Tracy Bucher T 6275720 Page
Are children’s experiences of poverty and ill health best understood as a local or as a global issue?
Statistics reveal that a quarter of all deaths in the world are of children less than five years of age, many of which are due to ill health. (UNICEF, 2001 Cited in Book 4, chapter 3 p 95) The sad fact is that improving conditions where children live would prevent many of these deaths as a considerable number of children’s healthy development is still being affected, and an even larger number experience life significantly disadvantaged due to issues relating to poverty, which makes for grim reading. These childhood experiences became a concern in the latter part of the 20th century and international charities, organisations and legislations like the United Nations Convention on the Rights of the Child in 1989, (UNCRC) for those countries who ratified to its principles were set up in response to improve the lives of children throughout the world.
I will begin by looking at two definitions of poverty, absolute, which can be found predominantly in the south, and relative, which can co-exist along with countries in the north where it is more prevalent. Using these two definitions of poverty through two examples will reveal the wide-ranging experiences children can have, one when it’s effects are not fully understood at local level, and the other example where it is. The global issue will then be addressed explaining how their organisations either hinder or help address issues relating to poverty. I will then lead into a discussion on how it links in with ill health which will lay the foundations to reveal how complex and challenging it is for local communities, countries and the wider world to respond to the plight of children. Although ill health is having an effect on children in the north relating to pollution and obesity for example, it is the south that is particularly vulnerable to diseases that are often preventable with the right intervention. It is for this reason that the examples I will use are from these areas, and will highlight the multifaceted approach that is needed in dealing with these two issues in partnership if we are ever to change children’s lives for the better worldwide.
There are communities even in the wealthiest countries of the north, where poverty can thrive. This form of poverty can mostly be defined in relative terms where children fail to benefit from what is taken for granted by the average child because the family income falls short of the average within their country. However it fails to take into account how children experience the effects of poverty, which can depend on local, and global economic or political issues, as well as the general social inequalities that can exist.
Then there is absolute poverty mostly found in countries in the south, and can be defined as children excluded to a large degree from resources that would provide them with the minimum standards of living within their particular country. The Copenhagen World Summit on Social Development in 1995 described it as ‘a condition characterised by severe deprivation of basic human needs, including food, safe drinking water, sanitation facilities, health, shelter, education and information.’ (Cited by Gordan etal 2000 in Book 4 chapter 3 p49)
An example where relative poverty can be experienced is in the United Kingdom. The government have responded by setting up initiatives backed by its commitment to the UNCRC, which states under article 27 that “parties recognise the right of every child to a standard of living adequate for the child’s physical, mental, spiritual, moral and social development.” (UNICEF 2003, cited in Book 4, chapter 2, p 80 reading A) Local authorities began to set up programmes such as Sure Start, providing services to help impoverished families with children under five. More recently there are benefits like, Child Tax and Family Working Tax Credit designed to boost incomes in line with the national average to help eradicate poverty, by the year 2020. (UK Parliament 2000 Book 4 chapter 2 p71) In theory steps like these should improve the lives of children. However in practice there are issues that aggravate this process highlighting how the effects of poverty are still not fully understood at a local level.
This is demonstrated in the video, ‘Kelly and her sisters’, who are living in Birmingham with their family in a home targeted for demolition, and have been there for 3 years. (Video 4 band 2) The damp, cramped conditions and lack of heating they have to endure are affecting their health, and general welfare. Although the family are waiting to be moved, delays by the local authorities in finding more suitable accommodation only exasperate their situation. After the girl’s father moved back into the family home after a period of separation from their mother, meant their benefits needed to be adjusted. This caused a delay in these benefits arriving on time, compounding the parent’s anxiety, and affects their ability to purchase the things they need. (Video 4 band 2 pages 159) This can put additional pressures on the children, for example Kelly’s sister Amy, talks about the effect this can have when she is teased and called names at school for what she hasn’t got, including designer trainers. (Video 4 band 3 pages 134) It is important to ‘fit in’ at school and adults may not always appreciate this aspect, as what parents and children associate with poverty are often two different things, and can also affect them differently. This is because it is more than what material processions one owns, for it is often the social status that comes with it that can cause the most damage for children. Luckily the girls have a supportive network both with family and friends, which are a protective factor in their ability to cope with adversity. (Book 4 chapter1 p19) However for other children in similar situations, who have little or no support, will not cope so well, as the government have failed to understand the need to provide services like Sure Start, to support older children. Unfortunately with the government opting to cut taxes, at the expense of securing better child welfare services, these experiences of poverty are likely to continue.
