Programmes

How many people are now displaced in Turkey and Syria?

Following the devastating earthquakes in Turkey and Syria on February 6^th, the vice-president of Turkey, Fuat Oktay, has estimated that more than a million people are presently living in official encampments. This is in a context of bitterly cold nights where temperatures have been registering lows of -9 ̊C. However, in Syria the numbers are even higher. Sivanka Dhanapala, a Syrian official speaking on behalf of the UN commissioner for refugees informed a press conference that well over 5 million people were now homeless. The UK’s Disasters Emergency Committee (DEC) estimates that 17 million people are living within the overall affected area.

What has been the UK’s response to the natural disaster so far?

International humanitarian aid continues to arrive in Syria and Turkey. In the glare of harrowing media coverage, governments and charitable organisations have scrambled to be proactive in promoting, assisting and delivering relief work, and so made their own headlines. In the UK, members of the general public have generously donated over £65 million to help those who have lost so much. The UK government initially pledged a package of financial assistance of several million pounds, and aid including a 77 strong search and rescue team, life-saving equipment, medical experts, hygiene kits, tents, blankets, and loan of a Hercules transport plane. It has also made a commitment to coordinate further help with Turkey’s government, the UN working on the ground in Syria, and other international partners.

How have women and children in northwest Syria been affected?

Commentators and observers on the ground are calling the quakes a double tragedy. There were already over four million people living in northwest Syria who have lost their homes because of the ongoing war and civil unrest. Now many of these people have lost their temporary accommodation as well. The majority are children and women who have lost fathers, brothers and husbands due to the long running conflict. ActionAid has reported the comments of an emergency responder, Sawser Talostan, ‘Children do not even know the meaning of the word home because they were born in, or live in a tent, and some of them do not even know the meaning of the word school.’ Following the earthquakes there has been a complete breakdown in public services and support. Now others have lost their livelihoods and are facing more displacement. Several hours after the initial quake on February 6^th people started to return to their former homes to salvage some possessions, just as the biggest quake struck (measuring 7.5 on the Richter Scale), only exacerbating the plight of many.

Why should people prioritise the safety of children and women in particular?

In the immediate, chaotic aftermath of a natural disaster, governments and non-government organisations (NGOs) prioritise rescue efforts, alongside establishing shelter, food supplies, a clean water supply, sanitation service, and further aid in the form of clothing and more general support. Keeping transport links and border crossings open is a further vital part of this process. Regrettably, in times of crises, when law and order break down, and when people lose their homes, possessions and loved ones, it is women and children who are especially vulnerable.

In such difficult conditions it is easy to overlook the fact that women and children can be left in extremely exposed circumstances. For example, without the safety and privacy afforded by their own homes and families, they may face sexual exploitation. For those who find themselves bereaved, isolated and dispossessed, the threat of coercion into prostitution can become a new and dreadful reality. Moreover, desperate young people can be lured into child labour, or slavery, by unscrupulous cartels which will simply ignore children’s rights for the sake of profit.

Such shady operatives can justify their actions as charitable, claiming that they are aiding the most destitute people in their societies by employing young people and paying them something. Yet these cartels are hardly better than criminals who work beyond the law, and ruthlessly exploit young people. UNICEF estimates that globally there are already 160 million children subjected to child labour. The natural disaster in the Middle East may tragically mean that this figure increases.

What about desperate families?

When families have run out of any means to support themselves and have lost everything, sometimes they are forced to contemplate resorting to child marriage. What if they simply cannot support their eldest daughter anymore? They could reason that she would be better off married, even as a child bride. Moreover, they may be promised a small financial incentive.

What about domestic violence?

Statistically speaking, strained personal relationships are another tragic outcome of natural disasters. The stresses and anxieties arising from such sudden, bewildering loss mean that children and women are more likely to be exposed to the threat of violence and abuse, often from within their own family. In many societies women bear the lion’s share of domestic responsibilities. This role, in times of crisis, becomes even more challenging. Many older children find themselves becoming child carers for their younger siblings, and wherever a mother is injured, incapacitated, or lost, they can suddenly become primary carers.

What is the impact on mental wellbeing?

These lifechanging events can take a tremendous toll on people’s mental health. It is not surprising that anyone caught up in a situation like this natural disaster is particularly prone to stress, anxiety, depression, prolonged grief and panic attacks. It is all too easy to feel abject pessimism about the future. And this is also the very moment when medical services are totally overwhelmed and disrupted.

Should more women be prominent in rolling out relief programmes?

Sabine Adi Aad, the director of ActionAid’s Arab region, argues that one way to prioritise the needs and safety of children and women caught up in the aftermath of a natural disaster is to empower more women to direct the roll out and distribution of subsequent aid programmes. Women who are instrumental in delivering support and relief will, by definition, have instinctive insight into problems and dangers facing women and children struggling in crisis hit areas. Another organisation that encapsulates this concept is Forgotten Women. They only allow women to deliver aid on the front line. This ensures that vulnerable women around the world cannot fall victim to sex for aid exploitation. By centralising the roles of women within emergency programmes, those coping with crises will immediately have advocates who can readily empathise with them. It’s an appealing proposal, and one which could benefit countless women and children in the future.

What can be done to support?

If you would like to know more about the ongoing relief programmes in Turkey and Syria, the Disasters Emergency Committee website has up to date information.

Fact one: the number of multi-dimensionally poor children

UNICEF unequivocally finds that on a global scale approximately a billion children are ‘multi-dimensionally poor’. What precisely does that mean? Essentially, these children have limited or no access to fundamental services, rights and provisions. For example, they are unable to enjoy a formal education programme, or rely on decent sanitation services and a clean drinking water supply. Moreover, they lack healthy, nutritional diets which makes huge impacts on their physical and mental health. They also live in unsafe or insecure housing, or no housing at all. Moreover, they are unlikely to enjoy officially recognised human rights.  

Fact two: the number of children in extreme poverty

UNICEF estimates that 365 million children are living in ‘extreme poverty’. This means that they are in families or groups which survive on less income than the official extreme poverty line which, at present, is an all too arbitrary straight line drawn across global demographic income at just $2.15 per person a day. The consequences of the arising deprivation are stark: these children are twice as likely to die in childhood when compared to those from better off backgrounds. Save the Children explains that almost six million children die every year from illness and diseases which are curable. On average that’s over 16,000 a day, or about one every five seconds. The vast majority of these impoverished children live among very poor communities and conditions. Yet it is within the power of the world’s developed countries to prevent most of those deaths.

