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HEALTH AND HUMAN RIGHTS

Preventing child exploitation on the streets in the Philippines


ore than 40% of the Philippine
population live below the
poverty level, so it is not surprising
that children are often forced by circumstances to help their family eke
out a living or fend for themselves
on the streets of Manila. Most of
these childrens parents migrated
from rural areas in the hope of finding better job opportunities in the
city, but have been confined to a life
of abject poverty by lack of education.
Street children, a term coined in
the 1980s, are children who have
been forced to work or live on the
streets. Their presence is an indication of rapid urbanisation, environmental degradation, inequitable
distribution of wealth and income,
and the breakdown of traditional
family and community values and
structures. In the Philippines,
around 30 000 street children live in
and around Manila, 70% of whom
are boys aged 716 years.
75% of the 200 000 street children in the Philippines and in many
Asian countries return home daily to
their families after working or begging on the streets, and many manage to go to school for half the day.
They work mostly as child vendors,
scavengers, beggars, helpers, labourers, and watch-your-car boys.
Around 25% actually live on the
streets as a result of being abandoned or leaving home because of
sexual or physical abuse. These children have dropped out of school and
cannot maintain contact with their
families. Some are prostituted or
otherwise sexually exploited, and
many are victims of substance
abuse.
Since 1989, Childhope Asia
Philippines has been one of many
non-governmental organisations
(NGOs) working with street children, their families, and communities. Strategies include situation
analysis, advocacy, and organisation
of local city networks, human
resource development, and direct
service programmes.
In Childhopes street-based outreach and protection programme, 22
full-time street educators work daily
with children who live on the streets
(panel). Street educators are young
people, some former street children,
who provide love and attention, protection, and referral for treatment
and services such as psychosocial
care and education. Educators also
teach children to protect themselves
against drug abuse, sexual abuse

and exploitation, sexually transmitted disease, HIV/AIDS, and physical injuries. Finally, they work on
life skills and on planning life goals,
to help children decide whether to
enter a shelter or to identify an
alternative caring situation to the
streets.
Street educators refer and escort
children to temporary shelters. In
these centres, children are helped to
regain their self-esteem with caring,
healing, teaching, and acceptance

Children are helped


to regain their self-esteem
with caring, healing,
teaching, and acceptance
shown through being treated with
unconditional love and patience.
Children also benefit from the discipline and developmental and creative opportunities offered in a
centre and can participate in informal, formal, or vocational education. Social workers make every
effort to help a child identify a family relative who could provide foster
care. In many cases, however, children need to be prepared for independent, group, or individual living.
For working street children who
live with their families, Childhope
and its sister NGO, Families and
Children for Empowerment and
Development, run a communitybased programme. Families are
helped to identify alternative opportunities for livelihood and income,
including educational support or

scholarships for children to continue


primary and secondary education
and, if feasible, tertiary education.
Community organisers and social
workers motivate and mobilise parents, children, and community leaders to develop programmes and
activities for sustaining families, preventing child abuse, and stopping
children working or living on the
streets. Participants are trained as
advocates for childrens rights and
against all forms of child abuse.
Parents are assisted through
microsavings, microcredit, and production workshops.
Finally, through family and child
counselling, as well as parent education and responsible parenthood sessions, social workers strive to help
parents and children resolve family
conflict, domestic violence, and the
causes of child abuse and family
breakdown.
The mental, emotional, and physical health of children who work and
live on the streets of cities all over the
world is a human right that has been
taken for granted. It is of the highest
urgency that health professionals in
every city all over the world recognise this need. The alternatives are
long and costly rehabilitation and
recovery services for street children
who have suffered physical, sexual,
and drug abuse. These children are
the future adults in every country in
the world.
Teresita L Silva
Childhope Asia Philippines, 1210
Peafrancia Street, Paco 1007, Manila,
Philippines
(e-mail: chap@childhope.org.ph)

Case study: Emilio


Emilio was only 10 years old when a Childhope street educator, Butch Nerja, first
met him on the streets of Manila. Emilio was surviving by scavenging and reselling
vegetables discarded by market vendors. He is the only surviving child of a father
who is in prison and a mother, to whom he is very close, who occasionally suffers
from depression.
Emilio is feisty, witty, and has strong leadership skills. At age 13 years, he was
invited by Butch to attend training for junior health workers, a project supported by
WHO. Although Emilio had finished only the first grade of primary education, he
became a very active health worker, helping to refer other street children for
medical assistance.
In 2000, aged 14 years, Emilio was referred to several shelters, but did not stay
long because the shelters were too near the streets and areas where his friends
lived. Butch referred him to Stairway Foundation, an NGO with a residential centre
on the island of Mindoro. After several months, Emilio returned to Manila to visit
his mother. He went back to scavenging and selling vegetables on Manilas
streets for 3 months, during which time he resumed his health work. After
counselling and motivation from Butch, Emilio realised that he could not help his
mother unless he received help himself, and decided to return to Stairway. Emilio
now enjoys songwriting and performing, and, earlier in 2002, took part in a
theatrical performance mounted by the children at Stairway. He has used
Stairway's tutorial services and has now gone back to school.

THE LANCET Vol 360 November 9, 2002 www.thelancet.com

1507

For personal use. Only reproduce with permission from The Lancet Publishing Group.

