One in Ten

A PUBLICATION OF REHABILITATION INTERNATIONAL/UNICEF COLLABORATION ON CHILDHOOD DISABILITIES

Volume 24 - 2003

Cover page

Violence and Children with Disabilities

CONTENTS

Violence & Disabled Children........2
Crisis in Orphanages.......................4
Report from Nepal...........................6
Making Media that Matters............8
Armed Conflict & Emergencies......9
Institutionalization..........................12
Gender, Disability & Violence......15
Targeting Violence........................16
DAA Statistics on Violence...........18
Resources.......................................19

This issue of One in Ten is a global overview of a troubling subject-the various ways that violence is perpetrated against children and youth with disabilities and how violence is itself often a cause of disability. The aim of this issue is to raise awareness of the dangers and impact of violence perpetrated and tolerated on a societal level, as well as the less visible violence towards disabled children and youth carried out within families, institutions and communities.

In 2005, UNICEF, together with the United Nations Office of the High Commissioner for Human Rights and WHO, is scheduled to release a comprehensive UN global study on violence against children. With this in mind, the current issue of One in Ten looks at the different kinds of violence - both as a cause of disability, such as armed conflict, and as response to disability, such as abuse.

While a past issue of One in Ten looked at armed conflict and disability, this issue focuses on a broader range of violence affecting children including war and armed conflict, abuse and criminal neglect found in institutions and orphanages, sexual abuse by caregivers, as well as additional forms of abuse directed at children and youth due to their disabilities.

Richard Sobsey, one of the international experts on violence and disability who prepared a report for this issue, believes that in studying violence against children with disabilities, most of our focus is on how terribly wrong things can be. Yet, he points out that by also studying healthy families and communities we may learn how things can go right for families and children.

Finally, we are striving to improve One in Ten and are eager to learn our readers' opinion about this publication. A mini-evaluation will be carried out later this year. In the meantime, you are welcome to contact RI directly with your comments.

Tomas Lagerwall Karin Landgren
Secretary General, Chief, Child Protection Section,
Rehabilitation International UNICEF

Photo subtitle
Photo by Teun Voeten, Freetown, Sierra Leone, December 1999.
Kids at a shelter waiting for family reunification. Some were amputated by rebels, others were wounded in the war.

Page 2____
Violence and Children with Disabilities:
An International Perspective

By Dick Sobsey

Violence is a serious problem for all children. War, terrorism, family violence, child abandonment and neglect, ethnic and sectarian conflicts, organized crime, and many other forms of violence take their toll on children around the globe. The World Health Organization (WHO) indicates about 57,000 children are reported to die as a result of homicide each year, pointing out that significant numbers of additional cases go unreported and that deaths as a result of war and other collective violence are not included. For each child killed by violence, it is likely that at least 100 children are injured and many of those will have permanent disabilities as a result. Although some children are spared from the direct effects of violence, they all suffer from the indirect effects. The enormous economic costs of war and other forms of violence divert resources that might be used to better living conditions, while damage to the social infrastructure may be even greater. Many children are orphaned or become refugees. Others live with parents who are physically or psychologically injured by their own experiences with violence, and countless numbers of children live in fear.

Although violence affects everyone, children with disabilities are among the most adversely affected. Research from the United States and Canada reports that children with disabilities experience maltreatment at rates two to four times the rate experienced by other children. Furthermore, in both the United States and Canada the killing of disabled progeny by their parents have at times been presented as "mercy killings." Studies from the United Kingdom and other Western European countries suggest similar high rates of maltreatment for children with disabilities in other industrialized countries.

In both rich and poor countries, some children with disabilities have been denied the necessities of life because someone makes a judgment that their lives are not worth preserving. People with disabilities are often subject to hate crimes. In some cases, the bias that leads to the crime and causes the victim to be a target has to do directly with his or her disability. In many others, hatred targets a gender, lifestyle, sexual preference, religion, skin color, or ethnic origin, but is directed toward an individual with a disability with the targeted trait because he or she is more vulnerable than others.

In some countries, children with disabilities are forced to become beggars or are sold so they can be exported as beggars in wealthier countries. In other cases, children with mild disabilities are often forced into child prostitution and other criminal activities. In Taiwan, for example, a recent study found that the proportion of child prostitutes who had mild developmental disabilities was six times that which might be expected from the incidence in the general population. The May 2003 gang rape of "a 14-year-old mentally challenged girl" (Shakti Sharma, 2003 May 14, Hindustan Times) in New Delhi provided one frightening example of the many other forms of sexual abuse and exploitation faced by children with disabilities in many countries.

Over the last decade in several countries, human rights organizations have identified brutal abuse and neglect in children's institutions that primarily or exclusively serve children with disabilities. The lives of children in these institutions can range from the barest subsistence to gross torture. For example, the 1998 Human Rights Watch publication, Abandoned to the State, described Russian institutions where emaciated children often spent their days tied to a bench in an unheated building without education, toys, activities, or even light provided. Those children who could talk detailed inhumane punishments by institutional staff, such as placing cotton balls between the children's toes and igniting them.

A report tabled before the Jamaican Parliament on the conditions faced by institutionalized children indicates a similar situation. In a Jamaica Gleaner news story dated July 16, 2003, reporter Trudy Simpson paraphrased the Keating Report: "Children, including those with disabilities who could not clearly state their needs, were placed in solitary confinement or were forced to kneel on sharp objects. Some were raped and verbally abused…Children were being restrained by adults who pressed their knees to children's chests and, in some cases, children were whipped on their breasts and pubic areas." A similar story published the same day in the Jamaica Observer pointed out, "while the environment is bad for mostly all children in institutions, it is worse for children with disabilities-an estimated 37%, substantially three times (the number found in) the rest of society." In short, children with disabilities are much more likely to live in institutions than other children; institutional care is often abusive; within institutions, children with disabilities typically receive the worst abuse; and because of their disabilities, children with disabilities are most vulnerable to the effects of abuse.

Compounding this problem is the fact that some international children's aid organizations exclude children with disabilities. This may happen because they assume these children are some other agencies' responsibility, because they feel the need is too great, or for other unknown reasons. Whatever the reason, there can be little doubt this exclusion occurs. Two years ago, our family was asked to contribute to a paired family in a developing country. When we agreed but asked to be paired to a family with a child with a disability, we were surprised to hear that there were no needy families of children with disabilities in the 30 or so countries served by this agency. After an exhaustive search by the agency we were told they had found one child with a disability.

