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Glue Sniffing Among Street Children in Kathmandu Valley A research report on

(For the Partial Fulfillment of the Requirement of Bachelor in Public Health)

Submitted to: Department of Community Medicine and Family Health Maharajgunj Campus, Institute of Medicine Tribhuvan University Kathmandu

Submitted By: Dinesh Kumar Chaudhary Bachelor of Public Health, 19th Batch Roll No.276

October 2008 Approval sheet Tribhuvan University Institute of Medicine

Department of Community Medicine and Family Health Maharajgunj Campus Kathmandu This is to certify that Mr. Dinesh Kumar Chaudhary has prepared this research report entitled “Glue Sniffing Among Street Children in Kathmandu Valley” under our guidance and supervision. The research has been carried out as partial fulfillment of the requirement for the Bachelor’s in Public Health (BPH) of Maharajgunj Campus, Institute of Medicine, Tribhuvan University, Nepal. This research has been accepted and recommended for approval. Approved by ……………………………………….

………………………….. (Date)

Assoc. Prof. Dr. Ritu Prasad Gartoulla (Research Supervisor) Department of Community Medicine and Family Health Institute of Medicine ………………………………………

..……………………….. (Date)

Assoc. Prof. Dr. Bandana Pradhan (BPH Coordinator) Department of Community Medicine and Family Health Institute of Medicine

……………………………………

…………………………. (Date)

Prof. Chitra Kumar Gurung (Head of Department) Department of Community Medicine and Family Health Institute of Medicine

Summary Growing number of street children in urban areas especially in city like Kathmandu added significant problems in the context of substance abuse especially glue sniffing. Several push and

pull factors are associated with the lives of large number of street children. Temptation to earn more by getting opportunity and employment and live a better life in the city are pull factors while maltreatment at home, lack of food, abusive and alcoholic parents are the main push factors. The study was carried out with the objective to identify the various factors which contribute them to sniff glue, to suggest appropriate measures to the concerned authority in order to combat glue sniffing among street children. This is a descriptive and cross-sectional study applying both qualitative and quantitative approach. The data were collected form 42 respondents from 7 different kawads. The mean age of street children range from 13-14 years age group. Most of the street children (45.2 percent) fall under Brahmin/ Chhetri group followed by indigenous group (42.9 percent) which includes Lama, Magar ,Tamang Gurung and Limbu. About 86 percent of the respondents were completed primary level education. Domestic violence (40.5percent) followed by abuse & exploitation (19 percent) were main reasons for leaving home and came to street. Regarding the glue sniffing, almost ninety percent population were know about glue from their friends who work and live on the street and about two third of population started to sniff glue before reaching ten years. They used to sniff glue for pleasure (71.4 percent) followed by peer influence (21.4 percent).easily availability and accessibility of glue from shop lead them use such substance. This behavior late leads them to addiction and dependence. As children unknowing suffering from glue sniffing, there is urgent need to launch social action programme that generate against substance abuse.

Acknowledgement I am very glad to have this opportunity to carry out this research on “Glue Sniffing Among Street Children in Kathmandu Valley”. I would like to express my gratitude to all those who helped me to make this study possible.

First and foremost, I would like to express my sincere gratitude to the Department of Community Medicine and Family Health, Institute of Medicine for providing me an opportunity to carry out this research work. I would like to thank Head of Department, Professor Chitra Kumar Gurung and all my respected teachers of Department of Community Medicine and Family Health. I would like to express my cordial thanks to my research supervisor Associate Professor Dr. Ritu Prasad Gartoulla for his valuable guidance, suggestions and co-operation, which have greatly helped me in the process of proposal development and completion of report. I am grateful to subject teacher Prof. Chitra Kumar Gurung, Associate Professor Dr. Madhu Dixit Devkota and Dr. Amod Poudyal for providing classes and clarify the main theme of the research. I am very much indebted to CWC, Nepal, Mr. Tirtha Raj Rasaili of CWCN, Kathmandu, Mr. Moti Lal Rai, and Mr. Hira Lal Giri who helped me in the process of data collection. Last, but not least I would like to acknowledge all the people who helped me directly or indirectly during the study especially to my friends Gyanu neupane, Santosh Kumar Sah and Prakash Raj Sharma.

