STREET CHILDREN: A GLOBAL DISGRACE

HEARING BEFORE THE SELECT COMMITTEE ON HUNGER HOUSE OF REPRESENTATIVES ONE HUNDRED SECOND CONGRESS

FIRST SESSION

HEARING HELD IN WASHINGTON, DC, NOVEMBER 7, 1991

Serial No. 102- 17

Printed for the use of the Select Committee on Hunger

U.S. GOVERNMENT PRINTING OFFICE 51 - 244 "" WASHINGTON : 1992

For sal e by the U.S. Government Printing Office Superintendent of Document s, Congre ssional Sales Office, Washington, DC 20402 ISBN 0-16-038355-2 SELECT COMMI'ITEE ON HUNGER TONY P. HALL, Ohio, Chairman LEONE. PANETTA, California BILL EMERSON, Missouri VIC FAZIO, California Vice Chairman PETER H. KOSTMAYER, Pennsylvania MARGE ROUKEMA, New Jersey BYRON L. DORGAN, North Dakota SID MORRISON, Washington BOB CARR, Michigan BENJAMIN A. GILMAN, New York TIMOTHY J . PENNY, Minnesota ROBERT F. (Bob) SMITH, Oregon GARY L. ACKERMAN, New York DOUG BEREUTER, Nebraska MIKE ESPY, Mississippi FREDERICK S. UPTON, Michigan FLOYD H. FLAKE, New York DUNCAN HUNTER, California ELIZABETH J. PATTERSON, South Carolina FRANK R. WOLF, Virginia ALBERT G. BUSTAMANTE, Texas CHRISTOPHER H. SMITH, New Jersey MICHAEL R. McNULTY, New York WAYNE T. GILCHREST, Maryland ENI F.H. FALEOMAVAEGA, American J . DENNIS HASTERT, Illinois Samoa ELIOT L. ENGEL, New York LES AuCOIN, Oregon ALAN WHEAT, Missouri JILL L. LONG, Indiana MIKE SYNAR, Oklahoma

MARTIN S. RENDON, Staff Director BARBARA EARMAN, Minority Staff Director

(II) CONTENTS

Page Hearing held in Washington, DC, November 7, 1991 ...... 1 ,, Statement of: Eme_rson, . Hon. Bill, a Representative in Congress from the State of M1ssoun...... 2 Engebak, Per, Central American Representative, UNICEF ...... 11 Gilman, Hon. Benjamin A. , a Representative in Congress from State of New York...... 3 Hall, Hon. Tony P., a Representative in Congress from the State of Ohio... 1 Hastert, Hon. J. Dennis, a Representative in Congress from the State of Illinois...... 30 Kaminsky, Dr. Donald, Executive Director, Project Alternatives...... 8 Palacios, Carlos, Former "Street Child"...... 4 Rocky, Marilyn, Regional Director, Childhope ...... 5 Prepared statements, letters, supplemental material, et cetera: Emerson, Hon. Bill, a Representative in Congress from the State of Missouri: Questions Submitted to Mr. Per Engeback...... 32 Questions Submitted to Dr. Donald Kaminsky...... 34 Questions Submitted to Carlos Palacios...... 37 Questions Submitted to Marilyn Rocky ...... 38 Engebak, Per, Central American Representative, UNICEF, Prepared statement...... 43 Fact Sheet on Street Children, Select Committee on Hunger...... 53 Hall, Hon. Tony P., a Representative in Congress from the State of Ohio: Questions Submitted to Mr. Per Engeback...... 55 Questions Submitted to Dr. Donald Kaminsky...... 57 Questions Submitted to Carlos Palacios...... 60 Questions Submitted to Marilyn Rocky...... 61 Kaminsky, Dr. Donald, Executive Director, Project Alternatives, Pre- pared statement...... 64 Killing the Children of the Third World, Washington Post, April 21, 1991, Article by Lori Heise ...... 76 Lynching Increases in Brazil's Shantytowns, November 3, 1991, New York Times, Article by James Brooke...... 77 Rocky, Marilyn, National Director, CHILDHOPE USA, Inc., Prepared statement ...... 78 Third World Children, Washington Post, Supplemental material ...... 93 Williams, Aaron, Deputy Assistant Administrator, Latin America and the Caribbean Bureau, Agency for International Development, Prepared statement...... 94

(III)

STREET CHILDREN: A GLOBAL DISGRACE

THURSDAY, NOVEMBER 7, 1991 HOUSE OF REPRESENTATIVES, SELECT COMMITTEE ON HUNGER Washington, D. C. The Committee met, pursuant to call, at 9:30 a.m., in Room B- 318, Rayburn House Office Building, Hon. Tony P. Hall [Chairman of the committee] presiding. Members present: Representatives Hall, Long, Emerson, Gilman, Gilchrest and Hastert. OPENING STATEMENT OF HON. TONY P. HALL, A REPRESENTATIVE IN CONGRESS FROM THE STATE OF OHIO The CHAIRMAN. Good morning. Today the Select Committee on Hunger will focus on the issue of street children. This is a problem of devastating proportion that demands our immediate attention. One hundred million children between the ages of four to 15 live and work on the streets of the developing world. Twenty-five mil­ lion of these children are completely homeless. They sleep under the bridges and in dark alleys and shanty towns of the cities of the developing world. These children are often hungry. They are prone to disease, drug abuse, sexual exploitation and even murder. They are without ade­ quate health care or education. The plight of these 100 million street children is a direct result of poverty. In the 1980's, debt, poverty increased in the developing world. It has been characterized as the lost decade. The lost decade of the 1980's may create a lost generation in the 1990's. The problems faced by these street children have not been ac­ knowledged or adequately addressed by the international communi­ ty. These children fall through the cracks of most assistance pro­ grams. We have survival programs which provide assistance for children from birth to five years of age. There are programs for refugees es­ caping war, but there are no U.S. programs directly focused on the problems of street children. We must show the same concern and attention to those children over the age of five that we show to those under five, and we must show the same concern and atten­ tion to those children suffering direct effects of poverty that we show the children suffering from insurrection and war. It is too often said that children cannot speak to the policy­ makers and world leaders. We hope that today's proceedings will provide the opportunity for their voices to be heard. (1) 2 We are fortunate to have a very distinguished panel this morn­ ing. Three of our panelists have traveled to Washington from Cen­ tral America for the sole purpose of testifying at this hearing. Their experience will greatly assist this Committee in our immedi­ ate and future efforts to understand and address this pressing prob­ lem. What we are going to do this morning is to have one panel. We are going to have them all come up, starting with Carlos Palacios, and we are going to go right down the line, Marilyn Rocky, Dr. Ka­ minsky and Per Engebak. I am going to introduce you, and I would like for you to go through your testimony before we get to ques­ tions. But before we do this, I would like to ask the other Congressmen that are here if they have a statement and if they want to say any­ thing before we introduce the witnesses. Mr. Emerson. STATEMENT OF HON. BILL EMERSON, A REPRESENTATIVE IN CONGRESS FROM THE STATE OF MISSOURI Mr. EMERSON. Thank you, Mr. Chairman. I want to commend you for convening this hearing to bring at­ tention to an issue of great urgency to communities everywhere, protecting the welfare of the millions of children living and work­ ing on the streets of the world's cities. This is the first time this committee has examined this matter directly, and I hope it will not be the last. It is a problem of tragic magnitude that requires our enduring concern. From Rio to Khartoum, from Bangkok to Bombay, generations of children are growing up on street corners and in back alleys. Many of them are the victims of broken families or abuse, and most of them are the victims of desperate poverty, the kind of poverty that finds a six year old child shining shoes for pennies to help his par­ ents make ends meet. These are children living on the very edge of survival for whom street smarts and sheer determination must take the place of medi­ cal care, education, shelter and daily bread. These kids are too often invisible to mainstream society. They do not fit easily into molds or categories. They do not show up on the national census. Just because they are not counted does not mean they do not count. They count with the Members of this committee. They count with our witnesses and with many others like them, and they count with me. It seems apparent the institutions which might offer these chil­ dren protection against violence, hunger and disease are presently ill-equipped to meet their many needs. So we look toward innova­ tive, new programs, both public and private, to give these children what ought to be their birthright, a healthy mind in a healthy body and a fair start in life. I look forward to hearing from our witnesses today and hope their testimony helps us to get a handle on these complicated prob­ lems. 3 Again, Mr. Chairman, I commend you for holding this hearing and focusing on the issues that will be addressed today. Thank you very much. The CHAIRMAN. Thank you. Mr. Gilman. STATEMENT OF HON. BENJAMIN A. GILMAN, A REPRESENTATIVE IN CONGRESS FROM THE STATE OF NEW YORK Mr. GILMAN. I also want to thank you, Mr. Chairman, for bring­ ing this hearing together because maybe we can make a small step in the beginning and later a significant contribution to solving this problem. I have three children. All children should have a good home, clean sheets to sleep on, wake up to a friendly atmosphere with a good breakfast and a solid family and a good community, and we know that that is not the case for these children of the streets. About 25 years ago I was in Southeast Asia, and I can remember the poverty, especially among the children who used to sometimes cling to your leg when you walked by, begging. Recently this summer I went back to Southeast Asia, and it is 100 times worse than it was 25 years ago. Mr. Chairman, you talk about the lost decad~, and that rings such a hollow sense of loneliness when you hear those words which we know will lead to a lost generation. So I guess it is high time that we begin in as sophisticated a way as possible to prioritize the limited resources we have and target them toward the most dire emergency, which is the children as you see on those pictures. Again, Mr. Chairman, thank you for this hearing. I think we can make the first step toward doing something positive. The CHAIRMAN. Thank you for your very good words. I would like to now introduce our panel. Mr. Carlos Palacios has joined us this morning. He will be relating his experience as a former street child on the streets of Bogota, Colombia, and now as a street educator. In fact, he is a recipient of the Kohl Internation­ al Peace Prize for his outstanding work as a street educator to street children in Central America. We are honored that Mr. Palacios has come from Guatemala to tell us his story, and it is gratifying to see that there is hope even in situations that often appear to be very hopeless. We thank you for coming. We also have Ms. Marilyn Rocky. She is the Regional Director of Childhope of North America. Childhope is the world renown inter­ national advocacy organization for street children. This nongovern­ mental movement for street children conducts projects in the areas of international and domestic advocacy for street children. It also provides training and technical assistance to private voluntary or­ ganizations and conducts action oriented research. Ms. Rocky is here to share Childhope's experience and the les­ sons learned in attempting to address the pressing issues that face children who live and work on the street. We are very happy to have someone who is a leader and a trailblazer in this area. Thank you. 4 We are also very fortunate to have Dr. Donald Kaminsky with us today. He, too, has traveled a great distance to testify this morning. Dr. Kaminsky is the Executive Director of a program between the Tulane University School of Public Health and the government of Honduras. This program is called Project Alternatives, and it is a community-based program that focuses on addressing the health and social needs of the abandoned and working street children in Honduras. He is here this morning to share the knowledge he has gained regarding the health and nutrition issues that affect street chil­ dren, and particularly those of Honduras. And then we have Mr. Per Engebak. Mr. Engebak is here as the Central American representative for UNICEF, and in this capacity, he oversees UNICEF's operations in the country of Belize, Costa Rica, Guatemala and El Salvador, Honduras and Panama. Mr. Engebak has helped focus attention on the pressing needs of children in these countries and especially children in difficult cir­ cumstances, which includes street children. He, too, is here from Guatemala to tell us about UNICEF's efforts to assist street chil­ dren, and we thank you, too, for coming. We welcome all of you, and, Mr. Palacios, if you would proceed and tell us your story. STATEMENT OF CARLOS PALACIOS, FORMER "STREET CHII'..D" Mr. PALACIOS. Mr. Chairman and the honorable members of this committee, my name is Carlos Palacios, and I am working with Childhope in Guatemala. I am Colombian and a former "street child." First of all, I would like to thank those of you who have orga­ nized this important and significant meeting which could have an impact on a tremendous problem in Latin America. I would like to thank those who have given me this opportunity to be the spokes­ person for the millions of children in my part of the world waiting for the outreach of persons who are in a position to help like those of you present here in this auditorium. When we speak about the street kids, those who have made the streets their home, without family, and the street as the only way of life, the first question we must ask is: why are the children on the street? Logic tells us that the children belong to families and long to go to school, to go to parks and to playgrounds. But instead of being protected and loved they get beaten. These children head for the street and seem to belong to nobody. But the street will not give them security. It is full of danger. It is hard. It is hostile. It provides no permanence to those who are living their lives on it. On the other hand, some societies feel that this blemish is not so small after all. They order street children to be put in jail. They do not have any papers. They are social dropouts. However, the more inhabitants of the streets, the better the de­ fenses. They organize themselves, unite, and establish through phone calls and a street language, the only society that society has left them. 5 The street children come from the poorest neighborhoods. It is frequently the case that their families have come from the country to the city and have had to resign themselves to different labor be­ cause they don't have any specific skills beyond their experience on the farm. Under these circumstances, poverty weighs heavily upon them. The pressure is extreme, and the children are the first to suffer the consequences. The problem of street children is hard to solve for marginal groups in the big cities without water and without access to basic services, such as housing, health and education. These families do not have the ability to manage the complexities of city life where they find no help, no orientation. Street kids are very young. Their ages range between five and 17 years old. In some countries their clothing generally is too big for them because that makes it easier for them to hide stolen objects. They live in areas where they can steal, beg and also disappear quickly. At the same time, in these places they meet pimps, prostitutes, thieves and drug dealers. It also means places where there are crowds of people, such as bus terminals, places where they can easily get marijuana and cheap cocaine. They frequently take pills, inhale gasoline fumes or sniff glue. Most of the time they do these drugs in order to escape from hunger, cold and their miserable way of living. Street kids are not lonely. They live in gangs. Depending on the country, the children organize themselves in groups in order to sur­ vive. These groups vary in size. They may have a chief, and they have their own laws and traditions. They have a specific place to sleep and their own territory. The children learn the rules of the game very quickly. They learn that society is their enemy that chases and bothers them and violates them. In the street logic, the only resource they have is self-defense and attack in order to survive. But the street children are still children, and are waiting for that one opportunity. But the street children cannot wait any longer. We must help them today. Tomorrow will be too late. Thank you. The CHAIRMAN. Ms. Rocky.

STATEMENT OF MARILYN ROCKY, REGIONAL DIRECTOR, CHILD HOPE Ms. RocKY. Mr. Chairman, Members of the committee, my name is Marilyn Rocky. I am the National Director of Childhope, USA, a U.S. based subsidiary of Childhope Foundation. Childhope is an international organization that works with street children in the urban centers of the Third World. On behalf of Childhope, it is a pleasure to submit this testimony today before the Select Committee on Hunger. We are thankful for the committee's interest in and recognition of the needs of these youngest and most vulnerable citizens, and we commend the committee for its vision in including the needs of these boys and girls in its agenda. 6 The purpose of my testimony today is to provide the members of the committee with an overview of the origin and current problems confronting street children, particularly within the countries of Latin America. An estimated 100 million children and youth live or spend the majority of their lives in the city streets of the developing world, with an estimated 40 to 50 million of these children in Latin Amer­ ica alone. Most of these children, perhaps as many as 75 percent, are work­ ing street children. They live at home, but are forced into the streets to contribute to their family's meager income in whatever way they can: shining shoes, selling newspapers, hauling garbage, begging or survival sex-selling their bodies to earn income. When examined by country and city, the sheer number of street children is overwhelming. In Brazil alone, UNICEF estimates that 17 million children and youth work on the streets and seven mil­ lion live on the streets. In Mexico, an estimated ten million children are working on the streets and 250,000 are living on the street. In Ecuador, 100,000 children work on the streets. In India, 44 million children are working on the street. In the past and even today in some parts of the world, the grow­ ing street children population and their problems have been ig­ nored. They comprise a population that does not show up in health statistics, in the public education system, or in national consensus. The traditional response to homeless and abandoned youth in both the developing and industrialized worlds has been to institu­ tionalize them, housing them in state reform schools or isolated residential institutions. In other cases, street children have been treated as a public nui­ sance. Today in some countries they have become the targets of death squads, vigilante groups who willfully torture and murder street children as a solution to the growing crime statistics. Since the middle of the 1980's almost 3,000 children on the streets of Brazil have been executed by death squads. In the November 1991 issue of "Omni Magazine," an article based on the difficult and dangerous environment of street youth in Guatemala notes that the situation of street children in Guate­ mala has been worsened by the presence of active death squads. According to "Omni:" Eyewitnesses confirm that Guatemala's "ninos de la calle," children of the street, are being subjected to a spree of tortures matched only by the Holy Inquisition. Many children have been abducted, beaten, burned with ciga­ rettes, subjected to mock executions and sexually assaulted. Some have had their ears torn off, their tongues ripped out, and their eyes gouged before the merciful coup de grace was applied, general­ ly a blow to the head or a bullet to the base of the neck. Others were pushed into the countless ravines that gird Guate­ mala City's shanty towns, stinking chasms littered with garbage and human waste, and patrolled by feral dogs and cats. The most commonly asked question about these street children are: where do they come from and how can there be so many? The causes range from the obvious and not so obvious: urbaniza­ tion and its underlying causes, the debt problem and structural ad- 7 justment, economic stagnation, drought, deforestation and other forms of environmental degradation, rapid population growth, un­ sustainable agricultural practices, and government policies that have subsidized urban dwellers at the expense of rural farmers, forcing increasing numbers of families and youths in the develop­ ing world to move to the cities in search of economic opportunities. During the past four decades, the Third World has also been the stage for manmade calamity, the earth's battlefield where armed violence has shown consistent increase and where civilians have ac- · counted for up to 90 percent of all casualties. Violence in the rural areas has sent families and unaccompanied minors racing for the protection of urban strongholds, and conse­ quently, to the streets. Orphans, refugees and displaced children without the family's safety net have been made prime candidates for street life. As more and more families in the developing world settle in mar­ ginal areas near large cities, they will continue to lose the social and kinship networks found in rural areas. The side effects of this increasingly urban-based poverty are devastating: a lack of access to education, the break-up of families, under and malnourishment, inadequate health services, susceptibility to infectious disease, vul­ nerability to AIDS and other sexually transmitted diseases, physi­ cal and sexual abuse, drug abuse and prostitution. All of these side effects impact most directly on the children of these poor urban dwellers, forcing increasing numbers of these children to turn to the streets to contribute to their family's meager income. Street children today represent one of the most exploited and rapidly growing minorities and one of our most poignant social challenges. Although many local projects have been established for them, the most basic needs of the vast majority of children for whom the street is work place, playground and even home remain unmet. The severe economic crises which currently cripple the econo­ mies of many developing countries further exacerbate the risks facing these youngsters whose childhoods are too often spent in al­ leyways, marketplaces, and city slums. Without comprehensive services and targeted programs to meet their needs, the vast majority of these street children are destined to lives of poverty and despair. Yes, there is a financial cost to improving the quality of the life of children on the streets. Ladies and gentlemen, we are talking about a nation of street children, 100 million children, four times the size of the population of Canada. However, if we do nothing, if we attempt at this time to turn away from these children, the cost in human terms will be tragic. The number of children on the streets will double by the year 2010. The loss to the community, to societies and to humanity will be staggering, and the integrity of our civilizations will be threatened. This might well be the major battle of the decade, the struggle to save a generation of children from the streets. We have probably lost the tens of millions of children who are at this moment on the streets of our cities. 8 I have already cited many of the daily difficulties they must face in an environment of urban indifference. Quoting from Susanna Agnelli's book, "Street Children: A Growing Urban Tragedy,'' she says, "The fate of the street generation is inseparable from the un­ certain future of cities. Bursting or decaying, they were never built with the needs of children in mind. Today, the notion of man as the measure of all things has long vanished from urban life, and huge urban agglomerations have become increasingly inhuman and unmanageable. Beyond a certain point, their problems multiply faster than the means of solving them. Administration becomes more remote from the people it is meant to serve. Street children are poignant evidence of this reality." We must move out of the traditional boxes of institutions and onto the streets. It is here, on the street, that the children can be found, and it is on the street where the work must be done. This is an emergency and we should not wait any longer to re­ spond. I am speaking about life and death. I am referring to suffer­ ing taking place at this very moment, this very second. I am asking this committee to be bold and audacious and visionary and to commit itself to making the lives of street children worth living be­ cause their lives are the very mirror of reality and of our future, too. They are prophetic in their suffering. Look at them and see the future, for them, for us and for our own children. Thank you. [The prepared statement of Ms. Marilyn Rocky appears at the conclusion of the hearing, see p. 78.] The CHAIRMAN. Thank you. Dr. Kaminsky. STATEMENT OF DR. DONALD KAMINSKY, EXECUTIVE DIRECTOR, PROJECT ALTERNATIVES Dr. KAMINSKY. Mr. Chairman, honorable members of the Select Committee on Hunger, good morning. Thank you very much for the opportunity to testify today. It is a pleasure to see that after so many years you and some other mem­ bers of the committee whom I had the chance to meet with back in 1984 in El Salvador continue to be very interested in the welfare of the children of Central America. Back then you and your colleagues were concerned with the dis­ placed children as a result of civil war. Today we are still con­ cerned with displaced children, displaced from the home and the school to the streets, now for economic and family disintegration reasons. And we continue to be concerned about children's basic rights. I am fully aware that this committee was created to respond to the biological needs of the hungry persons of this world of ours. Today I will be sharing with you our experiences not only with those children who are hungry for food, but also for the street chil­ dren, the working and abandoned children who are starved for af­ fection, attention, a friend, a place to play, the opportunity to study, someone to care for them, to take care of them when they are ill, in essence, the opportunity fo r that child to be wanted. 9 I look forward in our question and answer period to sharing with you the methodologies which Project Alternatives is utilizing to provide a community-based, comprehensive, primary health care, social services delivery system, which addresses the needs of the children and, when there is a family, the family as well. Tulane University has recognized the importance of being in­ volved in addressing a problem of today and the future, a problem which is still invisible to many: the health and social service needs of working and abandoned children. Working children can be characterized as children without a childhood. Abandoned children are social orphans. They are lead­ ing a life of misery, but with liberty. The abandoned child has a life which is a mixture of work, hunger, anxiety, aggression, fear and juvenile delinquency at times, truly an adventure. Within the best tradition of public health, public/private sector collaboration and strong community and family participation are required to address the problems of these children, but these fac­ tors are frequently missing. Since the magnitude of the problem has been largely invisible even to many individuals and institutions, who are significantly in­ volved in the social sector, it is incumbent upon you decision­ makers with the power and the influence to make a difference to become actively involved in supporting a continuing analysis of the situation, the services structure for the children, and advocacy for societal response to the problem. I have repeatedly utilized the word "problem," but where is the problem? The children are not the problem. They are a mystery to be solved. They are a symptom, not the disease. They are children, innocent victims of an adult world which has too frequently not recognized and protected the basic rights of the child, and societies which have not demonstrated the commitment to promote and pro­ tect those rights. Parents, communities, governments and society overall can be said to be a part of the problem, and they need to become a part of the solution. In the past, governments and international lending institutions have created the necessity for the economic structural readjust­ ments we see taking place worldwide today, and they, thus, have at least partial responsibility for the adverse effects we see the poor and those in extreme poverty suffering and for the large popula­ tion groups who are found without an adequate social safety net having been developed to help them absorb the impact of such eco­ nomic change. But a lost childhood or youth cannot be remitted or rescheduled. Local communities have frequently not acted on behalf of children, and parents too often have acted irresponsibly. Therefore, all of us must recognize the role we have played in the past, see and under­ stand this invisible situation of today, and commit ourselves to be­ coming a part of the solution to the problem. Great success has been achieved in the child survival efforts un­ dertaken worldwide, but survival to what? Now we need continued commitment to not only infant and early childhood survival, but to survival which ultimately results in a healthy, educated and pro­ ductive child and adolescent. 10 What situation do we encounter specifically in Tegucigalpa, Hon­ duras? Unprecedented rural to urban growth has taken place. The marginal areas are growing at a rate of eight to nine percent annu­ ally. This has been going on for some years, and is projected to con­ tinue into the future. Children pour out daily from the marginal areas to the streets of the city where we work. They are escaping beatings, escaping sexual harassment and/or rape, escaping depressing living condi­ tions, seeking money to support family members, looking for some­ thing to eat, sometimes just looking for excitement. Some turn to drugs and prostitution. Some live and sleep in the streets. Some turn to closed door institutions for shelter and food, but most return to their humble dwellings late at night only to be back in the streets early the next morning. We find them everywhere. They are begging. They are guarding cars, selling newspapers, shining shoes, selling other goods, vending in the market, stealing. They are found alone, in pairs, sometimes in groups. They are in the street gaining their livelihood in any manner possible. The process of socialization which normally occurs in the family's home and in the school is now occurring more and more on the streets and usually in the absence of one or more parents. There are increasing numbers of physically and mentally defi­ cient and dependent citizens who suffer from a loss of basic human values and self-esteem. To summarize, the situation of these children is one of family disintegration, undernourishment and malnourishment, inadequate health services, increased susceptibility to infectious disease, in­ creased susceptibility to physical and sexual abuse, constant threat of injury from accidents and street violence, and sometimes in sub­ stance abuse. Approximately one-third of the abandoned children with whom we are in contact are abusing inhalants, are sniffing glue. The abandoned children, as a result of their life style, are at an in­ creased risk of HIV infection. Our ongoing survey of the situation of all children enrolled in Project Alternatives reveals that at this time 7 .2 percent eat one meal a day; 36 percent eat two meals a day; and only 56 percent are able to eat three meals daily on a regular basis. This does not speak to the quality of their meals. A preliminary analysis of our survey data conducted by Dr. James Wright, who is my co-worker based at Tulane University, re­ veals the following characteristics of mainly the working children at the time of enrollment in the project. Nearly 40 percent live with their mother only. Fifty-five percent are not in school. Eighty-two percent share the money that they earn with their family. It had been more than one year since 47 percent had visited a doctor or other health professional. Once again I wish to thank the committee for having provided the opportunity to share some of our experiences, and in the annex to this statement, I have summarized the activities which Project Alternatives is providing in response to the situation. Also, I have included a listing of the institutions which have been supporting 11 our efforts and the public and private entities with whom we have been collaborating. I look forward to sharing in more detail our experiences during this session and/or at some future date. [The prepared statement of Dr. Donald Kaminsky appears at the conclusion of the hearing, see p. 64.] The CHAIRMAN. Thank you. Mr. Engebak.

