Results revealed that the children had a median age of under 7 years. Abuse was confirmed in 389 children, of whom 160 had experienced physical abuse and 229 had experienced sexual abuse. Abuse was suspected and not confirmed in 114 children. Half the children came to the hospital outside normal working hours. Eighty-one percent of the children less than 5 years of age were seen in the trauma unit by surgical residents with minimal pediatric training. One hundred thirty-four of the children were Xhosa speaking, while only one social worker and no medical staff could speak Xhosa. Pediatric residents were involved in the care of less than 2 percent of the children. Findings indicate that the management of child abuse requires a significant commitment; an appropriate staff allocation is essential. Children should be seen by the staff with the most expertise. The staff allocation must take into account the needs for education, training, and audit as well as service provision. Tables and 13 references (Author abstract modified)