This begs the question, why don’t they do so? Financial constraints play a significant part, but insular, domestic policies and legislation programmes also tend to dominate the political landscape, that is, until priorities shift. Unfortunately, presenting evidence that the eradication of child poverty would be beneficial for everybody is more of a challenge than it sounds. Traditionally charities, pressure groups and religious organisations have focussed on presenting child poverty as part and parcel of all poverty, rather than as a discrete and vital component part. By contrast, the United Nations’ first sustainable development goal is to end poverty ‘in all its forms’. By this subtle change of emphasis, it is proving possible to endorse and incentivise action in a more focussed way. The shift from a traditional approach to global poverty is placing children’s wellbeing at the centre of direct intervention, a desperately needed improvement as facts three to six show.

Fact three: why are more children living in extreme poverty than adults?

There are twice as many children living in extreme poverty than there are adults. The arithmetic is compelling: about a third of the world’s population is under the age of eighteen, but about half of all people living in extreme poverty are children. This of course makes perfect sense if you remember that very poor families tend to be large. And the older children tend to find themselves helping their parents with informal childcare and taking on work, which is very low paid and sometimes dangerous.

Fact four: poverty leads to exploitation

Save the Children demonstrates that children who live in extreme poverty are vulnerable to early marriage, violence at the hands of gangs, child labour and trafficking. It is a grim reality that poverty leads to desperation and exploitation. The least protected in the global community face stark dilemmas in their struggle to raise even a little income. Turning to crime and black-market activity is hardly a choice for countless young people. There is something appallingly inevitable, and cyclical, about the consequences of extreme poverty.

Fact five: the global malnutrition crisis

Save the children have recently drawn attention to what it describes as the global malnutrition crisis. The situation in Somalia and Sudan, in particular, has reached a devastating point. The charity cites another halting statistic, that approximately sixty million children under the age of five are suffering from ‘wasting’. Technically that means that they have an unhealthily low weight to height ratio. Save the Children estimate that in Somalia alone there are about 513,000 young children who face the risk of death because of their undernourishment.

The key point is that malnutrition is almost always reversible, so long as there is appropriate funding from national and international communities. So, this is really a question of priorities. Where on the ever-shifting scale of political agendas does child malnutrition sit? 

Fact six: the biggest danger, child poverty is self-perpetuating

Children who live in extreme poverty have few prospects for self-improvement. We are not talking about improving things so that more children survive to adulthood. Political transformation in approach to child poverty is urgently needed to give the poorest children opportunities to thrive and not simply survive. Expectations need to be challenged, otherwise there will be an uptick in survival rates, but poverty will inevitably continue to stifle ambitions and prospects. Moreover, lack of access to opportunities, both educational and vocational, is double edged. First, it is a major contributing factor to child poverty in the first place. If children cannot enjoy a decent education they are likely to continue to live in poverty. Many will feel unmotivated to attempt to self-improve and change their circumstances because of the conditions in which they live.

Of course, an equally significant consequence is that child poverty is also, therefore, a barrier to preventing shared prosperity in the future. Child poverty becomes self-perpetuating leading to more of the same. If a family living in poverty has more children, then they inevitably become poorer still because the overall household income is divided by a higher number and that income needs to stretch further. Therefore, this means that children living in poverty are in several ways a consequence of poverty and, simultaneously, a further cause of it. It also means that poor families living just above the poverty line are destined to fall beneath it if they have more children. This is a difficult reality to come to terms with. Moreover, child poverty also squanders potential, which disadvantages everybody in all echelons of society.

What can be done to improve the situation?

It’s all too easy to ask why we have not addressed and resolved the world’s most pressing issues, such as child poverty. The answer is not straightforward. A statistical approach such as Katharina Fenz adopts suggests that it ought to be possible to target resources at particular countries and communities to reduce child poverty by a significant amount. The eight countries with the highest rates of child poverty, amounting to over 50% of the global tally, are (in descending order): Nigeria, Democratic Republic of the Congo, India, Tanzania, Ethiopia, Madagascar, Yemen, and Afghanistan.

If initiatives to tackle child poverty were especially targeted at these eight countries it would be feasible to reckon that over fifty percent of the global problem were being addressed in a coordinated manner. That does not mean that other countries where child poverty is prevalent would just be ignored. But concentrating for a short period on these named countries would ensure that the headline figures would drop quickly. With the momentum generated and knowledge gained it should be possible to roll out similar programmes in an efficient way elsewhere. Africa and India provide an opportunity to collaborate and focus attention onto particularly challenging areas. This is where data and its analysis can be exploited to galvanise awareness and to progress priorities and initiatives.

The two-generation approach to solving child poverty

Addressing both parental and child status when tackling child poverty is becoming a progressive methodology. For example, parents can be offered training and opportunities to study. The economic benefit is tangible whenever improved job prospects are a natural outcome of such intervention. Higher pay naturally means the chance to improve family living standards. If, on the other hand, low-income parents are provided with access to professional childcare services then the benefits for the children are also indisputable. For instance, children aged three whose parents work and use childcare services typically have a working vocabulary of 575 words. This compares to children of unemployed parents who did not go into higher education, whose vocabulary is typically only 300 words.

Moreover, parental expectations regarding the general value and utility of education impacts on the expectations of their children. This is a significant insight which underscores the importance of a two-generation approach to tackling causes of child poverty. After all, attendance at school is broadening, and can foster aspirations. If it is motivational then is it potentially transformative. 

In conclusion, empowering people, especially children, to lift themselves out of impoverishment is a top priority for addressing the injustice of child poverty. Increasing access to education and training can generate desirable aspirations at a personal level which are central to this strategy. Targeting specific communities and countries remains an important priority, and not just for UNICEF. There is a whole sector of organisations of various sizes and cultural backgrounds that operate in this way which is driving improvement across all poverty metrics.

Child labour

UNICEF records that globally nearly one in ten children are forced into child labour. It’s an arresting statistic. Moreover, there’s an important caveat: some of those children are subjected to especially dangerous and degrading work, a consequence of child trafficking. Of the 160 million children estimated to be trapped in child labour approximately half undertake work which is harmful for their physical, moral and mental wellbeing. The International Labour Organisation (ILO) and UNICEF estimate that 79 million children aged 5-17 are presently subjected to hazardous work. That amounts to roughly half of all children trapped in child labour, a number not far off the entire population of Germany.

Why are children forced into child labour?

When a family faces financial ruin children are at their most vulnerable. Perhaps a parent or carer has been made redundant or become ill and is consequently unable to earn an income. Such a personal financial crisis, whether temporary or permanent, is shattering for families which just manage to scrape a living from one week to the next on what little money they have coming in. Children are likely to want to help their families, and in some cultures would be expected to do so.

How harsh is child labour?