The current situation is grim, but it is not hopeless. There are some encouraging developments in progress. While some Human Rights organizations still seem to shy away from issues that solely or primarily affect children with disabilities, others have increasingly committed their efforts to these issues. Human Rights Watch is one that deserves credit for its outstanding work for children in institutional care. Others are also increasingly involved: The current United Nations Study of Violence Against Children conducted by UNICEF, The World Health Organization and the United Nations High Commission on Human Rights promises to help address the special problems faced by children with disabilities along with those faced by all children. Because negative attitudes toward people with disabilities, isolation, and power inequities all contribute to the risk for abuse, disability rights advocacy and the movement toward full inclusion have also helped control the risk of violence for children with disabilities.

There is more that can be done and every one of us who cares about violence against people with disabilities can make a significant contribution. Child welfare, human rights, and disability advocacy groups need to find common ground. It is essential that contacts among these groups are made and maintained. At times, agencies supporting children and families in developing countries need to be reminded that there are children with disabilities who need their help and that if those children aren't being served, they should be.

People who care about children with disabilities also need to work for peace and tolerance. This is not to imply that the road to peace and tolerance is easy or that everyone believes that these things can be achieved in the same way, but as long as war and hate crimes exist, children with disabilities will suffer.

Finally, we need to continue efforts toward inclusion, empowerment, and attitude change. Negative attitudes are key factors in the abuse of children with disabilities. When people around the world view children with disabilities with more positive attitudes, they will treat these children with respect instead of violence.

Dick Sobsey, Director, JP Das Developmental Disabilities Centre, University of Alberta
6-123 Education North Edmonton, Alberta T6G 2G5 Canada, T: (780) 492-3755
F:(780) 492-1318, dick.sobsey@ualberta.ca.

Page 4____

The Crisis in Orphanages

The following article is an excerpt from the Human Rights Watch September 2001 report Easy Targets: Violence Against Children Worldwide.Ó

In some countries, children are abandoned at alarming rates, due to poverty, restrictive population control policies, and cultural traditions that value boys more than girls. Prejudice or policies against children with disabilities may lead parents to institutionalize children who are disabled or perceived to have disabilities. Once institutionalized, orphans and abandoned children may experience such extreme neglect or abuse that their lives may be endangered. They may be denied interaction, stimulation, medical care, and education and frequently learn to live in fear of the people who are their only providers of care.

In Russia in the 1990's, children were abandoned to the state at a rate of more than 100,000 per year. Many were placed in orphanages, where they were exposed to appalling levels of cruelty and neglect. They were often beaten, locked in freezing rooms for days at a time, or sexually abused, and were often subjected to degrading treatment by staff.

We found in a 1998 investigation that Russian babies who were classified as disabled were segregated into separate rooms where they were changed and fed, but were bereft of stimulation and lacking in medical care. Confined to cribs, they stared at the ceiling and were not encouraged to walk or talk. At age four, these and other children who are labeled retarded or "oligophrenic" ("small-brained") were sent to locked and isolated "psycho-neurological internats." According to one Russian doctor, these internats were "like a prison to the brain. There's a total lack of sensory stimulation. There's no input, no competition with other children if the others are even more retarded. It's just a process of slowing down, slowing down, then idling - and then - stop."

At least 30,000 children at the time of our inquiry had been labeled "ineducable," and relegated to the psycho-neurological internats, where many were confined to cots, often on bare rubber mattresses, and left to lie half-naked in their own urine and feces. Children deemed "too active" or "too difficult" were often placed in dark and barren rooms, sometimes tethered to a bench or their bed by a limb. Others were restrained in makeshift straightjackets made of dingy cotton sacks pulled over the torso and drawn at the waist and neck.

One child welfare advocate estimated that the death rate in internaty was twice the rate in the general population. Similar findings were made in other parts of the former Soviet Union. A 1996 national statistic from Ukraine indicated that "approximately thirty percent of all severely disabled children in special homes - a staggering figure - die before they reach eighteen."

Children deemed "educable" and who passed a test at age four were sent to a dyetskii dom, or children's home. While conditions in these standard orphanages were better than in the internats, children were also subject to abuse, neglect, and gratuitous cruelty. In some cases, adult staff members, with the informal consent of the orphanage director, struck and humiliated children. In other instances, the adults engaged other orphans with them to punish a child "collectively." One student recalled that one teacher would grab a student, strip off his or her clothes, and force the student to crawl on all fours in front of everyone. "Then the rest of us children had to kick the child and sit on him like a horse - to humiliate him. The kids push and kick and pull hair and ride him like an animal. [The teacher] was an active sadist."

This pattern was particularly insidious because the favored children developed a repertoire of vicious and injurious punishments which the older, stronger orphans inflicted upon the younger or weaker ones. Some of the punishments included forcing a smaller child into a small wooden clothes chest and throwing him out the window; "in the wind," where smaller children were held upside down outside a window; and "velociped" ("bicycle"), an army technique where balls of cotton were stuck between a child's toes and then lit on fire. One boy recalled:

They did a torture called "electric chair" on me. I was laid on a metal bed, naked. Then someone takes wires that are connected to 220 volt electricity and touches the metal bed. The power runs through it and the kid lying on the bed shakes.

Abuse by staff members included beatings, shoving a child's head in the toilet, squeezing a hand in a vise, squeezing testicles during interrogation, locking children in a freezing, unheated room for days, and engaging children in sexual relations. Public shaming was also utilized. One child was thrown out a first floor window by the staff psychologist, a teacher, and the deputy director of the orphanage. After complaining about this treatment, he was subsequently punished by being stripped in front of an entire classroom of both boys and girls. The teacher took off all his clothes and threw them away.

A 1996 report by Human Rights Watch on China's state orphanages found a horrifying pattern of cruelty, abuse and malign neglect. The most recent nationwide figures available at the time (for 1989) showed that the majority of abandoned children admitted to China's orphanages were dying in institutional care, with mortality rates in some institutions exceeding 75 percent. In China's best-known and most prestigious orphanage, the Shanghai Children's Welfare Institute, the majority of infants brought to the Institute before 1993 died within a few months of arrival. Between 1986 and 1992 alone, the brutal treatment of orphans in Shanghai, which included deliberate starvation, torture, and sexual assault, led to the unnatural deaths of well over 1,000 children.

Medical records and testimony obtained by Human Rights Watch from official inquiries that had been suppressed showed that deaths at the Shanghai orphanage were in many cases deliberate and cruel. Child-care workers reportedly selected unwanted infants and children for death by intentional deprivation of food and water-a process known among the workers as the "summary resolution" of children's alleged medical problems. When an orphan chosen in this manner was visibly on the point of death from starvation or medical neglect, orphanage doctors were then asked to perform medical "consultations" which served as a ritual marking the child for subsequent termination of care, nutrition, and other life-saving intervention. Deaths from acute malnutrition were then, in many cases, falsely recorded as having resulted from other causes, often entirely spurious or irrelevant conditions such as "mental deficiency" and "cleft palate."

