December Issue 2007

Fourteen-year-old Mansoor hails from Lahore. In 2004, he injured his neighbour in a quarrel. Afraid of being punished, he left home and came to Karachi. His second night on the street, Mansoor was sexually molested. “I did not have anyone to protest to as other children told me that they are all used to this behaviour.” Eventually such encounters became a means of making money. Three years later, he is still living on the streets. Now he is addicted to this habit and proudly admits that he himself abuses younger boys or any new child who joins their group — all in the name of fun. However, he says, “Even after so many years I still don’t feel safe on the street. Living on the street is difficult, but I have no choice. Still, I dream of living a respectable life one day,” he says.

There are an estimated 70,000 street children in Pakistan. According to Azad Foundation, Karachi has the highest number of street children: 13,000. There are two categories of street children. Those who work on the streets and go back to their homes at the end of the day are known as street-working children. The children who spend 24 hours a day on the street and are completely dependent on it (physically, economically and emotionally) are known as street-living children. The first group is considered far better off, as, at least, they have some protection at night. Street-living youth constitute the lowest of the low section of this population. The dynamics of these two groups are entirely different.

The phenomenon of street children in Pakistan poses a complex social challenge. These children are at high risk of a myriad of physical and psychological problems. And one of the most threatening consequences of life on urban Pakistani streets is the spread of sexually transmitted diseases (STDs). In fact, street-living children are the most vulnerable to STDs, including HIV/AIDS. Today, sex exploitation is such a common practice among these children that the number of commercial sex workers among them is increasing at an alarming pace.

Mansoor is just one example of how a helpless runaway becomes sexually exploited, changing his life forever. Street Children, Pakistan: Group at Risk for HIV/AIDS is a research project carried out by Azad Foundation in 11 cities across the country. It reveals that 88% of these children reported a lifetime prevalence of experiencing sexual intercourse, while 83% of them admitted to being sexually active at the time of the study. Sadly, only 35% of the children recognise AIDS as a disease. Worse still is that only 26% from the 35% understood that it can be spread through sexual intercourse, while a skimpy 17% identified the use of an infected needle as the major way of transmitting the disease. Karachi, with 47%, represented the largest chunk of those street-living children who were acquainted with the transmission of the virus through sex.

Photos: Courtesy Initiator Foundation/Salman Mukhtar

Although the statistics are appalling, what aggravates the situation further is their conviction that they will not catch the disease in any case — either due to innocence or ignorance. “Involvement in sex is considered as a casual activity by all these children, irrespective of their geographic location. It is fun, part of their life,” says Dr Farha Iqbal, head of research at Azad Foundation and associate professor of psychology at the University of Karachi.

Sex becomes a part of their lives for many reasons. Within just one or two weeks of their arrival on the street, they are sexually molested. In most of the cases these children are already psychologically broken and have often experienced sexual abuse even before they reach the streets. Once on the streets, children are in a far weaker position to be able to refuse or negotiate with their exploiters. Protection and survival are the major reasons for joining the already existing gangs of street children, and within five to six days they surrender to the demands of the group leader who teaches them that sexual activity is part of the street life.

But just as in Mansoor’s case, an activity initially taken up for survival soon becomes a habit. “The first experience is usually forceful and they remain in trauma for nearly a month. But once out of it, they start to enjoy it as 57% have become habitual,” says Raana Asif, president of Initiator Foundation. Their vulnerability to HIV increases more as most of the time the abused is also an abuser of his younger lot, increasing the probability of transmitting the disease.

With this habit begins the vicious cycle of exchange. “Exchange can be both in cash and in-kind,” says Dr Farha Iqbal, “such as a Samad bond, a visit to the mini cinema house or even a 10-rupee note, depending on the mood and requirement of the child. It’s a means of making quick money, a game of 15-20 minutes.” Interestingly, these street kids consider having sexual intercourse with anyone outside their group as gandaa kaam, and 76% admit that they have been raped while living on the street. However, sexual activities among themselves are considered as part of their life — not gandaa kaam.

Essa Nagri is considered a safe haven for sexual abusers in Karachi. “The rooms in small hotels are available for as low as 120 rupees. These places have all the required arrangements, like a television and DVD player to show pornographic movies,” says Asif. According to him, truck and bus drivers are involved in this act and mostly come from the Taj Complex and Mauripur truck stands. These people usually select the youngest and the most attractive kid from the group and the group leader facilitates the whole deal.

Their lives are so dismal that some children resort to drugs to numb the physical and emotional pain. Addiction to drugs, glue and alcohol means that children must find ways to support their habit, so they become an easy target for exploiters. Of course, these kids often require increased levels of drugs to cope with the on-going abuse. This creates a vicious circle of dependency, perpetuating their vulnerability.