We are not talking about some informal domestic work, or a school holiday job, which may even facilitate a child’s natural development, or instil some sense of self-esteem in a young person. UNICEF explains that child labour is much more exploitative. It’s bad enough for a child to receive a very low rate of pay. Yet such economic exploitation is only the beginning. Child labour can often mean physical and mental harm, it can lead to slavery and sexual abuse. Examples of hazardous work include handling and applying potentially toxic agrochemical substances, undertaking strenuous tasks such as carrying very heavy loads, and using dangerous tools and machinery. Moreover, these practices can often necessitate working in very high temperatures, which naturally and quickly lead to dehydration, among other health concerns.

What about the plight of migrant and refugee children?

Refugees have, in the vast majority of cases, been forced from their homelands because of natural disasters or political conflicts. If children are migrating on their own, they are especially exposed to risks associated with child labour. Trafficked children face constant threats of violence and are deprived of even the most fundamental human rights. They may be compelled to participate in illegal operations, for example, acting as drug mules or prostitutes, or be usurped into paramilitary groups. Trafficking and child labour sever children from their daily routines, their education, and their healthcare. They steal young people’s aspirations and bulldoze through their personal rights.

Unscrupulous businesses

There are also unscrupulous businesses which ignore children’s rights for the sake of profit. They may even claim that they are acting in an altruistic fashion, helping to support the poorest people in their societies by being prepared to employ young people and at least pay them something. Beyond these are societal subcultures and criminal elements who operate autonomously beyond the law, and will ruthlessly continue to exploit young people, irrespective of new legislation, ongoing initiatives and research. Sadly, young people who face desperate circumstances can easily become drawn to dishonest profiteers. Unless politicians wholeheartedly invest in rooting out illegal cartels child exploitation is likely to continue. The bottom line is simple enough: until the poorest people are provided with some financial support, some guaranteed legal standing, basic human rights and improved security, illegal practices which exploit children are likely to continue.  

What legislative steps can be implemented to stop children being exploited?

The IPO collects data relating to child labour. This research is pivotal in generating reliable evidence which can be used to draw attention to the harsh reality of child labour. The data is publicised, for example, it can be presented to political decision-makers to heighten awareness. Moreover, UNICEF and the IPO are promoting administrative strategies, for instance, one goal is to ensure that children are issued with an official birth certificate. Such legal documentation should confer unambiguous proof that a child is not old enough to work, so long as potential employers are respectful of such protocols. In addition, if it is devised and implemented in a supportive and rigorous manner, appropriate legislation should help to ringfence children’s status and rights. At the heart of this political intervention stands the issue of deprivation: tackling poverty will significantly reduce child labour. Government policies which protect and promote social development programmes in education, healthcare, gender equality and decent employment will contribute a great deal in halting child labour.

What obstacles remain?

There remain serious societal and political headwinds. For one, the challenges to ending child labour are complicated by the global scale. There are also difficulties associated with officially and accurately documenting child labour, and addressing economic circumstances on a nation by nation basis. Yet collaborating with different peoples and managing varying demographics in which cultural values place differing expectations on children is vital to halting child labour. Additionally, there are developmental trends to assess, including the widespread nature and impact of poverty, and the social implications of limited access to education, and future employment opportunities for both the adult population and young people. The ILO and UNICEF cite sub-Saharan Africa as the region in which child labour is at its highest, globally speaking. The international community needs to support countries in this area to bring about lasting change.

What else is UNICEF doing to help eradicate child poverty?

UNICEF and organisations like ILO continue to publicise and lobby. They state that people around the world need to engage energetically and wholeheartedly in confronting the causes of child labour. They must resist settling for second best practices or, worse, the status quo. By envisaging the better world that we would like to see around us, UNICEF believes that we can finally end child labour and fulfil a central target of the United Nations’ 2030 seventeen Sustainable Development Goals, namely 8.7, which urges that we collectively “Take immediate and effective measures to eradicate forced labour, end modern slavery and human trafficking and secure the prohibition and elimination of the worst forms of child labour, including recruitment and use of child soldiers, and by 2025 end child labour in all its forms.”.

This sounds refreshingly ambitious. Yet an overwhelming majority of people around the world would sincerely subscribe to these ethical principles. It is a question of priorities. UNICEF, the IPO and the United Nations are in the vanguard of championing children’s rights. They continue to lead the fight to stamp out the exploitation of children, and they remain determined to enshrine these fundamental tenets in galvanising and shaping collaborative global thinking, planning and effective action.

The far-reaching benefits of a common, multi-dimensional definition of child poverty

The issue of defining child poverty is a surprisingly knotty one. It is a challenge not made easier because the concept of poverty is also an emotive one. Conventionally it has demanded a consideration of financial means, but definitions have only recently begun to look more broadly at available resources, services and freedoms. This is a vital step forwards since poverty is about much more than a lack of income. Definitions need to consider the extent to which people’s basic needs are below their means, whether people have access to a variety of fundamental services, such as rudimentary healthcare and education, and the extent to which they enjoy personal and cultural freedom. Having access to a reliable electricity supply is another fundamental factor.

Future prospects, freedoms and aspirations

Moreover, researchers need to assess employment prospects and whether people have access to meaningful opportunities for work. There is also the question of the level of social protection and support available, and the stability of the local community. However, beyond economic factors, a definition of poverty needs to encompass political circumstances, for example, the extent to which people enjoy social, religious and gender specific freedoms. To what extent do they feel able to speak out for themselves and negotiate with representatives of those in authority? Additionally, what aspirations do people living in poverty hold dear?

The arbitrary nature of a calculated poverty line

Charities and pressure groups still tend to cite a seemingly arbitrary poverty line. This is an estimated economic point below which it is considered impossible to obtain necessities for everyday living. The numbers published, of course, amount to something of a moveable feast. Originally, in the early 1990s a dollar a day became a yardstick by which global poverty could be measured. Subsequent official attempts to update this definition have led to the publication of the latest headline figure of just over two dollars a day. One concern is that definitions like these are based on one currency and therefore the economy of one nation, the relative value of which is constantly fluctuating because of a vastly complex web of domestic and global factors. This makes the processes of formally estimating poverty levels based on the value of the dollar seem less helpful.

Issues arising from a headline figure

Despite some impressive research in the formulation processes, the headline figure unintentionally invites a rather lazy response from people and organisations alike, because by its nature it relies on a very specific figure without conveying any simultaneous insight into personal lifestyles and living conditions. In September 2022 The World Bank revised and republished its monetary quantification of abject poverty. It categorically establishes its ‘new, extreme poverty line’ at $2.15. This crudely means that anyone living on less than this amount of money spends their life in extreme poverty.