At the Shanghai orphanage older children in particular were subject to many forms of cruel and degrading treatment, including beatings and torture at the hands of orphanage employees. A number of girls also reported that they had been raped or sexually assaulted by various men on the orphanage staff, including the orphanage director.

One six-year-old girl suffered brutal abuse by a senior staff member over a period of over twenty-four hours. After stealing several pieces of candy, the girl was beaten by the staff member with a plastic shoe and wooden mop handle. The staff member tied the girl's wrists to the metal frame of a high window, forcing her to stand on tiptoe, and then began pummeling the girl with her fists. The girl was left hanging from the window for the remainder of the day. Once she was finally taken down, she was not allowed to sleep, but was kept tied in a standing position throughout the night. The following morning, she was beaten again.

In another instance, a fifteen-year-old boy was knocked to the ground and beaten for some ninety minutes by the orphanage director, and then locked inside a shed for four days with little food. Although the beating was witnessed by a number of other orphans as well as staff, the director later forced staff members to deny that the incident had taken place. One who refused to do so was demoted as a result.

Brutal punishments were often inflicted for relatively minor disciplinary infractions, or simply on the whim of child-care workers. These included:

-- forcing children to assume the "airplane" and "motorcycle" positions for long periods of time (respectively, bent forward horizontally at the waist with arms held vertically upward, and sitting unsupported at half-squat with arms stretched forward horizontally). In some cases, children were also forced to balance bowls of hot water on their wrists, heads, or knees or to squat over bowls of boiling water, so that scalding occurred when the child fell;
-- forcing children to kneel on ridged washboards for long periods of time;
-- hanging children upside down with their heads submerged in water, until nosebleeds and near-suffocation ensued. This technique, known as qiang shui ("choking on water"), was reportedly the one most feared by children.

Please go to www.hrw.org/reports/2001/children/ to view the full report and references.

Photo subtitle
UNICEF photo by Alexander Rosler, Boy with psichiatric disability, Children's hospital in Lima, Peru.

Page 4___
A Report from Nepal

The following is an excerpt from Gerison Lansdown's report "Disabled Children in Nepal" which is produced on behalf of Rights for Disabled Children by Disability Awareness in Action.

Political and Social Context

Nepal is one of the poorest countries in the world. It is also one of the most mountainous. To these problems add the [Maoist] insurgency, the fact that most of its people are subsistence farmers, that the majority of the population have not had any formal education and that the predominant Hindu culture promotes a view of disability as a punishment for sins in a past life, and it becomes clear that life for disabled children is going to be particularly harsh. In a country where children are needed as economic assets within the family, and where it is assumed that a disabled child is incapable of making such a contribution, that child will inevitably suffer from low status, rejection and marginalization.

The right to protection from all forms of violence

Current legal protections
The right of children to protection from all forms of violence, embodied in Article 19 of the Convention on the Rights of the Child, has not been given priority by the Nepali government. To date, no legal protections have been introduced to prohibit physical punishment in the home, in schools or in the penal system1 . Furthermore, there are no explicit responsibilities within government for addressing child protection issues. Whilst the Children's Act prohibits neglect and abuse of children, section 7 of the Act allows parents, members of the family and teachers to beat a child "if it is thought to be in the interest of the child". The Committee on the Rights of the Child expressed deep concern at this provision following its examination of the Nepalese government's initial report in 19962 . It also expressed concern that appropriate measures have not been taken to effectively prevent and combat any form of ill-treatment and corporal punishment of children within the family and at the absence of adequate legislation and mechanisms for rehabilitation of child victims. In its recommendations to the government, it suggested the introduction of a range of measures including legislation to combat ill-treatment and sexual abuse of children, including within the family. It also suggested that a study be undertaken to improve the understanding of the nature and scope of the problem and that social programmes be established to prevent all types of child abuse and neglect.

To date, none of the Committee's recommendations have been acted on. In consequence, there is still little available data or research evidence relating to the extent and nature of violence perpetrated against children, including disabled children. And although some NGOs have conducted awareness raising programmes to highlight the right of children to protection from violence, few rehabilitation programmes have yet been introduced. Violence, particularly sexual violence, is not discussed in Nepali culture. The issue, therefore, remains largely hidden from view, denied and ignored.

The experience of children

Although no hard data exists about children's experience of violence, there is considerable anecdotal evidence. For example, recent work by Save the Children indicates that a very significant proportion of the children who run away from home and on to the streets are escaping violence and brutality at home. And there is concern amongst many of those organisations working with disabled children that the scale and severity of violence is considerable. During the course of this study, the issue of violence against disabled children was raised repeatedly by NGOs and others working with children. The examples given included:
-- Deaf children being beaten for signing
-- Many blind children being abused within their families
-- Parents beating children who exhibit signs of mental illness, interpreting the behaviour as disobedience and wilfulness
-- Significant abuse of children with learning disabilities
-- Disabled children being rejected emotionally in families and abused because of their low status
-- Disabled children being hidden away in the family home, treated like animals, sometimes even locked in cages, particularly in rural areas
-- Concerns over the widespread existence of sexual violence within families which is denied or covered up because families are not willing to expose the problem
-- Examples of girls with learning disabilities being put on depo provera in order that they can be abused with relative impunity
-- Difficulties for children in challenging abuse by teachers because of their high status in society
-- Problems of abuse by older disabled men.

Children themselves repeatedly stressed the physical abuse they experienced both within the family and in their communities. They also described the extent of emotional abuse - verbal aggression, hostility, humiliation and emotional rejection. They talked of the loneliness of their lives because they were not loved in the way that non-disabled children were loved. And when abuse does occur, there is nowhere for children to seek help. The general tolerance of relatively high levels of violence against children, coupled with the extent of discrimination against disabled children, means that they are very unlikely to gain sympathy or protection from the wider community.

Ending violence altogether will necessitate a comprehensive strategy spearheaded by the government to challenge the current widespread presumption that it is legitimate, or even desirable to hit children. Whilst these attitudes prevail, it is inevitable that disabled children, often the most vulnerable within any community, will continue to be exposed to violence, with no means of redress and the perpetrators immune from punishment.
Contact Disability Awareness in Action for a full copy of the report. DAA, 11 Belgrave Road, London, UK SW1V 1RB. E-mail admin@daa.org.uk.

References:
1- information from the website: www.endcorporalpunishment.org .
2- Concluding observations of the Committee on the Rights of the Child : Nepal, CRC/C/15/Add.57, June 1996.

Photo Subtitle:
AFGHANISTAN, A man and boy support each other as they learn to walk with their
artifical limbs, in the ICRC Hospital, in Kabul,

Page 6___
Disability and Human Rights, Making Media That Matters

By Michele Morgan, Program Coordinator, Rehabilitation International

Two recent film festivals, one sponsored by Media That Matters and the other by Human Rights Watch, highlight human rights issues throughout the world, including violence and disability. The festivals not only bring important social, political and environmental topics to the forefront by giving a voice to stories of oppression and hope from around the world, but they also encourage the use of film as a springboard for discussion and action.

