which they live. It takes a community to protect a child: protecting children really is everyone’s business, including yours.

Lisa Harker, Director of Strategy Policy and Evidence at NSPCC, said

This report provides a valuable consideration of a diverse range of challenges faced by professionals and members of the community when seeking to improve safeguarding of vulnerable children in the UK.  By drawing on the insights gained from reviewing and observing practices in a wide range of international contexts this report offers a fresh perspective on these issues and the potential responses.

Jamie Balfour CBE DL, Director General of The Winston Churchill Memorial Trust, said

Dr Rowland’s excellent report demonstrates the significant results that can come from a Winston Churchill Memorial Trust Travelling Fellowship. These Fellowships provide a unique opportunity for British citizens to travel overseas to bring back fresh ideas and new solutions in order to address many of the current social challenges facing the UK.

Download the full report (PDF, 3.9Mb) or Executive Summary (PDF, 763Kb).

For further information contact: Andrew Lynn, The Pennine Acute Hospitals NHS Trust T. 0161 604 5459 [email protected]

Notes to editors:

The report’s title ‘Living on a Railway Line’ comes from Professor Rowland’s experience in Cambodia, where children and their families are literally living beside train tracks. This dangerous environment, where one is never sure when or from where harm is coming next, is a metaphor for what many people experience world-wide, including in the UK, through their exposure to abuse.  

Other quotes: 

Barnardo’s, the UK’s leading children’s charity, said

Barnardo’s welcomes this report and the evidence it draws together to gain a better understanding of what needs to change to ensure that vulnerable children are being safeguarded. Barnardo’s supports the recommendations relating to child sexual exploitation, particularly around changes to grooming legislation and the need to remove the term ‘child prostitute’ from our laws. 

Dr Geoff Debelle, Officer for Child Protection at the Royal College of Paediatrics and Child Health, said 

This is a timely, wide-ranging and comprehensive report on vital aspects of child safeguarding. Its recommendations are global in their reach, and pertinent to many jurisdictions, particularly the UK. For example, consistent high quality training in child abuse and neglect for all professionals who work with children and families should be the norm, and organisations involved in clinical research should indeed promote this more widely with patients and the public. We will take time to consider all the recommendations in order to determine how they can be best supported by the RCPCH and, where appropriate, implemented. This report is written with a sense of urgency and I urge others to read it, digest it and engage in active discussion on how safeguarding children in the UK and abroad can be improved.  

Dr John Devaney MBE, Chair of the British Association for the Study and Prevention of Child Abuse and Neglect, said

I welcome this important and timely report on child abuse and neglect. While recent high profile cases, of both a recent and historical nature, have raised public awareness of the very difficult lives many children lead, the findings and conclusions in Professor Rowland’s report highlight what can be achieved through the promotion of greater inter-agency and multi-professional co-operation and working, greater support and training for professionals and a more robust evidence base to inform policy and practice. I hope that the findings can further the debates and discussions about how we deal both nationally and internationally with the issue of the abuse and neglect of children and young people in all its forms. 

The President of the College of Emergency Medicine, Dr Clifford Mann said

This report is excellent and represents a substantial body of important work.  There are some recommendations relating to Emergency Medicine which have merit and we look forward to working on these in due course. 

Dr Gillian Fairfield, Chief Executive of The Pennine Acute Hospitals NHS Trust, said

We are delighted that one of our senior consultants in emergency medicine has been involved in such an important area of research. Professor Rowland has taken the opportunity to use his wealth of clinical experience and research to further explore ways we as healthcare professionals and multi-agencies, including those in emergency medicine, can improve the protection and safeguarding of vulnerable children. On behalf of the Trust we would like to congratulate Professor Rowland on this report and hope that it creates wider debate and work across health and social care at all levels. 

