CHILDREN LIVING IN DIFFICULT CIRCUMSTANCES-Group F Edited-1.pptx

Children living on the streets

1. Presented by GROUP F MEDICAL STUDENTS To DR. IFUNANYA EBIEPKI JULY, 2024 CHILDREN LIVING IN DIFFICULT CIRCUMSTANCES

2. EKEREKE, KUFRE VALENTINE OKPUDOH, IDONGESIT PIUS UDOFIA, EKEMINI UDEME ASUQUO, WISDOM EMMANUEL OKE, EBENEZER REUBEN AMOS, CORNILIUS NSIMA ODOEMENA, AMARACHI EYO, UBONGABASI EDEM OSAGIE, EPHRAIM NOSA GROUP F MEMBERS

3. INTRODUCTION AND DEFINITION EPIDEMIOLOGY EXAMPLES OF CHILDREN IN DIFFICULT CIRCUMSTANCES PREDISPOSING FACTORS PREVENTION CHILD RIGHT ACT CONCLUSION REFERENCES Table of contents

4. Children living under difficult circumstances is a UNICEF concept that refers to children whose families cannot provide them with adequate care, safety and protection, this also include children whose right and privileges have been violated and needs protection by the law. definition

5. INTRODUCTION A child is a person who has not attained the age of 18 years. There is no agreed definition for children in difficult circumstances. Generally, these are children who live outside the norms of mainstream society, and lack the care and protection of adults. The major causes are poverty and disruption of family support systems. The types of children who are classified as living in difficult circumstances include: working children, especially those involved in hazardous of dangerous conditions, children living on the street, children affected by conflict, such as refugees and child soldiers, children who are sexually abused or exploited (including within marriage), orphans, child carers and children in prison. Children living in difficult circumstances suffer immediate and long-term risks to their health and educational attainment, as well as their lifelong prospects.

6. Children’s right are sub-set s of human right with particular attention to the right of special protection and care afforded to minors . In 1989 convention on the right of a child defines a child as “any human being below the age of 18years. Children’s right include: Right association with both parents Human identity Right for provision of basic amenities Physical protection Food Universal state paid education Healthcare Equal protection f the child civil right Freedom from discrimination on the basis of the child's race, gender, sexual orientation, gender identity, national origin, religion, disability, colour , ethnicity and other characteristics. Children’s right

7. EPIDEMIOLOGY Accurate estimate for the number of children affected globally and children living in difficult circumstances are impossible to obtain, but around 120million alone are thought to be in some form of employment, with the , highest prevalence in Sub- saharan Africa, middle east, Asia. Epidemiology

8. Children on the street, of the street, street families Children affected by wars and conflicts Orphaned/abandoned children Adopted/fostered children Homeless children Migrant and refugee children Institutionalized children Children born to teenage parents Children with SAM Example of children living in difficult circumstances

9. Children in prostitution Children suffering from abuse Children with particular health needs/ terminal illness Children discriminated against Exploited children Example of children living in difficult circumstances

10. Street children

11. CHILDREN OF THE STREET These children reside permanently on the street and they don’t have homes or parents to go back to. They sleep on the street, commit a lot of crimes and they are vulnerable to be tools in the hands of bad influences. They have little or no education and they just want to survive. They are at risk of RTA, rape, skin infections, sexual molestations and extremes of weather conditions. Children of the street

12. CHILDREN ON THE STREET These children are there for a purpose. Example is to hawk or to sell. They have a home where they go back to and the income or returns are taken back home to their parents. There are there for a certain time and they have moral discipline and a relationship with their parents. They are not easy tools in the hands of bad influences. They are exposed to respiratory tract infections, accidents and molestation. Children on the street

13. CHILDREN OF FAMILY ON THE STREET These children live on the street with the rest of their families. They maybe displaced due to war, poverty and natural disasters. Examples, the almajeris of northern Nigeria that were displaced due to boko haram insurgency. They live a nomadic; life carrying their possessions with them Children of family on the street

14. Conflicts and emergencies around the world pose detrimental risks to the health, safety and well-being of children. There are many different kinds of conflicts and emergencies, for example, violence, armed conflicts, war and natural disasters. The lives of young children are significantly disrupted and their families have great difficulties in offering the sensitive and consistent care that young children need for their healthy development. E.g. Post traumatic stress disease seen in children living with natural disasters or chronic conflict CHILDREN IN WAR AND CONFLICT ZONES

15. Physical impact: E.g. headache, fatigue, bone pains, fractures, deformities, etc. Cognitive impact: E.g. trouble concentrating, recurring dreams and nightmares, inability to process event , attention deficit Emotional impact: E.g. depression, sadness, anger, irritability, despair, phobia, anxiety. Social impact: E.g increase conflict with family and friends, sleep problems, crying, changes in appetite, social withdrawal, refusal to go to school Impact on child development: Delay developmental milestone, poor sucking, bedwetting, inability to dress or eat without assistance,. Post-traumatic stress disorder. IMPACT ON CHILDREN LIVING IN WAR AND CONFLICT ZONES

