Refugee children,Street children,Slum children, Children of Migrant workers, orphans, children with HIV/AIDS,Trafficked children-Issues and problems-causes

2. We will be discussing on issues
faced by…

3. • A refugee may be person who flee from his/her
country out of fear of death and persecution due their
race, religion, nationality, or membership of particular
group.
• A child refugee is a child who crosses international
borders and has specific rights.
• India is a great role model for other countries in
taking care of the refugees, despite of having the
world’s 2nd largest population (Antonio

4. • An amendment in the India’s Citizenship Act seeks to
provide citizenship to minorities in neighbouring countries,
even if they don’t have essential documents.
• Thousands of Hindus, Sikhs, Christians, Parsis, Jains,
Buddhists enter India without valid documents after facing
religious persecution in countries like Pakistan,
Bangladesh, and Afghanistan -Among them are children
fleeing their homelands with their parents or caretakers, in
hope of a better life.
• Based on the rights under CRC, Article 22 –Refugee
children have the right to special protection and help.

5. Entry into India for most refugee is done keeping with
international principles of protection and non –
refoulement
Work permits –employment in informal sector without
any objection from the administration-often exploited.
Detention-
• Face many problems that have to be treated with due
sensitivity, care and caution by the concerned
authorities.
• Refugee children between age of 15-18 yrs and those
who has been detained for non- possession of valid
documents face difficulties as their residential permits
are linked with parent’s permit
10/21/2017

6. Lack of resources-Face difficulty in getting
 Food
 Shelter- a safe place to live
 Education
 ‘The roads are potholed and there are no streetlights
and stench of garbage hangs in the air’(Hindustan
times,Sept.2015)
 They often live on railway station platforms and open
fields.10/21/2017

7. Lack of medical aid
While in detention the refugee may be suffering from
some physical ailments requiring immediate medical
attention- Often they don’t get enough medical care.
 Leaving home has a profound physical, emotional and
psychological impact on children affects mental and
physical development
 child born to a refugee mother (while at refugee camp)
 undernourished

8.  Unhygienic and poor sanitary condition in camps
Waterborne disease infant mortality rate increases
 Face threats from insurgents who try to recruit them.
 Young girls victims of rape  STD and HIV
 Many girls are taken to prostitution (UNICEF,1996;
UNHCR,1997)
10/21/2017

9. • “Any girl or boy… for whom the street (in the widest
sense of the word including unoccupied dwellings,
waste lands, etc.) has become his/her habitual
abode and/or source of livelihood, and who is
inadequately protected, supervised, or directs by
responsible adults”(UNICEF)
• India has an estimated no.of 1 million or more street
children in :New Delhi, Kolkata and Mumbai.
• Female street children are sometimes called–
‘Gamines’
10/21/2017

10. Causes of streetism
• Often related to
– domestic, economic or
social disruption
including poverty,
breakdown of homes
and/or families;
– political unrest
– sexual/physical/emotiona
l abuse
– domestic violence
– Internet predators
– Begging syndicates
– Mental health problems10/21/2017

11. • Street working children and street living children and
children at risk of coming to the streets indulge in
delinquent behaviours, are aggressive than other
children.(Ferguson,2012)
• Some become withdrawn/ distractible, hyperactive
and have night terrors
• May show submissiveness, aggressiveness,
insecurity, sadistic tendencies, shyness,
stubbornness and no –compliance (Symonds,1993)
10/21/2017

12. Lack of adequate nutrition -They usually get some
food to eat  don’t have a nutritious diet Anemia,
malnutrition and vitamin deficiencies..
No proper education
Homelessness –
 face difficulty to find shelter
 Vulnerable to all range of weather conditions
 Suffer physiological homelessness and
psychological homelessness because they have ‘no
where to belong10/21/2017

13. Poverty
 Prime cause of streetism.
 Poverty in family makes them forced to sacrifice
education and training.
 About 37,059 children live in streets of
Mumbai(TISS, Nov 2013-2013)
 65% live with familes in temporary structures
 70% were boys and 30% were girls
 2 out f 5 children witnessed physical,verbal or sexual
abuse,torture and forced starvation
 24% of school going children- illeterate
 78% are unaware of the possibilities for any assistance
from police,Govt, or NGO10/21/2017

14. Health problems
 Live in atmospheres of
continued physical and
mental strain.
 Some of them
rummage through
garbage to find foods
 Some go hungry for
days drinking water or
taking drugs to
diminish their prangs10/21/2017

15. Insecurity
 Many of them do not
have guardians, family,
home
 They fight for themselves
and against
 Often harassed by
police, employers, local
criminals.
 Insecurity may be a
reason for which street
children exhibit
Substance abuse,
Delinquency &
criminal behaviour-
Many resort to
psychoactive substances
(alcohol, illegal drugs)to
escape from traumatic past
& daily issues
Anti-social elements hire
them for criminal activities

