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JOURNAL OF COMMUNITY MEDICINE |
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INDIAN ASSOCIATION OF PREVENTIVE AND SOCIAL MEDICINE ORISSA CHAPTER |
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*Associate Professor, **Senior Resident, ***Professor and Department of Community Medicine, Maulana Azad Medical College, New Delhi – 110002 |
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J.Kishore, P.Sharma, GK Ingle |
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Abstract
Child labor is considered when a child below 18 years of age, out of school and has no vocation other than particularly hazardous. Child labor is a universal phenomenon that needs concern of all countries. Little is known about the attitude and awareness about child labor among medical students and their role in its prevention. Objectives: To study the effect of dialectic lecture on the knowledge of medical students regarding child labor. Methodology: A sample of 150 out of 180 undergraduate students posted in department of community medicine of Maulana Azad Medical College, New Delhi was selected to conduct the study. Their responses on the issue were collected. They were then sensitized on the subject by giving a dialectic lecture of two hours duration and their responses were recollected. Results: Education and motivation of parents, employees and children were recognized as important measures in elimination the problem of child labor. About 88% of the medical students recognize their role in generating awareness among masses against employing children and also raising the level of awareness among children regarding their rights. After sensitization the response rates further rose to 96.6% and 92% respectively. Conclusion: An improvement in attitude of medical students was observed after sensitization for elimination of child labor.
Key words: Child Labor, Medical Professionals, Preventive Measure
Introduction
Child labor includes children permanently leading adult lives, working long hours for low wages under conditions damaging their health and their physical and mental development, sometimes separated from their families, frequently deprived of meaningful educational and training opportunity that could open up a better future for them.
When a child is below 18 years of age, out of school and has no vocation other than child labor is considered particularly hazardous from time immemorial children have worked as helpers and learners in heredity determined family occupation under the supervision of adult family members particularly in India. Industrialization and modernization have changed the working environment in last two centuries that have caused the rural people migrating to urban areas in search of better livelihood. The children also migrated with their parents in majority of cases; however a large number also came individually and settled down in slums, jhuggi jhopri (JJ) clusters, on pavements and on streets. Under these circumstances these children work to earn their livelihood or contribute to the family income that could be dangerous for their mental and physical health leading to abnormal growth and development. Child labour commission defined child labour as “any work by children that interfere with full physical development and their opportunities for a desirable minimum level of education or their needed recreation”.
Child labour is a universal phenomenon that needs concern of all countries. The planning commission reports around 17 million children working in the country. It is estimated that child labor contributes to 20% of India’s GNP. An ILO study in 2002 puts the number of working children at 246 million and 60% of them belong to Asia-Pacific region. According to the estimates 80% of them are exposed to work that is hazardous for their health and safety and eradicating child labor is a rationalist approach. Such children must be visiting to health care settings for treatment and cure but little is known about the attitude and awareness about child labor among medical students and their role in its prevention. Can sensitization in the form of dialectic lecture on prevention of child labor affect the attitude of medical students? The present study has been taken up to find an answer to this research question.
Methodology A sample of 150 out of 180 undergraduate students posted in department of community medicine of Maulana Azad Medical College, New Delhi was selected to conduct the study. They were requested to give their opinion on “What is the role of health professionals in prevention of child labor?” in an open-ended questionnaire. They were then sensitized on the subject by giving a dialectic lecture of two hours duration. After sensitization, their responses were recollected to see the effect of education on their responses. The data were compiled and analyzed using McNemar test (a variant of chi square test).
Result Most of the students think that education and motivation (94%) of parents, employees and children are important measures in eliminating the problem of child labor. About 88% of the medical students recognize their role in generating awareness among children regarding their rights.
Table I: Responses of Medical Students regarding child labor (N = 150)
After sensitization the response rates further rose to 96.6% and 92% respectively. The role of health professionals in boycotting the products whose manufacturing requires child labour is identified by only few (10%). This response is significant increased to 96% in post sensitization period. Ninety seven percent of respondents belief that a doctor can contribute in elimination of child labour by issuing genuine age certificates of the children to the employer. The percentage of respondents is further increased to 98.6% after sensitization. Participation in enactment and enforcement of laws (76%) and free and subsidized medical and rehabilitative care (90%) are other areas identified. Direct role of health personnel by motivating masses in poverty alleviation by limiting family sizes (5%) and involving NGOs (35%) for the same are poorly recognized but the responses show a significant increase to 65% and 70% respectively after sensitization. Overall findings are indicating that there is an improvement in attitude of medical students after sensitization for elimination of child labour.
Discussion Mankind owes to the child the best it has to give. The children should be given opportunities and facilities by law to enable them to develop physically, mentally, socially, morally and spiritually in health in condition of freedom and dignity. For this each profession should contribute something or the other in this direction. Health professionals are considered as the leaders of health delivery team in the community and they can play an important role in educating parents and families about the disadvantages of child labour besides benefits of educating them. Greater emphasis on education of girl child would be even a better step in achieving aim of healthy nation and world. They can also help in initiating a special drive to improve health education amongst masses. The study group responded quite favorable for awareness, motivation, and education, as roles of health professionals in curbing child labor.
The health professionals can also contribute by avoiding purchase of materials made by children from the markets or not employing them in their houses, health centers, nursing homes and even avoiding tea or food in restaurant or hotel employing children. Only a few subjects in the study group were aware of this as their role before sensitization whereas a remarkable increase in the number of responses was seen after sensitizing them on the issue.
Health professionals working in organizations like Employers state Insurance Corporation (ESIC), mines and other formal health sectors may use walk-in surveys to identify child labor in hazardous conditions and preventive measures. The role of specialists of community medicine in awareness generation regarding the role of small family in poverty alleviation can again be a stepping stone in elimination of child labour. Understanding the child labor epidemiology and health impact of working exposure could help them in providing a better medical and rehabilitative care for children. In the study, the concept of role of small family and proper care provided by the doctors in case of child abuse and exploitation are better understood by the subjects after sensitization.
Health professionals being the leaders of health delivery teams for the community can play an important role in uprooting this evil. These with other professional groups like social work, human rights, non-governmental organizations (NGOs), and other public sectors should come forward to accept the fact that children are future and must be protected. Simply sensitizing them for having favorable attitude and raising their voices for these “Voiceless tender beings” can achieve elimination of child labor. But to begin with, it would be important to make children aware about their duties and rights so that tomorrow they play their roles efficiently in the community as a leader. In an integrated approach that involves all sectors of society and government health professionals should play active role and should preserve the bright future generation that ultimately improves the economy of the nation.
Conclusion Through dialectic lectures an improvement of medical students was observed as far as various issues of child labor are concerned. In view of future role of these students in health care delivery system these positive attitudes will help them tackle problems of child labor.
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Child Labor and Role of Heath Professionals |
