The health and well-being of neglected, abused and exploited children: The Kyiv Street Children Project

Abstract

Objective

To report on the backgrounds and physical and emotional well-being of street children using two street shelters in Kyiv, Ukraine. This study is important because personal accounts of street children may highlight individual or family factors that are associated with vulnerability for and risk of poor mental health, and these could have serious repercussions for the future. This study also poses a challenge to research because street children are a highly elusive population that services find hard to reach.

Methods

Ninety-seven children were recruited and interviewed using a semistructured, psychosocial interview schedule; psychopathology was measured using the Strengths and Difficulties Questionnaire (SDQ) and the Mood and Feelings Questionnaire (MFQ).

Results

Seventy percent of street children scored for behavioral and emotional difficulties on the SDQ, and 74% scored for depression on the MFQ. Current health problems were reported by 78%, with 43% described as persistent or severe. Two thirds of the children in this sample were not homeless but had chosen life on the streets in preference to permanent residence with their families. Their “survival” history on the streets contributed to the development of three different profiles of vulnerability.

Conclusions

High rates of physical and emotional problems in a population of street children, many of whom were still connected to their families, emphasize the importance of developing different approaches for children with different vulnerabilities. This study also demonstrates the feasibility of embedding on-going field research into the service dimension of “front-line” social care agencies.

Résumé/Resumen

French- and Spanish-language abstracts not available at time of publication.

Introduction

Since the fall of communism and a move towards democratic government in Russia and the former Soviet Republics, major social change has occurred and, like any massive upheaval within previously authoritarian and tightly controlled societies, these changes have produced many casualties. Ukraine followed the “two step democratic transition process” (Diamandouros & Larrabee, 2000), having originally thrown off communism in 1991, only to have it replaced by a restyled but politically unchanged communist party that remained in power until the “Orange Revolution” of 2004–2005 brought about real democratic transition.

The trajectory of postcommunist welfare state development as seen in employment and labor market policies, health and social care, and the pensions system has fluctuated since the early 1990s, bringing with it many victims, casualties and persisting problems (Sotiropoulos, Neamtu, & Stoyanova, 2003). As a consequence of increased family breakdown, substance abuse, poverty and crime, homeless children are a major concern throughout the former Soviet Union, and governments are beginning to recognize the need to develop policies to help rescue these children from poverty, abuse, and exploitation. The reality, however, is that developing and delivering policy is difficult because homeless children are a shifting, diverse, impulsive, elusive and mobile population that may not, initially at least, respond positively to offers of help or support. In addition, it is difficult to plan welfare services for this group because its size is unknown, and there are few legal powers available to welfare staff to rehabilitate these children or to prevent them from returning to the streets.

The size of the problem is difficult to estimate because statistics are either incomplete or unreliable. In Russia in 2002 there were reputed to be around 40,000–50,000 children living on the streets of Moscow alone, more than were left orphaned or homeless after World War II (BBC, 2002; Page, 2004). According to official 2003 statistics provided by the Ukrainian Government, there are approximately 50,000 street children in Ukraine, and almost a quarter of these are in Kyiv (Adventist Development & Relief Agency International, 2003). This is around .63% of the total population in the 0–15 years age group in Ukraine which, for 2003, was calculated as 7,838,000 (World Bank, 2004). Politicians, social researchers and professionals alike agree that these figures greatly underestimate the true size of the problem. The problem of a growing population of street children occurs in other parts of the world; for example, Latin America was estimated to have around 40 million street children in the early 1990s, prompting one observer to note that although these countries had only 10% of the world's population, they had 50% of the world's street children (Apteker, 1991). There are also reports from India (D’Lima & Gosalia, 1992), Africa (Campbell & Ntsabane, 1996), Brazil (Hecht, 1998) and Venezuela (Marquez, 1999).

Comparisons with other countries are difficult because of differences in terminology, population sampling, analysis and reporting, and the major contextual differences in terms of political and cultural institutions, socio-economic structures, and governmental and nongovernmental service frameworks. As will be seen later in this study, the term “street children” is not synonymous with “homelessness” and there are dangers in making comparisons based on unclear definitions. What these international studies have concluded is that in developing countries and those undergoing political restructuring street children comprise a significant part of the “inconspicuous” labor market where they are a potent resource for exploitation by criminal networks and where quick, short-term rewards within a climate of continuing poverty ensures a ready supply of child recruits. These studies show the complexity and heterogeneity of a youth problem that all too often has its context ignored through the imposition of superficial explanations derived from “Western” models of political, socio-economic, and individual psychological development.