16. 10/21/2017
Exploitation
 Vulnerable to employer’s
exploitation who make
profit out of them
 They lack bargaining
skillfor fair pay/to fight for
their rights
 Girl children-faces sexual
abuse
Child Labour
 Many engage in rag
picking, collecting
firewood, dyeing,
begging, prostitution and
domestic labour
 Suffer from exhaustion,
Injury , exposure to
dangerous chemicals

17. • Children growing up in dirty, unhygienic cluster of
impoverished areas with long lines of people
crowding around a solitary municipal water tap
,bowling babies literally left on street corners to fend
themselves and endless cries and found voices
emanating from various corners
• There are 13.7 million slum households across 63%
of Indian towns(Census,2011)
• More than 8 million children below 6 yrs live in
49000 slums across India
10/21/2017

18. Improper hygiene and sanitation-Open defecation
and ineffective drainage system Diarrhea
Low literacy levels-low education-more vulnerable;
– unable to get access to nearby schools due to
poor social acceptance
– Slum children who are rag pickers have higher
school dropout
Traditional customs- women remain unaware of the
health information and follow unhealthy practices
affecting child health- homedeliveries(by unskilled
person)-neglect of immunization10/21/2017

19. 10/21/2017
Child labour-
• Starts to work at a very early age –no education
• Engage in rag picking, selling newspapers
• Risk of being exploited is very high

20. • Migrants are people who
move to various parts of the
country to earn livelihood
• India has about 400 million
migrants-children
accompany the migrant
workers
• Approx 15 million child
migrants are there in10/21/2017

21. 10/21/2017
Most children are forced to leave schools - there are
no institutional arrangement at home for their
education.
They lack healthcare, safety and wellbeing
They get inducted into employment or are left
unattended/becomes victims of trafficking, as there
are no facilities to meet their specific developmental
needs
Older children-accompany parents –become a part

22. Girls are engaged in domestic chores -fetching water,
fuel wood and taking care of the siblings.
Local administration doesn’t include children of migrant
workers to provide basic entitlement to health,
education, sanitation and hygiene and other referral
services available through crèches, schools, local
PHCs and hospitals
Lactating mothers are deprived of breastfeeding breaks
at worksites and often one of them take care of all
toddlers on a rotation basis, losing the wage of that
particular day
10/21/2017

23. 10/21/2017
Children of age group 12 years and above are
accompanied by their families
middlemen/contractors give them fake assurances
of food, job and good education- once they reach
the new area ,children are abused and exploited.
Adolescent girls whose parents are migrant workers
–forced to do domestic work and are prone to
sexual abuse
Exposed to diseases and disability

24. • An orphan is a child under 18
years of age who has lost one or
both parent to any cause of death
• Nearly 140 million orphans are there
globally
• 15.1 million have lost both parents
• Majority of orphans are living with a
surviving parent, grandparent or
other family members

25. Bereavement
• children are grieved by the loss of their parents
• Fail to understand the finality of the death and
sometimes continue to grieve.
• This prevents them from recovery of the loss
(Brodzinsky et.al 1986)
• High risk of growing up with negative emotions like
anger and depression
10/21/2017

26. Social changes
– May involve a shift from middle/upper class urban
homes to a poor rural area/relative’s home
– May involve separation from siblings
– Educational facilities, fee payment etc will be in
difficulty
– Those who doesn’t have any one to take care of,
forced to live on their own constituting Child headed
family.
– Creates psychological problems-anxiety,depression,
confusion and behavioural disorders-may become
frustrated and fearful.
10/21/2017

27. Orphan children are often taken care of until 18 yrs.
Then they have to live on their own. may lack
direction– face scarcity of resources, job
opportunites etc.
Quality of education is poor.lack infrastructures
and good teachers.
10/21/2017

28. 10/21/2017

29. • HIV/AIDS have a high impact on individuals
• India ranks as the 3rd largest number of people living
with HIV in the world.
• Globally every minute, a baby is born with HIV/AIDS,
passed on from mother during pregnancy/ delivery
(UNICEF UK,2010)
• Indian Govt. has estimated that 3.5% of the total HIV
+ve individuals , are children <15yrs
of age (The World Bank Speakers Bureau ,2015)
10/21/2017

30. PEDIATRICS
HIV/AIDS-
CHALLENGES
Increasingly
serious
illness
Psychosocial
distress
Death of
parents
Economic
problems
Problems
with
inheritance
Withdrawal
from school
Nutrition,
shelter and
material
needs
Reduced
access to
health care
services
Exploitation
for sex,child
labour
Increased
vulnerability
to other
diseases.
10/21/2017 ***Moti & Mamatha,2012