In the Media That Matters Festival, "Esmeraldas: Petroleum and Poverty", a short documentary, focuses on the intense human suffering that occurred when a Texaco oil refinery exploded in 1998 and destroyed an Afro-Ecuadorian community. The poor, minority community dependent on the contaminated river and soil for survival suffers from continual after effects of oil poisoning. Burns from the explosion, plus innumerable birth defects, increased cancer rates, open lesions and severe skin burns caused by the oil in the bathing and drinking water, spares no one, least of all the children. The community has no option but to continue to rely on their one source of water, the contaminated river. In Esmeraldas there is neither environmental clean up, nor adequate medical or rehabilitation service, only a community struggling to survive on the edge of existence.

"As We Sleep," another short documentary in the Media that Matters Festival, follows the journey of Marcie, a middle-aged woman with cerebral palsy and intellectual disabilities, and her family as they struggle to deal with aftermath of Marcie's rape by an employee at her assisted living facility. Her parents, who move Marcie back home, try to help her deal with depression, anxiety and a subsequent pregnancy caused by the sexual abuse. According to the filmmakers, 72% of assisted living homes in America reported incidents of sexual abuse in 2000. And as evidenced by Marcie, only the suffering is immeasurable.

Two films shown at the Human Rights Watch Festival address other types of violence. "Jiyan," a film produced in Iraqi Kurdistan, is a drama about the building of an orphanage five years after the infamous chemical and biological bombing of Halabja by the Iraqi military. It tells the story of a community and a young girl, Jiyan, struggling to live with the aftermath of the physical and emotional scars left by the brutal attack. "Asylum," a short documentary, follows Baba, a young Ghanian woman, as she must choose between a man her father wants her to marry and the female genital mutilation her father insists upon and freedom by fleeing to the U.S. Unfortunately, this promise of freedom eludes Baba as she becomes entangled in the immigration system.

Now in its third year, The Media That Matters Film Festival hopes to inspire people to speak out and take action for social change.
The Festival is streamed at www.MediaThatMattersFest.org and it is also available on DVD. Contact www.mediathatmattersfest.org/mtm03/dvd.php to order a copy.

Started in 1994 in New York, as a way to put a face on human rights abuses, the Human Rights Watch Film Festival expanded to London in 1996. More information on the movies and upcoming festivals can be found at: http://www.hrw.org/iff/2003/index.html.

Photo subtitle
A boy shows two younger children a poster describing different kinds of
explosive devices, part of a UNICEF-assisted landmine awareness programme
in El Salvador.

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Childhood Disability - Armed Conflict and Emergencies

By Gulbadan S. Habibi, Child Protection, UNICEF New York

Definition

Child: In the Convention on the Rights of the Child, Article 1, "a child means every human being below the age of eighteen years..."

Emergencies: Includes both complex man-made, (armed conflicts, civil strife and family and organized societal violence) and natural disasters, (earthquake, floods and storms).

UNICEF's Medium-Term Strategic Plan

Protecting children in armed conflict is integral to UNICEF's medium-term strategic plan, which articulates UNICEF's vision and framework for action for 2002-2005 spelling what UNICEF seeks to achieve, and how to achieve it. The plan combines a results-based management approach and rights-based programming, with focus on five key priorities. These are:

-- Girl's Education
-- Integrated Early Childhood Development
-- Immunization 'plus'
-- Fighting HIV/AIDS
-- Improved Protection of Children from Violence, Abuse, Exploitation and Discrimination

The impact of armed conflict on children is specifically mentioned as an issue for improved protection of children from violence, abuse, exploitation and discrimination. However, all five priorities of the medium-term strategic plan are implemented during complex emergencies and, when there is a breakdown caused by conflict and natural disaster, each of the priorities must be adapted to meet the particular challenges of crisis situation.

Impact of Armed Conflict on Children

During the past decade, more than two million children died as a result of armed conflicts, often deliberately targeted and murdered. For every child killed by armed conflict, three are injured and permanently disabled. Even greater numbers have fallen victim to disease, malnutrition, abuse, exploitation and physical and sexual violence. It is believed that approximately 40% of the 26 000 persons killed and injured by landmines every year are children. Over 10 million children are psychologically traumatised by armed conflicts. As mentioned in Graca Machel's study, "according to WHO, armed conflict and political violence are the leading causes of injury, impairment and physical disability and primarily responsible for the conditions of over 4 million children who currently live with disabilities."

Abuse and violence

The World Health Organization has recently defined violence "as a major public health problem worldwide. Each year, millions of people die as the result of injuries due to violence. Many more survive their injuries, but live with a permanent disability. Violence is among the leading causes of death among people aged 15-44 years worldwide, accounting for 14% of deaths among males and 7% of deaths among females.

In addition to death and disability, violence contributes to a variety of other health consequences. These include depression, alcohol and substance abuse, smoking, eating and sleeping disorders, and HIV and other sexually transmitted diseases.

Violence, however, is preventable - it is not an intractable social problem or an inevitable part of the human condition. The wide variation in violence among and within nations over time suggests that violence is the product of complex, yet modifiable social and environmental factors."

Maltreatment of children can cause physical and psychological disabilities. Corporal punishment, like amputation, blinding of detainees, is responsible for children becoming disabled. In addition, beating, insulting and maltreating children can lead to mental illness, difficulties in school, at work or in the society in general.

Landmines are small but deadly weapons that armies use to keep enemy forces away from a certain area. They are designed to explode when a soldier steps on them. The explosion is powerful enough to kill a small child. Adults often lose a leg, or a hand, and many are blinded by the explosion. In over 60 countries, on almost every continent, hundreds of thousands of people have been killed or injured by these exploding munitions left behind from previous wars. Millions of landmines today lie in wait for victims. These landmines make it much harder for societies to recover from conflict. They threaten the stability of fragile governments, and hinder the ability of peacekeepers and humanitarian aid workers to assist people in communities that have been torn apart by war.

The good news is that in recent years a lot of work has been done around the world to address this problem, including clearing landmines from the ground, a process known as humanitarian demining.

In the early 1990s, a worldwide Humanitarian Demining Programme was established, and through it assistance to 40 mine-affected countries is provided. "Mine action" is the term used to describe all these efforts. There are three main pillars of mine action:

-- Humanitarian demining, which includes surveying and marking minefields and safely removing mines from the ground;

-- Mine risk education, which helps prevent injury and death by teaching people who live in mine affected areas about the dangers to be avoided; and

-- Landmine survivors' assistance, which includes medical care, therapy, prosthetics and retraining for people injured by landmines.

