“In recent decades some extreme forms of violence against children, including sexual exploitation and trafficking, female genital mutilation (FGM), the worst forms of child labour and the impact of armed conflict, have provoked international outcry and achieved a consensus of condemnation, although no rapid remedy. But in addition to these extreme forms of violence, many children are routinely exposed to physical, sexual and psychological violence in their homes and schools, in care and justice systems, in places of work and in their communities. All of this has devastating consequences for their health and well-being now and in the future.”(1)
“Child abuse is not simply any harm that befalls children. Children throughout the world suffer from a multitude of harms- malnutrition, starvation, infectious disease, congenital defects, abandonment, economic exploitation, the violence of warfare, to name a few. Not all harm that befalls children is child abuse.” (2) Child abuse is harm resulting from intentional human action. The most fundamental attribute of child abuse is that it is harmful to the child and detrimental to his/her well-being. There is also an important difference between unintentional and intentional harm. “It has been observed that what is so destructive about child abuse and neglect (as opposed to other forms of injury) is that the betrayal of the child’s trust leads to defective socialization.”(3) Child abuse is correlated with unemployment and poverty. “Rates of abuse and neglect can be thought of as indicators of the quality of life for families, and maltreatment can be viewed as a symptom, rather than a cause, of difficulties in family and individual functioning.”(4) Thus, overall rates of child abuse are higher in regions characterized by a higher proportion of low-income families and in regions with unusually high rates of unemployment.
There are four main categories of child abuse: physical abuse, emotional abuse, neglect, and sexual abuse.(5)
Studies from countries around the world suggest that up to 80 to 98 % of children suffer physical punishment in their homes,(6) and it is estimated that 57,000 children under the age of 15 die as a result of physical abuse per year.(7) Physical abuse can range from minor bruises to severe fractures or death as a result of punching, beating, hitting, shaking, or otherwise harming a child. One of the most common types of physical abuse in infants includes Shaken Baby Syndrome.(8)
Emotional abuse is behavior that impairs a child’s emotional development or sense of self-esteem. It may include threats, constant criticism, as well as withholding love, support, or guidance. Neglect is a pattern of failing to provide for a child’s basic physical and emotional needs. Neglect is a very common type of child abuse, and according to Child Welfare Information Gateway, more children suffer from neglect than from physical and sexual abuse combined. (9)
Sexual abuse of a child is any sexual act between an adult and a child which may include sexual intercourse, incest, rape, oral sex, sodomy, inappropriate touching, or kissing. “An overview of studies in 21 countries (mostly developed) found that 7-36% of women and 3-29% of men reported sexual victimization during childhood, and the majority of studies found girls to be abused at 1.5-3 times the rate for males. Most of the abuse occurred within the family circle.” (10)
Child prostitution “involves offering the sexual services of a child or inducing a child to perform sexual acts for a form of compensation, financial or otherwise.” (11) Worldwide, approximately 1 million children are forced into prostitution every year, and it is estimated that the total number of child prostitutes is as high as 10 million. “Generally children do not commit child prostitution but the adults who engage in prostitution or offer a child’s sexual services to others force them. It is estimated that at least 1 million girls worldwide are lured or forced into this scandalous form of child exploitation. Child prostitution is more frequent in developing countries such as Brazil and Thailand where more than 200,000 children are exploited.”(12) Child prostitution is not only a cause of death and high morbidity for millions of children, but also a gross violation of their rights. Prostitution negatively affects children’s sexual health, causes psychological harm, and puts them at risk for enduring increased violence.
Sexual Health: Child prostitutes are at a high risk of contracting HIV. HIV infection rates in prostituted children range from 5% in Vietnam to 17% in Thailand. One study reports that 50-90% of children rescued from brothels in Southeast Asia are infected with HIV. Prostituted children are also at a high risk of acquiring other STDs. For example, one study found that child prostitutes have STD rates in Cambodia of 36% and in China of 78%, compared to the 5% yearly incidence of STDs in adolescents worldwide.(13)
Psychological Harm: Child prostitution also causes serious long-term psychological harm, including anxiety, depression, and behavioral disorders. Prostituted children are at a high risk of suicide and post-traumatic stress disorder. A study conducted in the U.S. found that 41% of pregnant prostituted adolescents reported having seriously considered or attempted suicide within the past year.(14)
Violence: Prostituted children are at a high risk of enduring injuries and violence. The children may be physically and emotionally abused into submission, while girls may be beaten to induce miscarriages. A study of 475 child prostitutes in five countries found that 73% of participants had been physically assaulted while working as a sex worker, and 62% reported having been raped. (15)
Child labor is a problem worldwide, but it particularly affects children in developing countries. Child labor is characterized by full-time work at too early of an age, and too many hours spent working. The work often exerts undue physical, social, or psychological stress, hampers access to education, and may be detrimental to social and psychological development. The ILO’s Statistical Information and Monitoring Program on Child Labor recently estimated that 211 million children, or 18 % of children aged 5-14, are economically active worldwide. 60% of these working children live in Asia, and 23% live in sub-Saharan Africa. Most economically active children are employed in agriculture. For example, in Nepal, 85% of economically active children are in agriculture. In Cambodia, the rate is 73% while in Morocco it is 84%.(16)