16. Orphans and abandoned children: ORPHANS are children that enter into difficult situations due to separation from their parents/care givers either at birth or early childhood. Death of biological parent or abandonment by them leads to the child becoming an orphan. ABANDONMENT maybe due to poverty, illness of the parents, gender of the child (especially if parents desired a different gender), being an unwed mother or just being an unattractive child or a disabled child. ORPHANS AND ABANDONED CHILDREN

17. The key difference between adoption and fostering is a legal one. An adoption order ends the child’s legal relationship with their birth family. Whereas, children in foster care remains the legal responsibility of their local authority and their birth parents. FOSTER care is common in Nigeria and Africa, however, it is unregulated and unofficial . Unfortunately, children in foster care can be exposed to multiple traumas and disruptive events even before and as they transition into adulthood. This include: Adjusting to ne situation Interaction with birth family Problems in academics, relationship, physical and mental health Feeling unwanted Uncertainty of the future Lack of Attachment with foster parent FOSTERED/ADOPTED CHILDREN:

18. Fostered/adopted children: ADOPTION. Here, the caregiver has full legal rights to the child and this could be open or closed. CLOSE ADOPTION; parent giving out the child has no contact with the receiving care giver and there is no intention to reveal such in the future OPEN ADOPTION: There is a liaison to reveal the identity of the biological parents to the child when they are of an age (18years in most countries) and they have requested such. Examples of these adopted / fostered children are those born to teenage parents, orphans, children who are separated from their families due to death, divorce and those institutionalized. Some common issues faced by adopted children include: Grief Separation Loss Low self-esteem, etc FOSTERED/ADOPTED CHILDREN:

19. Homeless, migrant and refugee children: HOMELESS CHILDREN: A child who lacks a fixed, regular and adequate night time residence; and includes children who are sharing the houses of other persons due to loss of housing, economic hardship, or a similar reason; are living in motels, hotels, trailer parks, car parks or camping ground due to alternative adequate accommodations; are living in emergency or transitional shelters; are abandoned in hospitals or are awaiting foster care placement are homeless children. Homeless children can also be children who have a primary night time residence that is a public or private place not designed for or ordinarily used as a sleeping accommodation for human beings such as car parks, public spaces, abandoned building, substandard housing, bus or train stations or similar setting and migratory children who qualify as homeless. HOMELESS, MIGRANT AND REFUGEE CHILDREN

20. Job loss Domestic violence Poverty Low wages Lack of child support Physical illness Mental illness Lack of affordable housing Drug and alcohol related problems lack of transportation FACTORS CONTRIBUTING TO HOMELESSNESS

21. Children suffering from abuse Child abuse can take several forms i.e., physical, psychological, emotional, sexual abuse and child neglect. It also includes children who are being exploited like child slavery and child labor. However, neglect is the highest form of child abuse and maybe most experienced by those with physical challenges from poor backgrounds. 80% of sexual abuse is on the girl child and 20% on the male child. The offender is most likely a family member or one whom the trust. Guilt, self blame, nightmares, STDs, suicidal tendencies, stress disorders are the major effects. So it is important to tell a child the difference between a good touch and a bad touch so they can be intolerant to any form of child abuse. CHILDREN SUFFERING FROM ABUSE

22. Child migration or children in migration or mobility (sometimes more generally “children on the move”) is the movement of people aged 3-18years within or across political boarder with or without their parent or a legal guardian to another country or region. They may travel with or without legal document. They may arrive to the destination country as refugees, asylum seekers, or economic migrants MIGRANT CHILDREN

23. Economic reason Educational aspiration Natural disasters Persecution and humanitarian crisis Escape of violence Exploitation abuse or conflict REASONS FOR MIGRANTS

24. These are children who are seeking refuge status outside the country of their nationality or former habitual residence or who are considered a refugee in accordance with applicable international or domestic law and procedures whether accompanied or unaccompanied by their parents. They are minors who are separated from their families once they reach the host country or minors who decide to travel from their home countries to a foreign country without a parent or a guardian. REFUGEE CHILDREN

25. Economic reason Personal choice Force from their home or country as a result abuse, war, famine, political or religious persecution, torture and every other reasons. CAUSES OF REFUGEE CHILDREN

26. Lack of food Clean water Clothing Proper hygiene supply Vulnerable to disease and infection Trafficking Kidnapping Sexual and gender based violence Force recruitment into armed groups Exploitation Child labour , etc. PROBLEMS FACED BY REFUGEE CHILDREN