STATEMENT OF PER ENGEBAK, CENTRAL AMERICAN REPRESENTATIVE, UNICEF Mr. ENGEBAK. Mr. Chairman and honorable members of the com­ mittee, my name is Per Engebak, and I am a representative with UNICEF in Central America. I am grateful for the opportunity to share with you today some prospectus about UNICEF's programs for Central America's least protected children, exploited children whose numbers are multiply­ ing at an alarming rate. Every eight hours or in the course of this working day 1,000 babies are born in Central America. Of these 1,000 babies, 84 will die before they reach their fifth birthday. Of the 916 that survive, 476 will live in poverty, and an additional 216 will live in extreme poverty. Five hundred twenty-three of these children will be mal­ nourished. Only 779 will enter school, and a meager 270 will com­ plete their primary education. Forty-five will either work or live on the street, and even a greater number will be exploited in a variety of manners equally or more appalling than those who find them­ selves on the street. Those who have testified before me have painted a vivid and a disturbing picture of the personal life of each of the so-called street children. Yet both the immensity and the complexity of the situa­ tion can overwhelm us with a frustrating sense of impotence. Nevertheless, my message today is one of tangible hope and opti­ mism. A systematic and comprehensive approach to this tragic sit­ uation can substantially improve it within this decade. My presentation today focuses on the UNICEF program for street children in Central America. Obviously time does not permit us a thorough explanation of this program. Thus, I will limit my remarks to a brief description of its major components, some back­ ground of why we have chosen these lines of actions, what we have done, and what we are currently doing in our plans up to the end of 1994. UNICEF's project for street children in Central America is part of a larger program directed at a high risk group known as "Chil­ dren in Especially Difficult Circumstances." While street children are one of the main groups that we reach through this program, its target population also encompasses other children, including work­ ing children, abused and abandoned children, children affected by disaster and institutional children. It also includes children affect­ ed by armed conflicts, that is to say, child soldiers, war orphans, refugee children and displaced children. These categories describe the extremely difficult circumstances that many Central American children are experiencing. The major 12 components for the UNICEF program for children in especially dif­ ficult circumstances in Central America are research, advocacy and social mobilization, institutional development and support for projects and specific actions. This comprehensive program takes a systematic and multi-facet­ ed approach to the situation which is based on the UNICEF's four decades of experience in Central America. The program is also complemented by a package of larger programs in the area of health, education, literacy, water, environmental, sanitation. These programs are tackling some of the underlying causes of the street child problem. As I mentioned, the first component is research. Early interven­ tions on behalf of Central American children in the 1980's were hindered by a lack of information on the subject. Although some educated guesses could be made, there were little objective data of the extent of this alarming situation. Without specific data on the magnitude of the problem, it was difficult to design interventions that would have significant impact. Because of this lack of information, the first responses were made often with quick, stop-gap measures. However well meaning, they treated the symptoms rather than the root of the problems, and by the very design, were too costly to reach even a significant minori­ ty of the affected children. UNICEF has since supported a general analysis of the situation of these children in each Central American country. Data has been systematically compiled and analyzed from a multitude of sources, and is already being used by government, nongovernmental organi­ zations, international institutions to improve the effectiveness of the interventions. As an outcome of the analysis done today, we have gained major insights. First, street children are the visible minority of a much larger group of exploited children. Second, the responses required are complex and they require a multi-sectoral approach, and final­ ly, that there remains much more to be learned. To elaborate, the children we see on the streets are merely the visible element of a much larger group of exploited children who remain hidden from the public view. Street children are forcing the world to recognize their heretofore unnoticed, exploited brothers and sisters who include, among others, child workers, abandoned and abused children, infants and children sold or given away by the parents, sexual abused children who live their hidden lives of prostitutes, and child soldiers. All of these children are exploited. To obtain an answer to this and other questions, UNICEF will continue to support hands-on research that can quickly be applied into concrete actions. Although we certainly have a better grasp of the breadth and the complexity of the issues we face, it is essential to continue this process. The second component of the program is social mobilization and advocacy. It is one of UNICEF's most successful areas of interven­ tion as the major lobbyist for children in the region. Since 1990, UNICEF's advocacy for child intensified with a goal of obtaining the highest level of political support for survival, pro­ tection and development of children. This advocacy and mobiliza­ tion has centered around two major initiatives: the International 13 Convention on the Rights of the Child, and the World Summit and Plan of Action for Children. An outcome of rigorous advocacy was that each of the seven Cen­ tral American countries last year ratified the Convention on the Rights of the Child. Thus, there is now in place a legal framework for advocating for exploited children within the region. UNICEF recognizes that the promulgation of legislation does not insure enforcement. Currently we are assisting governments to es­ tablish official entities to advocate for and to monitor compliance with the convention. In Guatemala and Costa Rica, a National Ombudsman for Chil­ dren has been appointed, and in Nicaragua a National Child's Rights Commission has been organized. In a number of countries, UNICEF is supporting the review and the revision of legislation so that national laws are in compliance with the convention. Complementary to the legal framework established by the con­ vention is the World Declaration and Plan of Action for the Surviv­ al, Development and Protection of Children that was adopted at the World Summit for Children held in September last year at the United Nations. Each of the presidents of the Central American countries is a sig­ natory to the World Declaration and the Plan of Action for Chil­ dren, which commits the country to achieve 27 goals for children by the year 2000. The Summit has already yielded extraordinary practical re­ sources in Central America. These plans set an incredible political course of action in which children are the priority. Each national plan makes a provision for street and exploited children. Next month, on the 12th and the 13th of December, the presi­ dents of Central America will be meeting in Honduras for a Summit on Children, Youth and Human Development. At this summit, they will commit themselves to insuring implementation of the national plan and to make available resources to do this. In short, the highest level of political commitment will be secured for insuring concrete action to protect the development of the region's new generation. Along with UNICEF advocacy with national governments are similar actions with churches, professional groups, labor unions, private enterprises, mass media and community groups. Institutional development is the third element of the program. UNICEF confronts the reality that governments, voluntary agen­ cies and other service providers simply do not have the institution­ al, financial and technical capacity to adequately address the prob­ lems of street and working children. Our challenge is to strengthen the capacity of existing institu­ tions and to expand the services. In general, our primary interven­ tions in this area are through training and technical assistance. The final program component is support for projects. UNICEF is supporting numerous and diverse projects for exploited children in each of the countries. As a point of clarification, UNICEF's modus operandi in Central America is to financially and technically support the project from a nationally based counterpart rather than to directly provide serv­ ices. This is an essential approach for sustainable development. 14 Our criteria for project selection is that they be cost effective, af­ fordable, and that they can be maintained after our support is no longer available. Agreements have now been reached in each country to intensify this component of the program through alliances with government, voluntary agencies, churches, service groups, clubs and community organizations. In its support of nongovernmental organizations and community groups, we take a pragmatic and a flexible approach that spars cre­ ativity and innovation. Demonstration projects are actively encour­ aged. The myriad of projects that UNICEF supports are, and will continue to be, carefully monitored, analyzed and evaluated. As successful methodologies that can be replicated are developed, they will be documented and widely disseminated. These method­ ologies will be the foundation for greater coverage in the future. An interchange of experiences between countries is facilitated with the goal of establishing a regional network of those agencies assisting street and working children. To summarize, UNICEF's program for street children in Central America aims at gaining a better understanding of the problem, mobilizing commitments at all levels, developing institutional ca­ pacities and supporting projects and specific actions. Mr. Chairman and members of the committee, thank you for this opportunity. I hope that you support our efforts to insure that the 1,000 children that are born in the course of this working day in Central America will not find the future on the street and in situa­ tions of extreme exploitation. The choice is ours. Thank you. [The prepared statement of Mr. Per Engbak appears at the con­ clusion of the hearing, see p. 43.] The CHAIRMAN. Thank you, sir. Thanks to all of you for your ex­ cellent testimony. We in Congress, especially on this committee, ap­ preciate your work. It is very, very important work. It is work that very few people are doing in the world, and it is hard for us to un­ derstand it. It is hard for us to understand how there can be 100 million chil­ dren working on the street, 25 of which live under bridges. It is hard for us to comprehend. It is hard for us to understand that people go around shooting these kids, torturing them, hurting them. I do not understand why, because I know this story has been around for a few years, why there has not been more focus on the issue. Maybe you can shed some light on it. What is it about the poor­ not just children, what is it about the poor that we have trouble getting people to pay attention to their problems? Is it that society is scared or that we despise the poor? Why is it that we cannot seem to get mobilized to make children one of the top priorities not only in our country, but everywhere? Can any of you shed some light on that? Ms. ROCKY. Mr. Chairman, if I had the answer, I would not be here, but perhaps I can give you some insight from my own experi­ ences. These pictures were taken by me in the Philippines a few years ago in Smokey Mountain Dump, which is a "city" within metro 15 Manila. It is a city within a city. The dump is home to approxi­ mately 27 ,000 people who live on the garbage and earn income off the garbage and are part of a culture that you and I will never un­ derstand. To this day I cannot believe I actually saw what I saw. Every­ body there, of course, is outside of the normal prescription for de­ velopment assistance because they do not live within the communi­ ty at large, and that is what happens to what we call the poor people. They are on the fringe. They are not within the mainstream of development. They are hard to reach. When you live on a dump, where the sound of the flies is louder than the sound of the trac­ tors moving the garbage, you are not going to find assistance there as we would expect it to be. These people eat the garbage. What you see there in that picture over there is part of the dump. It is hard to tell. At the bottom of the picture, that is a river. The river is just congealed with filth and garbage, and the people stand waist high and wash out the plastic bags which they then take down to the street with their kids, and they sell them. They recycle them. That is how they earn their living. The houses that they live in are built from the garbage. The food that they eat is recycled from the garbage and in some cases sold back to the people who live in the dump. That is a microcosm of poverty, all 27,000 people living on this stinking, reeking place on earth, but it is real. And the work that we are trying to do or you are trying to do, is not going to trickle down to these people because we are confined to institutional development. These people are not in institutions. They are in a dump. It is not part of the community, and that is what happens in a lot of these countries, especially with street chil" dren. They are in the under belly of the city. They do live under bridges and in the subway tunnels, and they do live away from the stream of development assistance, and their numbers, like their families' numbers, are the numbers of the poor increasing so geo­ metrically that you cannot reach them through institutional devel­ opment or care, not traditional institutional care. There is a new wave. It is taking the activity to where the people live. The CHAIRMAN. Like Cite du Soleil in Haiti. Ms. RocKY. That is right. That is right, exactly. The CHAIRMAN. Anything else? Mr. ENGEBAK. I think that what we have seen is that perhaps, you know, the economic theories are that if you invest in the middle class and the upper segment of the population, you will spark life into the economy, and consequently there will be a trick­ le-down effect to the poorest segment of the population. I think these economic theories have proven to be wrong, certain­ ly in most parts of the world. Unless there is a significant invest­ ment in human development, it is inconceivable to me that we will be able to come to grips with these problems of economic and social development that we are confronted with in the world today. I think there is gradually a recognition of these factors, and I certainly hope and I trust that perhaps in the 1990's that we will 16 have equal attention to social and human development as we have had to economic development that largely has failed basically be­ cause we have not had a foundation to build this so-called economic development. I think that this recognition is an undercurrent in a lot of the things that we are doing in Central America today, and I think it is the advocacy and the promotion for high political commitment in this area that perhaps can make the difference in the 1990's. The CHAIRMAN. Doctor. Dr. KAMINSKY. Just another point of view and I wish to share a story with you. I refer to these children as "invisible". How can you be invisible when you number in the millions, but yet somehow or other these children are invisible. They are invisible to society, and they seem to be invisible to those who make the decisions as to where re­ sources are allocated and who is going to be served. The story is the following. I have a businessman friend in Teguci­ galpa, and I was looking to see whether he could help us out. He produces fabric. We have some sports teams, and we wanted to see whether or not he would donate fabric to help us have some uni­ forms made for these young boys mainly, but for girls as well. So I went to him to discuss the project in general terms, present­ ed him some material, and a couple of days later we came together again, and he said, "You know, I have lived here all my life. I am in the community, and I am sure that these children have always been here, but until you brought them to my attention, I must admit I just did not realize extent of the problem, and since you have brought it to my attention, I now see that we have a big prob­ lem." A couple .of weeks later, two young boys tried to rob his factory, l;lnd they were caught by the security guards. They were taken to him to ask what would he like to do with these young boys. So he started to talk to them. He asked them where they lived and inquired, "Do you have a family?" They said yes. So he said, "Why don't we go talk to your parents?" He hopped into his car with the boys. He went out to an area which we can hardly call a home. He did find a mother and a father there, in this case; but it turned out that there were many other children in the home. The parents were both unemployed, and they literally had been sending their children out into the streets to steal, saying, "What can we do? We cannot feed our children in any other way. We must send our kids out." So he encounted this situation, and he proceeded to find a job for the lady in his factory and assisted in helping the boys to enter school. This is the kind of societal response that I refer to, and how basically it is a problem that is not only one of government, not only the private sector, not only those of us who are interested in development; but we really have to work together, and it is going to have to begin with very widespread advocacy so that people un­ derstand the problem better. This is my experience. The CHAIRMAN. Mr. Palacios, you were a street child, and you made it out of there. As a matter of fact, you did such a tremen­ dous job, you got an international prize for it. 17 You did not tell us anything about your personal life. Can you try to make us understand what goes on in the minds of street chil­ dren and how it started with you? I mean when did you become a street child? How did that happen? Mr. PALACIOS. OK. I was in the streets, since I was six years old, and for the question that you asked here about why we look invisi­ ble to the people, I think it is not that we look invisible to the people. They do not want to see us. So, for instance, I mean I came here to speak in front of you be­ cause I think that this is a good opportunity to let people like you hear and to understand what is going on down there. So when people get interested, they make a difference. I have friends who used to be on the streets with me. They are now in Washington in the University. We are showing that we can change. You are asking me to tell a little bit about my life. Okay. When I was six years old, since I was three years old I was put in an insti­ tution, an orphanage. My family, I do not know my family. Until now I have stepparents, those who gave me the opportunity in Co­ lombia to change my life. I spent ten years in a project for street kids in Colombia. It is the most important project in Colombia called Bosconia (phonetic) La Florida. It is run by the Salesians. So I started to study after eight years on the streets, sniffing glue, smoking marijuana and all of those things. We had a group. We were 15 street kids, stealing in the streets. I mean I did not think that I was supposed to change my life. I got comfortable in the streets. I had money. I had food. I was having fun in some ways, you know, because some people do not understand that you get accustomed to a certain way of life. Like I said, we learned the rules of the streets, but when we asked for opportunities to better ourselves, the people did not give the opportunity. I mean we did not have papers. We did not have families who represented us. That happens with people who have families, you can imagine how it is with people who do not have anybody. So fo r us it was very difficult to confront the situation. When I was on the streets, I was in jail maybe 20 times. I forgot already. For me it was very hard to come out of the streets, be­ cause of the drugs, because of my friends. Also we were 15. I am still alive. Five, ten of my friends are already dead. And five of them, in a good position now. I have finished the university now. My friend who I am going to meet today for lunch, he has finished. Already he is working with the Salesians, too. So for us, it was very hard to come out of the street because the biggest problem is that you have one. An institution can do a lot of things for us, but no one can replace our own family. We already lost it. We have to face it. We have to work that out and learn to live with it. So, to live in the street is like living in the jungle. The strongest survive. The weakest die. That is how it happened in my group, and it is still happening, and especially now when there are those in Colombia who are exterminating them. I already have letters from the project where I used to live. Some of my friends are un­ lucky, they started to get their degree, and then went out in the streets again. Some of them have been killed already. 18 So the situation is becoming worse, but thank God I am here, and I am trying to tell you how it feels, and it is different to tell than to feel it. I feel it in a different way. I cannot tell you. I mean I wish I could speak better English to explain to you how it really feels to be in this position, but I am very happy to be here to share with you. And I wish you can do something not only for my friends in the street in Latin America, but for your own kids in the United States because I know that there are too many problems here, too. I have been in Manhattan and been in San Francisco and have been in Los Angeles because of my work, and there are kids, ten, 12, 11, dying from AIDS and working in bus terminals on 42nd Street, selling their bodies during the night. I mean the problem is too big, not only down there, but here, too. So there is too much to do for us. The CHAIRMAN. So this group that you had, became your family? They became your family because you did not have a family, and it was hard to leave them. Is that what you are saying? Mr. PALACIOS. Yes. In one way, yes, they are my family. I mean these men are like my own brothers, you know, but they don't really take the place of your blood family. The CHAIRMAN. Yes. Mr. PALACIOS. But it is important they fill the need. I mean I have a step-family now who helped me to finish my university and all of those things, but it is different. It is so difficult to work in the streets now, especially now that the drugs are becoming the most important thing in the streets. For instance, in Colombia, most of you know what is going on with the drugs in Colombia, and also I had too many problems when I came here because they stood me in front of barricades for three hours. Always when I travel I have problems because I am from Colombia. I mean everybody from Colombia is having trou­ bles, and especially now because of the street kids. When I was in the streets in 1974 and 1975, the biggest drug was marijuana and gasoline and glue. Cocaine was not there in the streets, not yet. I mean the projects who used to work with us, it was easier for them to work with us because we were not involved with very strong drugs, but now the work is very difficult because there is already crack in the street. So when I was six, seven, eight, I only used marijuana and I sniffed glue, but now these kids are sniffing and also using crack, like in Manhattan. So for the projects it is very difficult to rescue them because they are damaged already. The CHAIRMAN. So you were six, and then you were in the streets for ten years. Mr. PALACIOS. Eight, years. The CHAIRMAN. You were in there eight years, and then how did somebody grab hold of you and help you to come out of there? How did that happen? Did you meet somebody? Did you meet a group? What was it that got you out of the streets and where you are today? Mr. PALACIOS. This project is the pilot project in Latin America for street education in Colombia that I was telling you about. 19 The CHAIRMAN. How did they get hold of you? How did they find you? Mr. PALACIOS. They have street educators who go out during the night in the streets. So I was one of the street kids in these groups, and these people started to come during the night to talk with us, to bring us food or to play guitar. They accepted us as we were. I mean we were smoking marijuana, and they did not care. We smelled terrible, and they did not care. But they believed in us. They stayed with us. They invited us to join the project. From the beginning, let me tell you that it took 20 or 40 times for me to come into the project and to come until I got ready to change because everybody thinks you give someone the op­ portunity and they are supposed to change the next day. I spent eight years on the streets. How can I change from one day to the other? It is impossible. So we must wait until the situation appears right. If your own child has problems with you, you do not throw him away from the house. You wait until the opportunity is right for him to change. That is the way this project was started. So they came out in the street every night, and also we had op­ portunities to go to places like Dr. Kaminsky's safe place for food, a place for health and everything, but it took almost eight years for me to get real integrated in this project. The CHAIRMAN. So what would be the one or two things that you think street kids need to get out the streets? What needs to be done that is not being done today? Mr. PALACIOS. Yes, the thing that is not being done today is to promote the communities. So it is important not only to open projects in the streets for the street kids, because that means that we are not isolated, but we need to have a community behind us. So we need support, not only a good heart. We need economic sup­ port for the community. You have to begin change in the communities where the family is, and then provide education and opportunities to change their own lives. If we do not educate our families and give the opportunities, we suffer the results of that. The CHAIRMAN. Marilyn, what kind of U.S. assistance programs do we have specifically for street kids in the world? Ms. RocKY. U.S. assisted programs? Well, there are several U.S. based PVOs that have institutional care programs in the field in the Third World. Certainly the work of the Salesian Fathers is well known in several different countries. There are efforts being made most recently by groups like Chris­ tian Children's Fund, who have begun to look at the street-based child as a member of the community. There are lots of little projects that are national NGO's, or non­ governmental organizations, that receive support from the North, that is, from here. Traditionally, the U.S. supported programs, if you're talking governmentally here, are basically institutional kinds of programming. I think what Carlos is saying is really the key factor that we have to look at if we want to change things systemically and slowly so they work, and that is to really look at the child as the symptom 20 and the result of a difficulty, and back up a little bit and say where did this begin. It begins in the community. When you live like that, when you migrate from the rural to the urban center and you find no work, you have to find some way to survive, and that is what happens. And in that environment, your children become victimized by that environment. So you have to look at how to strengthen the community roots as best you can, not to raise everybody to the middle class, not to use our values in this kind of situation, but understand and recognize as I did in this in­ stance, meeting a family in one of these houses in the dump who was absolutely excited to tell me how the mother had found a job learning how to sew stuffed animals. She was earning $3 a week, and the father had been able to gather enough vegetables out of the dump to resell to earn another couple of dollars a week, and that was enough to keep one of their children in the local school. There you have the connection. This family is given some oppor­ tunity, as meager as it was there in the Smokey Mountain Dump in metro Manila, the father and the mother are working together, keeping the child in school, and therefore, the child was not going to show up in metro Manila, on the street, in the section where all of the sex bars are catering to the American tourists. It is as simple as that. And I think that that is one of the things that has to change be­ cause .the other thing, Mr. Chairman, is that when you look at in­ stitutional care, we are talking about bricks, mortar, walls, wood. We do not have the money; you do not have the money; I do not have the money to support the infrastructure of the institutional care systems that we have built over the years. You have got to break down the walls, and you have got to bring the help into the street. It is cheaper and much more effective when you bring the com­ munity together, at the grassroots level and get the educators out to the streets. Carlos is very modest. He now works for Childhope in Guatemala. He is the coordinator for all of the street education in Latin America for Childhope, which has been graciously funded through Per Engebak's office in Guatemala, UNICEF. · We have found that the response to this training is overwhelm­ ing. The need is to get these people on the street, and that is where we are finding that most resources have to go. Funding that has happened traditionally from here to there is in­ stitutional. It has cost us a fortune. Look at the budgets of some of these organizations. So I think what we have to look at now is not where the money has gone, but where it will go and where we will find more people like Carlos to work in that environment. The CHAIRMAN. Doctor, what are the major health and nutrition­ al problems that you see in these typical street kids? Dr. KAMINSKY. We have had the opportunity for about a year and a half to serve the street kids, but I would like to once again bring to your attention that the street children are a very complex group, and that the majority of them are working children. There is a percentage that UNICEF estimates today may not be more than seven percent maximum that is typified by the children who are the focus of the discussion today, that is to say, the com- 21 pletely abandoned child. But there is this other group of working children, the ones that go to some dwelling at night; they are the vast majority. So we have been working with both groups, that larger group, as well as the truly abandoned. The morbidity pattern is slightly different between the two groups, as one might suspect. In the working children, basically the leading causes of morbidity that we have found working in the community are, number one, skin problems; number two, respirato­ ry disease; third, almost every child has dental problems of one sort or another; then come problems such as bacterial conjunctivi­ tis, gastro-intestinal problems, headache of undefined etiology, and some allergic problems. For the truly abandoned child that list changes somewhat in that the fourth leading cause of problems that we have found is trauma, usually mild to moderate; and sexually transmitted diseases enters into the top ten, and then of course, along with sexually transmit­ ted diseases comes the problem which concerns everyone who works in the health field today; that is the potential for HIV infec­ tion. Now, in regards to under-nutrition and malnutrition, virtually all of the children with whom we come in contact have a problem of chronic malnutrition, not acute. So that both in the working group and the abandoned group, we find short children basically. They are short for their age. The national statistics of a survey that was done just a couple of years ago reported that roughly 55 to 60 percent of the children had a normal height for age. In our group, we find that about 20 percent have a normal height for age. In other words, this is a group that obviously, over time, has been much more significantly affected with chronic malnutrition. Then we do have that problem that I described to you of chil­ dren, and these are working children, that may eat once a day. Some eat twice a day, and a little over 50 percent eat three times a day. It is interesting that the truly abandoned child, because of their condition, sometimes has a better daily nutritional intake than the working child. People feel sorry for those children. So they provide them with some food. They are in the streets. They can rob and steal food. They may be able to go to a restaurant and someone will give them food. So it is rather paradoxical. You would think that possibly that group would suffer more significant nutritional prob­ lems, that is the truly abandoned children, but that is not what we have found in our work. Children that are working in the markets where foodstuffs are being sold, because they have to sell in order to get a little bit of money to support the family; they suffer in that there is really not enough food or money for the family to provide them with proper nutrition. So that actually they have a worse nutritional problem. The CHAIRMAN. I want to ask one last question, and then I want the rest of the Congressmen, especially Mr. Emerson, to ask some questions, but it is a question for both you, Doctor, and Mr. Enge­ bak. 22 How receptive are the governments and the society in Central America, to your efforts and what you are trying to do? Mr. ENGEBAK. I think that we have to perhaps look at things in a little historic perspective in Central America. We are basically working in societies that have gone through an extremely violent historic period, if you take into account, you know, what happened during the last 20, 30 years in Central America, with civilian up­ heavals, with 2.4 million refugees, displaced persons spread around in these countries. Obviously when you look at the street children problem in soci­ eties, in Guatemala, for example, there are 36,000 children who die every year of perfectly preventable diseases under five. Obviously when you deal with street children in this context, perhaps one really does not see perhaps street children as a very high priority against other mounting problems, you know, which the society is struggling with. However, we have seen that certain changes are taking place. There is a much better awareness. There is political acceptance that, indeed, we are faced with enormous problems with street and working children in Central America. Out of a child population of 13.8 million children under 16, out of this we have around ten, 15 percent of the children who fall into the category of street working children that are, you know, considered the high risk groups. And you can no longer ignore them. Newspapers are bringing it out virtually daily, and within the government there is the slow process of recognition. Traditionally most of the social intervention programs, many of them are handled by the First Ladies in Central America. There is a tradition there. Most of them are involved in one way or another with specific action programs. We certainly have that situation in five of the Central American countries. We also see that within the legal system, there are certain changes that are coming about. Certainly the Convention on the Rights of the Child has been a tremendous stimulant in this re­ spect. Now the National Plan of Action, as a follow-up to the summit meeting last year, certainly has brought it-because one of the seven principal objectives is exactly to deal with children in espe­ cially difficult circumstances. Specific objectives, specific goals have been set by the Ministries of National Planning. So, therefore, you can no longer ignore the problem. Certain specific programs have been defined. Certain financial resources have been allocated, but I think we also have to recog­ nize that without an international solidarity, without an interna­ tional purse, we probably will not see the acceleration that is re­ quired. I certainly believe that with the solidarity, with the gradual rec­ ognition we have seen in Central America, we can come to grips with the problem. I really think and I sincerely believe that within the decade we can probably have extended service programs to these children, and I think it is tangible. It is certainly tangible in Central America. In other parts of the world perhaps we are dealing with more mounting problems than what we see in Central America. We are still in the early stage of the urbanization process. 23 But I believe that with the current trends, we certainly, you know, will be able to deal with it, provided that it is accorded the international recognition, as well as the local recognition that it de­ serves. Thank you. Dr. KAMINSKY. I guess we have a very fortunate situation in Honduras, and we do have this similar situation where the First Lady of the country, who is the president of the National Family Welfare Association, has placed the problem of children in difficult circumstances and street children at the top of her list of interests which the National Family Welfare Association should address, and therefore, there is at least a small project which is operating with street educators and other human resources. Per did not men­ tion this, but it has the assistance of UNICEF, as well. At the Ministry of Education, there is some interest in this prob­ lem. As far as our project is concerned, we are working closely with the Ministry of Health too, and they seem to be sincerely con­ cerned about the health needs of abandoned and working children. And just to mention, although it is not the government, in Hon­ duras we have found a tremendous interest from the National Au­ tonomous University in this problem, which speaks to this concern we have about a societal response today and in the future. The only other particular experience I personally have is that I have been asked by the First Lady of El Salvador to visit San Salvador at some time in the near future to chat with persons there about a project which they are starting for street children through the equivalent of the National Family Welfare Association and they are utilizing a community-based approach. The CHAIRMAN. Mr. Emerson. Mr. EMERSON. Thank you, Mr. Chairman. I am pleased to hear our witnesses end on a somewhat positive note with their reflections and suggestions that it is going to be possible for us to get our arms around the problem. These are problems of just indescribable magnitude. I mean when we are talking about the numbers of people that we are talk­ ing about, and I think it is going to take all of the combined efforts of governments, the private sectors, and religious entities to get truly a handle on this. As all of you have talked here this morning and as I have lis­ tened, it occurs to me' that we come back to a problem we talk a lot about in this country and are in various ways trying to address in our own situation, but it is to the strength or lack thereof of fami­ lies. It is that nurturing element that is needed. Is there-and any of you may comment on this-is there an ef­ fective clearinghouse anywhere for what approaches work in cer­ tain situations and what ones do not work in certain situations? It seems to me that one of the most important things could be the effective exchange of ideas, and if someone somewhere is con­ fronting a particular problem and wants to consult with someone who has already dealt with it, that they know where to turn. In the PVO community, among governments, among churches, they should know. Is there such an apparatus, a clearinghouse? Ms. RocKY. May I? Mr. EMERSON. Certainly, anyone. 28 To follow up what Mr. Emerson said about a coordinated effort, you talked about a Child Survival PVO Desk. Is that in AID? Ms. RocKY. Yes, FHA PVC. Mr. GILMAN. Are they doing some sorting out and trying to co­ ordinate and trying to bring together some of the leaders and make certain that we are not duplicating efforts? Ms. ROCKY. When you say bringing together some of the leaders, what do you mean by that specifically? Mr. GILMAN. Some of the PVO leaders. Ms. RocKY. Oh, well, no. What they are trying to do is interest some of the PVO leaders into accessing this population of urban street girls. Most of the groups that work in the field, the Ameri­ can PVOs, are dealing with very simple child survival issues, Vita­ min A, oral rehydration, inoculation, et cetera. But it does not take into account that a lot of these children that they are giving, you know, this health care to are soon to go back into their communi­ ties or out to the streets and become very vulnerable to other health issues. Mr. GILMAN. Yes, but besides encouraging them to get into some of these areas, with the limited funds that are available nationally and internationally, are they doing anything to try to get a coordi­ nated program so that you are not tripping over each other and du­ plicating efforts? Ms. RocKY. No, there is no coordinated effort. Mr. GILMAN. Do you see a need for that besides your own Child­ hope trying to do that? Ms. RocKY. Oh, sure. Mr. GILMAN. I do not think you have the wherewithal or the funding or the personnel. Ms. ROCKY. No. Mr. GILMAN. It would seem to me that both UNESCO or AID people ought to be able to work together. Mr. ENGEBAK. UNICEF. Mr. GILMAN. UNICEF. I am sorry. To work together to bring about better coordination and the better utilization of the limited funding that is out there. Do you have some thoughts about that? Mr. ENGEBAK. Yes. I think that the group that sits around this table, I think we are exactly a testimony that we have accepted that challenge. I think it is safe to conclude that, indeed, there are very good coordinations between agencies in Central America. This is not the first time we have had an opportunity to meet and talk about this thing. I think that one can safely say that the meager resources that are available at this stage are very coordi­ nated in the countries where we are working. I think that what we have seen is that the sharing of experiences between the countries and between the agencies; I think that the networking is very important to insure that accumulated experi­ ences, the range of global experiences, is available to the various agencies that work in this field, and I think in that particular area I think we have seen a good sharing and a good networking, you know, that has been developed certainly in Central America. I cannot speak on the global. 29 Mr. GILMAN. Well, Mr. Engebak, besides the sharing, I guess what I am looking for is, is there any worthwhile international strategy that has been developed or is there a need for that right now, someone to provide a strategy and coordination of effort? Mr. ENGEBAK. Sure. I think that most of the successful programs have now been documented to a certain degree, and as we accumu­ late more experiences, they seem to become available between the countries, certainly the countries in Central America. Thanks to organizations that have a regional approach, I am re­ ferring to UNICEF and I am referring to Childhope. I think one can conclude that through this network, these experiences are be­ coming available. Mr. GILMAN. Well, has UNICEF adopted some sort of a world­ wide strategy for attacking these problems? Mr. ENGEBAK. Yes, we have. We have also regional documenta­ tion, regional strategies, regional objectives. All of these documents are available with the agencies, yes. . Mr. GILMAN. Is there some formal document that sets forth the international strategy for attacking the child street problem? Mr. ENGEBAK. Yes, there is an international document which is being made available to agencies. I believe that probably all of the agencies that are represented here and the ones that work in the field have access to this information. Mr. GILMAN. I do not know if we have that document, Mr. Chair­ man, but if not, I would welcome your providing our committee with copies. Mr. ENGEBAK. Sure. We would be very glad to. Mr. GILMAN. Does anyone know whether our AID has a strategy for attacking the child problem? Ms. RocKY. The issue of street children is very new. Five years ago we would not be sitting here, and we would not be using the term "street child" as a national or international issue. Mr. GILMAN. We have heard about it for ten or 15 years. Ms. RocKY. Well, from a legislative point of view, the language that h,as been incorporated into the Congressional Records, et cetera, and the focus of developing assistance has not been on street children per se. But, yes, just this past spring the House Subcommittee on For­ eign Operations did earmark in the orphans and displaced children an amount of ·money specifically designated for street children. Prior to that in the orphans and displaced children earmark, street children were not mentioned. In other words, you could define a street child as being displaced because obviously they are, but you could not get funding out of that earmark. That earmark now exists with the words "street children" and some of the funds have to be used specifically for them. So that is a movement towards inclusion. I have been asked to testify at least six or seven times in the last year and a half on the issue of street children before different com­ mittees, and basically to get AID educated on the issue and to begin to include them in their programming. Again, it is not an issue that had popular appeal. So what is hap­ pening now is really wonderful. It is very encouraging.