The type of child labor is the most important determinant of the incidence of work-related injuries. An estimated 6 million work-related injuries occur among children annually, which results in 2.5 million disabilities and 32,000 fatalities every year. In developing countries, children often work under hazardous conditions in the manufacturing and agricultural sectors. For these children, crushing accidents, amputations, and fractures account for 10% of all work-related injuries. Working children are not only at risk of physical injury, but are vulnerable to workplace toxins and chemical hazards as well.(17) Specific hazards vary according to the industry type. Child workers may be exposed to high temperatures, and a high risk of accidents caused by cuts and burns if they work in the brassware and glass-bangle industry. Children who work in matches and firebox shops may be exposed to chemical hazards and a risk of fire and explosion. Children who work in the carpet industry are exposed to repetitive movements, chemical hazards, inhalation of wool dust contaminated with biological agents, and inadequate working postures. Lastly, children who work in the shoe industry are often exposed to glue.(18) “Using data derived from the Global Burden of Diseases Study (GBDS), estimates of child occupational mortality rates by region were found to be comparable with adult mortality rates, indicating that the conditions in which children work are as dangerous as, or more dangerous then, those in which adults work.”(19)
Child labor not only negatively affects a child’s health, but it also negatively impacts his/her ability to receive schooling and perform academically. When children are forced by their families to work, they no longer have the time to attend school. Though there are a significant number of children who go to school and work, the work may negatively impact their studies. Data from 12 Latin American countries find that third and fourth graders who attend school and never conduct market or domestic work perform 28% better on mathematics tests and 19% better on language tests than children who both attend school and work.(20) Child labor is also problematic because it creates a vicious cycle. A study conducted in Egypt found that many fathers couldn’t find work or were unemployed for health reasons that were a result of them having worked too long hours, in conditions that negatively impacted their health as children. For example, one man had worked in pottery factories since childhood and was blinded as a result. Thus, one of his sons was then forced at the age of 8 to provide for the family and engage in full-time work. (21)
Low income, poverty, and poor educational institutions are the driving forces behind the prevalence of child labor worldwide.(22) “Child labor exists because education systems and labor markets do not function properly, because poor households cannot insure themselves against income fluctuations, and because perverse incentives exist that create a demand for child labor.”(23) Thus, many families, especially those in developing countries, need extra income or can’t afford to send their children to school, so they send them to work. “Historical growth rates suggest that reducing child labor through improvements in living standards alone will take time. If a more rapid reduction in the general incidence of child labor is a policy goal, improving educational systems and providing financial incentives to poor families to send children to school may be more useful solutions to the child labor problem than punitive measures designed to prevent children from earning income.” (24)
(1) “World Report on Violence and Health.” The World Health Organization. (2002). Accessed on 11 February 2011.
(2) Finkelhor, D., and Korbin, J. “Child abuse as an international issue.” Child Abuse & Neglect. 12 (1988). Accessed on 8 February 2011.
(3) Blyth, M. “Child Abuse and Neglect in Developing Countries.” Accessed on 14 February 2011.
(4) Steinberg, L., Catalano, R., and Dooley, D. “Economic Antecedents of Child Abuse and Neglect.” Child Development. 52.3 (1981). Accessed on 14 February 2011.
(5) Finkelhor, D., and Korbin, J. “Child abuse as an international issue.” Child Abuse & Neglect. 12 (1988). Accessed on 8 February 2011.
(6) “Rights of the child.” UN General Assembly. (2006). Accessed on 11 February 2011.
(7)“Child Abuse and Dangers for Children Worldwide.” Accessed on 14 February 2011.
(9)“Child Abuse and Dangers for Children Worldwide.” Accessed on 14 February 2011.
(10) “Rights of the child.” UN General Assembly. (2006). Accessed on 11 February 2011.
(11) Willis, B., and Levy, B. “Child prostitution: global health burden, research needs, and interventions.” Lancet. 359.9315 (2002). Accessed on 8 February 2011.
(12) Yadav, S., and Sengupta, G. “Environmental and Occupational Health Problems of Child Labour: Some Issues and Challenges for Future.” J. Hum Ecol. 28.2 (2009). Accessed on 10 February 2011.
(13) Willis, B., and Levy, B. “Child prostitution: global health burden, research needs, and interventions.” Lancet. 359.9315 (2002). Accessed on 8 February 2011.
(16) Edmonds, E., and Pavcnik, N. “Child Labor in the Global Economy.” Journal of Economic Perspectives. 19.1 (2005). Accessed on 9 February 2011.
(17) Graitcer, P., Lerer, L. “Child Labor and Health: Quantifying the Global Health Impacts of Child Labor.” World Bank 1998. Accessed on 10 February 2011.
(18) Yadav, S., and Sengupta, G. “Environmental and Occupational Health Problems of Child Labour: Some Issues and Challenges for Future.” J. Hum Ecol. 28.2 (2009). Accessed on 10 February 2011.
(19) Graitcer, P., Lerer, L. “Child Labor and Health: Quantifying the Global Health Impacts of Child Labor.” World Bank 1998. Accessed on 10 February 2011.
(20) Edmonds, E., and Pavcnik, N. “Child Labor in the Global Economy.” Journal of Economic Perspectives. 19.1 (2005). Accessed on 9 February 2011.
(21) Rifaey, T., Murtada, M., and Abd el-Azeem, M. “Urban Children and Poverty: Child Labor and Family Dynamics Case Studies in Old Cairo.” Accessed on 7 February 2011.
(22) Edmonds, E., and Pavcnik, N. “Child Labor in the Global Economy.” Journal of Economic Perspectives. 19.1 (2005). Accessed on 9 February 2011.
(23) Rifaey, T., Murtada, M., and Abd el-Azeem, M. “Urban Children and Poverty: Child Labor and Family Dynamics Case Studies in Old Cairo.” Accessed on 7 February 2011.
(24) Edmonds, E., and Pavcnik, N. “Child Labor in the Global Economy.” Journal of Economic Perspectives. 19.1 (2005). Accessed on 9 February 2011.