By Rhonda Bartle

Robin Fancourt at home in New Plymouth: Image Puke Ariki Pictorial Collection.

It's summer. High on a grassy plateau overlooking the city, a rabbit hops around the edges of a well-groomed lawn next to a prized stone carving of a lizard hugging a rock.

It's sanctuary here at Robin Fancourt's home, and one she must have welcomed at times as a respite from her job.

Dr Robin Fancourt is a paediatrician with a special interest in abused, neglected and disadvantaged children.

She was President of Doctors for Sexual Abuse Care, and the inaugural chairperson of Children's Agenda, a national organisation providing advocacy for children that she helped found.

She was also an executive member of the council for International Society for the Prevention of Child Abuse and Neglect.

In 2003, Fancourt was awarded the Companion of the New Zealand Order of Merit (CNZM) for her services to children - the fourth highest award that can be made in this country.

Impressive credentials? You bet, and ones that cannot fail to register when you imagine more than 30 years as a leading light in the specialist treatment of damaged children.

A long line of medical people

Born in Dunedin, Fancourt has lived in New Plymouth since the age of four. She comes from a long line of medicos - her father was a pathologist and two uncles were radiologists.

A brother, Matthew Allen, is a New Plymouth GP. Husband Michael works as a surgeon at New Plymouth hospital and two of Fancourt's three children have gone into medicine.

Robin and Michael met as med students and married in 1968. Later, in England, Fancourt became interested in maltreated children.

"When Michael and I were doing our post graduate degrees, we worked in London. I had a very, very good position in Hammersmith Hospital but no one was really interested in these neglected children. They just dismissed them. I started getting a lot of referrals."

Back in New Zealand at Blenheim hospital, where her profound care and interest became apparent, she began to see such children as out-patients.

"I took them down to my room and though they were hospital patients, I never charged them. I saw so many of these children in two years. I decided I needed to do something about it," she says.

"The worst group were my own professionals. They would just say, 'For God's sake, how can you undo it? It's all social, it's all family. Boy did I get mad."

Passion for the patients

Despite her small stature and tiny frame, it's not difficult imagining Fancourt getting all fired up over an apparent lack of sympathy, of apathy. Passion still shines from her eyes.

The turning point came when she read two papers by Dr Bruce Perry, a paediatrician in Houston, Texas, who had produced unequivocal scientific evidence to back up a theory about the effect of abuse on the brain development of children.

Perry proved to the world that the time between birth and three years old is crucial for the shaping of an infant's brain.

Fancourt's face lights up when she relates how learning this changed not only her life, but the lives of some New Zealand children.

"When I read his articles I was so thrilled. I wrote to him and gathered some money together and asked if I could go and see him. He wrote back, 'Yes, come by all means.'

"Then I came back and started talking to anyone who would listen," Fancourt says.

The Brainwave Trust

The Brainwave Trust began in 1996, after Fancourt spent many weeks with Perry, learning how badly the infant brain is affected by fear and neglect in the primary years.

Eventually, Fancourt took to the road, making presentations all around the country in an attempt to educate people about the terrible damage inflicted on children, often by their own parents.

Being CEO of a congress put on for the International Society for the Prevention of Child Abuse and Neglect (ISPCAN) gave her the chance to bring in guest speakers. She brought in Perry who gave a powerful presentation.

"He knows everything about what he's saying to the audience. He translates any information into words people can understand, which is absolutely sensible, don't you think?"

The Brainwave message is simple: It's the day to day experiences of babies and toddlers that orchestrate the development of their brains.

Infants raised in a safe, nurturing environment make crucial cell connections, with the most progress made in the first three years.

Neural systems react when a child suffers traumatic experiences, and that trauma can alter a child's brain, producing terrible lifelong effects.

Brainy Babies

In 2000, Fancourt published her ground-breaking book Brainy Babies, which she wrote in an added attempt to get the message through.

Now considered essential reading for all parents and people working with young children, it takes the reader on a journey from conception through the early years.

Its aim is to unravel the mysterious process of how babies learn, and cope with life around them.

In it she writes: "A new-born baby is cuddled and talked to; a father reads to his young daughter; a sister plays with her small brother. Unseen, a hidden miracle is at work.

Instantly thousands of cells in these small children's growing brains are stimulated and respond."

While fruit flies have 100,000 neurones, mice have five million, a monkey 10 billion, a human has 100 billion and most of the work connecting them is done intuitively by parents before that child is three.

Persistently high levels of cortisol released through stress, interfere with all the body's main functions, like the metabolism and immune system, but more terrible is that it affects the forming brain.

Fear and flight mechanisms

As Fancourt explains, "What the abused child's brain is doing is adapting to the situation they are in at home. They switch off the cerebral cortex, they can't think or listen or do anything normal. They have no ability to make social contacts.

"They are totally in this area all the time, watching for non-verbal clues. It might be the sound of a father's voice when he comes home drunk, knowing that means he will attack their mother. Or just a certain look which means a bashing.

The child's mind is focussed solely on this and on fear and danger. They cannot participate in life."

A child's whole existence can be spent poised in fear, ready for flight. And while much of the damage is irreparable, Fancourt believes there is always room for hope. Though difficult to achieve, ultimately changes can be made.

"Our aim is to ensure every child born in this country gets their needs attended to, that makes them become confident and caring as adults. It's possible, because everybody in New Zealand who hears the information can't help but be affected by it.

"A few people will be very angry because they think they were wonderful parents and they weren't. But that doesn't matter. We say come and talk to us afterwards and we'll help."

A life of commitment to damaged children: Image Puke Ariki Pictorial Collection.

An unwelcome diagnosis

Sitting on her sofa at home Fancourt talks in a slow precise way. Diagnosed 18 years ago with an oligodendroglioma in the front lobe area behind her forehead, she was given four years to live.

More than a decade and a half later, she is still here, though the tumour has come back with a vengeance.

These days Fancourt must rely on a walking frame to get around. She puts up with short-term memory loss and tiredness.

The irony of a woman involved with brain studies being debilitated by a brain tumour doesn't escape her.

"Of course, it's ironic," she smiles. "Originally it was not such a terrible thing. When I was diagnosed, I remained positive about my survival."

These days, though, reality bites. She misses the writing, the public presentations, but until it's over, she'll go fighting all the way.

"I was treated by doctors, all of whom were interested in showing me the physical changes, nothing to do with my spiritual or emotional wellbeing. I don't know how you can do that, do you?

"I mean, surely, when your brain is your major organ in your body and it controls everything you do, then you have to put effort into ensuring the mental health of your patient."

And it's this way of thinking, of course, that has made Fancourt such a committed children's advocate. Though she believes the state of our nation's children is 'not good' she holds steady hope for the future.

"Yes, Brainwave is in good hands. We have some wonderful, wonderful people on the kids' side, child-orientated people. We struggled for quite a long while, trying to set it up, but now it's really strong."