51-244 0 - 92 - 2 30 Mr. GILMAN. So as far as you know, we have not really evolved any strategy or policy? Ms. RocKY. It is coming slowly. Mr. GILMAN. We hope to get there? Ms. RocKY. Yes. We are moving. You know, yes, it is slow. Mr. GILMAN. Next week our committee is going to be addressing the urbanization of poverty, and I would assume a great deal of the problem comes from these families moving from the countryside into the cities. Has anyone made any statistical analysis? Ms. RocKY. This is an interim report to Congress. The urbaniza­ tion in the developing countries, U.S. Agency for International De­ velopment, November 7, 1988. This is a very-- Mr. GILMAN. 1988? Ms. RocKY. 1988, yes. Mr. GILMAN. Is there any current analysis of that? Dr. KAMINSKY. Only an analysis of our beneficiary group, and that is to say that out of a little more than 1,300 children, and I cannot tell you where their parents were born and whether they migrated to the city, but 20 percent of the children were born out­ side of the capital city, and we know that for many years in Tegu­ cigalpa the marginal barrio areas are growing at eight to nine per­ cent annually. Mr. GILMAN. Any recommendations by these panelists of what we can do to try to alleviate the urbanization and the poverty that comes when these families move from the countryside into the city and are not able to provide for themselves? Ms. RocKY. Well, we see it as the demographics of the future. It is a global movement. Rural to urban migration is going to peak at a point where 70 percent of all people will live in urban centers by the turn of the century. Mr. GILMAN. We know it is happening. We are looking for some solution. Ms. RocKY. Well, what can you give people out there in the rural areas to give them a way of life or give them back the way of life that they came from? You have a lot of wars going on right now in these areas. You have a lot of famine, under or unemployment situations. The fami­ lies come into the cities historically for income generation or to flee the violence in the rural areas, I think what you are seeking is changing political and cultural values and economic problems that are beyond an immediate fix. I mean they took time to develop. The CHAIRMAN. Mr. Hastert. STATEMENT OF J. DENNIS HASTERT, A REPRESENTATIVE IN CONGRESS FROM THE STATE OF ILLINOIS Mr. HASTERT. Well, thank you, Mr. Chairman. It is certainly an intriguing topic and of more than just a passing interest, I am sure, to this committee. I am going to be very brief here, but I do have a question. Ms. Rocky, what U.S. PVOs or NGOs are really getting involved in this issue in your estimation now? 31 Ms. RocKY. U.S. PVOs? Well, Childhope has its only focus as street children. There has been some change in the focus and the objectives of PVOs in the last few years because of the problem. I do know that Plan International has begun to look at the issue. Save the Children has begun to look at the issue. Christian Chil­ dren's Fund now has a specific program effort to look at street chil­ dren as a part of their development assistance. Again, most of our PVOs are historically and traditionally insti­ tutional and have very, very clearly defined goals and objectives that deal with development as opposed to alternative care systems, but it is changing. Again, I know that from the amount of presentations I have to make, the amount of requests for information that I am asked to get for these groups, there is interest. But they are going to have to change their focus because street children are not a part of that institutional box. Mr. HASTERT. I think you have hit the nail on the head. It is a social, parental care, economic situation. Ms. ROCKY. Right. Mr. HASTERT. This is sometimes the result of something that has been going on for a long time. I am not going to ask any further questions, Mr. Chairman. I ap­ preciate you bringing this issue before us, and I think it is of spe­ cial interest to some of us. The CHAIRMAN. Thank you, Mr. Hastert. Mr. HASTERT. Thank you very much. The CHAIRMAN. We do have some questions that we would like to submit to you, but again, this concludes our hearing. We very much appreciate your testimony. We need to make this more of an issue not only with AID and our government, but with Congress as well. I have talked to some Congressman and told them about this hearing, and they had never heard of this. People really do not know. So while you think that you testify a lot before committees and you have gotten a lot of publicity, the fact is people really do not know. We find this to be a major problem in hunger eradication throughout the world. We keep hitting this nail on the head as much as we can, but it is something that we have to keep hammering year after year, month after month. You have helped us today. We are going to try to help you. Thank you very much. [Whereupon, at 11:32 p.m., the committee was adjourned.] [Material submitted for inclusion in the record follows:] 32