The first goal of the programme is to help survivors to believe in themselves and work hard to ensure their future. The programme helps them develop skills to enable them to provide for themselves and their families, and lead productive lives in spite of their injuries.

Landmines: From Prevention to Rehabilitation

Prevention: Raising awareness

In many countries, landmines injure children who are especially vulnerable because they are mobile, curious and prone to risky behaviour. That is why appropriate mine awareness programmes are essential to sensitise children to the dangers of landmines. UNICEF's action also consists of promoting the ratification and implementation of the Antipersonnel Mine Ban Convention. In addition, UNICEF's landmine prevention work has raised awareness in many countries through a variety of projects. For example:

-- In Iraq, UNICEF has been involved in numerous mine awareness activities, with the Ministry of Education, such as painting exhibitions, producing TV and radio shows that carry mine awareness messages, the printing of posters, teachers and students booklets, and training courses.

-- In Nicaragua, UNICEF has been implementing the Child-to-Child Prevention project in co-operation with the Nicaraguan Red Cross. The strategy used by the project is to train children and adolescents to disseminate prevention messages as "broadcasters" among children living in at-risk communities. The objective is to inform children about the dangers of mines, promote appropriate behaviour in case they encounter a mine or a mine-related accident and encourage them to transmit these messages to their families and friends.
Rehabilitation: Community Based Rehabilitation

UNICEF has also supported Community Based Rehabilitation programs in many countries as an effective way of providing support and services to children and families injured by landmines.

-- In Sri Lanka, UNICEF is sustaining the Training of Rehabilitation Workers through the Association for Rehabilitation of Disabled through a project which has the purpose of training 12 rehabilitation workers to provide physiotherapy for landmine victims and provide psychosocial support techniques and provide first aid treatment for landmines victims.

-- In Guatemala, the UNICEF Landmines Project provided for the training of 115 teachers and community volunteers in physical rehabilitation, sign languages, Braille scripture and art therapy. The organisation of five centres of integral rehabilitation, located in five affected departments, was promoted. These centres will offer specialised attention to identify handicapped people who were affected by landmines.

Psychosocial support to children traumatised by armed conflict

Children living in regions affected or having been affected by armed conflict are very likely to endure long-lasting trauma. As part of the rehabilitation process for children affected by war, UNICEF leads psychosocial support programmes aiming to address children's traumas resulting from war.

-- In the Democratic Republic of Congo, a mental health assistance programme was developed in Kisangani and Bunia in favour of children traumatised by war. In order to reinforce and improve intervention and care capacity, more than 90 social workers from North and South Kivu have been trained.

-- In Bosnia and Herzegovina, UNICEF has provided support to traumatised children within the schools and through NGOs working on psychosocial rehabilitation and inclusion of especially vulnerable children. UNICEF has developed a series of community projects with local and international NGOs. Through World Vision, UNICEF has provided psychosocial and education support to 1,350 refugee children and 500 parents in 10 refugee camps. Through the NGO, Zdravo da ste, UNICEF has supported psychosocial rehabilitation programme for children with hearing and speech damages in Republika Srpska as a first step to de-institutionalisation of these children.

Photo subtitle
"Why should we be the martyrs of these stupid, ridiculous conflicts?"
Young girl, Burundi

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Unanswered Cries: Institutionalization and Violence against Children with Mental Disabilities

By Alison A. Hillman, Director, Americas Advocacy Initiative, Mental Disability Rights International, and Eric Rosenthal, Executive Director, Mental Disability Rights International

Around the world, children with mental disabilities are institutionalized in psychiatric hospitals and orphanages in large part because there are insufficient community services to help parents raise their children in the community. Children who are institutionalized experience violence in myriad ways, including overt physical abuse as well as the more subtle forms of abuse endemic to institutionalization: degrading treatment in unhygienic conditions, exposure to contagions, and neglect by overwhelmed staff. Young children who grow up without a family or consistent caregiver may experience irreversible psychological damage as a result of being raised in an institutional setting. For older children, growing up in an institutional setting can cause developmental delays, even in clean, well-staffed facilities.

Reflecting the findings of empirical studies that have documented the danger of raising children and detaining adults in institutional settings, the Pan American Health Organization adopted the Declaration of Caracas in 1990. The Declaration of Caracas recognizes that institutionalization, as the sole response to mental disability, hinders the achievement of effective mental health care and threatens basic human rights, stating that institutions:

(a) isolate [individuals] from society, creating greater social disability;
(b) create unfavorable conditions that put the human and civil rights of [individuals] at risk;
(c) absorb the bulk of financial and human resources allotted mental health care; and
(d) fail to provide professional training that is adequately geared to the mental health needs of the population, the general health services, and other sectors.1

Mental Disability Rights International (MDRI) is a human rights organization dedicated to protecting children from social policies that would leave children at risk of neglect and abuse in institutions. The organization documents conditions in mental health and social facilities, trains and collaborates with grassroots advocacy organizations, and works with governments to promote rights protection and community integration. Increasingly, MDRI has used human rights reporting to influence UN technical agencies and international development organizations to support rights protection and community integration for children with mental disabilities.

In Armenia, Bulgaria, Hungary, Kosovo, Romania, Russia, Serbia, and Uruguay, MDRI has found that development organizations and international charities have supported the rebuilding or refurbishing of custodial institutions. In some cases, when funding is provided to create alternatives to institutionalization, group homes are built. While group homes are preferable to large institutions, they have serious drawbacks for children. Similar to institutions, in group homes children typically grow up without parental figures with whom they can establish long-term attachments. Group homes also continue to segregate children from society, often leading to long-term isolation in adult facilities. Many children institutionalized at an early age-even some assigned to an institution "temporarily," so that the family may work through a difficult period-are condemned to a life of institutionalization, as family and community ties weaken over time, and the child's disability increases with protracted institutionalization.

Findings

MDRI documented the impact of institutionalized care on children and adults in its 2002 report, Not on the Agenda: Human Rights of People with Mental Disabilities in Kosovo. In 1999, when the United Nations Mission in Kosovo (UNMIK) took over control of Kosovo's mental health and social service system, the UN inherited authority for the Shtime Special Institute, which housed seventeen children among a population of almost 300 adults. Conditions were atrocious for both adults and children in the facility. UN authorities contracted with Doctors of the World (DOW) to remove the children from the institution as quickly as possible. Yet for these children, the damage of institutionalization had already taken its toll. DOW staff reported that almost every child at Shtime had been physically or sexually abused in the facility. Moreover, mental disabilities were exacerbated by the trauma and isolation of institutional life.
DOW quickly established two group homes that resulted in great improvements in the quality of life for these children. While UN authorities planned a new community-based mental health system for adults with psychiatric disabilities, it was assumed that adults with developmental disabilities would remain in Shtime for life. Unfortunately, this left children in the group homes at risk of being returned to Shtime once they turned 18 years old. Through lobbying by disability activists in Kosovo, Dutch and Norwegian donors agreed to create additional group homes for people with mental disabilities in Kosovo. One of these homes will be used to house young adults who graduate from the DOW children's home. While these children may escape a future at Shtime, there is still no family support or substitute family program in Kosovo to allow them to grow up in a family or family-like environment. MDRI's report commends the UN and Kosovar government for getting the children out of Shtime-yet more community-oriented policies would be preferable. In addition to supporting community integration, MDRI's report provides detailed recommendations for the support of advocacy by people with disabilities and their families. Despite extensive international support for civil society in Kosovo, there has been almost no funding for advocacy by and for people with mental disabilities.