In contrast, Sub Saharan countries experience poverty in absolute terms. However one of the more wealthy countries in this continent, South Africa, has adopted a unique way of providing for its children. It has focused it’s attention on the experiences of children living this way in addition to the social inequalities that goes with it, by setting up The Children’s Budget. It puts children on the top of any agenda that is being endorsed regarding policies, and practices, that affects them. An advocate of this system, Shirley Robinson, points out how it works by evaluating and monitoring what the government is spending on children and relaying the facts to them who then ensure it provides the funds. (Cited in Book 4 chapter 2 p72) This way the equal distribution of available monies reaches even the poorest of children living in the shantytowns. This can be particularly important for the children from ethnic minorities who tend to experience multiple forms of social exclusion and deprivation. (Book 4 chapter 2 p73)
Globally, children’s experience of relative and absolute poverty is better understood, at least in the north. For example, evidence suggests the effects of it are to blame for many of the social problems today ranging from crime to low achievement in school to shortened life expectancy. The European Union is one organisation who has responded by setting specific goals to ‘make a decisive impact on the eradication of poverty’ at the turn of this century. (UNICEF Book 4 chapter 2 Reading A P81) This may help children like Kelly, but in the south there is still some way to go.
The Structural Adjustment Programmes (SAPS) enables countries to borrow money from the World Bank. However there are conditions that favour the north, the result of which can mean children’s experiences of poverty, especially in poor areas of the south, are increased causing detrimental damage to children’s all round development. Although SAPS is designed to create economic growth, the reality is very different as some governments struggle to get their economy going. Poverty can have a direct influence on ill health as the two reinforce children’s experiences of life and therefore also needs to be understood at all levels.
To promote health is difficult as it is entwined with the effects of poverty affecting not just children and their families but communities and countries too. Unlike famines after a natural disaster that makes media headlines, absolute poverty one of the root causes that affect the health of children in the South from preventable diseases like diarrhoea and respiratory infections, are not reported, yet they are among the top causes of death. (Dabis etal Book 4 chapter 3 p98) Although the World Health Organisation (WHO) has defined health as “a state of complete physical, mental and social well being, and not merely the absence of disease and infirmity” in 1992, it has been criticised as it lacks acknowledgement of the many beliefs and cultural traditions that make up our world. (Book 4 chapter 3 p99) In order to penetrate through the many health issues we face today, an understanding and basic respect for these beliefs and ways of life must therefore be addressed at local level.
Children’s experiences of ill health in the south vary depending on how it is understood locally as trust regarding medical help and advice is vital, especially in the south. The biomedical model, where the illness itself is treated with little regard to what caused it has made them wary, without the understanding from the local community children will continue to die. For example, in South Africa, statistics in 2001 revealed 1 in 9 were living with HIV and AIDS in which the hardest hit, is the black community, and this number is growing. (Video 4 band 3) Many of these seek help from traditional healers in whom they trust, which delay them receiving any medical advice that may prolong their life. However there is an even bigger problem, as a lack of resources to control the spread of this epidemic, is also having an impact on children’s experiences. Although there is a range of initiatives from radio broadcasts to free condoms to try to halt its spread, for those to late to benefit from them is quite a different story.
