Police have called it a case of severe abuse, but no arrests have been made.

Providers of social services say it is increasingly common for children to be left with aunts, grandparents and other relatives while their parents struggle with problems. The practice is in keeping with Hawai'i's cherished hanai tradition, and provides an important family-based safety net for many children.

Authorities have not said drugs were involved with the Puna abuse case, but in general, rising use of crystal methamphetamine in recent years has left many Hawai'i parents unable to hold their households together, service providers said.

"A lot of people who go out and are using drugs and their lives are in a shambles and so forth, they may leave these children with family members," said Angela Kalani, West Hawai'i local coordinator for the Coordinated Rural Community Response project of Turning Point for Families.

If they are under school age, and no one files to collect welfare benefits on their behalf, these children may be nearly invisible to the state child welfare system, Kalani said. In fact, some families who are willing and able to care for another child without state assistance may not want government involvement for a variety of reasons.

One Windward O'ahu resident said she has been helping care for her cousin's daughter since the child was an infant suffering from methamphetamine exposure. The woman is not being named to protect the child's identity. The woman said her own mother took in the baby, although the child's mother briefly regained custody, only to drop her off again at the Windward home a year later and never come back.

The woman's family didn't report the arrangement to the state until the child was 2 and needed medical attention for a bladder infection. They were unable to get treatment because they were not the legal guardians, so the woman said the family contacted Child Welfare Services to report the girl had been abandoned.

The woman's family then became the child's foster family, and the woman's mother adopted the girl when she was 6. She is now 10.

The woman said these kinds of arrangements are common among her acquaintances and members of her extended family.

"There are just a lot with grandmothers, with uncles, with aunties, and it's not legally reported that they are with somebody else," she said. "These kids are taken care of — well taken care of. It's better (than foster care), I feel. That's what I have to give my family, my cousins — a hand. That's the best thing they could ever do is to go ahead and give the children to the grandma, their uncles or whatever because they're on drugs."

The 2000 census showed there were about 55,000 children in Hawai'i living in households headed by adults who are not their parents. About 37,500 were living with grandparents and more than 10,000 with other relatives, although in some of these cases the parents may be present in the home.

Approximately 5,500 were living with adults who were not related to them at all, the census said.

In testimony before the House Health and Human Services committees earlier this month, Carole Mulford of the Grandparents Raising Grandchildren Coalition said many grandparents who take in their children's children fear Child Welfare Services.

"They are afraid the children will be removed from the home or have to declare that their own child is an unfit parent," Mulford said in written testimony. Many grandparents in that situation do not want to alienate their children by interfering with their parental rights, she said.

In other cases, absent parents may be illegally collecting state welfare benefits meant to support their children.

The Windward O'ahu woman and Turning Point's Kalani said relatives may be reluctant to blow the whistle on another family member by reporting that the child and parent no longer live together.

Mary Hyslop, program director of the YMCA Neighborhood Place of Puna, said the 'Ainaloa case is probably extreme. Most children in similar situations end up with relatives, she said.

Of the 160 families served by her program, Hyslop said she is not familiar with a single case in which a child has gone from house to house where there are no relatives.

In cases where a child is adrift, someone needs to call the state to report abandonment, she said.

"I know people around the 'Ainaloa area, around that ('Ainaloa Estates) house, are frustrated," Hyslop said. "They don't want it to ever happen again, and they don't know what to do."

Schools are a critical area from which authorities may obtain information about such children, and the Puna girl was absent from Keonepoko School for about a month before she was hospitalized. She had enrolled earlier in the school year, but never returned after the Christmas break.

Keonepoko principal Kathleen Romero said her staff contacted the girl's caregiver several times to learn why she was absent, and were told the 10-year-old was receiving medical care. Romero said she could not be more specific, but said she believes that the school acted appropriately.

"As long as we have parent contact or, in this case, caregiver contact, we think we were doing what we had to do," Romero said.

State Department of Education spokeswoman Sandra Goya said school officials can file a complaint to summon the child and parents or guardians to Family Court if a student is consistently absent or if there is a suspicion something is amiss.

At what point such a complaint is filed is left to the discretion of school officials, Goya said.

"Every case is unique, and each case is evaluated by school officials to determine if contacting other agencies may or may not be appropriate," she said.

Hyslop said Puna schools have called her agency to ask that it check on children who have been absent for long periods of time.

Lydia Hemmings, executive director of the nonprofit Blueprint for Change, said the school system is "on the front line" because it is one of the few places where children who need help can be detected. That is one reason why expanded early childhood education programs are so important, she said.

"We have identified for a long time this issue of kids disappearing from the school system and no way to track them after they disappear," she said.

A number of social service providers expressed surprise that none of the adults who had contact with the Puna girl decided to call the authorities to report what was happening.

"It's a great question: What are we supposed to be doing for our community's children, and what's the line?" said Nanci Kreidman, executive director of the Domestic Violence Clearinghouse and Legal Hotline. "When does it no longer become my business or when is it always my business?"