Describe child rights, child labour and child abuse.

Child Rights, Child Labour and Child Abuse

• The rights group into four categories, which is the standard way to present them:
• Survival rights — life, health, nutrition, name and nationality
• Development rights — education, play, leisure, cultural activity and access to information
• Protection rights — protection from abuse, neglect, exploitation, trafficking and harmful work
• Participation rights — freedom of expression and the right to be heard in matters affecting them
• Child labour — India’s child labour (prohibition and regulation) amendment act, 2016 prohibits employment of children below 14 in all occupations, aligning with the Right to Education Act, and prohibits adolescents (14 to 18) from hazardous occupations
• An exception permits a child to help in a family enterprise outside school hours, or work in the audio-visual industry
• That exception has been criticised, since much Indian child labour IS in family enterprises and home-based work, which is the hardest to inspect, and the exemption may legitimise it
• The causes of child labour — poverty, which is the root; parental unemployment and indebtedness; lack of accessible or acceptable schooling; migration; large family size; demand for cheap, docile labour; and social acceptance
• Its health effects — injury and occupational disease, with children more vulnerable than adults because their tissues are growing and they are given inadequate or adult-sized protective equipment; stunted growth and malnutrition; exposure to dust, chemicals and heat; fatigue and sleep deprivation; psychological harm; and loss of education, which perpetuates poverty into the next generation
• The approach must recognise that simply banning the work without addressing the household’s need for the income may drive the child into worse, less visible work — which is why rehabilitation, education and family income support must accompany prohibition
• Child abuse takes four forms, all of which should be named — physical, sexual, emotional and neglect
• Neglect is the commonest and the least reported, and includes failure to provide food, medical care, supervision, education or emotional support
• The warning signs a clinician should recognise — an injury inconsistent with the history given; delay in seeking care; injuries of different ages; injuries in unusual sites; a changing or contradictory history; fear of the parent; failure to thrive without medical cause; behavioural change, withdrawal or sexualised behaviour; and repeated attendance with injury
• The POCSO act (Protection of Children from Sexual Offences, 2012) is the key legislation and its features should be known — it is gender-neutral; it defines a graded set of sexual offences; it makes reporting mandatory for any person, including a doctor, who knows or suspects an offence, with penalty for failure to report; and it provides child-friendly procedures — recording the statement at the child’s residence, by a woman officer in plain clothes, without the child confronting the accused, with in-camera trial and a special court
• Medical examination is conducted by a registered medical practitioner, in the presence of a parent or trusted adult, and by a woman doctor if the child is a girl; and treatment is provided free and cannot be refused
• The mandatory reporting duty creates a real ethical tension — it overrides the usual duty of confidentiality, and an adolescent may be deterred from seeking care if they know it will be reported; the clinician must be honest with the young person about this limit rather than promising a confidentiality that cannot be kept
• Other protective legislation — the juvenile justice (Care and Protection of Children) Act, 2015, covering children in need of care and protection and those in conflict with the law; the right to education Act, 2009, guaranteeing free and compulsory education from 6 to 14; the prohibition of child marriage Act; and childline 1098, a national helpline for children in distress
• The institutions — Child Welfare Committees, Juvenile Justice Boards, Special Juvenile Police Units and the National and State Commissions for Protection of Child Rights
• Banning child labour without replacing income can push the child into worse and less visible work
• Be honest about the mandatory reporting duty rather than promising a confidentiality that cannot be kept
• Neglect is the commonest and least reported form of child abuse, and is the one clinicians most often miss
• An injury inconsistent with the history is the single most important warning sign of physical abuse
• Injuries of different ages suggest repetition, as does delay in seeking care and a changing account
• POCSO is gender-neutral and applies to every child under eighteen, which is worth stating explicitly
• Failure to report is itself an offence under POCSO, which is what makes the duty mandatory rather than advisory
• Treatment must be free and cannot be refused, and a girl must be examined by a woman doctor where possible
• Children may work in family enterprises under the 2016 exception, which is exactly where most child labour occurs
• Children are more vulnerable to occupational harm, having growing tissues and adult-sized protective equipment
• Loss of education perpetuates the poverty that caused the child labour in the first place
• Survival, development, protection and participation are the four groups of child rights to name
• Childline 1098 is the national helpline, and is worth knowing as a practical referral point