Anyone who saw the recent "60 Minutes" segment on sexual abuse of children had to be left shuddering at the story of a little girl who was allegedly being molested by her father while his ex-wife, the girl's mother, unsuccessfully sought help from the social institutions that should have protected her.

The widespread bumbling of these cases by hospitals and public agencies is something that Robert Cramer, the pioneering district attorney in Madison County, Ala., has tackled head on with measurable success.

In 1983, the county formed a sexual abuse task force of doctors, treatment experts, teachers, school officials, lawyers, prosecutors, police and social workers. "We did a reenactment for them of a case involving a 12-year-old girl whose grandmother discovered she had been sexually abused by her father and stepfather," says Cramer. "We were very critical. We wanted to illustrate to the professionals that a child couldn't survive the system as it was.

"The child had bounced from law enforcement, to social services, to the hospital, which had done the exam improperly, and on top of that they had to wait hours for it to be done." After the child entered therapy, the therapist kept telling her she didn't have to tell her story to anyone.

"The child's stepfather had admitted to everything to the protective service worker. We had done a background investigation on him that indicated he had molested 10 to 20 other young girls."

Cramer's office decided to prosecute the case, but no one explained to the child or her grandmother how the criminal justice system works. The child showed up at the DA's office for a grand jury hearing thinking the case was going to trial. "She didn't speak one word to us. The grandmother told us the child is tired of telling her story."

Ultimately, his office assigned its victim witness clerk, a woman who had been working with murder and rape victims, to go into the child's home and spend time explaining what was going on. She also explained to the child's therapist that the child's testimony could put a man who had molested numerous children away.

"After 5 months of coordination like that, the child went back and testified to the grand jury and three months later we went to trial." The stepfather was convicted and got a life sentence for sodomy, says Cramer, although the medical testimony that could have proved rape was so poor it was not introduced. The child's natural father is scheduled to be tried in December.

"After this was reenacted to the task force, even professionals who thought they had learned so much about sexual abuse looked at each other and said this is intolerable," says Cramer.

The upshot was the creation of a private, nonprofit Children's Advocacy Center in Madison County, which, by the end of January, will be set up in a house where all agency involvement with an abused child will take place, including exams by trained volunteer doctors. Special teams of protective service workers and police, who are skilled at interviewing children, will interview the child in rooms appropriate to the child's age. Further interviews will be done by that same team, rather than have a child exposed to more strangers.

The Children's Advocacy Center has been adopted by clubs, medical and civic organizations, which are raising money for it. So far, in donations and in pledges of manpower from government agencies -- aside from personnel who would regularly be assigned to these cases -- the center has raised $120,000, says Cramer.

A coordinator for child advocacy in the DA's office has developed a community education program reaching pediatricians, teachers, parents and children's clubs. A panel from his office meets regularly with doctors to educate them about what prosecutors need in court.

Two or three years ago, says Cramer, his office prosecuted 3 to 5 percent of the sexual abuse cases it reviewed. This year, protective services has taken in 125 cases, and Cramer's office has decided to prosecute 36 of them. "In the week of Dec. 3, we have 11 different children involved in 11 different cases. If somebody told me that back in 1979 I would have said they were crazy. If they'd told me we would have 11 cases in the court system in one year I'd have said they were crazy."

Whatever is going to be done about child sexual abuse nationally is going to require a complete overhaul of the way society and its institutions handle it. In Madison County, Ala. there is a model of commitment from public and private agencies that other jurisdictions would do well to follow.