Questions Submitted by Bill Emerson, Ranking Minority Member, to Mr. Per Engeback

1. What role can :he United States play in helping to ease the plight of street children ai:ound the world?

2. As a result· of UNICEF's assistance to Central American governments in the formulation of their post World Summit for Children National Plans of Action, what specific initiatives.bas UNICEF encouraged to improve the health and nutritional status of street children in Central America? Is UNICEF pursuing these initiatives in other coml!fies outside of Central America as well? 33

Answe rs To Bill Emerson's Questions

J.. The ·United States .ot America . c:an. play a major . rol.e to aH·eviate .:the.· situation of striili1t boys and gir-ls·.- The adoption of some simple measures within the fr•mework of e>

a) The incorporation of a specific component for ~treet children into the Urban Basic Services Programmes being implemented by U.5.AID in the developing countries would imply the leverage of major technical and financial rasources for th·ese children·;· .. UNICEF .Cparticularly in Central America) could provide technical assistance and ii:;'O'~l..;.ef f iden t/ rrie~liQdol'og '.ies ~· c;oni;fr::uent' · with' the; ~'!grii:tude 'i:i1 " the p'robie'm';·., urii:le'r a'. tra:iriework of " inter-ag'ericy ·collaboration. This · approach could serve to t¥i;ini t icantry~r~Ei~:?a'iid ·, · t.he ,: ·~o'!'er'ageL . 0.t J in terverjJi\:Jii'j!i;\ and capacity building within the government as well as in public and private sec-t;or institutions to address the problem.

b) The United States of America could help promote special measures to protect street children during economic ·structural adjustment period in develooinq countries. Con~ideration should be given to preventive/rehabilitation programmes in the areas of Primary Heal th Care, Pre-School and Basic Education, Nutrition, Street Teachers Training and/or the creation of transitory and open homes as variables for the evaluation of loans or non-reimbursable financial assistance. Reiief or debt-buy-back programmes should also consider the incorporation of a specia-1 Street Children Care component. In this approach, UNICEF in Central America has accumulated valuable e>

2. UNICEF in Ci;>ntral America supported the development of the countries' National Plans of Action in compliance with agreements reached during the XI Summit of Central American Presidents, particularly regarding the adoption of concrete goals for each country. In Health and Nutrition, goals are established at national and sectoral levels (i.e., BOX coverage of immunization, elimination of iodine and Vitamin A deficiency disorders, decreased morbidity and mortality due to diarrhoeal diseases and acute respiratory infections), Included in these sectoral goals are high-ri!lk and street children (boys and girls). However, health and nutrition · s·ervice delivery for street children are characterized by the approach and methods to reach them: · mobile preventive and curative health units are underway in Tegucigalpa,· Honduras, or . temporary shelters which provide heal th and nutrition .services a re opera ting in all of the Central Ame r ican countries. through.gC]vernment insti,tµj:ions., NGOs; religi_ous and . community organi i.it ·i. ~ns. 34

Questions Submitted by Mr. Bill Emerson, Ranking Minority Member, tc Dr. Donald Kaminsky

1. How does one deliver adequate health care to a street child on a continuing basis? It is possible to do this, but special systems must be set up. For the working children, especially those working in the markets and who may well have a parent or relative near-by, it is easier to provide continuing care and adequate follow-up. With the establishment of the prescence of s~reet educators with a defined population group, they can continuously survey the health status of their beneficiary group of children and the children or their parent know where to go in their community, i.e. the market, to l ook for assistance when it is required. The street educator advises the physician of the reliability of the child and/ or his parents. Upon the prescription of care by a visiting physician, the street educator determines whether the child or parent can be considered responsible enough for complying with the advice provided by the physician ; and if the determination is that they can not do this alone, the street educator assists with carrying out the physician's recommendations. In this way, the physician has more liberty in deciding whether to prescribe oral· medications requiring daily and repeated compliance with ingesting them or injections requiring less patient compliance. Usually compliance with dressing changes and wound care is not a problem. Referrals are followed up by the street educators and students working with the project. With the abandoned street children, who are much more mobile and at times difficult to find for case follow-up purposes, the care pattern is slightly different. The ph ysician determines whether a given patient has a hi~h or low risk of compliance with recommendations provided. Frequently, if antibiotics are required, long lasting single injections are provided. We suspect that when oral medications are provided for some of these children, they take them to the street to sell them. This is not the case for all members of this group, and we have found many of them to be very responsible in carrying out our recommendations. For those who require daily wound care or dressing changes or a follow-up visit for medical evaluation, a fixed site clinic is necessary, where they know the hours when the medical staff will be avai !able to attend them. Compliance in general is less with this group than with the working children, but excellent results have been achieved in resolving their primary health curative needs with the provision of care in the street and in the fixed site clinic. With the development of confidence by the street child in the health care provider s/he will seek out that provider on a continuing basis. 35

2. What is the extent of cooperation and coordinatio11 among PVOs, NGOs and governments, specifically in Honduras, given the extent and complexity of the problems confronting street children? There is a continuing attempt by the publir. and private sector to improve cooperation and coordination. Although it is not perfect , great strides have been made in Honduras towards achieving the levels of cooperation and coordination which will make us all more efficient. It is very difficult for a single organization to provide all of the services required to resolve all of the complex problems of these children,, although I personally believe that when the services or program offered by a given organization are more comprehensive, they will achieve better results. Project Alternatives attempts to provide a comprehensive service structure which can response to individual, family and community needs. In Honduras, there is one umbrella organization structured to include representatives from the public and private sector organizations concerned with street children. At this time this organization is not functioning well. There is a second organization which is structured to serve to coordinate private PVOs and NGOs working with street children. This organi zation is functioning very well at this time. The National Family Welfare Association has publicly stated their desire to work closely and collaborate with the non-governmental sector. The Ministry of Health, the National Autonomous University and the Mayor's office have been collaborating with Project Alternatives . UNICEF Honduras is very supportive of all ~ctivities performed to benefit the street children and actively promotes cooperation and cooperation among all organizations interested in the welfare of street children. There are still other institutions which could cooperate and coordinate ~ but the extent already existing is excellent. 3. To what degree are the families of street children included in the care of these children, and how receptive are the families to the assistance you provide. For the working children group, the families are almost always included in the curative medical care provided for the ir children .It is usually the mother who is involved, but the father is there sometimes as well. Many mothers accompany their children so as to discuas the case and listen to the recommendations of the doctor. This is done especially for the younger children. The famililes are very receptive to this assitance provided to them. Good quality care is offered in their community. They do not have to spend long hours away from their selling in order to accompany their children to a clinic or hospital miles away. 36

For those children selected for nutritional supplementation, the families are veri cooperative, receptive and grateful. They realize that the meal provided for their child frequently will be the only decent one of the day.

There is more mixed receptivity to the other asssistance we provide, such as group health education and recreational activities. Although in general the receptivity is very good, we do encounter the occasional parent who does not want to allow his or her child to be away from their selling duties in order to participate in these types of activities. For those children who receive assistance in non-formal education, the receptivity is excellent by the families. We could do much more of this type of work with additional resources. Also the families would be very receptive to vocational training for their children, if we had the resources to provide it for them. Only on rare occasions have we been in contact with the families of the children living in the streets. On those rare occasions the parents have expressed appreciation for the assistance we have provided their children. 37

Questions Submitted b~ · Mr. Bill Emerson, Ranking Minority Member, to Carlos Palacios

l. During your years of living on the street, what services did government agencies provide for you? Specifically, did you receive any health care, extra meals or vocational training?

2. To the best of your knowledge, what happens to street children when they grow up?

Answers To Bill Emerson~ Questions

L. The programme that I attended in Colombia during my time on the street .is paid 90% by the government.

2. If the street children get in contact with programmes at an early st~e there is a aood chance that they will change their life style. Most street children that "recover" will then work in the area as mentioned above (carpentry, electricity etc.), but there some are also reachini the university level. 38

CHILDHOPE USA AH IHl[RHATIOH.ll MOYCUEHT OH llEHAlF 0f$TllEf.TCHILDACH

Questions Submitted by Bill Emerson, Ranking Minority Member, select committee on ·Hurig1;fr,to Marilyn Rocky.

1. To what extent do trle programs currently involved with street children target the specia l needs of street girls? Furthermore, how do the problems of street girls differ from street boys? In developing countries around the world, economic difficulties are taking their heaviest toll on young women from low income families, who are often forced to work on the streets , in their ow n home s or in other settings. Research and anecdotal evidence have found that girls comprise between 3 and 30 percent of the population of working and street chi ldren in a handful of cities for which data is available. While existing data does not tell for sure, many programs which assist street and working children are speculating that girls are now working and living in city streets in greater numbers. The cause, they suggest, is that traditional family structures which once kept girls somewhat more protected than boys are breaking down in the face of long-term economic difficulties in many developing countries . A 1987 study conducted by CHilDHOPE found that 68 percent of projects assisting street children surveyed were working with street girls, but only a handful focused on the specific needs of young women. In essence, what many of these programs did was "add girls and stir" rather than focusing on the specific needs of low income urban adolescent women. Programs are now realizing, ho wever, that street and working girls have different needs, particularly those related to health, early childbearing, sexual abuse and self-esteem. While many of these issues also affect street boys, the impact on young women is almost always greater. For instance: In la Paz, Bolivia, recent interviews with 35 street girls conducted by the Fundacion San Gabriel found

t/o U.S. Committee for UNICEF 3l3 Easl :lath Street 6th Floor New York, New York 10016 USA 1212) 983-1422 39 that 72 percent of the girls had been pregnant, 19 percent had sought unsafe abortions, and 100 percent had a sexually transmitted disease at the time of the study, In Thailand, one source reports that 6 percent of the country's 10,000 HI V-positive people are female sex workers between the ages of 15 and 20. In Guatemala, a recent study conducted by CHILD HOPE found that 95 percent of 38 street girls interviewed reported that they had been sexually abused, and 55 percent had been pregnant at least once. There is a growing need for uniform data on the issues of street girls, particularly their health needs. There is also the need t o address the issue of street girls within the overall scheme of the status of women in developing countries. In essence, the programs should advocate for a feminist paradigm for approaching the issue of street girls. ******* 2 . To what extent has the private sector contributed to addressing the needs of street children, specifically, in the area of income-productionry The private sector has moved slowly over the last decade in its reaction to street children. However, little was known about the specific needs of these boys and girls until recently. Even now, good data is elusive. Also, street children were not a singular, specific category of chi ldren. They were tossed in with refugee children, worki ng children, orphaned children, children of war, etc. During The International Year of The Child in 1979, the situation of street chi ldren was addressed as a singular phenomenon in Third World cities. In 1982, a group based in Geneva, formed the Inter-NGO Program for street Children and street Youth. This Program was commissioned to do a three year stud y on the situation of street children. They found that these children were a major population group with minimal services available. They also found that almost all of the children on the street were there to generate income to help support their families. They were not abandoned. 40

The research that the Inter-NGO Program produced convinced numerous organizationas working with children, including UNICEF , that street children needed to be integrated into development programming . In 1986, with the support and endorsement of UNICEF, CHI~DHOPE was formed to be an international agency whose only concern was the situation and needs of street children. Since that time and through the research done by CHI~DHOPE, agencies are beginning to provide programming for street children. The main difficulty is that most programs are institutionally based. The number of street children is too large to be confined within the structure of an institutional care facility, Also, most street children have families and return from the streets each night to their homes. Therefore, the trend now is to develop alternative, street-based services for these children. Income generation is one of the areas that has taken the spot-light. ·The work of street children can be dangerous and difficult. But, the reality of their lives dictates . that they produce income for their families. Many times, if a child cannot bring home money, the family will abandon the child to the street. survival is the stronger drive. The focus on income generation is centered on those vocations or jobs that are non-exploitive and productive. street children are being taught skills that are usable and needed within the community, Many small local NGO's in Third world countries have created whole mini labor forces of trained street children who repair small appliances, fix cars, build furniture and manage bakeries. Also, they learn embroidery, metal work, sewing and hair styling. some children continue to shine shoes, but they are protected and given territories where they work. These shoe shiners have access -to inexpensive supplies in order to keep their businesses going. Alsd, another trend is to supply these working street children with "banking" services. They learn to protect their incomes and also to manage their funds. The work of these children is performed within the "informal" sector of the economy, Most of the cities where street children live and work cannot provide jobs within the "formal" sector. or, if jobs are avai.lable within the 41 factories, they are mostly exploitive, difficult and dangerous. Child labor in Third world countries is another subject that needs consideration. However, in many cases, children who are forced from their factory jobs , eventually end up on the streets working in the informal s ector.

******* 3. To what extent are large donors receptive to innovati ve ideas for reaching street children such as street schools and street educators? UNICEF has become an innovator in providing funding for street education. In Latin America, UNICEF has funded CHILDHOPE to begin institutional training of street educators throughout the region. Man y European funders have begun funding alternative educational activities on behalf of street children. The Swedish International Development Agency has provided significant funds t o save the Children Sweden for street education. over the years, save the Children Sweden has funded CHILDHOPE to train street educators in Latin America with these funds. save the chi 1dren in Norway and the Children's stamp Foundation in the Netherlands has also provided funding to CHILDHOPE f or this activ itiy. Most recently, two Japanese Foundations have funded CHILDHOPE's training and alternative services for street children in Southeast Asia. unfortunately, u.s. funders are not familiar with the needs of the s treet child. CHILDHOPE has had experiences with large u.s. foundations that show they have traditionally funded programs for youth in the developing world, but when approached on the funding needs of programming for street children, they indicate they are not interested in the population. USAID had to be given a special earmark within Orphans and Displaced Children this year that specifically mentioned street children, because the office that received the funds refused t o consider street children as either "displaced" or, in some cases , "orphaned." rt is essential that funders understand that the growing population of street children not only demands their 42 attention as an important issue, but it also demands that the funding be directed t owards the most effective programming that benefits the child. The needs of street children and the spec ial methodo l ogies created to help them are new elements for funders. Yet, in the places where street educators do their wor k , there i s no doubt that street children are helped and prov ided with the support they need desperatel y . The idea that street children need t o be institutionalized is wr ong and destructi ve to the child, his / her famil y and to the community . CHILDHOPE is f ortunate t o have at least UNI CEF support the training of street educator s in Latin America. Howe ver, there has to be more support from others t o make this valuable service availab l e t o more and more children on the street. 43 44

Mr. Chairman and Honorable Members of the Committee,

My name is Per Engebak. I live in Guatemala where I serve as the Representative of the United Nations Children Fund - UNICEF - for Central America. I have been with UNICEF since 1975 and _have worked in almost 100 cou,ntries· ·of the developing world. I am grateful for the opportunity to share with you today some perspectives about UNICEF's program for Central America's least protected children ••• exploited children, whose numbers are multiplying at an alarming rate. Every eight hours 1,000 babies are born in Central America. Of these 1, ooo babies, 84 will die before they reach their fifth birthday. Of the 916 children who survive, 476 will live in poverty ••• and an additional 216 will live in extreme poverty with their parents earning so little that they cannot afford to buy the basic food items of rice, beans, corn and bread to feed them. Five hundred and twenty-three of these children will be malnourished. They will feel the pangs of hunger almost every night before they fall asleep. Of these 916 children, only 773 will enter school; a meager 270 will complete their primary education. By age ten, most will have assumed some adult responsibilities required for their families' survival. Forty- five will either live or work on the streets and an even greater number will be exploited in a variety of manners equally or more appalling than those who find themselves on .the streets.

Those who have testified before me have painted a vivid a nd disturbing picture of the personal plight of each of these so called street children. This touches the depths of our humanity. We all want to reach out and abate their pain. Yet both the immensity and_complexity of the situation can overwhelm us with a frustrating sense of impot ence to confront what may seem to be· an insurmountable problem. ·

Nevertheless, my m9!Ssage today is one of tangible hope and optimism. UNICEF knows that with a systematic and comprehensive approach, this tragic situation can be substantially ameliorated within this decade • ••• if a wide enough base of commitment and support can be obt ained: This is not a utopian dream. _Twenty years ago in Central America infant and child mortality was also considered a supposedly "insurmountable problem". Today infant and child mortality _rates are less than half of what they were at that time. Now, as the region continues to strive for greater declines in the death rates of its children, it faces the disturbing question "after saving their lives, then what?". Amid the achievements of programs that have reduced infant and child mortality has arisen the challenge of protecting the development and essential humanity of those who do survive. ·

1 45

UNICEF's work on behalf of Latin American street children began in Brazil in 1981 and in Mexico, Ecuador and Colombia in 1983. Over the years, our assistance in these countries has substantially grown. For example, in Brazil we are now supporting 300 projects for street children. These early interventions provided a base of experiences and lessons that are .now being applied throughout the region by governments, non-governmental organizations, churches and pommunity groups.

My · presentation today focuses on UNICEF' s program for street children in the Central American countries of Belize, Costa Rica, El Salvador, Guatemala·, Honduras, Nicaragua and Panama. Obviously time does not permit a -thorough explanation of this program. Thus I will limit remarks to a brief description of its major components, some b<.>.ckground of why we have chosen these lines of action, what we have done, what we are currently doing and our plans for the period up until the end of 1994.

UNICEF's project for street children in Central America is part of a larger program directed at the high risk group known as "Children In Especially Difficult Circumstances". While street children are one of the main groups that we . reach through this program, its target population also encompasses other exploited children including: working children, abused ·and abandoned · children, children affected by disasters and institutionalized children. It also includes children affected by armed conflicts, i.e child soldiers, war orphans and refugee or displaced children.

These categories describe the extremely difficult circumstances that many Central American children are experiencing. More often than not, a street child may fall into more than one of these categories at various times in his or her childhood. For example:

an 11 year old who lives and sleeps on the streets in one of · Central America's major cities may have lost his family in armed conflict ••• when and if he finds work, he may only receive $1.00 per day for his labors.