Dr Mujeeb Khan, who heads the blood bank at JPMC, says that the vulnerability of these children to unsafe sex is higher than among adult sexual workers because being young and less powerful they are involved in more passive sex, and the passive party in anal sex is at higher risk than the partner who plays the more active role.

Recently, some organisations worked to promote the use of condoms among these children and distributed condoms among them. But it failed to bring the desired results. As Dr Farha Iqbal says, “These children don’t like the use of condoms as it restricts their enjoyment. Life is about day-to-day survival, so long-term health is not a priority with them.”

The reality, however, is that it is more than sex that is putting street kids at the risk of HIV. Drug use increases their probability of contracting the disease as well. Dr Mujeeb Khan says that the population of street children is at risk of developing into injection drug users (IDUs). He feels that there are two crucial aspects that facilitate the spread of the disease: the presence of an infected population and unsafe behaviour. Sharing of needles involves both, and therefore it has resulted in high transmission rates. Though no present data verifies these claims, this group has surfaced as a high-risk group for infection.

Photos: Courtesy Initiator Foundation/Salman Mukhtar

Though the authorities accept the high vulnerability of street children contracting the disease, they have yet to carry out comprehensive research to find out the ground realities. However, according to the data provided by the Sindh AIDS Control Programme, the province has 1,909 cases of HIV, representing 50% of the affected population of the country, with 127 full-blown cases. Forty per cent of them are found in Karachi.

In response to the grave scenario, PAVNAH, an NGO working on health issues, initiated a project, Kirnain, in collaboration with the National AIDS Control Programme and the Global Fund for TB, malaria and AIDS, and aims to sensitise street children about the threat of HIV/AIDS. They run five drop-in centres in different parts of the city, where besides providing primary healthcare facilities to the children, they also hold awareness-raising sessions regarding the repercussions of sexual activities, including STDs.

“Awareness-raising is the only option,” says Anjum Shaikh, project manager of Kirnain. “These sessions have brought very positive results among those with whom we have worked.” So far PAVHNA has registered 12,448 street children and provided life skills sessions and primary healthcare services to around 16,000 children.

A number of other drop-in centres are also operating in the city. These may provide shelter during the day, but at night children are at risk and their susceptibility enhanced. But these are all band-aid solutions. Most civil society groups believe that stopping the influx of these children on to the street is the only viable solution. “It has been recognised the world over that there is a need for an integrated approach, such as opening community centres in low-income settlements and stopping the children from leaving their homes by providing them the basic necessities of life,” says Asif from Initiator.

Another reservation on drop-in centres arises from the fact that they provide an opportunity to both categories of street children to interact with each other. A negative impact on working children has been observed in a number of cases. A child from this group feels that after spending a whole day at work he only earns Rs.70-80, which, in the end, is taken by his family, while a boy who lives on the streets also earns a similar amount through apparently ‘easier’ means, has fun and enjoys complete independence. As Dr Mujeeb puts it, “These NGOs should not make the drop-in centres so very attractive that more children will leave their homes.”

But still, with the cultural taboos pertaining to homosexual exploitation, these boys are perhaps even less likely than girls to disclose that they have been abused and seek medical and psychosocial support.

Helping street children regain their sense of dignity and self-respect is crucial to each child’s return to a healthier and safer life. According to Dr Qamar Abbas, deputy programme manager at Provincial AIDS Control Programme, Karachi, “HIV/AIDS is not only a threat to street children but our youth as a whole. We are in the process of initiating a youth programme to tackle the issue on a large scale very soon.”

Photos: Courtesy Initiator Foundation/Salman Mukhtar

Sounds good. But not good enough. Youth programmes like this are localised and focus on direct service, as opposed to being systemic and focused on policy. This temporary approach tends to address the immediate needs of street children, but fails to attack the root causes of the problem. Even as more and more demands are being placed on local NGOs, there are problems in relying too heavily on them for programme management. There is a need to have better coordination, collaboration and networking among NGOs and other concerned authorities dealing with street children.

It is hard to say whether or not Mansoor’s dreams will be realised, as the vast majority of the children currently return to the dangerous streets of Karachi each evening. The diversity of circumstances of these children and their vulnerability to exploitation and abuse suggest that a broader framework is required to make an effective response for their welfare. Most importantly, they need to be steered back to the mainstream of social life through proper education opportunities, reformation and rehabilitation. The process has, perhaps, already begun with a number of initiatives by some NGOs, but it requires a more concerted effort. The ratification of the Convention on the Rights of the Child and the development of child rights-based programmes by Pakistan offers scope for a framework that seeks to realise children’s rights. But a law in itself has never been enough as it always needs a mechanism for implementation.