Prolonged Institutionalization Violates International Human Rights Standards

It is now widely recognized that even children with severe mental disabilities can benefit from a family life and can thrive in the community. A growing body of international human rights law establishes community integration as a right for persons with mental disabilities.3 This has major implications for the work of international development organizations. The Convention on the Rights of the Child (CRC) states that children with disabilities have the right to "enjoy a full and decent life, in conditions which ensure dignity, promote self-reliance and facilitate the child's active participation in the community."4 Health, education and social service programs "shall be designed to ensure that the disabled child has effective access to and receives education, training, health care services, rehabilitation services...in a manner conducive to the child's achieving the fullest possible social integration and individual development...."5 Article 23(3) provides a clear mandate to international development organizations to take action to assist governments to develop alternatives to institutions. The Standard Rules on the Equalization of Opportunities for Persons with Disabilities further provides that "[p]ersons with disabilities are members of society and have the right to remain within their local communities. They should receive the support they need within the ordinary structures of education, health, employment and social services."6

Community Integration Needed

Behind the closed doors of orphanages and other institutions, children will always be at risk of violence. One of the most effective ways to combat violence is to challenge the underlying problem of institutionalization. To achieve the "fullest possible" community integration, it is better to create family support programs (or substitute family programs for children without families) than to create new group homes. Rather than building new, clean, better-staffed institutions, international development organizations should take the lead in demonstrating that models for the most integrated service systems can be successfully adopted in developing countries.

Organizations of people with disabilities and their family members have played an important role in promoting integrative public policies in countries that have successfully developed community-based service systems. MDRI's report for UNICEF provides further recommendations for programs that international development organizations can establish to empower families. As MDRI has recently found in Kosovo and Uruguay, these recommendations are of tremendous importance in very different parts of the world.

For more information, contact:
MDRI
1156 15th Street, NW, Suite 1001
Washington, DC 20005
Tel. (202) 296-0800
Fax. (202) 728-3053
mdri@mdri.org
www.mdri.org

References

1 The Declaration of Caracas (1990), introductory note 2, reproduced in RODRIGO JIMÉNEZ, LOS DERECHOS HUMANOS DE LAS PERSONAS CON DISCAPACIDAD 186 (1996).
2 Observations made during an MDRI investigatory mission to Uruguay in April 2003.
3 Eric Rosenthal and Clarence Sundram, International Human Rights in Mental Health Legislation, 21 NEW YORK LAW SCHOOL JOURNAL OF INTERNATIONAL AND COMPARATIVE LAW 469, 510 (2002).
4 Convention on the Rights of the Child, G.A. Res. 44/25, U.N. GAOR, 44th Sess., Supp. No. 49, at 166, U.N. Doc. A/44/25 (1989) [hereinafter CRC], art. 23, § 1.
5 Id., art. 23§ 3.
6 G.A. Res. 96, U.N. GAOR, 48th Sess., U.N. Doc. A/Res/48/96 (1993), Introduction, para. 26.

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Gender, Disability and Violence

The following excerpt is taken from "Girls and Women with Disabilities: An International Overview and Summary of Research," (2000) by Harilyn Rousso, an internationally known author on women and girls with disabilities.

While physical and sexual abuse and other forms of violence affect the lives of all women and girls, research indicates that woman and girls with disabilities experience violence within the family, institutions and community at higher rates than their nondisabled counterparts. Also, the violence they face may be more chronic and severe, and take some unique forms, such as the withholding of essential care and medication.

Part of the explanation for the higher rates and different patterns may be the extent and nature of disability-related limitations themselves. It may be more difficult for some women and girls with disabilities to detect and fully understand the violent nature of perpetrators' behaviors. And the disability may impede a woman's ability to defend herself or move away from perpetrators, at least in traditional ways, and to report incidents of violence to others.

However, far more of the explanation lies in the negative attitudes that disabled woman and girls face in many areas of their lives. They are perceived in many cultures as sick, helpless, incompetent and asexual, and are relegated to a powerless position. It is this negative environment that gives license to perpetrators, who may view disabled woman and girls as easy targets. Women with disabilities are also regularly deprived of the skills and opportunities they need to recognize and address violence; for example, they rarely have adequate opportunities to learn about sexuality or culturally appropriate sexual behavior and mores. Finally, stereotypical attitudes undermine the ability of police and community members to respond appropriately to incidents of violence against disabled women when they occur; for example, they may doubt the credibility of the reporter.

Disabled women's organizations have begun to address the issues of violence by undertaking research, publicizing the problem, developing self-defense courses and advocating for the inclusion of disabled women and girls in shelters and services for abused woman and violence prevention programs. In addition, for girls and young women with disabilities, important strategies to combat violence include adequate sex education and opportunities to develop empowerment/self-advocacy skills. With an increased public awareness that gender matters when it comes to violence against people with disabilities and with better information and empowerment programs for girls and women with disabilities, the relationship between gender, disability and violence can be broken.

To obtain a copy of the full report, sponsored by the World Institute on Disability and Rehabilitation International, please contact Rehabilitation International at rehabintl@rehab-international.org.

Photo subtitle
® International Labour Organization/ Fiorente A.
The mother and child, Ethiopia

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Targeting Violence Against Children with Disabilities

Interview with Dick Sobsey, Director of the JP Das Developmental Disabilities Centre and an Associate of the John Dossetor Health Ethics Centre at the University of Alberta in Edmonton, Canada

By Michele Morgan, Program Coordinator, Rehabilitation International

When we talk about children with disabilities and violence we are talking both about violence against children who are disabled and children who are disabled because of violence. What are some of the most pervasive problems facing children in both categories?