HEALTH AND HUMAN RIGHTS

Street children in Indonesia*


Demographic data
Age: the average age at which children had started working on the streets was 1012 years (boys) and 912 years (girls).
Working hours: only 4% of children worked fewer than 4 h a day, and less than 2% worked fewer than 2 days a week.
Work: children worked as hawkers, street singers, scavengers, shoe shiners, beggars, parking attendants, and market labourers.
Housing: 74% of boys and 83% of girls lived with their parents. The rest lived in huts or semipermanent housing such as boxes, train
wagons, and floors of malls.
Case studies
(boy, 15 years) had been living in train stations for over 3 years. Hopping on and off the train was something he did every day.
One evening he jumped off a moving train in Jatinegara station (Jakarta) and the train struck one of his feet. His left foot below the knee
was broken. He fainted and no-one brought him to the hospital. One of his friends knew a Catholic priest nearby who took care of
homeless children. The priest took him to hospital. Mansyur's left foot was amputated.
Didik (boy, 13 years) was almost asleep in the Jatinegara station when the security police caught him, accused him of having littered the
station, and ordered him to lick the floor to clean the dirt.
Aryo (boy, 12 years) was brought to a police station and accused of stealing. The police put a hot iron on his lap until he acknowledged
his crime.
12-year-old boy: He asked me to accompany him sightseeing. Then he said: 'little brother, do you like a Walkman?'. 'Oh sure, I like
that', I replied. 'Then take off your pants and tilt up your rear end' he said. I wanted that Walkman desperately, so I closed my eyes and
suddenly I felt something was inside me and it was painful. I was ashamed and in serious pain. I said 'Ouch, it hurts. Please stop!
Please do not do that to me!'. It was a terrible experience. He left without giving me the Walkman. He gave me 5000 IDR (US$05). I
learned my lessons and I won't get close to a man like that again."
13-year-old boy: "I could not refuse since he gave me meals. I let him do what he did to me sexually. It was very painful when he did it
for the first time. Now I am ok. I do not feel the pain anymore. I could even enjoy the act."
Mansyur

Irwanto (e-mail: irwanto_i@yahoo.com)


Center for Social Development Studies, Atma Jaya Catholic University, Jakarta, Indonesia
*From a demographic survey of 8035 boys and 1228 girls in 12 cities in Indonesia (Irwanto, Sanie SY, Prasadja H, et al. Internal report to Asian Development Bank, 2000).

Child murders in Central America

1508

towards crime, and the formation of a


special police unit to investigate child
murders. More than 60% of these
murders have yet to be adequately
investigatedillustrating either an
inept police force or an unwillingness
to investigate certain crimes. Of the
565 murders that have been
investigated, a third were
committed by police, a third
by vigilantes, and a third by
gang members killing their
rivals in a turf war.
Murdering homeless children, although pragmatic in
the sense of getting rid of the
problem, is hardly acceptable to most people. Casa
Alianza is pushing for the
Honduran government to
fulfill its legal obligations to
investigate the murders of
children and youths and
bring the perpetrators to justicewhether they are uniformed or not. We cannot accept that
any children, anywhere in the world,
are disposable or so-called throw
aways. Those of us who have the privilege to live in a democracy must call
upon our elected officals and government leaders to ask the Honduran
authorities to stop the slaughter of
these children.
David Parker

In Honduras, 69 children and


old, hungry and tired, 15-yearyouths younger than 23 years were
old Alejandra finally found a
murdered in September 2002bringplace to sleep on the flat roof of a
ing the total killed since January,
small shop in Guatemala City.
1998, to 1412 (data from Casa
Abandoned by her family, violated by
Alianza legal aid programme).
her stepfather, beaten by the police,
Firearms are the most common
and raped by adults, sleep was the
only peace she could find.
But it was shortlived. As
morning broke, two unidentified men walked on a bluff
overlooking where the girl
slept and, lifting two huge
slabs of concrete, threw them
down at her 4 m below,
crushing her skull. For what
reason we shall never know.
The tens of thousands of
street children like Alejandra
in Central America deserve a
better futurebut they also
deserve a better present. In
this region, people who kill
street children can literally Street child vending on a beach in Mexico
get away with murder.
weapon, but in a particularly grueWhether they are people who kill chilsome turn, on Aug 13, two 18-yeardren for their amusement, police who
olds,
Rembar
Molina
and
murder children to clean the streets of
Jamin Lopez, were murdered in what
crime, or individuals who criminalise
seems to have been a satanic ritual.
poverty and adolescents, the results
The killers dismembered the youths
are the same. Death by violence
bodies and scattered bits of them
(excluding traffic accidents) is now
around the capital of Tegucigalpa.
the leading cause of death of 1525The numbers of murders of chilyear olds in Central Americamurdren and youths in Honduras conder has become a significant social
tinue to grow despite the formation of
health problem. In some districts of
a high level commission, a presidenHonduras, 54% of deaths in this age
tial campaign of zero tolerance
group are homicides.

Bruce Harris
Casa Alianza, Latin American Programmes
(e-mail: bruce@casa-alianza.org)

THE LANCET Vol 360 November 9, 2002 www.thelancet.com

For personal use. Only reproduce with permission from The Lancet Publishing Group.

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