Maggie Eno MBE, Co-founder and Coordinator of M’Lop Tapang, said

Professor Rowland has identified so intuitively how, with a little effort but with an open mind, lessons from UK can benefit partners across the world and, significantly, how the UK can utilise successful models from international partners who work with far less resources. Working together in communities simply works. It is very apparent that we all have significant changes and urgent, yet lasting, improvements to make before we can safely claim to be protecting our children effectively. It is unique and motivating to see a senior health care professional display such an inclusive, holistic approach fully understanding of the need for all of us to step up our safeguarding strategies: as parents, families, child protection organisations, health care professionals, the judiciary and law enforcement. This report gives us clear evidence that it is everybody’s key role in life to protect children and we need to listen to and learn from successful strategies around the world, adapting and applying them to our own settings fast, before another child gets harmed. This crucial and opportune report highlights the importance of what many of us have forgotten.  Effective safeguarding of children does not start with child protection experts or high level professionals working with child victims, it begins with empowering the children themselves: working closely with their parents, their families, their friends and neighbours, within the communities in which they belong, and in the places where they spend most of their time. These key, trusted community members are often in the best position to protect children from being harmed. If every community is alert and engaged in protecting their own children, offenders may continue to pursue, but they will meet far too many obstacles, and therefore will be less able to harm our children. It is by partnering and listening to the close community that really creates sustainable safe environments for children to grow up in, feeling safe, being protected, as they should be by adults, in any part of the world. 

M’Lop Tapang is a local non-profit organisation registered with the Royal Government of Cambodia and has been working with the street children of Sihanoukville since 2003.  They currently work with over 4000 children and 1500 families in the Sihanoukville area providing shelter, medical care, sports and arts, education and training, counselling, family support and protection from all types of abuse.

Sebastien Marot, Founder and Executive Director of Friends International, said

ChildSafe grew from the need for effective child protection in developing countries however its innovative multi-layered approach, including community based protection systems, resources for travellers and the business sector can be adapted to work just as well in the developed world, where the effectiveness of existing child protection initiatives is often called into question.

Dr Julia Surridge, The Chair of The Association of Paediatric Emergency Medicine (APEM), welcomed this report and said

Professor Rowland's in-depth and timely report starts by highlighting many issues that have, unfortunately, been raised in previous reports of child sexual abuse, both in individual cases and in cases involving multiple victims. The recommendations in his report are clear - we, as professionals caring for these vulnerable children and adolescents, need to act promptly, and move forwards in the training of recognition of those individuals who are at risk of, or who have already been subject to, sexual exploitation. APEM is in a unique position to be able to join with Colleges and other groups to work, in detail, on implementing Professor Rowland's recommendations relating to training and to the urgent care setting.

APEM is a charity affiliated to the Royal College of Paediatrics and Child Health, promoting excellence, training and research into Paediatric Emergency Medicine. 

Mrs Liew Sau Pheng, Founder of the Malaysian Child Resource Institute (MCRI), said:

Professor Rowland’s work is the best advocacy I have ever known for safeguarding and protecting children. It is clear that Professor Rowland has put his heart into his research and that he truly cares about bringing impactful and positive outcomes for vulnerable children and families. His report is a clarion call to all who long for a peaceful and non-violent world to start with educating and improving on a continuous basis if they are to be effectual in preventing child abuse and neglect. Children are our future and we have to join hands across the globe to ensure that they grow up to be fully-functioning adults who become peace-loving and contributing citizens of their countries. Child protection issues are becoming more complex and challenging not just in the UK or Malaysia but globally. These issues truly demand that professionals working for children and families are regularly fed with a diet of research-based evidence and theoretical knowledge to tackle them hence Professor Rowland’s recommendation for a standardised educational programme gives all of us who work with children and families a dynamic and instant blueprint for action. As a Non-Governmental Organisation MCRI has always been at the forefront of child rights and child advocacy and we agree with Professor Rowland that while most countries have the laws and policies in place for the protection of children and their well-being, advocacy by stakeholders, the community and the children themselves are crucial to ensure that issues that concern children are always at the forefront of every national agenda. Professor Rowland’s report is indeed timely. His recommendations will enable organisations who are working on behalf of children, MCRI included, to mobilise a groundswell of support to assemble resources to make things happen for the benefit of children globally. As the Chinese philosopher, Lao Tzu, said, "A journey of a thousand miles begins with a single step". That journey has begun and Professor Rowland’s recommendations wilI now take on a life of their own – projects stemming from his recommendations will sustain themselves because they are done ‘In the Service of Children'.