In total the World Bank estimates that 648 million people, or about a twelfth of the world’s population, live at this level. Nonetheless this stark, official calculation begs an important question. What about all those people who live on $2.16 a day, or $2.17, etc. What about the hundreds of millions more who live on or just below $3 a day? They would in theory be fifty percent wealthier than their counterparts who find themselves just below the new extreme poverty line. Yet does an extra dollar a day make all the difference? Moreover, the World Bank makes deductions based on the new poverty line. For example, in a bullish statement it lauds trends in poverty reduction made since 1990: ‘the world has made impressive progress in reducing poverty’.

A multi-dimensional approach to defining poverty

The World Bank, however, does acknowledge the importance of a multi-dimensional approach to defining poverty. It devotes a good deal of space and energy into commending an overarching assessment. So, it seems disappointing that the bank insists on headlining with a misleadingly precise-sounding monetary value, simply supplying eighteen links to other pages where important factors and analyses are cited. Many readers would simply not invest the time to look beyond the headline figure. Essentially, defining poverty needs to prioritise and embrace consistent presentation, emphasis and, above all, evidence-based information.

What makes poverty statistics influential?

Suffice to say that whatever poverty line figure is put forwards, the methodology produces a very low income value. However, any headline figure, however eye-catching, masks a far more complex set of circumstances. In dismissing such statistical approaches as highly limiting, Don Mathews has neatly pinpointed one reason that poverty statistics enjoy such influence, that is, to justify governments’ financial planning. A baldly statistical emphasis fails to shed light on specific social complexities that contribute to the notion of living standards.

The need for a holistic approach

So, a more holistic approach to defining poverty, and with it child poverty, is preferable. Increasingly, experts have argued that poverty needs to be viewed through the eyes of the people in question. For example, we should be assessing what their aspirations are, and to what extent they consider that they enjoy personal freedoms and rights. It may be a mistaken approach simply to judge situations through western eyes.

In building a robust, multi-dimensional definition of poverty and child poverty, we need to challenge lazy assumptions and expectations. While this is not an easy prospect it is vital in attaining a meaningful definition and the benefits which can arise from it. Moving away from a reliance on headline statistics and sound bite descriptions also requires a concise and embracing verbal explanation. Another hurdle concerns people’s conceptions of poverty relative to their own circumstances and societies. For instance, a child living in poverty in the UK may still look considerably better off than a child who lives in sub-Saharan Africa, simply because of the level and quality of services available from the state.

Another statistical issue: revising figures promptly

UNICEF presents an unequivocal argument that globally speaking, the majority of people in poverty, are children. Their headline figures are shocking: ‘Across the world, about 1 billion children are multidimensionally poor, meaning they lack necessities as basic as nutrition or clean water.’ UNICEF concludes that although a third of the world’s population is made up of children, they comprise up to half of those trying to live on less than $1.90 a day. Of course, this figure clashes with the latest World Bank revision, and such inconsistencies are naturally unhelpful in defining and then devising strategies to reduce poverty. Imposing monetary benchmarks only shifts people in a narrowly statistical sense, but certainly not in terms of their actual circumstances.

A further numerical inconsistency

UNICEF goes on to deduce that 356 million children are presently living in absolute poverty, another socio-economic overarching term which also clashes with the World Bank’s tag. Addressing poverty inconsistently does not change the fact that these children experience the poorest living standards, develop the fewest skills for later life, and earn the lowest wages when they become adults. Moreover, UNICEF starkly presents the bottom line: these poorest children are twice as likely to die than their better off peers. Future collaborative efforts to reduce child poverty would surely benefit from the common use of universally accepted terminology and methodology.

Undoubted progress

UNICEF chairs the Global Coalition To End Child Poverty. It too celebrates the fact that over the past thirty years administrative and co-operative strides forward have been taken to address and reduce child poverty. There are encouraging data, leading to the affirming claim that child poverty has been reduced by over fifty percent since 1990. This statistic means that malnutrition has been reduced, safe drinking water has been made available to many more people, education has been expanded, and fundamental healthcare services have been established alongside better sanitation. Because of this life expectancy is improving in diverse communities, and children may even have improved employment opportunities.

Avoiding complacency

While such progress sounds reassuring, it is vital to remember that huge numbers of children remain in multi-dimensional poverty. Huge disparities persist, and naturally these guarantee that hundreds of millions of the poorest children are being left further behind. Political initiatives like UNICEF’s Sustainable Development Goals are bringing governments together on the international stage to address child poverty. The ultimate, and rightly ambitious, aim is to eradicate multi-dimensional child poverty within the next decade, meaning that children will have what they need not only to survive but to fulfil their potential and hopefully thrive. Achieving that efficiently and effectively would be aided by organisations and governments adopting a consistent, embracing overview, which relies less on statistical headlines and uses uniform terms coherently to reinforce descriptions of personal circumstances.

The John Lewis Partnership has teamed up with Action for Children, aiming to make a lasting difference to young people in care across the UK. This year’s Christmas advert adopts a refreshingly new style for the company’s traditional festive campaign. Their commercial, titled ‘The Beginner’, introduces Ellie who represents one of 108,000 children in the UK care system. Sad faced, she arrives at her foster home just prior to Christmas Day where she is warmly greeted by her new foster parents. As a first impression she notices a skateboard in the hallway and the cast on her foster father’s arm. In fact, he is battered and bruised from repeated attempts to master some fundamental skateboarding moves, a hobby he understands means a lot to Ellie, whose sole possession appears to be a well-loved board.What the advert doesn’t reveal is that a young person goes into care in the UK every seventeen minutes. That amounts to approximately 30,000 each year. Moreover, Action for Children, suggests that 60,000 children referred to social services each year were referred the previous year as well but, for a variety of reasons, were not offered any support. For some young people, receiving vital help from the state is a very slow process.

Media impressions of Christmas

Conventionally, the media tend to promote generic impressions of Christmas, with families gathered around a strikingly decorated Christmas tree, opening neatly wrapped presents, heartily eating and drinking fine fare, and generally enjoying a carefree time away from life’s more usually hectic routines. Perhaps there are red and green knitted stockings draped over the soft furnishings, a roaring fire with a pet dog stretched out in front of the fireplace, and ornate decorations completing the festive scene. However, for many families and children this impression of Christmas time is a far cry from the harsher reality of 2022. This begs two questions, how many children experience a less than happy Christmas? And, what can we do to make Christmas feel like Christmas, irrespective of material and commercially driven impressions and expectations?