A 12 year old prostitute may opt for institutionalization, for _a short time, so that she can receive treatment for a venereal disease;

A severely abused 7 year old may choose to survive on the streets for a time but then return ·to his family, making the decision that the beatings he gets at home are not as bad as those received from his older street companions.

In other words, our focus is on the child in whatever set of especially difficult circumstances he or she may endure. , our experiences in working with these children support this approach.

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The major components of UNICEF's program for Children in Especially Difficult Circumstances in Central America are:

1. Research

2. Advocacy 3. Institutional Development, and

4. Support for Projects

This comprehensive program, takes a systematic and multi-faceted approach to the situation which is based on UNICEF's four decades of experiences in Central America. rhe program is also complemented by a package of larger programs in the areas of · health, education, early childhood development, literacy, water and environmental education and women in development. These programs are tackling some of the root causes of the street child phenomena, that UNICEF is attempting to place high on the world's agenda during this. development decade.

1. Research

Early interventions on behalf of central American street children, by .governments and voluntary agencies, were hindered by the dearth on information on the subject. Although we could make some educated guesses, based on observations and an analysis of the economic and social situations of each of the countries, there was no objective data _on the extent of this alarming situation. To give you an idea of how little information was available •.•• in 1988, estimates of the worldwide population of street children varied between 10 million and 100 million.

Without specific and objective data on the magnitude of the problem, it was difficult to design interventions that would have sufficient impact. Because of this lack of information, the first responses made were often quick "stop- gap" measures. However well meaning, they treated the· symptoms rather than the roots of the problem and by their very design were too costly to reach even a significant minority of the affected children.

·At the same time, it is impossible to advocate to governments and the private sector to protect and assist these children if one does not have well documented facts.

During the past few years, UNICEF has supported a general analysis of the situation of street children in each central American country• Data has been systematically compiled and analyzed from a multitude of sources, including primary research, university studies, NGO reports and others. Already these analyses are being used by governments, NGOs and .international institutions to improve the effectiveness of their interventions.

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As an outcome of analysis done to date we have gained major insights. First, that street children i.e. children who e i ther live, work or dwell most of their time on the streets, are the visible minority of a much larger group of exploited children. Secondly, that the responses required are complex and require a multi-sectoral approach, and finally that there remains much more to be learned.

To elaborate, the children we see on the streets are merely the visible element of much larger groups of exploited childr en who remain concealed from the public view. Ironically and unknowingly, street children are forcing the world to recognize their heretofore unnoticed brothers and sisters whose plights are hidden calamiti es. These include, among others:

child workers, abandoned and abused children, young girls given away to serve as housemaids, infants and children given away or sold by their pare nts, sexually abused teenagers, who l ·ive the hidden lives of prostitutes, and child soldiers.

All these children are exploited.

Secondly, this situation has no quick-fix solutions. For example , the enforcement or strengthening of child labor laws is not the sole solution to the problem of children compelled to work for their own and their families' survival. Although we could all agree that an 11 year old child should not be working full time, how do we address the reality that the $25 dollars he earns each month is half of his family's total monthly income? If the child labor law is effectively enforced in his country, how will his single mother feed his four younger siblings?

Third, our preliminary analysis of the situation has brought into focus the many dimensions of the problems of street and exploited children that are still not well documented nor quantified. To cite a few examples:

little has been documented about the health and nutrit ional status of street children, although isolated studies and observation suggests that drug addiction, dental diseases, skin infections, malnutrition, parasites, respiratory infections, venereal diseases, and perhaps AIDS may be their major health problems;

the number of children who work in the informal sector and the conditions of their work is unknown in most countries due to problems of definition and access; and

accurate data on child trafficking is not available.

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To obtain answers to these and other questions, UNICEF will continue to support "hands on" research that can be quickly applied into concrete actions. Although we certainly have a better·grasp of the breath and complexity of the issues we face, it is essential to continue the process, ensuring that decision makers have the objective data they need to act on behalf of these children.

2. Advooaoy and Mobiliaation One of UNICEF's strongest and most successful areas of intervention for street children is advocacy and social mobilization. It is the . major lobbyist for children within the region. In the mid 1980s, UNICEF began to sensitize institutions and political authorities to the growing number of children living and working on the streets. Central America's economic crisis necessitated the adoption of economic adjustment policies that led ~o dramatic increases in the number of persons living in poverty. This came at a time when the economic austerity measures required governments to cut social sector spending and civil conflicts increased expenditures for defense. To illustrate: in Guatemala alone, in the three-year per iod.between 1986 and 1988 an additional . 1,640,000 persons joined the ranks of those living iri poverty. Street children are but one of the manifestations of the deterioration of the standard of living in the region. · Many children can no longer depend on their families for the support they need. UNICEF strongly and successfully advocated that economic adjustment be made "with a human face" to protect those most vulnerable to the economic crisis •••.. poor children. It mobilized a massive campaign to put CHILDREN FIRST in the political, economic and social policies of each .country. Since 1990, our advocacy efforts have intensified with the goal of obtaining the highest level of political support for the survival, protection and development of children. This advocacy and mobilization has centered around two major initiatives: the International Convention on the Rights of the Child, and the World summit and Plan of Action for Children.

An outcome of rigorous advocacy was that each of the seven central American countries, in the past year, ratified the Convention on the Rights of Child. In fact, three of the region's countries were among the first twenty in the world to ratify it, thus bringing it into force as binding international law. Thus, there now is in place the legal framework for advocating for· exploited children within the region.

5 49

UNICEF recognizes that the promulgation of legislation does not ensure enforcement. currently we are assisting governments to establish ~fficial entities to advocate for and to monitor compliance with the Convention. In Guatemala and Costa Rica, a National Ombudsman for · Children has been appointed and in Nicaragua, a National Child's Rights Commission has been organized. In a number of countries, UNICEF is . supporting the review and revision of legislation· so that national laws are in compliance with the Convention. Complementary to the legal framework established by the Convention is the World Declaration and Plan of Action for the survival, Development and Protection of Children that was adopted at the World Summit for Children, held on September 29 and 30 of 1990. At this unprecedented meeting, leaders of· 150 nations including the presidents and heads of states of 71 countries, met together at the United Nations, for the largest gathering of world leaders in the history of humanity. The leaders of each of these countries committed themselves to achieve by the year ·2000 a set of 27 goals for children. Each of the presidents of the Central American countries are signatories to World Declaration and Plan of Action for Children. The Summit has already yielded extraordinary practical results in Central America. One month after the World Summit, UNICEF played the leadership role in organizing a meeting of all the ministers of health and education of Central America where they began to plan steps for achieving the goals within their countries. Since that time, UNICEF has taken the leading technical role in assisting each country to formulate its own National Plan of Action for Children. These plans set an incredible political course of action . in which children are the priority. Each national plan makes specific provisions for street and exploited children. Next month, the . Presidents of Central America will be meeting in Honduras for an special Summit on Children, Youth and Human Development. At this time they will commit themselves to ensuring implementation of their national plans and to make resources available to do this. In . short, the highest level of political commitment will now be secured for concrete actions that will ·directly improve the plight of children in the region. Along with UNICEF's advocacy with national governments are similar actions with churches, professional groups, municipalities, labor unions,. private enterprise, mass media, and community groups. For example, several years ago, UNICEF instituted . a National Press Prize in each of the countries. The prize annually recognizes those members of the mass media who bring to public attention •.• via radio, television and the printed press •••• the state of children. In Guatemala and El Salvador, we have developed very fruitful alliances .with major corporations to undertake actions on behalf of children. Thus far our work with the private sector has been

6 50

focused on child survival; however, we envision an expansion of t he s e a lliances to other a reas. ·•.• including exploited children .

. J . Institut ional Dev e lopment

UN I CEF confronts the reality that governments, NGOs and other service providers simply do not have the institutional, financial a nd t echni cal capacities to adequately address the problems of str e e t and working children. We are ever cognizant of the l i mi t a tions of t hose who wish to take action.

Our challenge is t o strengthen the capacities of existing i ns t i tutions a nd to expand their services for exploited children. In ge neral, our primary intervent ions in this area are through t raini ng a nd technical assistance. This is a relatively new field a nd f ew na tionals a re t rained to work with street children. Our contacts t hroughout the a rea, as well as UNICEF's global range of e xper i e nces ena ble u s to bring to Central America a cadre of pro fessionals t hat can reorganize and fortify the services of i nst itut ions to rea ch t hose children at greatest risk.

Advocacy, when coupled with training and technical assistance can b r i ng f ruitful results . As a case in point, in Honduras, in 1986 there were only three projects for street children and the use of s t r e et e ducators was virtually unknown. Today there are 15 "street prog rams" and last year UNICEF assisted in the training of 50 s treet educators. The r ange . of gove rnment al institutions that will dir ectly benefit froru t r aining and technical assistance in each country includes: Mi nis t ries of Health and Education, Social Welfare Boards, social Se curity Institutes, National Commissions for Children, Juvenile Court s a nd Nationa l Police Departments. This assistance also continues t o b e of fered to NGOs, churches, service clubs and community groups .

UNICEF • s major pa r t ner in this effort in Central America is Childhope, an international NGO founded by a former UNICEF Senior Po l icy Specialist in 1986, to specifically address the plight of street c hildren with major support from UNICEF.

4 . s uppo r t f o r Projects .

At the same t ime t hat UNICEF is consolidating a base of information on e xploited children, cat alyz ing political ·will and developing institutiona l c a pacities to address this problem, it is assisting dir e ct s e rvice interventions. Our support extends to numerous and d i verse projects for · exploited children in each of the countries. Examp les include: a s t r eet educators- project in Nicaragua, and in Hondu ras an innovative "Sports for Life" project utilizing sports t o reac h vulnerable groups of children in cooperation with church groups .

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As a point of clarification, UNICEF's modus operandi in central America is to financially and technically support the programs and projects of nationally based counterparts rather than to directly provide services. This is an essential strategy for sustainable development. Our criteria for project selection is that they be cost effective, affordable and that they can be maintained after our assistance is no longer available. Agreements have now been reached in each country to intensify this component of the program through alliances with governmental agencies, national and international NGOs, churches, local governments, services clubs or community organizations. To cite but a few examples of how this cooperation will be directed during the coming five years: In El Salvador, an alliance has been established between the National Police, the Olaf Palme Foundation and Childhope to reduce the major threats to street children including: drug addiction, violence, prostitution and crime. This project will also support the organization of street children for self-management in the solution of their own problems. .BY 1994, approximately 10, 000 street · and working children in three of the country's largest cities will benefit from this effort. In Honduras, our counterparts are the National Commission for Assistance to Children in Irregular Situations, public centers of the National social Welfare Board, voluntary agencies and organizations of the private sector. Among the activities that are and will continue to be assisted through this alliance are health, education and recreational services and self help workshops for street and working children.

In Guatemala, in coordination with Childhope and the National Commission for Action for Children, a program has been launched that will reach 5,000 street and working children. An education scheme has been devised that tailors the school curriculum, calendar and hours to the circumstances of these children. Occupational workshops and income generating projects are also being established for street children.

In Panama, the ~uvenile Protection Court, the National Police and the Ministr,ies of Health and Education will be supported in a project that will attend to 500 street and working children. Services include: child protection from abuse and mistreatment and the rehabilitation of children addicted to drugs or who have been prostituted. In its support to NGOs · and community groups, UNICEF · takes a pragmatic and flexible approach that sparks creativity and innovation. Demonstration projects are actively encouraged. The myriad of projects that UNICEF supports are, and will continue to

8 52 be, carefully monitored, analyzed and evaluated - with the participation of the child beneficiaries themselves. As successful methodologies that can be replicated are developed, they will be documented and widely disseminated. These methodologies will be the foundation for greater coverage in the future. An interchange of experiences between countries is facilitated. Together with Childhope, UNICEF is establishing a Central American network of governmental and non-governmental agencies assisting street and working children.

To summarize, UNICEF' s program for street children in Central America aims at gaining a better understanding of the situation, mobilizing commitment at all ·1evels, developing institutional capacities and supporting projects for an amelioration of the plight of t hese children.

Mr. Chairman and Members of the Committee, Thank you for this opportunity. I hope that you will support UNICEF's efforts to ensure that the 1,000 children who will be born during the next eight hours in central America will not find their future on the streets and in situations of extreme exploitation. The choice is ours. I close with the words of the Nobel Prize winning Chilean poet, Gabriela Mistral "we are guilty of · many errors and many faults, but our worst crime is abandoning the children, neglecting the foundation of life. Many of the things we need can wait. The child cannot."

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FACT SHEET ON STREET CHILDREN

Poverty, hunger, disease and a lack of economic opportunities in the rural sector of the Third World have contributed to massive migrations of the rural poor to urban centers in search of improved economic opportunities and a better way of life. Already experiencing economic crises, these centers have in many instances been unable to provide these "sought after" economic opportunities. AJ; a result, many families have fallen prey to a host of economic and social calamities, including unempl.oyment, family disintegration, homelessness, hunger and disease. Recent estimates cite that approximately one-third of the population of the developing world live in urban areas, and it expected that within 20 years more than half of the population of Third World will live in urban slums.

The most visible reflection of the ''urbanization of the third world" are street children. Defined by the extent of theif connection to family ties, street children are generally characterized as either working street children, meaning they spend the majority of their time on the streets working, maintaining some family connection, or they live totally on the street and have tenuous, if any, connection to family support.

Street children are a part of the global urban landscape. Childhope, a leading international advocacy organization for street children, estimates that approximately 100 million children live and work on the street. For these children, their very existence is threatened daily by hunger, Jack of health care, violence, drug abuse, disease and even death. Below are a few statistics on street children:

o 100 million children live and work on the street in the developing world. Seventy fi ve percent of these children work during the day and go "home" at night. The remaining twenty five percent of these children live totally on the street.

o The most common age range for street children is between eight and fifteen, although children as young as age four can be found selling on street corners and begging. The most common age for a street child to leave home is age 12.

o Street children suffer disproportionately from malnutrition, have inadequate, if any access to health care, and receive little basic education. 54 o Data is limited, but statistics show that a majority of street children regularly use drugs. Surveys indicate that for most of these children, drug use is associated with hunger. Sniffing glue is often used to take away hunger pangs.· o -Street children are often sexually exploited and many engage in prostitution as a way to maintain some kind of income. The result of this activity is an increased risk of contracting AIDS. Although data is limited, studies from Sao Paulo, Rio de Janeiro, and Khartoum show HIV-positive rates of between 2 and 10 percent.

The U.S. Agency for International Development (AI.D.) assists street children indirectly through several sources including its Health and Child Survival accounts. However, direct U.S. assistance to street children is limited. AID assists street children under the following legislation:

Foreign Operations. Ewart Financing and Related Programs Appropriations Act of 1992 ("Displaced Children"): Appropriated $8 million to AID for programs and activities for children who have become displaced as a result of the effects of drought, civil strife, and other natural and man-made disasters. It is recognized that many of these displaced children become street children, thus, $1.5 million has been earmarked to specifically address street children. The $8 million is geared towards addressing Jong-term solutions to issues involving displaced children.

International organizations, private voluntary organizations (PVOs) and nongovernmental organizations (NGO's) provide the bulk of assistance currently given to street children. These organizations provide a variety of services to street children, including center-based, community-based and on-site services.

REGIONAL STATISTICS: o LATIN AMERICA: 40 million o ASIA: 25 - 30 million o AFRICA: 10 million

SELECTED COUNTRY STATISTICS: o BRAZIL: 7 million children live on the GUATEMALA: 5,000 children live on streets; 17 million work on the streets the streets of Guatemala City; 1.4 million work on the street o DOMINCAN REPUBLIC: 3,000 children live on the ·streets of Santo Domingo; PHILLIPINES: 1.2 million live and 45,000 work on the streets work on the street 55

QuestiOJJS Submitted by Tony P. Hall, Chairman to Mr. Per Engeb:ick

1. Please describe the difference between UNICEF's proposed pilot program for street children in Central America and UNICEF's past and ongoing efforts to address the need ~ of these children in Central America.

2. Approximately what percent of the total number of street chiidren in Central ·America do you anticipate could be helped off of the streets by the year 2000? What is a reasonable goal?

3. What financial resources have been mobilized for UNICEF's pilot program, and how far do these resources g·o in meeting the needs of the program?

4. Do you foresee any majo· hurdles in UNICEF's fu ture efforts to implement the pilot program? 56

·- i Answers To Tony P. Hall's Questions 1. The major differences between the present UNICEF Programme for Street Children •nd past cooperatio~ ~rovided by our organization are ba sically as follows: a) New and increased p6litical will expressed by the · Presidents during the XI Central American Summit Meeting and increased public o~inion concern which permits the mobilization · of .' the countries, ONGs, the Church, community organizations and the media to alleviate the problems faced by,, t~. ~sl\' . · Ch. ildren.

b) · Accumulation of valuable experiences and lessons learned ~-~; .~'Sff~.";~·~~~~~:~~-6 :~Y.: ~~-·r~~~2~~~rlr;>.~ t~· ~:~. ~p :H~~.:t. ~:~~~~ ·. go ye rnmen t .s 'an·d t·· prf\.i'at·e ·· irist{tut-io'ris·. ·. ·: Dem·onstration projects, systemilt:ization and. evaluation of the . impact of various ;i;~if;f~!=l: ; _'.~1,~t.'~f.~ ~i;li.~;ii i,i'..f'."~~:ff~l;> '. '.'t~f'?,·:·-~sifef:. i:fic ·. se.rvi~e proposals for street children and 1ncreas1ng the quafity and coverage of preventive and rehabilitative care.

2. Service provision for SOi( or more stree.t boys and girls is a reasonabie goal for Central American countries: UNICEF has undertaken a detailed analysis of the situation of "Children .in Espei_cia1 l y Di ff icul t Circumst_ances," which includes Street boys and girls. These investigations have demonstrated that children living . in the streets are relatively few (i.e. approximately 1,500 in Guatemala City, with a population of 2.2 . million inhabitants=. Howeve~, these represent the visible pea·k ·,;, the iceberg; with .

3. The Central American Programme for Children in Especially Difficult Circumstances has mobilized voluntary contributions ·. from. the governments of the Netherlands, Canada and, Just recently, ' a ··non-reimbursable a~sistance agreement was signed with the Inter-American Development Bank, in the amount of US$3,0 million. While these resources are extremely important for the Programme, th"'Y are insufficient to fulfill the commitments adopted by the Central A~erican governments during the XI Summit of Central American Presidents.

4. UNICEF does anticipate to encounter major difficulties with the implementation of this Programme, except tor problems of a s tructural nature (adjus tment policies, decreased social investments as well as cut-offs in the budgets for Education, Health and Nutrition, or increased basic commodity prices and decreased sal~ri e s, e tc.) The~e 1actors, in addition to the uncontrolled -growth of marginal urban slums · could negatively affect the impact of this programme and contribute to increase the number of street children. 57

Questions Submitted by Mr. Tony Hall, Chairman to Dr. Donald Kaminsky

1. On a percentage basis, to what extent do hunger and hunger­ related problems such as malnutrition affect the street children yot1 treat?

All of the children we treat whether they be working children or abandoned children come from a background of poverty or extreme poverty. Within those socio-economic groups virtually all children r eceive less than adequate or recommended food allowances in quantity and /or quality. Unfortunately , these c hildren are even affected as fetuses when their mothers receive an inadequate food intake during pregnacy. So they virtually are affected from the beginning of their existence. When we see them a s c hildren or adolescents about 80% are short for their age, reflecting a c hronic malnutrition status. On rare occasions, we see acute severe malnutrition. This we have seen in the children of working mothers, not in the abandoned street child. Although we have not had the resources or the oportunity to study the extent of anemia in adolescent pregnant girls, I expect that it is significant and would thus have an adverse effect on the morbity and mortality risk status of the infant. Thus we can state that at least 80% of our project population are affected at some time in their life by hunger and hunger-related problems.

2. Please describe what you believe to be the most effective approach to providing medical assistance to street childre~ .

If the r esources were available within the existent public health system, if personnel were trained to response to the usual as well as unusual needs of the street c hildren, and if the street children would express confidence in the public health system, then the best approach would be to integrate the provision of care for their primary, secondary and tertiary medical care needs into the existent medical care systems.