Dinesh Kumar Chaudhary October 2008

Acronyms AIDS

Acquired Immuno Deficiency Syndrome

BPH

Bachelor in Public Health

CWCN

Child Watabaran Centre, Nepal

CWIN

Child Workers in Nepal Concerned Centre

CWS

Child Welfare Society

HIV

Human Immune Deficiency Virus

IOM

Institute of Medicine

NGO

Non-Governmental Organization

NHRC

National health Research Council

STD

Sexually Transmitted Disease

UN

United Nation

UNICEF

United Nations children fund

WHO

World Health Organization

Table of Contents Approval sheet Summary

I II

Acknowledgement

III

Acronyms

IV

Table of Contents

V

List of Tables CHAPTER I – Introduction 1.1 Background

VII 1 1

1.2 Statement of the Problem

2

1.3 Rationale of the study

3

1.4 Research Question

3

1.5 Objectives of the Study

3

1.6 Variables of the Study

3

1.7 Conceptual Framework

4

1.8 Operational Definitions

5

CHAPTER II – Literature Review

6

CHAPTER III – Research Methodology

8

3.1 Study design

8

3.2 Study method

8

3.3 Study area

8

3.4 Study Population

8

3.5 Sampling Frame

8

3.6 Sampling technique

8

3.7 Sample size

8

3.8 Tolls of data collection

8

3. 9 Data collection techniques

8

3.10 Eligibility Criteria

9

3.11 data processing and Analysis

9

3.12 Validity and Reliability

9

3.13 Limitation of the Study

9

3.14 Ethical Consideration

10

CHAPTER IV -- Findings of the Study

11

CHAPTER V –Discussion

20

CHAPTER VI –Conclusion and Recommendation

22

References

24

Annexes

26

Questionnaire

26

LIST OF TABLES Table 1:

Area wise distribution of street children

11

Table 2:

Age wise distribution of respondent

11

Table 3:

Caste wise distribution of respondent

12

Table 4: Table 5: Table 6: Table 7: Table 8:

Level of education of the respondent Reasons for coming to street Reasons for leaving home Knowledge about glue sniffing Age of first experience of glue by single year

12 12 13 13 14

Table 9:

Daily pattern of glue sniffing

14

Table 10: Table 11: Table 12: Table 13:

Reasons for glue sniffing Reasons for addiction Levels of knowledge about harmful effects of glue sniffing Children who want to rid the addiction

15 15 15 16

Table 14:

Perception for addiction

16

CHAPTER I Introduction 1.1 Background Children are the source of hope and inspiration for society. That is why they have the right to be brought up in a positive environment. But there are many children in the world who have become synonymous with social deprivation at its worst. When we talk about such deprivation, the situation with regards to Nepal does not different much.1 The problem of street children is universal and is comparatively very high in those countries where there is rapid urbanization. The number of street children has grown in recent decades because of widespread recession, political turmoil, civil unrest, increasing family disintegration, natural disasters and growing urbanization.2 A street child or street kid is considered as a child who lives on the street – in particular, one that is not taken care of by parents or other adults and who sleeps on the street because he or she does not have a home.3 Child Workers in Nepal Concerned Centre (CWIN) defined “street children are those children who are completely street based, working and living in the street. They could be orphans or abandoned children or simply neglected or run ways they could be with or without family. They could have little or no contact with their respective families.” 4 Child Act of Nepal

(1991) Article 2(Ka) defines child as “both boys and girls below 16 years”5. According to the national census of Nepal 2001, out of total population 231,51,423, 41% are below 16 years and the proportion of male and female children is equal.6 As in other countries drugs are strictly illegal in Nepal but have found their way into the market place via various different channels. The easy access and availability of drugs has created an extremely conducive social environment for people to start taking such substances, especially among young people and children.2 For most street children taking drugs is inevitable while living on the streets. Their hardship and adverse circumstances are some of the reasons children cite for doing drugs of one kind or another. While many street children perceive substance use as a tension reliever, they have also experienced ill effects and a few even want to quit their addiction.2 As regards to glue sniffing, it has been viewed as one of the major coping strategies for street children all over the world. However, the easy accessibility and availability remain temptations for children to take up the habit of sniffing. Glue sniffing among street children is as serious problem as abuse of any other substance. In Nepal there is no medical evidence to ascertain its harmful effects, but studies carried out in several other countries in America and Africa have proved the ill effects of glue sniffing on children. At times this act is even fatal, causing immediate death after the inhalation of volatile agents.2 Glue sniffing amongst street children in Nepal can be taken as an initiation to the use of other hard drugs. Addiction to glue sniffing is making street children more dependent on substances. This dependency is resulting in an increase in street children getting different adverse social as well as health consequences. 2 Many crimes have been committed by drug dependents in Nepal. Although street children are not involved in violent and serious crimes, crimes like petty crimes committed for money support the drug habit and so arrested by police often. As substance abuse or its habit causes serious problems to family and community such as loss of money , loss of social prestige, fear of arrest, fear of contracting diseases like HIV/AIDS , it is necessary to advise to stop or give proper path to street children to keep away from such types of crimes.7 1.2 Statement of the Problem

