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Editorial

Dr Jai Singh Yadav

SUBSTANCE ABUSE AND STREET CHILDREN

Street children are defined as the children less than 18 year male or female who spend more time outside their home or in street, due to inadequate space of home and care. They mainly leave with lack of supervision, protection, guidance and scarcity of resource. They have minimal contact with their family, which make them more vulnerable physically as well as psychologically. The behaviors of street children not shaped because they devoid of education and care of their parents. The major threat of children defined 1 that when child involves in collection of thinks from garbage , has no permanent place to sleep, sleep in street ,escape from institution, bad/ delinquent behavior with guardians, less than 7 year of age, child has mental or psychological disorder, connection with prostitution, gambling or drugs. UNICEF estimated 100 million children were growing up on urban streets around the world, in India it was estimated 11 million1. The Indian Embassy has estimated that there are about 314,700 street children in metros such as Bombay, Calcutta, Madras, Kanpur, Bangalore and Hyderabad, around 100,000 in Delhi alone. The legal definition 2 of street children is the children affected by passive social look, exposure to delinquency on the basis of types of activities which include begging, street show, selling trivial items or other activities which is not considered positive resources for living. These children generally adapt their behaviour according to their needs and external environment. Child law2 considers child at risk, if his safety, moral, health or life is endangered and child exposed to deviance, whether through exposure to drugs, alcoholism, violence or prostitution. Outside the street these children depend on their general needs on society and they provoke these by small jab, labour work, beggaring etc.

There were many studies 3-4 reported that street children have multiple problems, in a survey among 100 street children at the New Delhi Railway Station in India revealed that 86% of boys in the age group 14 - 18 years were sexually active; however a very low number of them knew about safe sex protection and condom usage, none of them reported having ever used a condom. 65.9% of the street children lived with their families on the streets. Out of these children, 51.84% slept on the footpaths, 17.48% slept in night shelters and 30.67% slept in other places including under flyovers and bridges, railway platforms, bus stops, parks, market places. The overall incidence of physical abuse among street children, either by family members or by others or both, was 66.8% across the states. Out of this, 54.62% were boys and 45.38% were girls. On a study4 in India, 17.73% Female Street children forced to touch private parts of others body, 22.77% reported having been sexually assaulted. In other study 5 the most common substances used in street children were Gutkha (91.7%), powdered tobacco (71.1%), tobacco toothpaste (63.8%), smoking (26.6%), and alcohol (14.7%). The substance abusers used multiple substances (3.34 substances abused per adolescent). Synthetic narcotics and LSD were not used by any of the abusers. Adolescents in joint families were consuming significantly higher amounts (47.3%) as compared with their counterparts in nuclear families (38.1%). Of 163 street boys, in Mumbai 6 132 (80.98%) were substance abusers; 52 (31.9%) had been sexually abused and 87 (53.3%) had been physically abused. The most common reasons for substance abuse or the perceived functions of substance use mentioned by participants were peer pressure (62.1%), experimentation (36.3%) or to boost self-confidence (28.7%). Almost three-quarters (70 %) of all substance users wanted to quit and about 40% had tried to quit.

There are many reasons when street children start taking substances 7, 70% start due to street environment, 60% in peer presser, 50% for sleep easily, 30% for able to endure pain, violence and hunger. The majorities of these children had faced harassment or abuse (93%) by police and other street children and were sexually experience (67%). Among the sexually active 15-17-year-olds, most reported multiple partners (54%) and never using condoms (52%). In street children overlaps of HIV are at highest risk, manly in male children those have sex with other children, commercial sex workers, and injection drug users.