Christmas can be stressful

The answer to the first of these questions is difficult to determine but suffice to say that it is probably rather more than you would imagine. There are several important socio-economic factors which frame individual family contexts. Ironically, for many parents Christmas can prove to be a stressful time. There are deadlines to be met at work, shopping to be bought, meals to be prepared, presents to be organised, cards and messages to be sent, relatives to be visited – sometimes hundreds of miles away – and housework to be completed. Perhaps we can stand aside from the hype for a few minutes to think about what might make a genuinely happy Christmas, especially for children classed as living in poverty. One where materialism does not take centre stage, one where overindulgence is rendered irrelevant, and one where overspending to keep up with expectations doesn’t land families in debt. After all, financial stress and hardship are leading causes of anxiety and depression, and the impact of these mental health conditions can deeply affect children.

The link between poverty and mental wellbeing

Official figures confirm that child poverty in the UK is increasingly widespread. However, Christmas can prove to be a difficult time and not just because of the financial constraints imposed by hardship. Poverty and mental health issues are indisputably linked. For example, anxiety and depression are more prevalent among young people whose personal circumstances mean that they are eligible for free school meals. Moreover, statistically speaking, children whose families face hardship are less likely to attain good examination grades than their peers. This fact can naturally undermine their self-esteem and prove to be educationally demotivating. Consequently, the festive season with its material expectations is likely to present additional sources of stress to young people who may already feel socially disadvantaged. So, while for a majority of children Christmas can be an exciting and even a magical time of year, for a sizeable minority it might prove to be divisive, isolating, and it can even undermine self-confidence.

Challenges arising from Christmas school holidays

Beyond the financial and material associations of present giving, the school holidays can also become disruptive because daily routines inevitably alter. Most young people do not mind staying in bed later, nor going to bed later. However, a lack of routine can become disruptive and counterproductive. There can appear to be no obvious sense to each day’s shape, and some young people may simply drift through the holidays. Others have no choice but to take on huge responsibilities during the school break. For example, there may well be a younger sibling to look after during the day, meaning that the school pupil in question fulfils the role of a young carer. Others may be obliged to look for temporary work to help support their family. Perhaps this transpires to be informally arranged and consequently the experience might transpire to be exploitative. These types of change to everyday life can leave young people vulnerable to all sorts of external pressures and commitments. Moreover, given the short days and prevalently chilly, wet weather, there may be limited opportunities to spend time outside, which can lead to a sense of boredom, frustration, or just feeling pent up.

Domestic abuse can become more prevalent at Christmas time

Moreover, there are additional issues facing many young people during the festive season. For instance, some children live in the shadow cast by domestic violence, which is documented to peak at this time of year. At Christmas people tend to consume more alcoholic drinks than usual, and that fact, alongside financial worries and expectations, can intensify domestic tension leading to increases of violent incidents at home. Children are naturally sensitive to family dynamics and can unwittingly find themselves caught in the middle of parental arguments. These can quickly spiral out of control. If you, or somebody you know, is experiencing domestic violence and associated relationship breakdown, help is available at: www.nationaldomesticviolencehelpline.org.uk.

The most important gift this Christmas

Given these issues and pressures it is remarkable how resilient and positive many young people are when coping with their individual circumstances. We can all make a difference to young people’s wellbeing simply by bearing in mind what really matters at this time of the year. I really like Christmas. It can often be a reflective and relaxing time and there are opportunities to spread some happiness and positive sentiments among family and friends. Even in a secular society the idea of a midwinter festival which marks the passing of the shortest days of the year and anticipates a new year, spring time and sunnier days to come, seems instinctively appealing. The festive season does, of course, also offer an opportunity to reconnect with children, as families spend more time together. Lasting, affectionate connections can be rebuilt. Perhaps the most important gift that adults can give a young person is time, alongside sincere attention and love. There is a danger of prioritising a long list of chores which inadvertently side line children.

Planning Christmas together

Moreover, planning together for a simple Christmas time avoids the prospect of over-expectation, and enshrines the notion that little things matter a good deal. Young people have been exposed to Christmas advertising since the beginning of October. That commercially led, drawn out anticipation can be concluded in a matter of minutes as presents are hurriedly opened. Perhaps Christmas could be approached in a more measured manner, wound down gently, and lasting memories could be formed by establishing new family traditions. For instance, something as simple as a walk to look at the festive lights, or a game of charades, or reading excerpts of a traditional story, like some short passages from Charles Dickens’ Christmas Carol.

Making a difference at Christmas

Given that young people learn from what the adults around them do, it ought to be possible to demonstrate what really matters. For example, volunteering for a couple of hours may prove to be affirming and inspiring for a young person, engendering a broader sense of perspective. Or, where possible, planning a small donation to a charity together. For example, Barnardo’s Christmas appeal aims to tackle child poverty by providing food, warm clothes, bedding, and generally spreading a sense of Christmas spirit. Contributing in ways like these could help to offer young people a life changing gift that will empower them to navigate through the material associations of the festive season and nurture an appreciation of thinking about others, no matter what their own circumstances.

UNHCR presents some sobering statistics on the numbers of people around the globe forced to leave their homes. By mid-2022 there were estimated to be 103 million refugees. That is approximately one and a half times the total population of the UK, and about one and a half percent of the world’s population. Of that unimaginably huge number, over a third – or 36.5 million – were under the age of eighteen. Strikingly it is calculated that a thousand children every day are born with refugee status.

The challenges facing these young people and their families are bewildering. Everyday facilities, resources, and community benefits which people in the UK take for granted, amount to little more than pipe dreams. Basic shelter, sanitation, education, health care, nutrition, and earning a living appear dauntingly out of reach, while language barriers and cultural differences in host nations may provoke and embed prejudice and hostility.

Anxiety is commonplace among refugee children

As my previous blog explained, for migrant children anxiety is a prevalent condition for which there is limited scope for formal treatment in many host countries. Nor, regrettably, is there much prospect of that situation immediately improving for the vast majority of the 103 million people presently forced into migration. Resources and services in host nations like Uganda (one and a half million refugees), Columbia (two and a half million refugees) and Turkey (over three and a half million refugees) are critically overstretched and underfunded, despite these nations’ best humanitarian initiatives. It is issues such as the impact of personal and political crises on people’s mental health which leads to conditions like anxiety and depression becoming long term and widespread.

A place for self-help strategies

While there is no substitute for professional advice and help, experts do recommend a series of self-help strategies which can prove beneficial in addressing symptoms of anxiety. Raising awareness about the importance and fragility of mental wellbeing is vitally important for everyone, especially for the most vulnerable people in global communities. Mental health first aiders are trained to promote these self-help strategies to empower people of all ages to attempt to regain some sense of control over their emotional wellbeing. By informing young refugees about practical steps endorsed by specialists they are likely to feel more positive in their outlook on their lives. That would amount to a significant start in appreciating and countering symptoms of anxiety, although there is no denying the uphill struggle which they will continue to face without professional treatment.