Unfortunately , this does not seem to be the situation at this time, although it is hoped that the above approach can be achieved in the future.· Therefore, Project Alternatives is developing an alternative service model to reach these children and it appears to be effective. The alternative approach is to carry the services to the working children, and their families; to provide primary health care in the markets and in the streets whe re we find the children working. A generalist physician assisted by a nurse provides these services. Histories and physical exams are carried out in closed spaces provided by the community, e .g. the offices of the market administration, the room which the market vendor's association utilizes for their meetings, t he bac k area of a store . 58

This profesional team is accompanied by a street edu cator !us ua lly a primary school teacher who has been trained as a street educator) who has t he responsibilty to perform foll ow-11p visits o n the child treated a nd to r eport back to the physician if the case does n ot resolve or if complications occur . A system of multidisciplinary team meetings is set up so that no case goes more than a maxi mum of 24 hours before there i s t he opportuni ty to report on progress or problems. If l aboratory examinatio11 are necessary, a referral form is made out and the c hild i s sen t with the street ed11cator to the public health system laboratories where the examinatio ns are performed. The physician and the nu1·se carry basic diagnostic equipment and medical s u pplies in backpacks. All dental care is provided through referrals. All special ist consultations and hospital l e v el care is provided through r eferral to the public health care hospital system . It is necessary t o h ave a working arrange ment be tween the care providers in the community and in the streets and the public health care system. This arrange me nt is working well in Honduras. Private non-profit, non-governme ntal organizations such as the Red Cross , the Honduran Fight Agai n st AIDS, and primary care c linics dependent upon r e lig ious organizations sho11l.d be i.ncl11ded i n a net work of possible r eferral sources for the c hildren . The same approach is utili zed for the abondeded street c hild, but on additional element needs to be introduced, i . e. a f ixed site dispe nsary, central l y located, where services can be provided to that group on certain days and a t certain hours si nce that group of c hildre n is so highly mobile . One s hould prov ide c 11r ative co are to this group no matter whether they arrive a l the clinic und e r the influence of drugs or not. Spec i a l effort s must be made to assist the percentage of this group who present pharmacodependence, u s ua l l y to sniffing volatile s 11b stances. Frequently these children state that they s niff g lue in order to reduc e hunger pangs. First aid is provided in the markets and on the streets by all of the staff.

Besides resolving cL1rative care problems, addressing mental health car e needs is a very important part of providing the mo s t effect i ve approach. Co unseling by all staff , including a staf f psychologist, i s necessan•. Although it is not usually discussed, the expression of a ffection a nd unde rstanding b y providers while add r essi ng the o ther nee ds is an important element of effective provision of services for st1·eet c hildre n.

To have a compl ete care program and not just address the c urative needs, intensive hea lth edu cation in groups a nd individ11alb·, s uppleme mtnal feeding interventions for selected c hildre n a nd an active recreation acti,•ity a re important other elements . Good supervision and an active contint1ing educatio n progran for the staff, as well as an effective monitoring system of all activities should help assure an e ffective approac h . 59

3. In your opinion, what is the status of data collection effort s regarding health and nutritional concerns of street children in Latin America specifi c ally, and wo r ldwide?

I believe that data c o llection efforts are very gooa worldwide for tho se c hildren under 5 years o f age .

In my opinion, data co llecti o n efforts in Latin Ameri c a a n d worldwide for working and a bandoned s treet children under th& ages of 18 are severely deficient. This s ituaiton must be c orrected in order to assist u s in arr iv i n g at the mo st effec ti v e soluti o n s to the problem. In refe r enc e to s treet girl s , t he information is even mo re limited . 60

Questions Submitted by Tony P. Hall, Chairman to Carlos Palacios

1. What types of p~ograms (i.e., walk-in clinics, street doctors, orphanages, etc.) are most successful in improving the health, nutrition and education of street children?

2. Based on your e>qierience, what types of income-producing activities are most appropriate and effective for street children to pursue?

Answers to Tony P. Hall

1. Programmes with non-traditional methodology are most successful as the street children ars feeling more confident in such pro1trU1111es. · 2. Based on 1117 e::cperience the most income-producing activities to pursue for the street children are workshops in carpentry, electricity, music and ceramics. These are easy .to learn and sive fa;st results, which is very important for street children in seneral. 61

C;1!ii.IHOPE ~1 £.m SSlh STffCT CHILDHOPE MEW YOllK NLW YDKi{ 10016 USA AN IHTE"HATIOH.il Questions submitted by Tony P. Hall, Chairman, Select committee on Hunger, to MariH'Ii ·RotKY. 1. In your testimony, you stated that street children do not show up in health statistics or on a national census. How does CHILDHOPE derive its estimates that over 100 million children live and/or work on the street? ' The numbers of street children are a compilation of several groups within a community. CHILDHOPE's sources come from a variety of networks, including police statistics, Ministries of Health, street educators, programs working with street children, community based care givers, UNICEF, the ILO, WHO, and formal research. The traditional definition of street child has changed over this past decade from: "an abandoned urchin," 1 iving on the street , without family or support systems, to: a child or youth who spends the greater par~ of any day on the street; usually to earn income, but has a family that depends on this money for economic survival. Since the urbanization of the Third world began in earnest over the past two decades, more and more children have gone to the streets as "economic refugees." ' rt is important to note that most street children do not live on the street. They work on the street. Only about 5% of the total number ~f street children are actually abandoned or totally disconnected from the family. As more and more families migrate to the cities of the Third world, more and more children will come to the street to generate income. That is why the numbers are so great. **** 2. Your organization advocated an approach that emphasizes non-formal methods for reaching street children as opposed to institutionalization. To what extent do governments institutionalize street children and under what circumstances? street children have been institutionalized by the authorities in many countries as a solution of getting them "out of the way," unfortunately, most of the institutions housing these children are adult prisons. There are very

c/o U.S. Committee for UNICEF 333 East 381h Street 6\h Floor New York, New York 10016 USA (212) 983·1422

51-244 0 - 92 - 3 62 few other government facilities capable of confining the children . The horror of those prisons has been written about by many human rights groups. Children as young as a or 9 years old have been but in cells with adult murderers. Many, if not all of the children, have been raped and brutalized during incarceration. some countries provide "reform schools" for street youth, but the general consensus is that they would more correctly be designated as "deform" schools. ususally, t he conditions are sub-standard. There is little offered 'to the child during the stay. Most of the children are kept in cells; their health needs go unattended; no effort is made to provide them with education or vocational training. In effect, they spend months or years without any means of becoming better equipped to re-enter the community. In Sao Paulo, Brazil, for example, 85% of the prison population are former street children.

******* 3. What recommendations do you have regarding the direction U.S. assistance to street children should take, especially in the areas of health, nutrition and education? First, nothing can be done effectively in any of the above areas until the real situation of these children is recognized. Almost all of these children on the street have to work for the economic survival of their families. Therefore, they are unable to attend school. Health care, as it is provided by U.S. development assistance, almost never reaches this population of children, especially the female child on the street. Girls are especially vu lnerable to prostitution, unwanted pregnancies, illegal abortion, STD's and HIV / AIDS infections . . second, these children are extremely hard-to-reach because they do not live within the comm unity. They are slum dwellers, at best; or, their families live on the streets. The traditional development assistance goes through institutions or programs that are within the mainstream of the community. These children and their families deal with day-to-day survival. They are not aware of "development assistance" from their vantage point on some street corner. 63

More funds have to be diverted into the "street ·environment." Programming ' has to be developed with the needs of these children, specifically, in mind. At this time in our history, the numbers of young, poor, urban minors reflect the majority of the inhabitants of Third world cities. And, if statistics and long term projections are realistic, the cities of the Third world will continue to grow and swell with the youthful poor as the center point of the populations. These children of the streets, the working children of the streets, are the rule, not the exception, when viewing the demographics of the urban landscape. u.s. development assistance has to change to include these children in order to be useful. Otherwise, those who need the assistance the most will not benefit from it. Development assistance has to become visionary and change with the realities of the times. The service providers in Third World countries have found that the best and most effective way to bring services to street children i s to take those services to the street. Most programs working with street children use trained street educators to provide the street child with basic needs ... literacy skills, health care, income generation opportunities, etc . This street approach is inexpensive and very effective. rt also allows the street child to continue to earn income, but provides a "connection" for the child to his or her basic needs.

The most important consideration of all development assistance should always be focused on what the recipients of this assistance really needs and not what the donor needs. Development assistance should allow for true development, not for continued assistance. 64

TBSTIHONY BRPORE THE S&LECT COHHITTEE ON HUNGER NOVBHSER 7 1 1901

PONALD C, ltAHINSKV, N.D., M.P.R.~T.M. . TULANE UNIVERSITY HEDlOAL CENTER . SCHOOL OF PUBLIC HEALTH • - TRO~ICAL MEDICINB TULANE - HONDURAS OOLLA80RATIVi PROGRAM 1 . "PROJECT . ALTERNATIVES 1. · 65

llONORABLI!! HEMBERS OP THE !IELBCT COHHlTTBB ON fllTNOAR

I wi~h to extend greetings to the Com~ittee on behalf ot Tulane Univ~rgily, ita ~adi~al Canlar, and Tha &ehool of rublie Health l Tropical Medicine and to thank you ~ost sincerely on behalf of Tulane Ur.iv<>r,.ity, as: well Aa per~onally, for this uniquo oppo1·\.u11lly Lo teet.ify in rcgo.rds to the situation of the ~orking and abandoned (£trccl) children whom ~o onoountor in Toguolgalpa 1 .ttondui-es. Thr. Honduran ato.rt ot Project Alternativ'ee has ra~uoatod that I oxproce their gratitudo to tho Cclll!litte• me~b•r• tor the interest you are demonatratinB in the plight ot street children . All of us are highly honorad that ProJeot Altor)'lativeu has been selected tor presentation to the Cornnii ttee, I ha.vo been acked to limit my oo~menl• at thle ti~• to diuouaalng tho "problem", the altuatlon we encounter daily ln our wo~k with aLreeL chlldrQn, I look forward during the quootion and anowor session to shoring with you the methodologies which Project Alt<>l'natlv.,,. i1> uLilieinll to providG a oommunit.y-baeed comprehenslve primary health care/social eervlcea delivery system which addro&&e& tho neede of the ohildran and their faroily members, when present. ·

TulBne University ha~ recognized the import,nce or being !~valved and ~ddro~,.tng a pl'oblom of today and tho future, a problom which 1• still "invisible" to mo.ny, 1,e, tho health and social µervice n~od,. of working and obondonod children. Working children can be chorooteri~cd as "children without a childhood", Abandoned children aro ttoooial orphono", Th<>r aro living a lifo of "miaery 1 but with liberty". Within the best tradition or public ~ealth, publio-prlvate eoator collaboration and otrong oommunlty and te.mtly participation are required to addreee the problems ot ~troet children, but theee faotore are trequantly mieainS• ~inoo the ~agnltude or the problem has been largely "lnvlaSble", even to' .many individual a and inetitutione who are eignU'ioantly involved in the social sector, it ie incumbent upon you decision makere with the power and influence to make a ditterenoe to become activily involved in supporting a continuing analysis of the oituetion, a eorvioee etruoture for the children, and advocacy for 11. 1JOclet&J. re11ponse to the problem. I have repeatodl7 utiljeed the word problem, but where ie the problem? The children are not the problem. They are a symptom, not the etiology ot the dieeaee. They are children - innocent vic~l~e of an adult world which ha& too freQuently not recognized and protec\.e d the ba~ic righlb of the child and eocietiee which have not demouulrRted a commlt~cnt to promote and protect those rights. P"rent.e, oomm11nit.iee 1 gov10rnment .. •nd ooclety overall can be aoid ta be a po.rt of the problc~ and thoy need to become a p4lrt of the solution. Jn the past governmcnte and international lending institutions ho.vc crco.ted tho necessity for the e~onomlc etructural readjuetmente we eee taking place worldwide today and they thu~ have at lee.et partial responsibility for the ~dveree effectH we eee the poor and those in extreme poverty euffering today and for the larae population troupe who are found without an adequa\.e eoclal safety net havin~ been developed to help them 66

&beorb tho impact of euoh eoonomio change, Looal oommuitie• have freQucntly not acted on behalr or children, and too many parente h~VA ~O~Ad irreepaneibly too often. Therefore ~11 of us mu~t recogui£e the role we have played in the past, see and underatand thi• "invleible eltuation1" ot today, and commit oureelvce to becoming a part or the solution to the problem. Great success hae beon o.ohieved in the ehild eurvival ef£orte undertaken worldwide, but eurvlval to what? Now we tteed continued commitment to not only infant and early childhood eurvivo.1 1 but to eurvival which ultimately results in a hcolthy , educated, and productive child o.nd "'dole~cent.

Wh~t eltu~tion do we encounter . epecifically in Tegucigalpa. Unprecedented rural to urban growth iB taking place. The marginal are~s are growing at a rale of 8-9K o.nnuc.lly. Children pour out daily fron the mar~inal areas to the Qtrccta of the city. Thay c.re: . , Escaping bantings + E5~aping sexual harasament and/ or rape • Escaping depressing living conditiona • Seeking money to aupport family ~e11bers * Loo~lng tor ~omelhing to oat + t.nok1ng tor excitement Some lurn to d~ug~ and prostitution. Some live and sleep in the streets. Some turn to closed-door 1net1tutlons !or shelter and food. Mo~l return to their humble dwollingu late at night only to return to the street early the next morning.

These ch l ldren are found ev_erywhere : * 9egging for money or food "' Gut1rd1ng cars * Shining shoos * Selling newspapers * Selling other goodR • Vending in the markets, * Stealing They ~re fbund alone, in pairs, or in groups. They are in the ~tra~t s•lning their livihood in any manner poeeible. The prooesa of socialization which normally occurs in the ra11ily'a home and in tho Bohool ie now ooodring ao~e And more on the etreete and us·uiil J.y in the absoenoe or one or both parenta. There are inorea~ing numbe r& of phy&ieall~ and mentally deficient and depende nt citizens who suffer from a loss of basic hu~an · values o.nd self-e~tccm.

To eumn1orize, the situation of these children ie one of: * Family disintegration + Undernourishment and mc.lnourishment * Inadequa te health Bervlces • Incr ea~e d eusceptablllty to infectioue dieeaeee * Increased su~ceptabillty to physical and sexual abuse • Cen~lanl thr~•t of injury from a ccidents and street violence + 6ubst.ancc abuse f 67

To conclude thie eummary anayeie of the situation which we enoounter in our work with atreet ohildren, would like to present to you the orifinnl epidemiological data which we are oolleoting thl'oush ou" "ei-viee etruo\,ure. Thi" data refleote the morbidity patterns for workin' and abandoned children which we have found within our coa>munity eettini. (I have reO:eon to believe throu'h verbal communicatio~s with collen,ues ~ork!n~ w~th etr~r.t children in other oontinente, ae well ae this one, that the health problems of street children · are aimiliar worldwide,)

Our dat~ to date reveal~ that the iO a>aJor caueee of ~orbidity of workln~ nhlldrcn Krc: 1, Di6cn6c5 0£ the ekin 2. Acute reapiratory diaeage ~. Dental c~riee 4. Bacterial eonjunctivitia 5, Acute diarrhael ayndro~e 6. Allergic rhiniti& 7. Intestinal parAsitism 8. Bronchial aalhma 9. Headache, etiology nonspecific 10. AbdomihAl pain, etiology nonopeeifie

When we> co1111,.,,..., th<> problonu• of the 1>ba.ndoned child to thoae of the working . child, we find that minor truama and sexually tranomitto~ diooaeoa ontor tho liat of tho 10 moot oommon primary health care problems encountered, The 10 major causes of morbidity, in our oxporienoo to dato, for abandoned children are: 1, Diseases of the sk1n 2, Acule reepirALory dieeaee 3. Dental caries ~, Hild trauma 5. Abdo~inal pain, etiology nonspecific 6. Headache, etiology nonapeoific T. Sexually transmitted diseases A. Ranter~al conjunctivitie 9. Allergic rhinitis 10, Acut~ diarrheal syndrome Appoximately one-third of the abandoned children with whom we are in oontagt are eniffihS glue. The abandoned children, as a reeult of th~ir life style, are at au in6reased risk of HIV infection.

In the workin' children group the followin~ are the most frequently encountered paychologioAI problem~ : * Poor school performance • Beh~vioura] problems * Family conflict • Lea~nlng difficu!Lies * Adolescent crisis • Id~ntlty crisis 68

The moQt frequent aocial caaa work problema we ·have found with the working children are extreme poverty, vagrancy, c0 netant abandonment, and phyalcal and paycholo"ical abuse,

In a "roup which . we have aelected (or nutritional assistance virtually all ot the children demonstrate evidence ot chronic malnulrllion. Allhou~h r have no apecific data to preaent ' to you in regardR to adolescent sexuality, it le the qplnlon ot the profcaaional community that early sexual relations and adolescent prAananny arA nn thA lnnrAaRA. our ongoing survey or the · e1tuation o! all chll~ren enrdlled in ProJovl Allo2'nalive11 ·>'eveala at thi" ti.,o that 7.2" eat 11 meal once a day, 36,6X eat. two meale a day, and only 66.6X are Able to QGt 3 mont~ dallf on• ro"ul•r baeia. A proliminary analyaia of our survey data, conduated by Dr, Ja~ea Wright who ls my co­ workor baged at Tulane Univeraity, reve&le the follo~ing charactcrietice, or 110.inly the working children, at the time or enrollmeht in the project: · * Nearly 40% live with their mother only * 66% are not in echool * 82.6% share the money they earn with their family * lt had been mol'e than one year eince 47.7% had vielted a doctor or other health profe~sional

Once auo.in 1 I wiRh to lhonk the Committee for having provided the opportunity to ahare · aoao of our eKperieneee to daie with workjnu o.nd abo.ndoncd children. In the annex to this statenent r haYc eummari~cd the activltlee whioh Projeot Alternatives is providina in resDonse to the situation we have encountere~. Aleo l have included a listing of . the instltutlona which have been supporliua our efforle . and . ~he public and private entities with whom we hav.e been·· collaborating, I look forward to 11h&ring in more detail our eKporlcnces durina this eeeeion and/ or •t some future d!lt<'• 69

INl'rol u:'l'IGI: Project Al-temative" ie coo<.>!rnc:d with not only the prolecH,,n of ll chilrl' c d9hll• and .auiatance in aceurlng ·survival th.rough infoncy and et1rl.y ch11<:1h0o.l until the age of 5 yea.re, 17..it oloo we are very coneerned wilh wh"t hoi::pena to tho child ao he and cha "ntcr childhood after tho 8\){l cir ( ive anj as they pas~ through ooole5cence. We nui;t pri:itect the right e of lreoo chlJclren ond e> w£> all.ow end in acine CllBeB support their particiDl'tion 1n the inr.onr'Ol o;eclor 05 a rrcchoniM> .. to overt carpl-ete Esnily dieinlegration oo<~•uw uf e.cancrnic nec£:s~itiea; · · Also th~ ·.ie. e very large tx:>tl\ll«t.ion or ·1:llll\JL':'I' 01tJ e>;lol.e51o>;nt" wt>J otterrl 11chool during On<' holf of thn day and 1o.urll 111«11y long J~s durfng . the rest of . the day, Thie is th:) t;<.X:ifJ­ econr.:mic; re,1llty. lhe chol ).,nsc 1tith theee working children :1.e h> <1AouL>' tl&UL ll.ey ace actually learning and not . significantly negatively 11ffccte<.1 by the ~ight of their working hoUr-e.

Wl"1}' do we thin>< that the etreet children will require ~r.>re ottrniHO!I in the ful11r0. Because urbanhatiat" is · incrca&ing an:l the ti-en1 ii'; project~'ll to ~ mpintoined .into the next · century; the d..mgroP,ie st.ruclure ol: llonduras(and many other e.lmilar leaooi: dovoloped countries) iii' one of B }'O\.!Uiful pop.ilation; Child su.rvivol activitios are having OSt•cceM<' 1m:l · inc.-.;,,.f;}ng nurrbers . of infants are 11µrviving to cntci:' c:hildhocd and 11(1ul.esc1.'nce. But, they are eurviving to whllt7 Now attention needs to be poid to dcvcl0pl.n9 o oetvicee · etructure · for thml. 'l°hC int(lrnaticnal e co=ir; is Btruggling. The effects· of structural reaajusoront flrc be.tng ooL-ely. felt by the ""'jority of peopl.e in the leeoor dovoloped nationi;, TIM) yooth wi.J l. ne.1d to be heal thy so es to actively participate.' in th<' .i!Tpri ·will be not · ooly ·a problan in Honcluras, but el w in the majorit)' ()f tn<< i9_iJ,.e'r developt.>d notion:; 0£ the world.

