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From Cosette to Climbié: “Progress is the aim, the ideal is the model”
  1. A N Williams
  1. Child Development Centre, Northampton General Hospital, Northampton NN1 5BD, UK; anw{at}

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In Hugo’s Les Misérables (1862), Cosette, a neglected and abused orphan is rescued from her exploitative carers by Jean Valjean who devotes his life to raising and caring for her.

This picture taken from the late nineteenth century is a timeless illustration of the exploitation and abuse of children, everywhere and at any time in history.

“The whole person of this child, her gait, her attitude, the sound of her voice, the intervals between one word and another, her looks, her silence, her least motion, expressed and uttered a single idea: fear.”1

As we read the Victoria Climbié report 140 years later, we pause and wonder whether things have really changed.

Of course we’re all more aware now, but that doesn’t make it any easier to consider, especially as the most likely scenario is another report sometime in the future on yet another child who was failed by the state.

Then we slowly realise this picture has a relevance beyond the single named child, embracing instead far too many children in the world. And whether we like it or not, all of us share some blame. One child’s unnecessary death is a tragedy; the death of millions becomes devalued to a mere statistic. The injustice of poverty in the developing world, our complaisance in the exploitation through unfair trade barriers, and the sanctioning by large multinationals of child labour (whose goods we willingly buy) are just a few examples. In the mid nineteenth century Hugo saw “the three problems of the age—the degradation of man by poverty, the ruin of woman by starvation and the dwarfing of childhood by physical and spiritual night.”

As child health professionals our role is not restricted to “our patch” but in endeavouring to improve the health of children everywhere.


Original illustration of the character Cosette by Emile Bayard (1837–91) from the novel Les Misérables by Victor Hugo. The inspiration behind the world famous theatre poster for the musical Les Misérables.


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