Malaysian Child Resource Institute (MCRI) was incorporated in 1993 as a non-governmental and not-for-profit organisation dedicated to promoting quality early child care and education through training of child-based services. MCRI supports the UN Convention on the Rights of the Child in all aspects of their work. MCRI, especially through its founder, Mrs Liew Sau Pheng, has contributed to the development of child rights through numerous initiatives including workshops, training and awareness raising events.

Author’s biography 

Professor Andrew Rowland BMedSci(Hons)  BMBS(Hons)  MFMLM  MAcadMEd  FCEM  FRCPCH  FRSA 


Professor Rowland is Consultant in Paediatric Emergency Medicine at North Manchester General Hospital, UK and Honorary Professor at the University of Salford in the research group [email protected]. He is the only Consultant in Paediatric Emergency Medicine employed by The Pennine Acute Hospitals NHS Trust, working in a unit seeing around 30,000 children per year in the emergency department, within a Trust in the North West of England seeing in excess of 80,000 children per year in the emergency departments and urgent care centre – making the Trust one of the largest providers of paediatric emergency medicine care in the UK. 

With a special interest in the child protection (safeguarding vulnerable children) aspects of Paediatric Emergency Medicine, Professor Rowland is a member of the organisation’s Safeguarding Children Group and he has lectured internationally on issues relating to protecting children from harm as well as recognising and responding to possible child abuse and developing processes and organisational systems to protect children at risk of significant harm. 

Professor Rowland’s research interests include development of a bespoke Emergency Department (ED) specific early warning track-and-trigger score to predict admission or discharge potential in children attending the ED as well as investigating professionals’ views on issues including mandatory legal reporting of child abuse and the development of child protection networks. 

At the Royal College of Paediatrics and Child Health, Professor Rowland is a member of an international group helping to re-write the next edition of Physical Signs of Child Sexual Abuse: an evidence based review and guideline for best practice. 

In 2014, Professor Rowland was awarded a prestigious Life Fellowship by The Winston Churchill Memorial Trust. The grant accompanying the Fellowship Award, combined with a bursary from Association of Paediatric Emergency Medicine and a Clinical Excellence Award, allowed him to travel internationally to produce ‘Living on a Railway Line’ - a report to improve the safeguarding of vulnerable children in the UK and beyond. 

The Winston Churchill Memorial Trust 

The report was commissioned by The Winston Churchill Memorial Trust with collaboration from the Association of Paediatric Emergency Medicine. The Winston Churchill Memorial Trust was established shortly after Sir Winston’s death in 1965, as his national memorial and living legacy. We carry forward his legacy by funding British citizens from all walks of life to travel overseas, to bring back knowledge and best practice for the benefit of others in their UK professions and communities. To date over 4820 Travelling Fellowships have been awarded. Applications are judged purely on project merit, and these opportunities are available to UK residents over the age of 18, of any ethnicity, religion, or gender. Successful applicants will receive an average Fellowship grant of over £6000, covering return airfare, daily living costs, insurance and travel within the countries being visited, for approximately 4-8 weeks overseas. In total 137 Fellowships were awarded in the UK in 2014, with grant awards totalling £876,540. To maximise the impact of our Fellowships we have developed partnerships with other organisations, focused on specific areas of concern and relevance for the UK today. Lessons learnt from overseas travel are effectively coordinated and disseminated, and incorporated into best practice in the UK for the benefit of others in similar communities and professions. In the ‘Medicine, Health & Patient Care’ category our partners are The Burdett Trust for Nursing, The Royal College of Nursing,  The Royal College of Physicians of Edinburgh, FoNS Centre for Nursing Innovation.