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UNHCR brings health care to Kabul's street children

UNHCR brings health care to Kabul's street children

As returning refugees flock to the Afghan capital in search of jobs, the UN refugee agency and its local partners are providing health care and education to thousands of street children working to support their families through menial labour.
23 December 2004
Poverty among the 300 families in Chaman Hozeri means that many depend on what little money their children can earn on the streets.

KABUL, Afghanistan, Dec 23 (UNHCR) - They are an all too frequent sight on the streets of the Afghan capital. Whether sifting through garbage looking for scraps of plastic or metal, selling newspapers at traffic lights or simply begging outside shops and restaurants, thousands of children in Kabul help support their families through menial and often dangerous work.

There are no reliable figures on the number of children working on Kabul's streets, though research conducted several years ago by an Afghan non-governmental organisation put the figure at nearly 30,000. The city's population has increased dramatically since then. More than 3 million people have returned to Afghanistan from Iran and Pakistan since 2002. While most have gone back to their original communities, inevitably some are drawn to the city in the hope of finding work.

In Chaman Hozori, an area in eastern Kabul levelled during the country's civil war, some 300 families live in a makeshift settlement of plastic tents and mud huts. Few children here attend school. Their parents rely on the small income they earn on the streets. But today they and their mothers are waiting to be seen by a visiting health clinic.

Through its support to a local Afghan partner organisation, the UN refugee agency is providing health care and education to the families of more than 3,000 street children in Kabul.

The mobile clinic makes twice weekly visits to Chaman Hozori. In one of the tents, women and children sit listening to lessons on basic hygiene and health awareness. In the other, two doctors - one male, one female - examine patients. Blood pressures are taken, hearts and chests monitored and medications distributed by the resident pharmacist. A small examining table is curtained off at the back.

The medical team works six days a week providing on-site health care in eight districts spread across Kabul. Each clinic treats an average of 50 patients a day.

"Most of the children we see are between the ages of seven and 17," said Dr. Ahmed Samadi, who works full time at the clinic. "And at this time of year we get a lot of cold-related illnesses such as pneumonia and other respiratory infections. When you have families living in these cramped conditions, there's no point just treating an individual. You have to make health care available to the whole community."

For the residents of Chaman Hozeri, and the thousands of other poor families in Kabul, the cost of seeing a doctor or purchasing medicine is often beyond their means. The assistance provided by UNHCR ensures that free medical care - and education on how to prevent further illness - is available to some of the city's most vulnerable.

For their work in the garbage, sewers and scrap heaps of the city, most children earn less than a dollar a day. The environment in which they work is often what makes them ill.

Aschiana, UNHCR's implementing partner in the mobile health clinic, has been helping Kabul's child workers for nearly 10 years. Lal Mohammed Shamin, its deputy director, says the organisation's approach is to balance the very real financial needs of the family with the rights of the child.

The majority of the mobile clinics' patients are women and children. Most are treated on site while more serious cases are referred to a hospital.

"We always encourage parents to put their children in school. In those instances where the family would suffer without the money the child provides, we are sometimes able to offer a short term grant equivalent to the child's monthly earnings," he said. "We then have to follow up to make sure the child stays in school. If we can keep him or her in school, then both the child and the parents can see the benefits."

Winter has arrived in Kabul and the city's residents are wrapped in blankets and shawls to fend off the cold. Fog frequently lies heavy over the city, obscuring the mountains that surround it. Air quality is poor and coughs and flus are common. For the city's street children, the task of providing for their families continues - as do the efforts to keep them safe and healthy.

By Tim Irwin