In study 8 of Lahore reported 40% of children having ever exchanged sex for shelter, food or entertainment than for drugs (13.5%) or money (16.7%). The Indian study 9 reported prevalence of sexually abused among non tobacco substance user was 30%. Seroprevalence of HIV was found to be 1% and STIs was 4%. The WHO formulated objectives 10 for prevention of risk factors in street children with substance abuses are

a) The identification of and collaboration with appropriate agencies, which work with street children in the communities being targeted, for the implementation of the project.

b) The establishment of a community advisory committee at each site with representation from services which work with or are in contact with street children, local welfare and other agencies involved in emergency relief, housing, education and vocational training; for local medical and other health care services; the criminal and/or juvenile justice system; the local community including the business sector; and street children themselves.

c) The development of a mechanism for establishing representative focus groups of street children and a structure within which these groups may be conducted.

d) The development of a strategic plan for the coordination of activities (including prevention, treatment and rehabilitation) directed at improving the health (in its broadest sense) and welfare of the local population of street children.

e) The formal or informal engagement of an appropriate local medical service, by the local organization, to provide primary medical care to the population of street children.

f) The development of an advocacy role for the community advisory committee with the purpose of:

Improving community attitudes towards and understanding of the problem, recognizing and tapping into sources of funding and other resources, reducing discrimination against street children influencing government policy and practice at all levels and identifying obstacles to change.

g) The development and utilization of operational research methods, as far as possible, to test the alternative methodologies of intervention.

h) The development and utilization of empowerment methodologies by local organizations where appropriate.

In a seminar of UNICEF 11 on” street a working children” recommended following points.

a) Searching of invisible children working in agriculture, small industries, and commercial prostitution, domestic and business work.

b) Multi disciplinary, multi sector approaches in informs of public sensitization,

policy development, advocacy, legislation, monitoring and evaluations.

c) Activities not should confine only up to children but in should be broaded up to their family, community, state, nation and international level.

In summary we find that street children are more venerable for trafficking, substance use, prostitution, rape, STDs and other health problems. They need specific guideline, legislation, participation of various agencies, communities, states, nations and whole countries to overcome these problems.

 

References

1.       UNICEF; State of the World’s Children 2003.

2.       Egypt Child Law. Child Law, Act No. 12/1996.

3.       Salaam Baalak Trust, ‘Health Program’ [online]. Available at: http://www.salaambaalaktrust.com/health.asp,Accessed 11 July 2009.

4.       Kacker, L, et al (2007), Study on Child Abuse: India 2007, p 38-39. Ministry of Women and Child Development, Government of India, [Online] Available at: http://wcd.nic.in/childabuse.pdf. [Accessed 19 July 2009].

5.       Lisa S, Himanshu P Acharya, Om P Panigrahi. Substance Abuse Among Adolescents in Urban Slums of Sambalpur. Indian J Community Med. 2008 October; 33(4): 265–267.

6.       Abhay M G, Quazi S Z, Lalit W, Shahbhag S, Zodpey S, Sudhakar R J. Substance abuse among street children in Mumbai. An International Interdisciplinary Journal for Research, Policy and Care, Volume 3, Issue 1, 2008.

7.       Nada KH, Suliman DA Violence, abuse, alcohol and drug use, and sexual behaviours in street children of Greater Cairo and Alexandria, Egypt. AIDS Suppl. 2010. 2:S39-44. doi: 10.1097/01.aids.0000386732.02425.d1.

8.       Vivian L Towe, Salman ul Hasan, Tariq Z, Susan G, Sherman. Street Life and Drug Risk Behaviors Associated with Exchanging Sex Among Male Street Children in Lahore, Pakistan. Adolesc Health. 2009 march 44(3); 222-224.

9.       Baishali B, Rupa M, Aiyel H. Mallick, Sekhar C and Kamalesh S. Nontobacco Substance Use, Sexual Abuse, HIV, and Sexually Transmitted Infection Among Street Children in Kolkata, India. Substance Use & Misuse August 2010, Vol. 45, No. 10, 1668-1682.

10.   WHO; Programme on Substance Abuse. July 1993 WHO/PSA/93.7

11.   UNICEF; Street and working children. Innocent Global seminar, summary report, Feb.1993.