What self-help strategies are accessible for young migrant people?

Sports and exercise

Experts suggest that taking regular exercise is beneficial in addressing mental health conditions like anxiety. This could be as simple as going for a short walk. For a lot of young people, linking the issue with physical wellbeing is a natural place to begin. Regular exercise is acknowledged to be affirming for mental wellbeing. It improves fitness and can inspire a positive mood. This is a first step on the way to a broader and more positive outlook, which in turn can start to create a sense of self-esteem.

So if, for example, a group of migrant children were given a second-hand football, they would have the potential to improve their physical and mental wellbeing. Of course, unsupervised they might risk physical injuries, but potential benefits could reach comfortably beyond the children’s wellbeing into the heart of their community, if local people became involved in organising some basic training or informal games.

Thanks to organisations like Fairplay For All Foundation, operating in Payatas, young football players who grow up facing extreme poverty have been selected to participate in the Street Child World Cup, representing the Philippines. This is truly aspirational for others in the community. Imagine the liberating sense of fulfilment galvanised by this opportunity. For the majority of those invited to Doha to participate in this year’s global competition, it would have been their first time flying, just one beneficial aspect of such a broadening experience. Having ambitions like these is a powerful motivator and can certainly impact positively on mental wellbeing. By taking some daily exercise, however informally, young people may benefit from a host of other lifestyle improvements. For example, they are more likely to adopt better sleeping routines.

Building friendships

Moreover, social interaction certainly benefits mental health. This is especially vital as young children develop. Building friendships impacts positively on mental wellbeing, for instance by fostering self-confidence and a greater sense of self-esteem. Aberdeen-based charity, Befriend a Child reaches out to young people who face difficult personal circumstances. Volunteers regularly meet up with the children to help them increase their sense of self-worth, develop new skills, reduce isolation and promote positive wellbeing. Friendships can generate a feeling of belonging, together with a positive and purposeful outlook. This means that interaction with other young people can boost confidence and help to provide a broader perspective on other issues, whether through diversion or by changing a child’s dominant moods. Even something as simple as listening to jokes can help to improve outlook. Enjoying good friendships can also foster a common sense of purpose, which is potentially transformative for mental wellbeing.

Maintaining a balanced diet

It goes without saying that eating a well-balanced diet and keeping hydrated are also important to physical and mental wellbeing. It’s vital that information about these important aspects of everyday life are publicised, perhaps even by word of mouth, as a rudimentary element of any basic educational programme. Funding and resourcing a well-balanced diet for refugees is a huge economic and logistical challenge for host nations, but it is still fundamental to address awareness of these issues among young people.

The benefits of safeguarding mental wellbeing

There are of course other important self-help suggestions to safeguard and improve mental health. For example, mental health first aiders recommend deep breathing exercises, which can be performed almost anywhere and at any time. They can quickly bring a sense of calm to anyone feeling symptoms of depression, anxiety or stress. Young people are also encouraged to write an informal journal, if possible on a daily basis, briefly focussing on positive moments in their lives. These could be as simple as a good sleep, or fine weather. Mental health first aiders also commend mindfulness. While this may not immediately appeal to young people the benefits of calmly focussing on our surroundings and listening to our sensory responses are indisputable.

One important yet understated benefit of being part of a community is the potentially positive impact on children’s mental wellbeing. Bringing young people together, integrating them into informal activities offers a way ahead for migrants and refugees. The benefit of addressing mental wellbeing through self-help strategies may not appear to be as tangible as other fundamental improvements, but in a number of ways it is the most significant of all, helping to transform and empower some of the world’s poorest children.

Signposting help

Various organisations give advice on safeguarding mental wellbeing. For example, the NHS discusses the benefits of self-help tips for improving mental health. Moreover, in 2022 the Mental Health Foundation has produced a series of short, educational films to support refugee mental wellbeing. One tells the story of Mariam, who fled from Syria and now lives in Scotland. The video endorses the Mental Health Foundation’s support programme and promotes tips to improve and safeguard young refugees’ mental health. Hearteningly, in initiatives which the foundation runs in Wales and Scotland, asylum seekers and refugees are recruited and trained to serve as peer leaders. Their role is to foster empathy, understanding, and mental health literacy. By empowering people in this way, young refugees can derive an affirming sense of self-esteem, while appreciating the difference that can be made through constructive mediation.

In conclusion, young refugees can benefit a great deal from talking about mental health issues. Raising awareness and encouraging self-help through educational programmes, however informally, can make a marked difference to the mental wellbeing of young people, particularly when little or no expert medical treatment is available. Community initiatives, especially those which empower people from the refugee community, can prove to be advantageous in more ways than one. Naturally, young refugees benefit from improved knowledge of mental health, but they are also likely to look up to community role models. Anything which inspires young people, no matter what their circumstances across the world happen to be, can become transformational for them, providing them with a more purposeful outlook. This in turn will impact positively on their mental wellbeing.

What does childhood look like?

Children cannot always contribute and say what they want: what is right for one may not be right for another.  Urban child poverty is a global issue.  Ensure a brighter future for children requires more action now.  Eradicating extreme poverty is a global concern.  There will be a perpetual downward spiral unless the bar is raised higher.  Many charities, organisations and community groups are already making great improvements.  However, to overhaul the system governments must also cooperate.  Social funds would reduce reliance on a child’s income.  Improved access to education and building safe environments for play would ensure the next generation of adults are more economically active.

Urban child poverty and labour

In 2016, the International Labour Office (ILO) estimated 152 million children were labourers. Almost half were working in hazardous conditions.[1]

Since 2000, the mission to decrease child labour was proving effective.  But the economic stresses of the pandemic began to reverse some of this good work.  In 2021, an estimated 160 million children were labourers.[2]

Pixabay – Sasin Tipchai

Agriculture is the most common type of work for children to be engaged in.  Rural areas have three times more child labourers than urban areas.[3]

However, that doesn’t mean the number of working urban children is low.  Families can be large, with 4 or more children.  The older ones are often enlisted into family businesses – weaving, selling flowers or selling food in the streets.  Some end up begging.  Or scavenging through waste for leftovers.  Others are preyed upon by sexual predators and traffickers, coerced into activities that will cause them nothing but misery and suffering.[4][5]

Improvements are necessary

This is not sustainable.  ILO and UNICEF have set out a list of changes essential for the future health of a neglected population.  There’s a dire need for social protection, including universal access to child benefits.  Schools must be free and inclusive.  Employment and education opportunities for adults need to be improved, so that they stop depending on the income of children.  Child protection systems and infrastructure is necessary to support the young.  Spending money on improvements now, will reap benefits in the future.[6]

Recognition of the changes needed and campaigning for them is only part of what it takes for change to occur.  A huge cultural shift is needed.   Focus should be placed on nurturing a child’s potential through education, play, and sport – rather than exploiting them.

