WMA Statement on Supporting Health Support to Street Children

Adopted by the 66th WMA General Assembly, Moscow, Russia, October 2015

PREAMBLE

 The WMA recognises that having children in living on the streets is unacceptable in a society even though this phenomenon is difficult to avoid in many communities around the world.

The WMA intends to raise awareness within civil and medical society about the fundamental role played by medical contact in improving the situation of street children. In this regard, it is important that the initial contact with street children be based on trust. Therefore, together with other healthcare professionals and social workers, medical contact should be viewed as the first step towards resocialising street children by building trust between the physician and the street child. Once achieved, a more global multidisciplinary and multidimensional approach can follow to improve the well-being of street children.

Childhood and adolescence are the beginnings of a long physical, mental, cultural and social growth process;

The health of young people shapes the health of tomorrow’s population;

Young people play a part in social cohesion and they are an asset to any country;

Addressing the social determinants of health is essential to achieving equity in healthcare. The social determinants leading to the appearance and growth of the phenomenon of “street children” are varied and complex;

The negative health impact of living on the streets for children, both in terms of the additional health risks to which these children are exposed and their lack of access to healthcare and prevention; street children are, in particular, more vulnerable to acute illnesses and traumatic injuries. In addition, preventive care and continuity of care are non-existent for street children due to frequent relocation;

The health of street children remains critical and has been exacerbated by the global financial and economic crisis, which has contributed to family break-ups, social upheaval and disruptions in healthcare and education;

Children may be victims of discrimination arising from their gender, ethnic origin, language, religion, political opinion, handicap, social status or population migration; Street children are especially vulnerable to abuse, violence, exploitation and manipulation, including trafficking;

Child homelessness often goes unrecognised at a national and international level since it is difficult to quantify and assess.

RECOMMENDATIONS

1. The WMA strongly condemns any violations of the rights of children living on the streets and any infringements of these rights, in particular discrimination and stigmatisation and their exposure to abuse, violence, exploitation and manipulation, including trafficking.
2. The WMA calls upon governments to address the factors, which lead to children living on the streets and to take action to implement all applicable legislation and systems of protection to reduce the health implications for street children. National authorities have an obligation to provide care for all children and, where necessary, to support their return to a living environment appropriate for a child. Reducing health implications includes not only direct treatment of health issues but also protection of Street Children from health risks such as exposure to drugs, HIV infection, smoking and drinking.
3. The WMA calls upon governments, national medical associations and healthcare professionals to acknowledge the scale of this phenomenon and to instigate prevention and awareness campaigns. These children must be able to access the full range of necessary health and social protection.
4. The WMA urges all national medical associations to work with legal counterparts, governments, health care professionals and public authorities to ensure the fundamental rights of children, who are a particularly vulnerable population in need of protection, particularly access to healthcare and education. The right to food and housing should be guaranteed, and any form of discrimination or exploitation should be forbidden.
5. The WMA condemns any improper age-assessment practices that make use of insufficiently reliable clinical or paraclinical investigations. Until they reach adulthood, adolescents must be able to enjoy their status as minors, as recognised by the UN International Convention on the Rights of the Child.
6. The WMA urges physicians to remain vigilant in terms of delivering all the support required to provide suitable and comprehensive care for ‘street children’. Physicians should be aware that homelessness is a pervasive problem. They should be knowledgeable about the existence of homelessness in their own communities and are encouraged to establish a relationship of trust between the physician and the street child to become involved in local relief and advocacy programs.
7. The WMA maintains that every effort should be made to provide all children, and particularly those that are homeless, with access to a suitable and balanced psycho-social environment, in which their rights, including the right to health, are respected.