The government failing to understand the implications of their non-compliance in distributing vital medicines due to the high cost associated with western medicine has so far secured the fate of its children, and ultimately its future. The Treatment Action Group has challenged the government in its refusal to provide anti-retroviral drugs such as AZT to reduce a pregnant mother passing the virus onto her unborn child, but its response has been slow. Then in July 2000 Nkosi Johnson, a young boy born with HIV, also publicly challenged the government at an AIDS convention raising awareness of what is happening there. (Video 4 band 3 pages 278) For without the understanding the local government about these issues, children will continue to experience its effects through abuse, neglect, poverty, i.e. sanitation, and the stigma that sees them ostracised from their community,
In contrast Bangladesh, although one of the poorest countries in the world, has managed to reduce the effects of ill health over a ten year period. From 1990 child deaths has fallen from 136 per thousand live births to 83 according to the World Bank in 2002. (Book 4 chapter 3 p109) They have the understanding as well as the commitment to ensure mothers and children have access to the basic help and support they need to achieve good health through education, assigning 26% of the national budget to promote school enrolment and adult literacy. (Cited by UNICEF 2001 Book 4 chapter 3 p110) They acknowledge equal opportunities for women and girls this is crucial in itself, as gender equality that comes from recognising their worth and contribution can increase positive experiences for children regarding their health. “One of the most consistent findings in development policy is the correlation between levels of female education and infant mortality.” (Book 4 chapter 2 p115) However Bangladesh still has a way to go especially in the poorer communities as the example highlights in the children’s hospital in Chittogong, where demands to treat the sick, exceed their capabilities. (Audio 7 band 3) This reveals how experiences of ill health can vary within the country, depending on where you live.
Ill health has seen its profile raised to global level over the years. Campaigns like Save the Children, which underpins UNICEF as well as the WHO thesis, has secured more positive experiences for children. For example, The United Nations agreed to 7 targets to improve the health of our nation in 1990. Among these targets was to halve severe malnutrition, gain better access to education, for children and adults, and to improve sanitation associated with absolute poverty, by 2000. Although at the Millennium Summit in 2000 it was revealed the targets were not met, they are being addressed. (Book 4 chapter 3 p105) Which without the backing of the UNCRC, which states the right to enjoy, the highest attainable standard of health and access to facilities to treat and rehabilitate this may never be realised. (UNCRC cited in Book 4 chapter 3 p 94) However global pressure to reach these targets can hinder the process in some countries, as UNICEF in its book ‘We are the Children’, in 2001 points out the differences between countries regarding their economy as well as the social inequalities will remain an obstacle that will be hard to overcome as “ Chronic poverty remains the greatest obstacle to fulfilling the rights of children.” (Cited by UNICEF in Book 4 chapter 3 p108) This highlights how addressing health in isolation, just isn’t enough.
What has been understood locally and globally in light of the many challenges facing such organisations like UNICEF, and the UNCRC, is disappointing as poverty continues to seep into even the wealthiest of countries and ill health persistently threatens children’s survival. The reasons for this are complex, as my examples have highlighted through examples, as there are so many factors that can hinder any progress being made that will improve the experiences children have of these two adversities. What is apparent, are those living in the south experience poverty and ill health on a far bigger scale than the north, highlighting how the targets set internationally to tackle them will be hard to achieve locally. For although millions of lives have been saved globally from diseases like HIV, my example in South Africa reveals the flaws that exist which restrict its children from being among the success stories. As UNICEF has pointed out, local interventions already seen will never stop the death of children from preventable and treatable diseases without acknowledging the differences between cultures and improving health by including a more comprehensive package that includes improving the conditions relating to the absolute poverty these children experience. With statistics that reveal 80% of the world’s population live in the south, yet only own a quarter of the wealth according to UNICEF Human Development Report in 1997 (Book 4 chapter 2) highlights the need to gain a better understanding of these two issues, both locally and globally together if we are ever to succeed in securing children’s rights as laid out under the UNCRC and indeed for those children not protected by its laws.
Word count: 2510
References
Biersteker & Robinson, (1997) cited in Montgomery, H Burr, R. & Woodhead M. (2003) Changing Childhoods local &global. Wiley. Open University
Gordan etal, (2000) cited in Montgomery, H Burr, R. & Woodhead M. (2003) Changing Childhoods local &global. Wiley. Open University.
Montgomery H, Burr R, & Woodhead M, (2003), Changing Childhoods local & global, Book 4, Milton Keynes, The Open University
The Open University (2003c) U212 Childhood, Video 4, Band 3, ‘Children’s experiences of HIV and AIDS in South Africa,’ Wiley, The Open University.
The Open University (2003) Audio 7 Band 3 ‘Chittagong Children’s Hospital’, Wiley, The Open University
The Open University (2003c) U212 Childhood, Video 4 Band 2, ‘Kelly and her sisters,’ Wiley, The Open University..
UNICEF cited in Montgomery, H. Burr, R. & Woodhead, M. (2003) Changing Childhoods local & global. Wiley. Open University.
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