As long as there are people and organisations willing to support the development of young people – to advocate and show them they can change their lives and dream big – there is a chance children born into poverty won’t have to raise their own children in poverty.  It takes action, courage and consistency from people willing to help and improve the world a little at a time.

Pixabay – Aditio Tantra Danang Wisnu Wardhana

Combatting urban child poverty through education

Education is nice to have but not always achievable.  Some families may depend on their children to supplement the family’s income by taking on employment themselves.  A lot of the work available to informal settlement and slum residents is precarious.  Contracts run out, and competition is high.  And yet, rent must be paid, food must be paid, electricity must be paid.  After providing the necessities, additional costs for school fees, books and uniforms become a burden.[7]

There are support services available to help struggling families.  But, accessing them can be difficult or conditional, and that’s only if people even know about them.  Groups like Street Child can assist families in meeting with support teams.[8] Meeting the conditions for assistance can be daunting.  Families living in informal settlements struggle to complete application forms: their addresses are not officially recognised.

Child centred learning

Fairplay For All Foundation in Payatas is a group that aims to improve the lives of local children by giving them the opportunities they need to thrive.

“We believe in child-centered(sic) learning; students learn at their own pace, have a say in how the school is run, in what lessons they take, and in how they shape their future.”[9]

Allowing children some say in their education gives them experience in making decisions, promotes inclusion and encourages them to keep at it.  Urban child poverty doesn’t have to be a foregone conclusion.

Pixabay – Ratna Fitry [10][11]

The United Nations Population Fund (UNFPA) has recognised an urgent need to improve sex education for young people and provide services to combat economic hardships faced due to teenage pregnancy.  They aim to influence policy making: to improve education and employment opportunities, to increase access to contraception and to provide support for families.[12]

The poverty cycle will continue like this unless there is a fundamental change in how children are valued.  Formal education can increase individual earning potential, standards of living, and GDP but it’s not the only aspect of childhood education to consider.  Learning through play helps a child develop emotionally and socially as well as encourage confidence and self-belief.

Pixabay – Joseph Samson

Importance of play for developing children

Playing, and learning through play, is vital for the development of a child. It provides opportunities to: develop social skills; combat stress and poor mental health; practice calculating risk safely and experience a sense of self-worth.  In a living environment that is often full of danger, stress and a cycle of low self-image, it is extremely important to give children the opportunity to see themselves positively.  A child who knows nothing of self-improvement – and the great feeling of accomplishment – will be unlikely to seek those feelings as adults, or encourage their own children to pursue them.

According to 2019 data, less than half of the world’s population has access to open public space within 400m of their home.  Just over a quarter of people in Eastern and Southeastern Asia have this luxury.[13]

This demonstrates that a very small number of children in urban areas can play safely in nature.  The majority of children (if they even have the time) play in alleyways or must complete long, unsafe journeys to reach a park.  In addition, entrance fees are often charged.

Playing for health

“Poverty itself can negatively affect how the body and mind develop, and economic hardship can actually alter the fundamental structure of the child’s brain.”[14]

Playing in a safe environment allows children the opportunity to forget, however briefly, some of the problems they live with.  Stress is extremely detrimental to growing bodies and toxic to brain chemistry.

Being exposed to a wide variety of extremely stressful situations is a lot for young minds to take on.  That’s why the work of local community groups is extremely important – to give children with nowhere else to turn, an opportunity to make the most of their early lives.

Fairplay for All (Payatas, Philippines)

The Fairplay for All Foundation in Payatas, Philippines works with local children assisting with  education as well as providing safe spaces to play. Giving children a challenge and an opportunity to grow is vitally important.  Allowing them the chance to hope, a chance to achieve self-worth makes all the difference.

Loren

During the early days of Covid-19, the children started a newsletter to occupy their time.  Loren (17) wrote an article:

“When I was younger, I didn’t really understand the importance of nature and why we should take care of it. I have only known the world which I grew up in, a place where there’s trash everywhere and no scenic views in sight”. Because Payatas’ informal settlement was built in a rubbish dump, the locals understand the importance of recycling – it is how they have survived.  As Loren notes: “..people here are more aware of how their garbage should be handled and don’t just throw things that can still be reused or recycled.”

Children are the next generation of leaders: given the opportunity and some confidence they can make their communities – the world – a better place.[15]

Cars before children

As cities grow and urban areas expand, very little thought has been given to youth.  Playparks are forgotten, green spaces transform into roads, and all the safety is yanked out of a young person’s day.

Work is ongoing across the world to undo the bad habit of favouring of cars over children. Charitable organisations continue to press the issue.  In addition, they highlight the need to plan child-friendly space in balance with economic needs.  Yes, adults do need to drive to work: but children also need a slice of nature preserved for a chance at physical and mental health.[16]

Mental and physical health effects of urban child poverty

The chronic stress of living in impoverished and unhealthy conditions can overwhelm a child’s stress response systems, causing what has been referred to as “toxic stress.”[17]

Children and adults who live in poor neighbourhoods are likely to experience mental health problems, as well as physical problems.  Poverty and a shorter life expectancy almost go hand in hand.  Furthermore, they are at risk from malnutrition, chronic illness, exposure to pollutants, food insecurity, violence and crime.[18]

Each of these factors inhibits a child’s development.  Outside help is often needed to break the cycle.  Organisations such as Fairplay are essential for giving the young a safe environment to enjoy their childhood, away from the stigma and stress of urban child poverty.

Risks of overcrowding in urban areas

There are inherent risks in growing up in overcrowded urban areas.  Informal settlements are often without hygienic waste disposal and are navigated by a series of alleyways where this waste gathers.  Children are exposed to all kinds of illness, physical injury and even death in these areas.[19]

As populations expand, informal settlements expand along with them.  It has been estimated that 2 billion people have little access to sanitation.  In Kenya alone, estimates say around 1-2% of GDP is lost because of insufficient hygiene controls.[20]

In a world contending with Covid-19, it seems unthinkable that so many people don’t have clean water to wash their hands.  They can’t hydrate without risking their health.  Their immune systems are assaulted daily, and for the emerging immune systems of children, this assault can be overpowering.

As well as illnesses brought on by a combination of inadequate nutrition and sanitation, overcrowding increases the risk of burns, falls, heatstroke and road traffic accidents.[21]

Children depend on adults for help

There are many reasons why a child must look after themselves.  Some are orphans and some parents work long hours.  Some are street children, separated from their families.  Without healthy supervision and guidance, children won’t spot potential dangers or be fully aware of their surroundings.  They depend on adults to teach them.  The pressures of poverty mean that, unfortunately, children are neglected because there is no other choice.