Research is not very helpful in sorting out whether the connection between violence and disability is primarily in the direction of children with existing disabilities being victimized or in the direction of abuse causing disabilities. Part of the reason why it is so hard to get a clear picture is that neither abuse nor disability usually has clear starting points. For example, a child may be reported to child welfare authorities at age 10 and confirmed to have been sexually abused at that age and may have been identified as having a disability several years earlier in school. This would suggest that the disability came first. However, in most cases abuse begins long before it is reported, and even if sexual abuse began recently, many children who are sexually abused have been neglected, emotionally abused, and sometimes physically abused since infancy or early childhood. Even when we can determine when the abuse began, the onset of disability can be equally uncertain. Most children with intellectual disabilities, for example, will not be diagnosed until they reach school, but it is often assumed that the underlying condition began much earlier.

In many cases, there may be a vicious cycle. Whether it begins with abuse or disability, one leads to the other and the other leads back. For example, some children may have minor behavior or learning problems. Under ideal conditions, these children might grow, develop to their full potential, and never be diagnosed with a disability. When these same children are exposed to abuse or neglect, their learning and behavior problems are substantially increased. Evidence suggests that a child's level achievement can drop by about one standard deviation if the child is abused or neglected. As a result, the performance of the child who might otherwise be a high achiever drops down to a more normal level, the child who would otherwise perform at an average level, has minor difficulties, the child who would otherwise have minor difficulties is now disabled. Deleterious effects on a child's behavior are often even greater. As the child has increasing difficulties and appears more disabled, negative cultural attitudes toward disability translate to more negative parental attitudes toward the child. The bond between the parent and child that plays a valuable role in protecting children is often threatened. As a result abuse and neglect become more likely.

In your experience, has the nature and/or rate of violence against children changed over the last many years?

There is little evidence to suggest that the rates of abuse and neglect have changed substantially for children with or without disabilities. However, abuse and neglect are more likely to be reported today and we are better able to understand the size of this problem. There are three ways in which things have improved for children with disabilities over the years. First, in times when large numbers of children were institutionalized and excluded from society, there is reason to believe that abuse and neglect was more prevalent but better hidden. While existing research has a lot of limitations, large institutions, group homes, and foster care have all been linked to much higher rates of abuse than typical families. Supporting healthy families and community inclusion does not put an end to all maltreatment problems, but it has unquestionably made a significant difference in the right direction. Second, our standards and are mechanisms for protecting children have improved, even if they have a long way to go. As an example, the chaining of children with mental or intellectual disabilities to their beds was not considered abusive in most societies fifty years ago. Today, it is considered to be appalling abuse in many countries and many others are beginning to address the problem. Finally, a large advocacy movement for children with disabilities has focused public attention on the problem and begun to reform legal, educational, social, and health systems to better serve the needs of children with disabilities.

How does the incidence or type of violence both against children with and without disabilities vary across geographic or development regions of the world?

There are no studies that report on relative incidence to compare countries or cultures. However, studies from a variety of countries indicate that high rates of abuse of children with disabilities occur throughout the world. For the most part, the types of violence experienced by children also seem to be similar around the globe, but there are some particular problems that affect children with disabilities in certain countries or cultures. For example, in some countries the shame associated with sexual victimization compounds the harm of sexual abuse. Preteen and adolescent girls with disabilities are sometimes placed as servants in other families' homes. Sexual abuse is not uncommon, but the stigma associated with sexual victimization is so great it is rarely reported. In some instances, adolescents with disabilities who have been victims of sexual abuse have been murdered by their own families in 'honor killings."

Areas of the world involved in war and other collective violence also present special problems for children with disabilities. Children who are deaf or have intellectual disabilities have been shot for refusing to obey the orders of soldiers or police who they cannot hear or understand. Many children with disabilities also become victims of land mines, bombings, and terrorist acts because they have difficulty learning what to do to minimize their risk. For example, trash containers have been used frequently to conceal bombs and many people have learned to keep clear of them but children with developmental disabilities rarely learn to protect themselves from this danger and have been reported to be among the most frequent victims.

The indirect effects of war are subtler but often more devastating. Children with disabilities and their families are often most vulnerable to destruction of the physical, economic, and social infrastructure. For example, a family may survive with one parent taking care of a child with a disability in the home and the other working. When one parent is killed or taken away to be a soldier, the remaining parent may not be able to work and take care of a child. Similarly, families may be barely able to manage the care for a medically fragile child at home, but when their home is destroyed or they become refugees, caring for their child may become impossible. In addition, war often means that the supply of medicines, such as anticonvulsants, is interrupted. Electricity and clean water may also be interrupted. These problems affect everyone, but children who depend on medical devices to maintain their lives are affected most adversely.

Has awareness about violence and disability increased on an international level?

Awareness of the problem is increasing on the international level. The United Nations is currently undertaking a major study of violence against children and what steps can be taken to prevent it. It is based on the recognition that violence is one of the most serious problems facing children everywhere. In establishing the Non Governmental Organizations Advisory Panel for the study, organizations representing children with disabilities were consulted and some members of the panel were selected specifically for their expertise in violence against children with disabilities. The study is still in its early stages, but there is good reason to hope that it will be a major step in increasing international focus on how violence affects children with disabilities.

What have been some positive ways to protect children from violence?

As previously mentioned, progress toward educational and community inclusion has also played a valuable role in risk reduction. The general progress of disability-rights advocacy and empowerment has also been valuable. As societies develop more positive views about people with disabilities, they become safer. When any group is isolated and devalued, they are also abused. Specific programs to teach people with disabilities their right and teach them how to protect themselves from abuse must be accompanied by reforms to the criminal justice system to ensure that crimes against people with disabilities are treated in the same ways as crimes against any other citizen. There has been encouraging progress but there is a long way to go.

Do you feel that there are important issues that have not been addressed in international dialogue over children and violence?

There are a number of issues that still need to be addressed, but in my view none is more important than addressing fundamentally discriminatory attitudes that dominate most cultures. People with disabilities are still viewed as less valuable and less valued. For example, when China was attacked for allowing children with disabilities to die of starvation and medical neglect in its orphanages, they pointed out that large numbers of infants with disabilities are "allowed to die" in American hospitals because someone assumes that it is better to be dead than disabled. The attitudes that underlie both the Chinese and American practices disinhibit all forms of violence against people with disabilities. Until these change, real progress will be limited.

One other point that I would like to make is that we need to study healthy families and communities. In our study of violence against children with disabilities most of our focus is on how terribly wrong things can be. Real progress may be difficult if we focus on this side of the equation. We need to increase our focus on how and why things go right for some families and children.

Dick Sobsey is a Director of the JP Das Developmental Disabilities Centre and an Associate of the John Dossetor Health Ethics Centre at the University of Alberta in Edmonton, Canada.

Photo subtitle
ANGOLA: Domingos, 12, who lost a leg in a land-mine accident, stands on crutches in front of tents where he now lives at Campo Minars, a UNICEF-assisted centre for people displaced by the war, near the central town of Kuito. Behind him, his mother, Margarida, who also lost a leg.