27. Children living with hiv /aids: HIV is Human Immunodeficiency Virus which predisposes a child to Acquired Immunodeficiency Syndrome (AIDS). HIV is a global threat of significance to child and adolescents emerging as a biological psychological problem because HIV is a chronic illness. These problems include: Depression Anxiety Feeling of isolation because of stigmatization Mental illnesses Physical problems include: Ear infection Pneumonia Skin diseases Blood infections Sinus Infections Decrease immunity CHILDREN LIVING WITH HIV/aids

28. According to International Labour Organization (ILO), the Term child labour is often defined as work that deprive children of their childhood, potentials and dignity that is harmful to physical and mental development. It refers to work that is mentally, physically, socially or morally dangerous and harmful to children. it also interferes with their schooling, by depriving them the opportunity to attend school; obliging them to leave school prematurely or requiring them to combine school attendance with excessively heavy work. CHILD LABOUR

29. Child labour act in Nigeria states that no child should be employed as a house help outside his/her home or family environment. No child should be employed in industrial undertaking, except work done in technical schools or seminar institutions. Any person who is found guilty of these offences is liable to a fine or imprisonment for five years or both. Child labour act in nigeria

30. Using children as street vendors, Shoe shiners Apprentice mechanics Carpenters Vulcanizes Tailors Barbers Domestic servants Types of child labour

31. The causes of child labour in Nigeria are complex and multi- facted , but poverty, lack of education and cultural norms are among the significant factors. Other factors include: Conflict and mass immigration Natural disasters and climate change Unhealthy family life Poor governance Causes of child labour

32. REASONS Children ARE IN DIFFICULT CIRCUMSTANCES: Children in orphanage homes Adopted and foster children Children living with HIV and AIDs and other chronic illnesses Children in wars and conflict Children living with illiterate or ignorant parents Children living in poverty Cultural and social beliefs Religious beliefs Lack of government laws, legislation and it's implementation that protects children's right Lack of fundings for government agencies and child protection services Lack of serious actions or punishment against parents/ caregiver who abuse their children Lack of Universal basic education Lack of Social health insurance Predisposing factors/factors that contribute to children living in difficult circumstances

33. PREVENTION Most of these circumstances to a certain degree are above human control ( like in cases of bereavement of a family member or parent/s, separation from parents and sometimes divorce , etc.) however the incidence of children living in difficult circumstances can be reduced through knowledge of the possible risk factors and certain preventive measures. Here, we are going to outline 5 levels of prevention to salvage these situations and circumstances. Preventive measures

34. PREVENTION General Health Promotion:
a) Health education through seminars, outreaches , talk shows , etc to create awareness on :
- Personal / environmental hygiene
- Nutrition
- Good health seeking behaviours - Vaccination and their role in health promotion
- Family planning services to prevent unwanted pregnancies - Maintaining good intra-family relationship Preventive measures contd.

35. PREVENTION - Gender inequality/ discrimination
- Antenatal care b) Implementation of laws / policies to ensure: - Discouragement of all forms of child abuse (including early marriage,child trafficking , etc) - Promotion of free and compulsory education for all children c) Government strategies to alleviate poverty through: - Skill acquisition programs
- Creation of jobs and employment opportunities Preventive measures contd.

36. PREVENTION Specific Preventions
a) Marriage Counseling: Through the services of religious leaders , medical doctors, relationship experts & older couples. b) Specific diseases prophylaxis against vaccine preventable diseases that could affect health ( e.g., HBV, TB , etc ). c) Parental vigilance, education and open communication. d) Adequate Nutrition: Including exclusive breastfeeding, adequate complementary feeds , balanced family diets to ensure proper growth and development . Preventive measures contd.

37. PREVENTION Early Diagnosis / Treatment
a) Screening programs to detect illnesses early
b) Early presentation for prompt diagnosis and treatment of specific diseases, infections, and injuries ( including trauma and other forms of physical & sexual abuse). Limitation of Disability
a) Adherence to prescribed treatments b) Adequate treatment of complications c) Adoption / Foster care
d) Psychotherapy / Social support Preventive measures contd.

38. PREVENTION Rehabilitation
a) Physiotherapy
b) Psychotherapy & social support for children with chronic illnesses, abuse victims and children of divorced parents. c) Special education for people with various handicaps d) Speech therapy e) Occupational therapy f) Adoption / Foster Care / Orphanage homes Preventive measures contd.

39. CONCLUSION Children living in difficult situations may not enjoy the right as enshrined in the child’s right act, hence, government, corporate bodies and institutions should as a matter of fact take up responsibilities of providing and protecting these children because most of the predisposing factors to these conditions are natural disasters. Conclusion

40. REFERENCES UNICEF official website https://www.unicef.org www.researchgate.net Oxford Textbook of Global Health of women, newborns, children and adolescents References

41. Thank you for listening!