Columnists Features

Access to health services: Street children

UNIVERSAL access to primary health care as enshrined in the United Nations (UN) Millennium Development Goals (MDGs) 2015 remain a far-fetched reality for the marginalised and vulnerable in Zambia.
As the MDGs lapse and get replaced by the Sustainable Development Goals (SDGs) this year, it is saddening that in Zambia’s case, an estimated 20,000 vulnerable children are street children, this is according a recent report by United Nations children’s Emergency Fund (UNICEF)
In addition to the deplorable conditions in which these children live, a number of street children are infected with a range of sexually transmitted infections (STIs) including HIV. They are often found with wounds resulting from gang fights.
And diseases such a scabies, ear infections, mouth ulcers are also common conditions among the street child population.
Unfortunately, these critical health issues usually go untreated due to poor adherence and lack of encouragement in receiving health care services.
Street children are often mobile. They move from place to place in search of food and shelter. This makes it hard for them to seek health services and to adhere to medication or to receive food supplements.
And because they are often dirty, they face challenges when seeking health care services.
Lack of access to health care services has contributed to the high incidences of STIs, early sex and teen pregnancies among street children.
Most street children spoken to indicated having suffered stigma and discrimination at the hands of health care service providers. They explained that they face challenges when accessing health care services from health facilities.
A Zambian artiste James Banda famously known as Red Linso, who is also a street children’s rights activist cited lack of awareness and uncoordinated policies as barriers to effective health care service provision.
“I no longer go to the clinic when I am ill. I just take some concoction till I get better. A medical person shouted at me when I went to a health facility about a year ago.
I had a fever and was bleeding from my nose. I was not even given a chance to explain how I was feeling. I left without being attended to as I was embarrassed because other patients had started staring at me,” recounts 17-year-old Moses Mubanga (Not real name).
He has since vowed never to subject himself to ridicule by seeking services from a health care facility.
“Access to health care services still remains a pipe dream if not a nightmare for many children living or working on the street. I have received numerous complaints from street children regarding the way they are treated at health facilities.  Most of them complain that they are often mistreated and harassed by health personnel,” Mr Banda said.
He adds that the majority of street children only seek health services when they are very ill and are only dragged to a facility by their peers or a Good Samaritan.
He was, however, quick to mention that there are some health facilities and health personnel that have accommodated street children and encouraged them to seek services.
Banda has since commended Young Men’s Christian Association of Zambia (Zambia YMCA) for putting in place a clinic whose main beneficiaries are street children.
The clinic is part of Zambia YMCA Street Kids Project, which also provides nutritional and educational support among others.
And 19-year-old Brian Sichula who lived on the street for over three years says he has a role to play in ensuring that street children are encouraged to seek health care services along with other social services that every young person is entitled to.
The national Health Strategic Plan for 2011-2015 clearly states Zambia recognises health as one of the priority sectors that contribute to the well-being of the nation and, therefore, remains committed to providing quality health services to all its citizens.
However, more needs to be done to ensure that vulnerable groups in society have access to quality health care services.
The author is a Zambia YMCA Youth Advocate.

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