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Disability, Violence and Statistics

Disability Awareness in Action (DAA), a British-based periodical sponsored by Disabled Peoples' International, IMPACT, Inclusion International and World Federation of the Deaf, has released a new database containing 1,910 reports of "abuse evidencing contravention of the Universal Declaration of Human Rights, affecting" a total of 2,466,348 individuals with disabilities around the world. These reports are based on information provided mostly by international disability organizations that have both national and local affiliates. Thirteen percent of these individuals have died from a direct result of human rights abuse. DAA notes that the Article 5 of the Universal Declaration of Human Rights was the most violated.

For more information on the report, Review of Evidence Contained on the DAA Human Rights Database March 2003, or for the full text, contact DAA at admin@daa.org.uk.

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Resources ? Resources ? Resources

Publications and Articles:

World Report on Violence and Health, World Health Organization, Geneva, 2002.
The World Health Organization launched the first World report on violence and health on October 3rd, 2002. The goals of the report are to raise awareness about the problem of violence globally, to make the case that violence is preventable, and to highlight the crucial role that public health has to play in addressing its causes and consequences.
http://www.who.int/violence_injury_prevention/violence/world_report/wrvh1/en/

Safeguarding adults and children with disabilities against abuse (2003), published by the Council of Europe. The report addresses abuse and mistreatment of all disabled children and adults. It draws attention to the extent and nature of this abuse and aims to ensure that people with disabilities are protected against deliberate and / or avoidable harm, at least to the same extent as other citizens, and that when they are especially vulnerable, additional measures are put in place to assure their safety. Reprint with a new format in 2003 of a title published in 2002. For ordering information go to: http://book.coe.int/GB/Cat/Liv/htm/l1917.htm.

Children, Torture and Power: The torture of children by states and armed opposition groups, ISBN 1 84187 038 2, 108pp 2000. This book looks at the issue of children and torture on the international human rights agenda and examines ways to combat this terrible problem. It looks at factors that lead to torture and ill treatment, as well as the effects on children and mechanisms for prevention. For more information email: orders@plymbridge.com.

Explosive Remnants of War: The Lethal Legacy of Armed Conflict, ICRC Publication 2003 ref. 0828. A concise brochure that highlights the deadly risks that unexploded and abandoned ordnance pose to civilians and war-affected countries long after the conflict is over. In addition to the human and social costs inflicted by these weapons, the brochure outlines the work being done at the international level to address the problem. The brochure is intended to increase awareness about explosive remnants of war and to urge comprehensive action by the international community to prevent and reduce the impact of these weapons on civilian populations.
http://www.icrc.org/Web/Eng/siteeng0.nsf/html/p0828?OpenDocument

Violence and Disabled Women by Iglesias, M.; Gil, G.; Joneken, A.; Mickler, B.; Knudsen, J.S., METIS project, European Unión DAPHNE initiative, 1998. This comprehensive report looks at women with disabilities and violence; specifically it tries to make the public aware of the complexity of the situation and can be used as a tool for those planning policy and programs for women with disabilities. For more information go to: http://www.independentliving.org/docs1/iglesiasetal1998.html

Meanwhile: Young girls in Africa cornered by AIDS, by Janet Fleischman, Washington, DC, International Herald Tribune, April 2, 2003. This article examines the AIDS epidemic in Africa and how it is being fueled by the abuse and subordination of young women. Young girls, especially those most vulnerable such as orphans, are seen as safe since they are often thought to be HIV negative which makes them targets for sexual abuse. Poverty and hostile legal and social structures make the situation worse. For the full article, go to www.hrw.org/editorials/2003/aids_africa1.htm.

The physical, economic and social costs of gun violence, Gun Control Alliance, South Africa. Assesses the high price that is paid from firearm related violence, including the resulting disabilities and economic and social hardship for many of those who survive. Available at: http://www.gca.org.za/facts/briefs/05costs.htm.

The problem of child abuse has become very serious, by Wafaa Al-Kredia, guest contributor to Arab View. The author calls attention to the increase of child abuse in Saudi Arabia, including against children with disabilities. For the full article, go to www.arabview.com/articles.asp?article=2.

Assistance to Children Affected by War, U. S. Agency for International Development. Lists different funds and assistance available to children affected by war (www.usaid.gov/press/releases/fs991101.html). For specific information on the funds, go to www.usaid.gov/pop_health/dcofwvf.

Breaking the earthenware jar: Lessons from South Asia to end violence against women and girls. Hayward, RF. Kathmandu, UNICEF Regional Office for South Asia, 2000.

Street children and gangs in African cities, guidelines for local authorities. Ochola L., Dzikus A. UN-HABITAT UMP Working Paper Services, 2000:18.

Guidance for surveillance of injuries due to landmines and unexploded ordnance. Sethi D., Krug E, eds. Geneva, WHO, 2000.

"Domestic Violence Against Women and Children," Sushma K. Innocenti Digest, 2000:6.

Children and Violence. UNICEF. Innocenti Digest, 1997:2.

Harmful traditional practices affecting the health of women and children. UNHCHR. Geneva, UN, 1997 (Fact Sheet No. 23).

Strategies for child protection. World Health Organization. Copenhagen, WHO Regional Office for Europe, 1998.

Organizations:

Children Injured by Restraints and Aversives (CIBRA)
This organization's central mission is to provide a national/international support network for parents whose children (including adult children) have been traumatized, injured or killed by abusive behavior modification (ABA) and restraint. This mission includes raising public awareness of the abuses taking place in the treatment community. For more information contact: http://users.1st.net/cibra/index.htm

Websites:

Committee on the Rights of the Child
http://www.unhchr.ch/html/menu2/6/crc.htm

Convention on the Rights of the Child
http://www.unicef.org/crc/crc.htm

Domestic Violence Against Women and Girls
http://www.unicef.org/vaw/domestic.pdg

Department of Injuries and Violence Prevention
http://www.5.who.int/violence_injury_prevention/

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ONE IN TEN
Volume 24 - 2003
Recent issues of One in Ten, in English, French and Spanish can be found on the RI web site, www.rehab-international.org

Articles represent the authors' views and do not necessarily indicate UNICEF policy.

EDITOR
o Michele Morgan
michele@rehab-international.org

PROJECT SUPERVISION
o Gulbadan Habibi, Project Officer,
Child Protection Section,
Programme Division, UNICEF
ghabibi@unicef.org

o Barbara Duncan, Director of
Communications, RI
bjdnycla@aol.com

UNICEF HOUSE
3 UN Plaza
New York, NY 10017, USA
Fax: 1 (212) 824-6473

REHABILITATION INTERNATIONAL
Tomas Lagerwall
Secretary General
25 East 21st Street
New York, NY 10010, USA
Fax: 1 (212) 505-0871
sec_gen@rehab-international.org