A pl.\ot exper1mentol m.ir:ld project k9011 .,,_,,,;.,L.Lu1.1i. ~.,;, Lhe c"i,>i.t.el dly or Trk:ing ·ii'i'e and a· l ite on the eheel~. l t · ie focusing on tho working ohild while silrul. taneously

51-244 0 - 92 - 4 70

Fr011 KFrllN9

oda althou!t> olO..r 50C11ll. ncc:ls ore ed

'the project !ct ct:ilutlonnl eloeed-door ..ettin9, It rrwdmi11ee axJoting 1-eaourcee and prarL>les joi11t problem-solving by the pdv.:ite am PJblic sector. Col Jneil lwtonamuc University of Hcriduras, tr-:: Ministry of Health, on(l o m.ill1tl.de o! privote non-profit ogenc1ee. Preventive, prarotivo, end educational activitl.ea &re Qtre&eai within the context of first entry level core .into an iptegroted social 5ervice8 i;upport 11ystem. l'.lthc.ush tha child !& targeted oa the pr!1n,;1ry benofJ.cfary of the proj~t. a basic concept iA to include the r6JT\i.ly . .:is the· unit ot ottentlon.

,,, .!.. •.L, LI •. ., .... J .... L I...... ,1 .... 1 : .. ,, u.1. Hlli11U.11 1.ntn~-1 .. .

1 t\ C(}JlllJIUJ.11!;1 'k4ll:A,y ..;,l LlN \JJ~&..~~L~ .Lloll~ uf lk ,.._~je~it!. 1 ,, bone ficl11ri<>i:. A regulor. inte~ive program of group health edvcation event<: le: conductetl (nurnlier of children particfliating varies frcm 15-60 per event and 11 event1; 1:1n hr.:M -.kly). flecreoHonal evants in order to stimulate poeitive m8ntal fa"~ltll an, p~ovil rcloted taeka, in ordar to si.i,Pport th.e l~rning process and to stiirulate rrore intPrest in fVWtUl educaliai, is offenid or;i well. The"e groupa arc $1\0ller on been ,.,.orking Bn:.l scoveng!ng food t:hrcLgh g:irb.'!J.. collection. · Sp<;irle ond youth ch1bFJ ore being organbed. Prin\'.l.tY heal t;h care is provided · to project bene1'iciariea who are x-cfcni:d to t:he project phyeicl.o.n and nurao by the etr<><•t educatD.!:'6 . All project eteff ~e trnined to provide f~st 010. in tne cx:mnJnities where they. ru:e otte1"1Llg lhe children. 1liey are aupplied with bai;:ic first old rreter.ials ond ccrry t00m with them Ht 1111 times. /\n extenoive nctYlt comrunity fo"""1 and info:m ~ l 166'.leri; has been esl:abl.ished afld contact is msintained regUlarly with · them, - · · · me pi:oject is responsible for the provia1on 0£ the primary . health cRrn nmrls of the 'el:!eel children" ~red for by 'the Natforiol FM\ily W1:lfeu:e llssociat ion · ( JNB3), .men they conduct their biweekly ·up activHie~. · To elate this· .rrodel project pro¥idµi.g intcgrat01 heal.t i\ BOCMl ee1viccs care bose'.l in the e<:rnTUI1ity ord · · i>treee~ng lhe irrportam:u of .iJwlui;ling the fa01ily has inscribed nem:ly 1300 c.hildren bcncflciaries ard 250 family members. - · · Moat wurk Ing oh.11dnm and .. t.eet childr

Fran V.R11 NSKY ell~ :S~22ei:543

·l-

!!!lli£!'_~.'1ElWITlVlll Bf:filTlCWUES

llY ~ ANIJ_~

------··-~······-·-··--- • 11 I F - /\GE( YEl\1!5 J 'IVfl\L ' 0 - 5 42 21 -21

6 11 72U 413 31~

12 - !Ci ~02 316 lHu

1Uf/\I, 1272 750 --·~------·· ... _. ______72

Fran KA.. Wi5"Y illl::i04Z20043 Pll

COLL~BORATINO IN6TITUT10NB

PUBLTC SECTOR

* N~tional Pamily Welfare Aeeociation (Junta Nacionnl Dieneetnr Social)· * National AuLonomou~ Univereity of Hondura5 * Ministry of Health • The Offico of the Mayor of Tegucignlpn * Juvenile court PRTVATF. SECTOk Casa AlianzB • Proyecto DihmnrJi . ~ * Proyeclo "El Meson Don Bosco" * Proy~cto 11 0ood Samaritan'' * Babti$l Clinic • Center for Integrated Family Development * Teleton Foundation • Honduras Red CroaR * Honduras A~$:ocietion for tho War Ag&inat Aids • Market administrators and leaders of different vendors &.B~oci.alion~ * Clinica de Nuestra senora de La Esperanza * Proy~cto "Compnrlir" • El Hagar Don BORCO * Hogar de Lo~ padr9~ Paoionieta~ • ASHONPLAFA (Family Planning) * CONAPlD (N~tional Spor~g CoMmieeion) * coca Cola • T9las Riolindo

FINANCIAL SUPPORT * Tulan~ Unlvcrsjty School of Public Health l Tropical H.;,dioine

* The PEW Ch~ritable Trusl~ * UNICEF/ Honduras * The Co.11 .. ghcr F"'mily Foundation •The H, B. Fuller Co.

** Childhope (Moral Support) 73

• pROJEC.."7 .i\l.T:ERNAITvfS• 'I ~ 0 cm. .LABORATIV.1' PRO\,R~...K 3

~UL,U..C: - HONDURAS

TUT.A..'!\i'F. Ulff\TER.sl'~Y SCHOOL OF PUBUC

HEl!..L':'lf "~.... ND TROPICAL ~ED!.L!NE

BACKGROUND:·

Th~ is a rapidly expanding social prohle:n in L~..in America and in tt.~ parts of the devtloying 'lfO.::ld. Chlldren, who shruld be in schccl and be developing tlleir family and 9:'ci.al relat:ionships, are iP~J?ad either 1oo1or)ting in the market places · and_ in the street and returning to their homes crJ.y to sleep , or they are ronipletely ab.?ndoned and living .L"l the street.· !'hej• are

"Social orphans n •

In >egucigalpc, H

-2-

lfHJ\T IS PROJECT AL TERNA'CTVFS: Project Alternatives is a sb:"eet. market, community based. health, nutr:it.i.co and .· social . ~JceS pr:ograrn designed to OOdreSS the basic reeds Of the street children aged 16 and under. It is an altemative tc the provision of services to a

sma!J. gi::uip of children withir. an institutialalized dosed-door setting.

The program initially focusses rn the child, but: attempts to :include the family · .as " mtit of atlentJon, when this is possible.

WHJ\'I DO WE DO: After studying the children's · situation the following serv.:ices are offered ~ a routine. basis: F.irst aid, group 6lrl individml hQalth edocatiai. • . a nut:ri!::1mru progrnm fur selected children, recreat:icnal activities, pdmaey ent::y level t>;,sic curative medical care and mental beol~ serJ'.iCes. Special events are planned far the cbildreri and ~ l!Ssisran:::-e is offered in the area of . ;infoimal. eduor._on. 75

-3-

~ ""1 Soc:ial case work is perfumed fur ~ 8

cases ar.d men1:ill CMe. is provided by .') psychol!:>gLst

·for ~h r'..sk children and famiUes. J\n extelsi've ret'tfork of. community forrr,al and :infor.ncl lP_aders are involved :in the project.

COLLABORATmG INSTl'1'UTION'S:

~he Nati.oml Faraily Progral'll, •h:ich is directed by the rir.st Lady; the Min:ist:ry r:£ HMlth

am! the :-Jational Unive__T"Eity &"e coll.a b~ting and

involved in th.i3 pilot, model, experimental pr~aro. 'l'he Notional fJruver:"Sity has 9elect:ed the project as one of tlle.ir sites fur scmding heali:h/social sci.erres students tn p>Jfurm their trban extension cc1111\r\ity

services activities~

For more infurrnat:icn a:mtact Dr. Donald C. Karn:insky, P. 0. Box 3570, Teguc::li_Jal.pa, ticnduras. Tel-(504]32-197B

~ t­ l4 76

K.Hnng the Children

Of the Wus/,, 'Pos+-1 Duffo0t/ Apr-;/ ::u1 /'f 'i'/ Third World

B>·Lori Hti.M

BOVE ALL, It Is the 1u!ferina children th.at the whole "'orld 11 watchin11. "No one,• &.&Id Ge<>r110 Bu1b Jut week of Kurdlsh reluie>e• A !tom Jnq, •an a.cc the picturtt or tiur the c:onloct er ~. dUldrco spend more 1ccountt oI thls hum1n 1u.Hertna-mcn, women and, time any. E\'tfltually. many bred: di ties, mo.it pmi!ully of all, innoctnt chU.dren-and not be w..tre ll>eJ li9td. The Druillan J~lt.e ol preferring 1~ lodepeadeoc:e aod caroua- ~e:r~ b~~;~J'>;;':..~~~~~~·th~.Jirke::~ Social ate! F.ooaooUc AnaJJSis, mem~ · lK streets to rioltoce aod cootict border: many of the dead are. children, ~ ::.::~~ . =In cili~ cases, aome prents enn eeO The eieh11 and aounda o( the rt.fusee CllTlpt hrve ant run. =Guatemala Cit1 tw k>'lt some ·their cliildrm's bodies in enhange for been wrenching. Dut whit i1 not belna thown on lhe .co strttl kids this rur to a piuge believed comethiDg lo ~I. In 'Ildand. Y.tcrc a.n . wortd'a tele\isk>n screena ls the pliaht of lhc srawlng perpetr.ited bJ JgeDts o( the NWon.d Po-_ c.stirwto:I .t0,000 childra\ under A&'C 14 a.re cad~ o! children ehewhert 'l'hO are being ~ed. to!'· lice, in\'Oh'Cd in pro.slituUon, tntbd o"WDCn of. tured and abu~d !ar Crom the wncra'1 eye. · ln an iDcident la.'\f. )tlr, documttiled bJ fee tl'Le cquivaknt of a poor farmer'• yeuly ln Rwlnda, they are ealled IO/i,iowJtU, "'naaty kJd.s•: Amnesty lotcnu.tioNl. mto in Aieei> Pcked Clmingsfoc" young, nubtle girl. ~~~b).~~~=i: ~~ ~~~~ ~ t!t~.ooana == ~=;~ How, AIDS is &:!tined lo swell druoat- Vihere lhty Ire conlidered hooligana, juvt.n.lle c:lelirr- wbo wu1l"OrfOOg ilt.bec:o.mlryat I.he lime, ~lly the nnb oI rttrccl •«ts in Africa and quent• or eJmply "'brown dmt. • ThC6e are the ~ mil· docribe.'I the fioctks ol three of. the boys othct impa,·cri'iltcd ar~ Based on a c:om- lion chlJdren who 1pez1d their da}'1 and nlibtl Uvins and found later. "Not ((lllef\t with killing them, puler model she dc\·elopcd. UNICEF"s scn­ workine on the atteeu oC ~e wodd'• PoOte•t citiu. UM: ·abdoce;,..s bumtd th~ CJtt ~nd cut out ~~~r~ ~~l~~fi ~ 81 ~:~e~&~~c~o~~~ ~e~~!:: the loagues: Hon ttnnfe<:tcd cbi!drfn«planed within lhe preda1Jon1 o{ hunger, diausd aod cold, but 1lt0 are T hrooghoot lhc l1"0riil, sl.red unhim decade in 10 cenlral Afriao .couatrie.J- 1pu.rned by polite 1odety, bel1en by polite and lrKm... are a symplom ol a 30CW fabric un- a1oog with tnmdrcds o( tOOmaod..s ol ia- ingly tortured-even murdered-b}' duth aquads bent rnd9\g, la Latin Arotric:a cspcc.WJy, foct~ children who will c.1ic from /\IDS be- on c.lcarlng the atreettofCpeJt.1.• increased cooccntration of bod o~ip fore tbc..iI fifth birthd.iy. AuOM the Third World, and p1rtkularly In Lfitln bu aaxxnpWed pclicies l~l fa\'Dt urban Jn the past, Afria'a stroog ! Cose of com- America, lhelr number b growing, Yet even e.stlmating ~ A1 a result. immigrants 1rom de.. rouiity prov1ded a safely net for abmdoned their rtnlcs is tricky: after 11U, u one child 1dvoeate ~ 1cr.d .;uus have eagerly 500ght lbe dUld.rcn. Bui, note& ~. "'Alric.an faro· obst:i'td, "Vi'ho botheri to count nonpeop\e?"' •<>wertunilics" of the city. IM libaolDtioa Wes who would b.are Unq~tioNhly taken In the 1treeta, th:.&e children, both boya ar>d girls, and mounting debt b.ire m>trwhelmed the in oq>htn9 a Jew yea~ ago miy be mot'C ql!.ieldy become 1urviva.l artista. By night, they huddle t3pacily ol Tb int World n.1li u 1 prodoct of IL" Cllnde1Uno \'lg· ootdU!reo wb> bil to briog homo~ oiitol. ~l>y sl>OOld Ibey. wony .00.t dyklg llantc Ill'- r=nUy.bm taken tbi• 'blunlng the vio- .-_ As hoo>c bcoomea a... , _..,. ol troo AmS 10 yeara Crom oowl" Um" to • bonil)'inll extrem<. Long bedeviled by the • holtility ti merd.&i\u ond poiioe, iU..1 kid. in Eoioo>-· · bl&, G1111enub .00 Brull •ow !eu for tht~ llyeo, Ono ColombWI dulh "!Uld, ullirlS IUeU Death to .Su.et Otlldrtn, bu 111<1 It o1mo to 'i:lou up tho_ of the c.Jombl&n "plt&I." At lout 20 )'OlltN "'""oho\ to death thtre lut yur. moat o! them ln t dtv Dlrl: 77

Lynching Increases 1n Brazil's Shantytownsi µn,.,.e \\ ~~!\\ i------'------.--1 By JAMES nnboKE Lynching, Jong an occasional event Salvador. I SpKl11toTMNr•Yor1r. Tunu in Brazil, is happening with chilling "In the past, lynchings were restrict- SALVADOR, Brazil - In Paleslina, regularityinthenallon'surb.an shanty- ed to hei nou s crimes - rapes of chil­ a crowded slum of narrow alleys and towns. In this city of 2.5 mill1on people, dren or sadis11c murders," said Ediva! raw brick shanties, word traveled .fast recorded lynchings have jumped from Passos, a Workers Party deputy who is I on a recent Tuesday nighl. According a rate of twice a month In 1988 to at president of the Human Rights Com­ to the rumor, Doralice Santa Rita, a least twice a week this year. miuee of the State Legislature here . . local girl, had been raped by Jose Adil· "On my street alone, there have been "Now a lynching can be sparked by the : son Reis, a stranger. three a ue.mpted lynchings this year," thert of a wallet." 1 .. Within minutes, a furious mob cor· said Alan Trajano, a lawyer for the Indeed, an archdiocese study of 56 of j ncred Mr. Reis, who was terrified. Justice and Peace Commission of the this year's lynching victims found that Taunts beca me kicks, and kicks turned Roman Catholic Archdiocese here. "I 58 percent of the vic1ims \\'CrC' accused l into a fatal rain of blows with clubs and was able to prevent one man from of petty thefL Contrary to popular Ile- i pa\'ing s1ones. being lynched on my doorstep because lief, the study found that only 18 per· I \\'hen the police arrived the next I knew people in the crowd." cent of the victims we re accused of I morning; Miss Rita told investigators In a five-month period this year, sexual assault With street children : that she had never been raped. there were 52 recorded lynchings in ohen targeted,· 23 percent of the vie- I

\". tims were under 1$ years of age. operas preach revenge as an accept· incited community resi~"" ' "' 10 lync.h · i People familiar. with the phenome· able act." criminals. ) non cile a variety of factors as reasons. Mr. Trajano added that the city po­ "People are living in a climate or j "The problem or Salvador is pov- lice force was underpaid and undcre· very high violence, and they have last 0 0 1 railh in the institutions," concluded Mr. · ) ~z;~·r;~~rJ~~ a~ l~1~~;~':.:. ~·'k~~fi;~ qufp~d~ people are largely unprotect- Passos, lhe state legislator. ? percent of the population Jives unem- ed from criminals," he said. To combat the practice, S

TESTIMONY

BEFORE

THE SELECT COMMITTEE ON HUNGER

U.S. HOUSE OF REPRESENTATIVES

NOVEMBER 7, 1991

Submitted by Marilyn Rocky

National Director

CHILDHOPE USA, Inc. 79

INTRODUCTION

Mr. Chairman,

Members of th~ Committee,

My name is Marilyn Rocky. I am the National Director of CHILDHOPE , USA, the U.S. based subsidiary of CHILDHOPE Foundation. CHILDHOPE is an international organization that works with street children in the urban centers of the Third World. On behalf of CHILDHOPE, it is a pleasure to submit this testimony . before the Seclect Committee on Hunger. We are thankful for the Committee's interest in and recognition of the needs of these youngest and most vulnerable citizens, and we commend the Committee for its vision in including the needs of these boys and girls in its agenda.

The purpose of my testimony today is to provide the members of the Committee with an overview of the origin and current problems confronting street children, particularly within the countries of Latin America.

A VIEW FROM THE STREETS

An estimated 100 million children and youth live or spend the majority of their lives in the city ~treets of the developing world , with an estimated 40-50 million of these children in Latin America alone. Most of these children,

- 1- 80 perhaps as many as 75 percent, are working street children. They live at home, but are forced into the streets to contribute to their families' meager income in whatever way they can: shining shoes, selling newspapers, hauling garbage, begging or "survival sex," -- selling their bodies to earn income.

The rest of these street children, called children "of" the street, live, work and sleep on Third World city streets, maintaining minimal or no ties with their families. These are the "brothers" and "sisters" of the street. They band together, forming surrogate families because their own families and societies have left them to fend for themselves.

When examined by country and city, the sheer number of street children is overwhelming :

--In Brazil alone, UNICEF estimates that 17 million children and youth work on the streets, and 7 million live on the streets. --In Mexico , an estimated 10 million children and youth work on the streets, and some 250,000 live on the streets . --In Ecuador, 100,000 children work on the streets, and 3,000 children live on the streets. --In Guatemala, 1.45 million children work on the streets in a country where the total population is about 8 million. --In India , 44 million children are working on the streets. --In the Philippines, 1 . 2 million children live and work on

-2- 81 the streets, with an estimated 50-75 thousand in Metro-Manila alone. --In Thailand, an estimated 800,000 girls under the age of 20 work on the streets or in brothels as prostitutes.

In the past , and even today in some parts of the world, the growing street children population and their problems have been ignored. They comprise a population that does not show up in health statistics , in the public education system or in national concensus. The traditional response to homeless and abandoned youth, in both the developing and industrialized worlds, has been to institutionalize them, housing them in state reform schools or isolated residential institutions.

In other cases, street children have been treated as a ptiblic nuisance. Today, in some countries, they have become the targets of "death squads," vigilante groups who willfully torture and murder street children as a solution to the growing crime statistics. Since the middle of the 1980's, almost 3,000 children on the streets of Brazil have been executed by death squads. Just in this past year, at least 460 street children and adolescents in Brazil have been murdered, extrajudicially executed, according to a recent report by Amnesty International.

And , in the November 1991 issue of Omni Magazine , an article based on the difficult and dangerous environment of street youth in Guatemala , notes that the situation of street children in Guatemala City has been worsened by the presence

- 3- 82 of active death squads. According to Omni , "Eyewitnesses ... confirm that Guatemala's nifios de la cal le - children of the stree~ - are being subjected to a spree of tortures matched only by the Holy Inquisition. Many children were abducted, beaten, burned with cigarettes, subjected to mock executions, and sexully assaulted. Some had their ears torn off Cthey heard too much) , their tongues ripped out , and their eyes gouged

In a recent report on the ABC News show Primetime Live , an official of the Guatemalan police force admitted that police have been involved in the killings of street children. He claimed that all of the cases are. being investigated. However, Amnesty International said that their attempts to have the cases investigated have been repeatedly delayed and that witnesses have been harassed by police.

THE PROBLEM AND ITS ORIGINS

The most commonly a sked questions about these street children are : Where do they come from and how can there be so many? The causes range from the obvious to the not so obvious : urbanization and its underlying causes, the debt

-4 - 83 problem and inevitable structural adjustment , economic stagnation, drought, deforestation and other forms of environmental degradation, rapid population growth, unsustainable agricultural practices and government polices that have subsidized urban dwellers at the expense of rural farmers, forcing increasing numbers of families and youths in the developing world to move to cities in search of economic opportunities .

