Among the excluded populations served by HealthRight International projects, children and youth remain the most vulnerable. Children and youth have limited access to resources and counsel, and little, if any, participation in the development and delivery of programs and policies directed at them. This is particularly true for the populations that HealthRight works with: children in institutions or at risk of being separated from their families, children and youth living on the streets, orphans and those affected by HIV. The UN Convention on the Rights of the Child clearly acknowledges that children are born with fundamental freedoms and inherent rights. HealthRight is committed to the realization of these rights, especially the right to health.
Although no data exist regarding the number of children institutionalized globally, in numerous regions, children are often placed in institutions when they lose parental support. In Central and Eastern Europe alone, UNICEF estimates that more than a million children are housed in institutions. Institutionalization often entails violations of fundamental human rights, such as physical and mental abuse, malnutrition and denial of the right to education. Isolation and mistreatment can lead to cognitive impairments, emotional disturbances, and physical ailments, and in some cases, even death. Alternatives to institutions, such as foster and kinship care, or halfway houses to promote independent living skills, are essential to promote the healthy development and wellbeing of at-risk children and youth.
Street and at-risk children and youth
Millions of children and youth live on the streets globally, facing widespread abuse and exploitation, and dealing with a host challenges ranging from drug addiction to infectious disease. In St. Petersburg, Russia, where HealthRight has worked since 1994, it is estimated that there are as many as 10,000 youth living on the streets; a 2007 HealthRight-CDC study found that over 37% were HIV-positive. Because they have little power to change their situation and have few advocates or allies, street and at-risk children and youth are vulnerable to physical and sexual abuse, acute and chronic health problems, and are often denied even the most basic health and social services.
HEALTHRIGHT INTERNATIONAL’S RESPONSE
Protecting the rights of children and youth through community-based care
HealthRight has worked for twenty years to strengthen access to health and social services for orphans and other at-risk children and youth around the world, and to advocate for their needs within health and policy systems. HealthRight projects prevent or redress deprivation of liberty and child development via early intervention and de-institutionalization efforts, and by building lasting access to a continuum of services – from HIV prevention and treatment to transitional housing and foster family care. Our activities include:
- Preventing institutionalization through support to at-risk families and community-based care alternatives such as transitional housing
- Restoring family or family-like support, including foster care programs and community-based programs to promote child welfare
- Designing and implementing services to children and youth along a continuum of risk, ranging from street outreach to drop-in centers to halfway houses and foster care
SUCCESSES AND RECENT INITIATIVES
Since 1994, HealthRight has reached approximately 8,000 street and at-risk children and youth in St. Petersburg, Russia, with services ranging from drop in centers to foster family placement to comprehensive HIV prevention, treatment, and care. HealthRight’s efforts in Russia have led to significant policy changes by local authorities, improving the lives and futures of tens of thousands of additional children and youth.
HealthRight’s innovative MAMA+ Project in Russia, Ukraine, and now Vietnam works to keep children born to HIV-positive mothers in the family environment by providing mothers and families with a comprehensive range of services to care for children, including those living with HIV. The project has helped thousands children affected by HIV remain in a family-based care setting.
In Russia, HealthRight and Doctors to Children have partnered with a pediatric hospital to assist victims of child abuse through the provision of mental health and social services. The project will build on this foundation to create an integrated, multi-agency system to detect child abuse early on, mandate interventions according to a social services protocol, and assist children and their families to address the damage done by the abuse and prevent it from continuing.
In Nepal, HealthRight trained 24 master trainers to raise awareness and to teach health providers from across the country in identifying and addressing child abuse. Through this project, Nepali providers have received training and information essential to effective intervention and treatment of abuse cases.