WHO estimates that out of 100 million street children, more than three-fourth are from developing world. A report based on the survey conducted by WHO indicated that it reaches about 25-30 million in developed countries.8 In 1992, CWIN estimated that around 5000 have landed on the street of cities of Nepal. Furthermore, the population of the street children in Kathmandu estimated by CWIN was around 1200 in 1996. CWIN was reported 330 new street children in Kathmandu in 1997; however they estimated total number around 1000. Their number has shot up three fold within 10 years and this problem in Nepal will pose a real threat in future, especially if the current trend towards unsupervised urbanization continues.9 Glue sniffing is relatively new trend in Nepal. It is fast becoming an addiction among street children in Kathmandu. The current prevalent of glue sniffing is 51.7 percent among street children in the Kathmandu Valley. 19.7 percent have started using glue two years ago, 34.4 percent started a year ago and 27.9 percent started just few months back.4 1.3 Rationale/ Justification of the Study •

According to the UNConvention on the Rights of the Child , every child has the right to benefit from social security and protection from exploitation and drug abuse;

•

Street children are part of our society who comprise large percentages among people working in the street but often they are misbehaved by society and socially excluded as well;

•

Glue sniffing has been viewed as one of the major coping strategies for street children all over the world and is as serious problem as abuse of any other substance;

•

Glue sniffing is taken as a 'debut' drug by street children. Mostly street children begin drug-taking by glue sniffing and end up on other, more hard-core, drugs. So, the factors affecting glue sniffing will be crucial for management.

•

As a personal interest of child health.

1.4 Research Question What are the various factors, which contribute street children to sniff glue? 1.5 Objectives 1. General Objectives To explore the various factors, which contribute street children to sniff glue

2. Specific Objectives •

To identify the age of the street children who sniff glue

•

To identify ethnicity of the street children

•

To identify the educational level

•

To find out the reasons why street children sniff glue

•

To assess knowledge about harmful effects of glue sniffing on health

1.6 Variables Dependent Variables The street children who get glue sniffing Independent variables •

Age of the street children

•

Knowledge about harmful effects of glue sniffing

•

Educational status of the street children

•

Peer pressure

•

Peer influence

•

Pleasurable experience

•

Availability of glue

•

Hunger

1.7 Conceptual Framework

Availability of glue

Knowledge about harmful effects

Hunger

Age

Pleasurable Experience

Educational Status

Peer Influence

Peer Pressure Fig: 1

1.8 Operational Definition a) Glue: A sticky substance used for joining things; generally used in shoes, carpet etc. b) Sniffing: The substance directly sprayed into the mouth and nose. c) Glue sniffing: The practice of breathing of certain types of glue as a drug, so as to

become excited or to escape from reality. In this, glue is dropped into a polythene bag and is inhaled continuously by taking short breaths into the bag while taking long deep breaths from the bag. d) Kawad: The place where solid waste like plastic, metal, glasses, paper etc. are sold by

street children. e) Caste/Ethnicity: Caste /ethnicity will be categorized under Brahmin/ chhetri, Indigenous

group, Dalit and others. f) Age: The age of street children (10-16 years) will be categorized into 3 groups with the

class interval of 2. g) Education: It refers to the formal education achieved by the street children. This is categorized as illiterate, primary, secondary and higher education. It will be measured in terms of numbers of grade. •

Illiterate- Children having no formal education.

•

Primary education- Formal education up to grade 5. It will be measured in terms of number of grade.

•

Secondary education- Education from grade 6 to 10. It will be measured in terms of number of grade.

h) Knowledge about harmful effects of glue sniffing: Mostly glue sniffing affects brain and nervous system. However, long term exposure to glue sniffing can produce significant damage to heart, lungs, liver and kidney. •

Good knowledge: who could state three harmful effects mentioned above.

•

Satisfactory knowledge: who could state one harmful effect mentioned above.

