continued . . . World's Children, by Jennifer Kasper, MD, MPH
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While the world's technological, agricultural and medical capacity has developed by leaps and bounds, the plight of children around the world has continued to deteriorate. UNICEF's State of the World's Children report describes their situation in a simple and succinct way. It calculates that if we gathered 100 children in a room to represent all the children in the world, this is what we would find: 32 would suffer from malnutrition before their 5th birthday; 27 would not be immunized against any diseases; 9 would die before they reached 5 years of age; of the remaining, 18 would never go to school, 18 would have no access to safe drinking water, and 39 would have no access to sanitation.
Such simplicity is very effective in drawing a vivid portrait, but in order to understand the magnitude of the problems children face, the hard statistics are necessary. Worldwide 150 million children are malnourished. Children make up a large percentage of the 1.2 billion human beings who try to survive on less than US$1 per day, the 1.1billion whose drinking water is anything but safe, and the 2.4 billion who have no safe sanitation. Two hundred fifty million children between the ages of 5 and 14 are working like adults. More than 8 million of them are being trafficked, sold into bonded labor and sexually exploited. The interplay of economic, environmental and political toxins results in the deaths of 12 million children under the age of five annually to respiratory infections, diarrhea, malnutrition, measles and malaria. These toxins have created 35 million refugees and displaced people, of whom 80% are women and children. While $1.5 trillion exchanges "hands" on the world market daily, HIV/AIDS is stampeding through our youth. Since the onset of the epidemic, 4.3 million children under the age of 15 have died, and more than 13 million have been orphaned. Of the 1.4 million children under the age of 15 living with HIV, 80% live in sub-Saharan Africa. And a harrowing statistic that portends poorly for the future is the fact that half of all new cases of HIV occur in young people 15 to 24 years of age.
Lest we forget about the children within our own borders, there are sufficient statistics to remind us that much work needs to be done here. One in six children in the United States, the wealthiest nation in the world, live in poverty. African Americans, Latinos and immigrants are disproportionately affected. In many cases, so-called welfare reform has only exacerbated this trend. More than 14 million children are hungry or on the brink of hunger. More than 500,000 are homeless and 10 million do not have health insurance. Less than laudable is the treatment of gay, lesbian, bisexual and transgender youth; homeless youth; unaccompanied minors in INS detention; and juveniles in detention. To what extent do we recognize the inherent dignity of these marginalized young people?
Dr. Jack Geiger, keynote speaker at the 2002 DGH General Assembly, said it cogently, "When we say poor children die in our country and in the developing world at rates far higher than those of the better off, we are saying that we permit a condition in effect that says they are less worthy of life, because we let it happen, because we have social policies that almost assure that it will happen, and we let this happen stubbornly and continually."
And yet we possess a document that can be used as a template and catalyst for what can and should be done: the United Nations Convention on the Rights of the Child (UNCRC). As human rights documents go, the UNCRC is a monumental achievement. It is the first of its kind to include social, cultural and economic rights (e.g. right to highest attainable standard of health, right to education) with civil and political rights (e.g. right to freedom of thought, conscience and religion; protection from economic and sexual exploitation), thereby recognizing their equal stature and interdependence. It is also the most universally accepted, legally binding international human rights document in the world, with only two signatories glaringly absent: Somalia and the United States.
The UNCRC is viewed as the blueprint for describing, assessing, and promoting infant, child and adolescent health and well-being. It has at its core that the best interests of the child should be a primary consideration in all actions concerning children. It is a challenging document: it requires governments to critically appraise the situation of children in their countries, and exert political will to allocate attention and resources where they are most needed. Equally, it exhorts the international community to assist those countries that carry the burden of morbidity and mortality, thus stressing our collective responsibility. The establishment of the UNCRC is itself evidence of the serious problems affecting children and governmental recognition of the importance of addressing them. Our common goal should be the progressive, expeditious implementation of the UNCRC.
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