31. Neuro developmental issues
– Researches on CNS manifestations of HIV/AIDS
suggests that 40-90% of infected children had
neurological/neurodevelopmental delays
– Severity depends on the severity of the disease
– Encephalopathy are often seen
– Delayed developmental milestones and motor
developmental skills10/21/2017

32. 10/21/2017
Emotional and Behavioural issues
– Shows psychiatric problems like
depression,anxiety and feeling of isolation
– Perinatally infected children show about 55-61%
of having psychiatric disorders.
– They often show ADHD, conduct disorders and
Oppositional defiant disorders and mood
disorders

33. Stigma, Secrecy & Disclosure
• Illness is kept as a secret.
• Child & his family may be socially
isolated/withdrawn
• Disclosures forces parents to confront
responsibility to acknowledge negatively
sanctioned behaviour related to sexual
activity/substance abuse Parents
unable to tolerate ,withdraw from kids and
deny illness
• Fear, anger, blame and stigmatization
from family, friends and society10/21/2017

34. Adolescent issues
– Faces challenged in normal development,
sexuality ,and desire to fit or to be normal
– Face problems in managing their own health,
disclosing to friends and significant others and in
making healthy sexual choices.
– As HIV infected adolescent become sexually
active-supportive management of complex issues
should be provided.10/21/2017

35. Death and Bereavement
• Confront the physical and mental decline associated
with AIDS
• Family members often find it difficult to communicate
with the children about the issues related to
prognosis and death.
• Find difficulty in understanding the chance for their
own possible death.
• Reactions can range from unawareness to
increasing awareness and anxiety in elementary age
period to major existential conflicts in teenagers
10/21/2017

36. Children with HIV/AIDS often drop out from school
Infections in parents may make them to earn for the
family
Many are orphaned and are highly exposed to
abuse, neglect and exploitation
Do not receive necessary treatment and medical
care
10/21/2017

37. • Trafficking children is a form of human trafficking
and is defined as
“Recruitment, transportation, transfer, harbouring,
and/or receipt” of a child for the purpose of
exploitation(United Nations,2000)
• Trafficking violates a child’s right to grow up in family
environment and thus exposes him/her into lots of
danger including violence and abuse.
10/21/2017

38. • Intrastate and inter state trafficking are common in
states like Rajasthan, Assam, Meghalaya, Bihar,
Uttar Pradesh, Andhra Pradesh, Tamil Nadu ,
Maharashtra etc.(www.childline.org)
• Over 40,000 children are reported missing every
year and over 11,000 remain untraced.(NMHRC of
India )
• Children from various states are brought to kerala
by train- often for sex tourism and pornography
10/21/2017

39. • Trafficking has psychological, physiological,
emotional and traumatic consequences
• Trafficking is related to HIV/AIDS
– As the no. of HIV/AIDS increases –no. of
trafficked children increases increased demand
for sex
– Young girls are more vulnerable –biologically and
physically chance of getting HIV/AIDS and they
lack of power to negotiate for condom
• Often girls are forced to have sex with multiple
partners-victims of injuries (caused by violence
during sex against their will)Increases vulnerability
10/21/2017

40. • Young boys are trafficked for work as ‘bonded
labourer’ in industries like coal, brick kilns, handloom
and embroidery, rice mills and agriculture –
– They are made to work up to 16 hrs/day in return
of subsistence food and very low/no wages-
often sexually exploited by their owners and are
beaten or tortured in cases of non- compliance.
• India is a transit point for young boys who are sent
to Dubai and other middle east countries for camel
racing.-sexually exploited and work are bonded
labourers
10/21/2017

41. • Psychological effects- trauma associated with trafficking is
high – if left unaddressed, can undermine victim’s recovery
and potentially contribute to vulnerability to re- victimization
• Traffickers use psychological manipulations and coercive
methods to maintain control over their victims and to make
their escape virtually impossible-
– sexual and psychological violence,
– isolation;
– dependence on drugs/alcohol,
– controlled access to food & water and
– monitoring through cameras, weapons, and dogs (
Zimmerman et. al ,2003)

42. • Prolonged exposure to abuse and torture –alters
behaviours, cognitive functioning and self concept
• Living in constant fear- creates feeling of isolation,
lack of control, low self esteem, self respect,
depression, anxiety, suicidal ideation, insomnia,
paranoia, dreams/ nightmares about being
abused/attacked, loss of appetite
• Have a feeling of disgust and shame,
worthlessness, numbness, attempts to self injury by
cutting, drug overdoses etc10/21/2017