Therefore, they must make their way in a world that hasn’t considered their perspective.  Urban areas are expanding fast, cobbled together without much planning.  There’s a lack of speed limits on roads, lack of walkable pavements, lack of easily accessible shops and an explosive increase in the number of road users.  Combined, these create a frightening scenario for young children.[22]

There are many positive changes taking place to improve the lives of young people affected by urban child poverty but the issues are so widespread that more, as always, must be done.  Covid-19 has eroded gained ground and change is precarious.  How many families would prefer their child to work in hazardous conditions over living their best life? Unfortunately, the needs of today are far more pressing than the ideals of tomorrow

Footnotes

1. International Labour Office (ILO) “Global Estimates of Child Labour: Results and Trends 2012-2016 Executive Summary”; Available at https://www.ilo.org/wcmsp5/groups/public/@dgreports/@dcomm/documents/publication/wcms_575541.pdf (accessed: 30/03/2022)
2. ILO “Child Labour Rises to 160 Million – First Increase in Two Decades” 10/06/2021; Available at https://www.ilo.org/global/about-the-ilo/newsroom/news/WCMS_800090/lang–en/index.htm#:~:text=GENEVA%20(ILO%20News)%20%E2%80%93%20The,Organization%20(ILO)%20and%20UNICEF (accessed: 30/03/2022)
3. Ibid.
4. ChildHope Philippines “A Closer Look At Child Labor in the Philippines” 08/06/2021; Available at https://childhope.org.ph/child-labor-in-the-philippines/ (Accessed 30/03/2022)
5. Halliday, J “Former Radio 1 DJ Mark Page Jailed Over Philippines Child Sexual Offenses” 10/03/2022; Available at https://www.theguardian.com/uk-news/2022/mar/10/former-radio-1-dj-mark-page-jailed-for-child-sex-offences-in-philippines#:~:text=A%20former%20BBC%20Radio%201,their%20poverty%2C%20the%20judge%20said (Accessed 30/03/2022)
6. ILO “Child Labour Rises to 160 Million – First Increase in Two Decades” 10/06/2021; Available at https://www.ilo.org/global/about-the-ilo/newsroom/news/WCMS_800090/lang–en/index.htm#:~:text=GENEVA%20(ILO%20News)%20%E2%80%93%20The,Organization%20(ILO)%20and%20UNICEF (accessed: 30/03/2022)
7. Children of the Mekong; Available at https://www.childrenofthemekong.org/asia-children-sponsorships/give-hope-to-children-living-in-slums-in-the-philippines/ (Accessed 30/03/2022)
8. Street Child “125 Million Children Around The World Cannot Go To School. We’re Working To Change That”; Available at https://www.street-child.ch/our-actions (Accessed 30/03/2022)
9. Fairplay For All Foundation; Available at https://fairplayph.wordpress.com/programs/#youthcenter (Accessed 30/03/2022)
10. United Nations Population Fund “Eliminating Teenage Pregnancy in the Philippines” Jan 2020; Available at https://philippines.unfpa.org/sites/default/files/pub-pdf/UNFPA_Policy_Brief_Teenage_Pregnancy_%282020-01-24%29.pdf (Accessed 30/03/2022)
11. The Independent “Uganda’s Teenage Pregnancies Five Times Higher Than Covid-19 Positive Cases” 05/12/2021; Available at https://www.independent.co.ug/ugandas-teenage-pregnancies-five-times-higher-than-covid-19-positive-cases/ (Accessed 30/03/2022)
12. United Nations Population Fund “Eliminating Teenage Pregnancy in the Philippines” Jan 2020, Page 4-5; Available at https://philippines.unfpa.org/sites/default/files/pub-pdf/UNFPA_Policy_Brief_Teenage_Pregnancy_%282020-01-24%29.pdf (Accessed 30/03/2022)
13. United Nations Statistics Division “The Sustainable Development Goals Report 2020”, Page 47; Available at https://unstats.un.org/sdgs/report/2020/The-Sustainable-Development-Goals-Report-2020.pdf (Accessed 30/03/2022)
14. Children’s Bureau “Children In Poverty – Poverty and its Effects on Children” 28/01/2019; Available at https://www.all4kids.org/news/blog/poverty-and-its-effects-on-children/ (Accessed 30/03/2022)
15. Loren “A World For Our Children” 04/08/2020, “The Payatas Paper” No.12; available at https://fairplayph.files.wordpress.com/2020/08/the-payatas-paper-issue-12-english.pdf (Accessed 30/03/2022)
16. Cities4Children “Conversations: How Can We Improve Children’s Experience of the Urban Environment” 01/03/2022; Available at https://cities4children.org/blog/conversations-how-can-we-improve-childrens-experience-of-the-urban-environment/ (Accessed 30/03/2022)
17. Francis, L., DePriest, K., Wilson, M., Gross, D., (September 30, 2018) “Child Poverty, Toxic Stress, and Social Determinants of Health: Screening and Care Coordination ” OJIN: The Online Journal of Issues in Nursing Vol. 23, No. 3, Manuscript 2; Available at https://ojin.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-23-2018/No3-Sept-2018/Child-Poverty-Toxic-Stress-SDOH-Screening-Care.html (Accessed 30/03/2022)
18. Children’s Bureau “Children In Poverty – Poverty and its Effects on Children” 28/01/2019; Available at https://www.all4kids.org/news/blog/poverty-and-its-effects-on-children/ (Accessed 30/03/2022)
19. Mathur, Aditya et al. “Unintentional Childhood Injuries in Urban and Rural Ujjain, India: A Community-Based Survey.” Children (Basel, Switzerland) vol. 5,2 23. 8 Feb. 2018, doi:10.3390/children5020023; Available at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5835992/ (Accessed 30/03/2022)
20. CDC Investment Works “The Sanitation Business Leaving Nothing To Waste”; Available at https://www.cdcgroup.com/en/story/the-sanitation-business-leaving-nothing-to-waste/ (Accessed 30/03/2022)
21. Mathur, Aditya et al. “Unintentional Childhood Injuries in Urban and Rural Ujjain, India: A Community-Based Survey.” Children (Basel, Switzerland) vol. 5,2 23. 8 Feb. 2018, doi:10.3390/children5020023; Available at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5835992/ (Accessed 30/03/2022)
22. Silverman, A. “Rights of Way: Child Poverty and Road Traffic Injury in the SDGS”; Available at https://www.fiafoundation.org/media/391038/rights-of-way-spreads.pdf (Accessed 30/03/2022)