The problems street children face, particularly girls, must be taken seriously, with comprehensive efforts made to understand their predicament, and to help, writes Hanna Abul Ghar* To be a child on the street is hard enough, to be a little girl on the street is even harder. Growing up on the street has a lot of meaning, the background that forces these children to leave their families often full of aggression, physical abuse, forced labour, psychological pressure, neglect, family breakdown, and sexual abuse in some cases. For a child to take the decision to leave "home", even if this home is not paradise, has meaning -- they are already starting off on the wrong foot. They already carry a psychological load too heavy for their age. So why are girls on the street so difficult to deal with? Why are they less likely to adapt to a rehabilitation programme? For girls, life on the street is dangerous. The street is a wonderfully free place, full of opportunity, friends, more money than any of these children's parents could ever dream of providing them with, freedom of movement, of experimentation, no timetable to follow, no chores to do, no school to go to, no grown up to report to. But then it is also a place of great risk; on the street you are all alone, you learn by trial and error, something that at home might be educative on the street could be fatal. The hazards of traffic, the dangers of getting caught by the police, the mere fact that if you get sick or are hurt you'll just have to handle it yourself (bearing in mind that your age can be anywhere between five and 18 years). Not to forget that these children are outcasts of society, they are dirty, they have no manners, they are seen as a menace, and so they are treated as such in shops, pharmacies, hospitals, etc. These are children who like all children have a need to develop their skills, to learn from adults; they need to grow up knowing someone will help them out if they need it. But street girls and boys don't have this luxury. They learn about math through counting money collected from begging; they learn about safety through accidents; they learn about sex through rape, about biology through pregnancy. By the time they meet someone to help them (a rising number of NGOs are now working on the rehabilitation of street children), these children have already lost precious time needed for development of their personalities, a loss that might be difficult to make up for. They have will also have developed a number of psychological problems related to the abuse they are exposed to on the street. For girls, this abuse is often unnecessarily brutal. The aggression that street children are exposed to is mostly from their peers. Often they live in fairly closed communities within the street, trying to solve their problems within the gangs they hang out with. They defend each other, they fight with each other, they force each other into sexual relationships, into crime, and they feed each other. A complicated relationship explains the famous crimes allegedly committed by the "torbini" and his gang, exposed two years ago as committed by street children against street children, a fact that has delayed society's interest in seeing the seriousness of the situation. The fact that these children will surely one day start expressing their anger at society instead of within their own community, and that there might be great difficulty controlling them, is ignored. The incidence of psychiatric illness among street girls is very high. In a 2006 study on 80 sexually active street girls in Egypt, the incidence of overall stress, emotional turmoil and behavioural difficulties was high -- most probably an effect of negative experiences on the street. The predictors for psychiatric illness in general were high, as for emotional disorders, behavioural disorders, hyperactivity and concentration disorders, meaning that these children even when helped off the street are much more likely to suffer psychologically than peers of the same age from a more stable background. The study also showed that the age at which girls left home was largely below 15 years, reflecting the independent personality of these girls in taking brave decisions at a relatively young age. The level of the girls' education and that of their parents was very low: 70 per cent of the girls had never gone to school. It might be argued that educated parents are better able to identify and handle their child's problems before they seek to solve them outside their homes. It is also probable that a girl who regularly receives some form of schooling might find psychological support among teachers and friends, something that would not be available to a child who has never received any schooling; hence the role that the failing education system in Egypt has played in the spread of the problem of street children. Aggression was placed by the girls in the study as their first cause for leaving home -- largely physical, although there were reports of sexual abuse also. On the street, the girls were better able to avoid physical aggression than boys, but their exposure to sexual abuse nearly tripled. They reported a high incidence of physical and sexual abuse, even at police stations and other detaining institutions, in spite of new legislation that aims at separating adults and children, an alarming sign that more needs to be done to protect children in custody. The girls were exposed to a very high incidence of physical trauma on the street. Over 50 per cent of girls in the study had suffered a major accident, many of which were car accidents, stressing the danger of leaving children to fend for themselves in Cairo's traffic. They were also exposed to accidental falls and stab wounds, and one girl included in the study reported a failed suicide attempt. Sexual abuse of girls on the street often involves the use of force, such as beating, kidnapping, prolonged unlawful detention, and gang rape. NGOs working with street girls have reported receiving girls in very bad shape following weeks of being locked up, with very little food, and repeatedly raped, sometimes by more than one person at a time. This is usually done by their peers on the street, increasing their sense of insecurity and low self-esteem. Anyone who works with street girls must notice the facial scars so common among them. These are often marks made by the rapist -- often a street boy -- on the face of his victim to show to others that 'he was the first to have her". This kind of cruelty is difficult to understand, but it explains the apathy and indifference often encountered when dealing with street girls. It also enforces the psychiatric risks involved in street life -- both for attacker and victim -- making rehabilitation difficult. This kind of regular, repetitive sexual violence often results in pregnancy, for some girls more than once. The violent means and the young age at which pregnancy occurs, and the fact that the pregnant girl is alone in dealing with the situation, often in the presence of an abusive partner on the street, is an important cause of medical problems later observed following childbirth, together with the social and legal problems encountered, making mother- child relations complicated, and greatly increasing the incidence of disease and death amongst street babies. The high incidence of disease, often chronic, sometimes life threatening, often with very little or no medical care, is another cause for alarm. Street children in general, and street girls in particular, cannot be dealt with as we do orphans. It is not enough to provide food and loggings and some care. They need a more complex, integrated approach, taking into consideration their psychiatric problems, social background, and their insecurity and difficulty in trusting others. Most of all, life off the street must appear more attractive than life on the street. The longer the girls have been on the street, the harder this task is. * The writer is Assistant Professor of Pediatrics, Cairo University