During the past four decades, the Third World has also been the stage for man-made calamity - the earth's battelfield where armed violence has shown consistent increase and where civilians have accounted for up to 90 percent of all c a sualties. Violence in rural areas has sent families and unaccompanied minors racing for the protection of urban strongholds, and consequently , to the streets. Orphans, refugees and displaced children , without the family's safety net , have been made prime candidates for street life.

Added to this grim picture of growing urban poverty in developing countries, the desperate circumstances of street children and their families is further worsended by both natural and man- made disasters, displacing them from already difficult circumstances . In these years, no one has to tell an Ethiopian family about the terrors of drought; no one needs to explain the awful consequences of flood to families in Bangladesh; and no one needs to describe to a Central American what happens to homes and families in earthquakes and hurricanes.

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As more and more families in the developing world settle in marginal areas near large cities, they will continue to lose the social and kinship networks found in rural areas. The side effects of this increasingly urban-based poverty are devastating : a lack of access to education; the break-up of families; under and malnourishment; inadequate health services; susceptibility to infectious diseases; vulnerability to AIDS and other sexually-transmitted diseases; physical and sexual abuse; drug abuse , and prostitution. All of these side effects impact most directly on the children of these poor urban dwellers, forcing increasing numbers of these children to turn to the streets to contribute to their family's meager income.

PROFILES OF STREET LIFE

Street children today represent one of the most exploited and rapidly growing minorities, and .one of our most poignant social challenges. Although many local projects have been established for them, ranging from initial street outreach and overnight shelters to multi-phase community initiatives with a wide range of integrated services, the most basic needs of the vast majority of children for whom the street is workplace, playground and even home, remain unmet. The severe economic crises which currently cripple the economies of many developing countries further exacerbate the risks facing these youngsters whose childhoods are too often spent in alleyways , marketplaces and city slums: Without comprehensive services and targeted programs to meet their

-6- 85 needs, the vast majority of these street children are destined to lives of poverty and despair. In Sao Paulo , Brazil, for example, four-fifths of the prison population is comprised of former street children.

One of the most pressing health problems facing the world's 10's of millions of street children is the issue of drug abuse . For street children drug use offers an escape from the harsh daily realities of family break- up, poverty, hunger and homelessness . The majority of street children in the developing world use inhalants, including industrial-purpose glue, paint thinner and other solvents, as well as marijuana and coca leaf by-products, because they are inexpensive and easily attainable.

In South America, particularly Colombia, Peru and Bolivia, there has been a tremendous growth in the consumption of cigarettes laced with a low-grade by-product of the cocaine production process, known as ''basuco" . It is especially toxic because it contains kerosene , sulphuric acid and other poisonous chemicals used in extracting cocaine from the coca leaf.

The side effects of regular drug use by street children are devastating. Industrial glue , when inhaled, produces light-headedness, occasional hallucinations, loss of appetite and nausea . The long-term health impacts include lung damage, irreversible brain and kidney damage, malnourishment and a general weakining of the children's health .

-7- 86

Street children are especially vulnerable and increasingly being exposed to the Human Immunodeficiency Virus CHIV> that causes AIDS . Because of sexual exploitation, prostitution and intravenous drug use , incidence rates of HIV are rea ching alarming rates among street children. In Brazil, the country with the third largest number of AIDS cases wor ldwide after the U.S. and ·France, public health officials describe" AIDS as a "time bomb" among street children. Social welfare officials are particularly worried because unprotected sex with multiple partners is a way to make a liv ing for ma ny 'of Brazil's 7 million abandoned street c hildren and 17 million working street children and youth.

Sex tour i s m, a common occurrence in many parts of the develop ing world, also contributes to the spread of HIV a mong street children. Untold numbers of street children a nd youth in Indonesia, Thailand , the Philippines, Sri Lanka, Brazil and the Dominican Republic , among others, are i nvo lved in the sex tourism trade. In Manila, the Philippines, for example, an estimated 3,000 boys and girls are regularly exploited through protitution and sex tourism .

Among the most vulnerable a nd exploited of the population of street children are street girls. According to most studies conduct e d in developing countries, the majority of street c hildren a re boys, but a number of studies have shown a signi fican t percentage of working street girls . A increas ing number of street girls work in brothels or on the streets as prostitutes, placing them at even higher risk of

-8 - 87 acquiring STDs, including AIDS. One Brazilian advocacy group reports that there are 500,000 young women under the age of 20 working as prostitutes in Brazil.

The majority of street girls in developing countries face an acute lack of basic health services. In Nicaragua, for example, 27 percent of 85 girls, ages 10-18, had been pregnant at least once, and 21 percent had suffered from a n STD. Yet the majority of these girls said they had no access to health services, and the few who had obtained family planning services received them from older wome n friends or market vendors; similarly, in Panama, 10 out o f 50 street girls, ages 6 to 17, said they had been pregna n t .

Street girls are frequently underserved, lacking education, vocational training and shelter. And, girls living on t he streets are subject to many abuses. In Guatemala, 95 percent of 38 girls, ages 13 to 18, living on the streets reported that they had been sexually abused and the incidents of abuse involved strangers. Street girls are also exploited in the workplace, because of the shortage of occupatio~al and income generating options due to their gender .

CHILDHOPE'S RESPONSE

In spite of these gloomy statistics, there are a growing number of programs in developing countries seeking to provide services to these chi ldren and youth . While the

- 9- 88 traditional response to homeless, abandoned or working youth has been to institutionalize them, the majority of programs are now turning to more innovative 'program models, including :

--Street education--working with children where they are : in marketplaces, under bridges, in city parks and streets . --Non-formal education that replaces traditional academic learning with practical living skills including literacy and numeracy. - - Vocational education and income generation programs that improve the opportunities for non-exploitative work . --Health services and health education projects that reach street children with messages that are understandable and frequently designed by the children and youth themselves .

Within the context of this innovative programming for street children, GHILDHOPE's objectives and activities include :

--Street Girls: Support and the development of programming on the special health needs of street girls. --AIDS Prevention: GHILDHOPE is proposing a major expansion in AIDS prevention among street children . This will include development of relevant education materials, training of personnel in AIDS prevention and incorporating AIDS prevention into a lready existing programs for street children. CHILDHOPE is also one of the sponsors of the 1992 International Conference on Street Youth and AIDS, being held in Brazil in conjunction with the International Society of Pediatrics.

-10- 89

--Protecting the Rights of Street Children: Among CHILDHOPE's specific projects will be a hotline and community protection system in Rio de Janeiro that will work in conjunction with local organizations to actively protect the rights of street children and seek legal prosecution for those who infringe upon their rights. --Regional and local training programs in street education: Having established its training program for street educators within Latin America, CHILDHOPE proposes to expand this training program to include other regions of the the world as well. --Income generation and vocational education : CHILDHOPE proposes to support a series of model programs in income generation for street children, including stree~ girls. --Awareness and advocacy : CHILDHOPE is increasing its efforts to raise awareness about street children among the international development community. --Expansion into new geographical areas, including Eastern Europe and Sub-Saharan Africa : CHILDHOPE will take its successful programmatic efforts into new regions, where it has already had requests for assistance.

CHILDHOPE was founded for the purpose of building a global support network for street children and to unite these networks nationally, regionally and worldwide . As an international movement on behalf of street boys and girls , CHILDHOPE works closely with UNICEF, international children's organziations , government agencies, as well as national and local groups in many countries. CHILDHOPE's chief goal since its beginnings in 1986 has been to work

-11- 90

with these groups to increase awareness about and provide effective and appropriate services for street children.

CHILDHOPE provides services only in conjunction with local organizations, public and private, by providing training, technical assistance and promoting awareness about the needs of street children on a local, national and international level. By working with local organizations, CHILDHOPE insures that its efforts are culturally appropriate, culture-specific and sustainable.

There is a financial cost to improving the quality of the life of children on the streets, especially when the numbers are in the lO's of millions. However, if we do nothing, if we attempt to turn away from these children, the cost in human terms would be tragic. The number of children on the streets will double by the year 2010. Their misery and suffering will increase geometrically. The loss to communities and societies and to humanity will be staggering, and the integrity of our civilizations will be threatened.

This might well be the major battle of the decade - the struggle to save a generation of children from the streets . We have probably lost many of the lO's of millions of children who are , at this moment, on the streets of our cities. I have already cited many of the daily difficulties they must face in an environment of urban indifference. Quoting from Susanna Agnelli's book, "Street Children: A Growing Urban Tragedy," she says, "The fate of the street

-12- 91 generation is inseparable from the uncertain future of cities. Bursting or decaying, they were never built with the needs of children in mind. Today, the notion of man as the measure of all things has long vanished from urban life, and huge urban agglomerations have become increasingly inhuman and unmanageable. Beyond a certain point, their problems multiply faster than the means of solving them. Administration becomes remote from the people it is meant to serve . Street children are poignant evidence of this reality."

However, we can prepa re for the next wave of children by acting now to improve their condition and working within their communities to provide them with the support systems they need.

We must move out of the traditional "boxes" of institutions and on to the streets. It is here, on the street, that the children can be found. And it is on the street where the work must be done. This is an emergency and we should not wait any longer to respond. I am speaking about life and death. I am referring to suffering taking place at this very moment, this very second . I am asking this Committee to be bold and audacious and visionary and to commit itself to making the life of the street child worth living .. . because their lives ar~ the very mirror and reality of our future, too . They are prophetic in their suffering. Look at them and see the future . .. for them and for us and for our own children.

- 13- 92

FACT SHEET ON STREET CHILDREN Prepared by CHILDHOPE, USA CHILDHOPE The International Movement on Behalf of Street Children

- An estimated 100 million children live and work on the streets in the developing world - a number roughly equivalent to t_he entire population of Mexico.

- Approxi mately 75 percent of these street children live at home. but spend the bulk of their lives on city streets. without access to education or health systems. UNICEF estimates that one-third of all children in the developing world are forced to drop out of school by the age of 10. primarily to help with family income. 'I

- The rest of these street children - known as children "of' the streets - live. sleep and work on Third World city streets. Frequently, they sleep under bridges, in doorways or in public plazas. They are often the victims of sexual abuse. violence. and exploitation, as well as lacking access to adequate health care. nutrition. and hygiene.

- As poverty in the Third World becomes increasingly urban-based. the number of potential street children will increase dramatically. Currently, about one-third of the population of the developing world lives in urban areas. Within 20 years. more than half of the persons of the Third World will live in cities. And the majority of these urban dwellers will live in low income. slum neighborhoods - adding to the 600 million people worldwide who presently live in urban slums.

- In the Philippines. an estimated 1.2 million children live and work on city streets. In Metro Manila alone. government sources estimate the number of children living on the streets at between 50.000 and 75,000. Three thousand of these children are thought to be regular victims of sexual exploitation.

- In Brazil. an estimated 7 million children live on the streets and another 17 million boys and girls work on the streets. In Mexico. 10 million children work on the streets and 250.000 live on the streets.

- Street children and their families are the hardest hit victims of Third V\brld debt, poverty, and urbanization in the developing world. Without comprehensive services and targeted programs to meet their needs, the vast majority of these street children are destined to lives of poverty and despair. In Sao Paulo, Brazil, for example. four-fifths of the prison population is comprised of former street children.

- CHILDHOPE, the international advocacy organization for street children. was founded in 1986 as an inter-NGO (non-governmental) movement for street children. CHILDHOPE conducts projects in the areas of international and national advocacy, training and technical assistance for street c hildren's projects. development education. and action-oriented research.

Fac t Sheet an Street Children compiled by Garv Barker and Edited by Marilyn Rocky, Director. CHILDHOPE USA. 333 East 38th Street. 6th Floor. New York . New Yark 10016 I 93 Third World Children

Grol md olh<.r chOd ad>Oeat.es are """ ~ prognms that ll'P"'"Cl - kids ii the V>C3nl Joa m:l ID<:k deJs """"' !:bey live. Theoe pnlCIXDO .._...ge oel(. ~ ud wock .to g;,.. cl!ilditt bmc sE1s, bolh oocial md techDiol. to hdp lhcnt ....me in toly, a amoltaat lo< Street Rm b~ ""actire out­ rex:ll ~ md a rtroo« strttt ~ arc essential Many gJOOpS ....t oot ""'-

seJvc.-to~teo kllroduce fonno W>nt lo get of! the rtreela. llogot.a'a Bosoonia-La Florida prnjed, lo< =lOOoaf hot mnug< of chsscs oc j>Oi "La Florida," Ille project'• sdf~g rcUlett -1. go tn school aod rch tr llly marlcct.lblc Wlb by amrtging ,._,U for"'°" jolio ill. Third World cities. In~ - progrntl ;, - .-.ly mcdiog - km' need b me..., and ...... nccd b qtil ~can­ ..oc.wn il. citJ pbpd ~ plntc­ zrd .i.,,. ..-. u.m , o:iun.r """' cM1 ·-Km loc., 00,.. wat .. bCJdo"""""'" KC> in the alttooon """ lll1tD:q in'Mml cm.,. in the nnag. . 'The Dll bn the ~ ri ll>aritg op lx""1too !W. .00 J.,.. tn>WI' bajib," 94

PREPARED STATEMENT OF AARON WILLIAMS Deputy Assistant Administrator Latin America and the Caribbean Bureau Agency for International Development before the Select Committee on Hunger U.S. House of Representatives Washington, D.C. November 7, 1991

Introduction: the Context

The estimated numbers of street children in Latin America are huge and represent a staggering social problem.1 To address this problem adequately means understanding the context in which it is taking place.

In the early 1980s, the economies throughout Latin America were hard hit by the combined impact of the oil crisis, the subsequent recession and lower prices for traditional commodities, higher interest rates and their effect on the ballooning debt burden, and the ongoing political instability. The economic decline was the worst since the 1930s. Poverty was deepened and broadened; urbanization and unemployment grew significantly; inflation eroded incomes for all groups; and rural-urban migration increased. Such social disruption has been devastating to families.

The social effects of the economic crisis were compound~d ' by decades of armed conflict and civil war in Central America. Narco-guerilla wars aqd civil strife in South America have also had their effects. Latin America has had its share of natural disasters in recent years, not to mention the AIDS epidemic.

Along with rapid population growth, these economic, political and social changes have torn traditional family bonds and have led to both families and children in crisis. Such changes are not new to Latin America, but the numbers of refugees, displaced families, orphaned children, and street children are evidence that the dimensions of the problem are worsening.

1Childhope estimates 40 million street children in Latin America. The Inter-American Parliamentary Group on Population and Development estimates 7.3 million. This range of estimates indicates problems with the data as well as definitions of street ·children. 95

2

The AID Approach: Prevention

Given the economic, political and social causes of the family and street children crisis, the Agency for International Development's approach to the problem is to take preventive action. We base our approach on three premises. First, the supply of social services needed by street children (food, shelter, clothing, basic and vocational education, health care, counseling) will never keep up with the demand for _them . While we should certainly work to meet short-term needs, our greatest efforts should be devoted to the demand side by slowing down the numbers of street children.

The second premise has to do with the cost of providing direct social services. Given an estimated 100 million street children2 in the world, the United States Government can't possibly provide direct services to all of them \vithin our existing funding levels. Assuming a rather low $100 per capita annual recurrent cost to provide adequate health care, housing, education and training to street children, then the additional foreign assistance budget would be $10 billion per year.

Rather than only addressing the symptoms of problems, the third premise is that our limited resources should be devoted to addressing their causes (economic decline/poverty, armed conflict, and AIDS) through efforts to restore economic growth and to strengthen democratic institutions. Sustainable economic growth and stronger democratic institutions will create opportunities for families 'to gain ac.cess to the resources to provide the housing, food, education, and health care needed to keep children off the streets. In the long run, supporting efforts to help 'children before they end up in the streets is the best way to address the problem.

What Action is Being Taken?

The United States Government is taking primarily preventive action at three levels to address the problem of street children: the national, the sector and the community levels.

At the national or macro level, active diplomacy has successfully brought about a peaceful settlement and an end to armed conflict in Nicaragua, Honduras, and will soon do so in El Salvador. In collaboration with the International Monetary Fund (IMF) and the World Bank, the U.S. Government is assisting the countries of the region adopt policies, regulations and laws to open up their economies to increased trade and investment which will create opportunities for sustained economic growth. In addition,

2the number estimated by Childhope. 96

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A.I.D. is also encouraging the private sector to respond to the improved policy environment with increased investment and expansion, thus leading to job creation and higher incomes.

A.1.D. is also working to strengthen democracy throughout the region. There is growing evidence that open societies that value individual rights, respect the rule of law and have open and accountable governments, provide better opportunities for sustained economic development than do closed systems that stifle individual initiative. This year's report on human development from the United Nations contains, for the first time, a liberty index which shows a very strong coincidence between the free exercise of political rights and economic well-being.

A.1.D. is also actively engaged in an Administration-wide counter-drug strategy to prevent the production and distribution of narcotics in the Andean subregion. Because of the devastating effects that narcotics has on families, it is critical that altema_tives be made available in order to persuade individuals to stop growing, producing, and processing illicit drugs.

At the sector level, A.l.D. is working on the adoption of policie~ ·and institutional reform measures that address constraints so that systems become more. responsive to social problems and help families cope with crises. Such measures expand access to social services and increase income generation opportunities'. These include:

1. support of primary health care systems directed at reducing 'infant and child mortality;

2. support of basic education programs to enable more children to have access to school and to increase the quality of education;

3. support for vocational education and training programs for youth in 8 countries of the LAC region to enhance their employability;

4. support for microenterprise programs in 12 countries of the region to increase the number of jobs available;

5. expanded coverage of family planning services to reduce the number of unwanted pregnancies;

6. strengthened national food and nutrition programs under PL 480 Titles II, III and 416 to address childhood malnutrition; 97

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7. support for social development funds and social safety nets; and

8. assisting PARO for several years to help the countries of the region strengthen programs to control the spread of AIDS.

These improved service delivery systems and economic opportunities are reaching a broad spectrum of families and individuals, including street children. There is ample evidence that demonstrates this. For example, childhood mortality rates in Latin America have dropped from 95 per thousand in 1980 to 75 per thousand in 1990. A second example has to do with cholera, which more than any other disease, is one that does not have to be fatal if simple treatment is administered. Despite the unprecedented number of cases in Latin America, the case fatality rate has stayed at around 1%, an extraordinarily low rate.3 Another example is that primary school enrollment rates have increased significantly during the decade of the 1980s. Clearly these positive results could not have taken place without these improved systems having had a significant impact on street children ~

At the community or grass roots level, A.l.D. is working directly with PVOs, municipalities, and communities to help poor people improve their lives, to keep their children at home in good health and at school. A.l.D. has an extensive network of field missions and a long history of working \vith U.S. and indigenous PVOs. A.l.D.'s approach with PVOs is to identify those already in existence having ii, .good track record working in important areas and to strengthen their capacity to plan, ·t'und and operate their own programs, thereby enhancing their self-sufficiency. ···:. '"'

Many of our PVOs activities, funded through our health, child survival, education, and food assistance programs, are having a direct or indirect impact on street children. For example, in Guatemala, a PVO child survival project with Project Concern International is working with other local NGOs to provide health services to street children.

Under the Displaced Children's Fund, A.I.D. has obligated $790,000 in FY 1991 to help street children in Latin America as follows:

-Colombia: a $140,000 grant with one U.S. PVO (the Salvation Army) and local pvos to establish counseling centers to help street children reintegrate into their families .

3By comparison, cholera case fatality rates in Africa this year according to WHO were 10%. 98

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-Bolivia: $200,000 granted to NGOs that have orphanages to establish vocational training courses, assisted by Peace Corps Volunteers.

-Guatemala: $300,000 to strengthen a large network of NGOs working with orphans and children and to provide health care as well as basic and vocational education to orphans and children displaced by civil strife.

-Peru: $150,000 to NGOs working with street children, especially those suffering from drug addiction.

-Nicaragua: $1.4 million was provided in FY 1990 for medical care, rehabilitation services, and vocational education to children displaced by civil strife in that country. ·

At all three levels, the focus is on the root causes of street children (economic stagnation/poverty, armed conflict, and AIDS). A.l.D. prefers to plan and implement its programs at the country level, rather than through global programs. Programs and projects developed bilaterally are much better tailored to country-specific realities. Such bilateral efforts also can be closely monitored and modified as needed .. ·

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ISBN 0- 16-038355-2 90000

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