•

Poor knowledge: who have been unable to state at least one effect mentioned above.

CHAPTER II Literature Reviews Global It is estimated that through out Latin America, there are over 40 million children aged 3-18 years, living and working on the streets. 75 percent of them work to supplement the family income. They beg, sell trinkets, shine shoes and wash cars to bridge the gap between impossible poverty and survival. The remaining 25 percent are homeless with no family; they slept in abandoned building under bridges, in shop drawings and in city parks. 10 Street children cited a number of reasons for being on the streets. These include earning income, being orphaned, abuse by stepfathers/stepmothers/some relatives, inadequate care and support by parents or guardians and peer pressure. The study revealed that the majority (35.3 percent) of the street children gave earning income for their families as their main reason for being on the streets .Just over thirty percent (30.7 percent) said they were orphans and did not have care-givers while 18.3 percent said they were abused by parent(s), 7.3 percent were employed to work on the streets and 6.4 percent had committed a misdemeanor and had run away from home. 11 For example Satiffman colleagues (1987) reported the rate of drug use among homeless group was five times higher than their home based peers.12 Street children use a wide variety of substances. The price and availability of these substances have a major influence on the behavior of substance user.eg. choices regarding the type and

method of substance use. The reason street children use substances are many and are closely linked to their problem and their situation.13 One in ten teenagers is a drug addict, of these 56 percent smoke, 26 percent inhale and 5.4 percent inject. According to one of the study carried out with 118 street children, 72.9 percent use cigarettes, 18.6 percent use tobacco, 30.5 percent alcohol, 51.7 percent dendrite and 30.5 percent marijuana.14 115 male street children aged 6 to 16 years were interviewed at the time of their admission to an observation home of Delhi. More than half (57.4 percent) of the subjects had indulged in substance use before coming to the observation home. The agents consumed were nicotine (44.5 percent), inhalants (24.3 percent), alcohol (21.8 percent) and cannabis (26.4 percent). On application of multiple logistic regressions, maltreatment of the child by family members was found significant predictor of substance use in the study group. So substance use in street children is associated with unstable homes and maltreatment. 15 Drug abuse among street children in Bangalore, of the 281 children assessed for drug use 197 were drug users and 84 were non drug users. Among them, 76 percent tobacco smoker, 45.9 percent tobacco chewing, 42.1 percent alcoholic, 48 percent inhalants, 15.7 percent cannabis and 2 percent use opoids. The age of onset of use ranges from 10-13 years.16 Interface of substance abuse and child prostitution intervening in the lives of slums and street children in Kampala- Uganda, among the street children 8 out of 10 children interviewed using one or more substances abuse ranging from paint thinner to cannabis and heroin. The reasons behind are: cheap and easy to get, mode of survival for children living on the street because it helps them face the danger and challenges of being in the street comfortably.17 National According to the center, most of the children living in the streets right now left their homes at the age of eight because of various problems happened in their families. These problems mainly caused by step mother, family conflicts, poverty, lack of awareness, orphanage and some of them wanted in search of better opportunities in the big cities. Most of the children living in the streets depend on begging from others, working as porters and construction workers in the construction sites inside of the cities and in the neighboring villages of the cities. In addition to begging and working, sometimes they also do stealing, robbing, and smoking. Their activities already created big problem in Nepali society. 18

According to CWIN estimation there are 5000 street children in Nepal and around 400-600 are based in the Kathmandu Valley. Glue sniffing is relatively new trend in Nepal. It is fast becoming an addiction among street children in Kathmandu. The current prevalent of glue sniffing is 51.7 percent among street children in the Kathmandu Valley. 19.7 percent have started using glue two years ago, 34.4 percent started a year ago and 27.9 percent started just few months back. Street children, who do not even smoke or drink alcohol often, sniff glue. Glue sniffing can be termed as ‘group activity’ among street children. 95.1 percent children use glue with friends, 77 percent use glue in peer influence and 60.7 percent children sniff glue daily. 2

CHAPTER III Research Methodology 3.1 Study design It was a cross-sectional, descriptive study of exploratory nature to identify the factors which contribute street children to sniff glue. 3.2 Study method Both qualitative as well as quantitative methods were applied in the study. 3.3 Site selection This study was conducted in Kathmandu valley, the capital of Nepal. It was selected purposively because most of the street children located in the Kathmandu. 3.4 Study population The study population was the street children of age 10-16 years who have sniffed glue within the past 6 months. 3.5 Sampling Frame All the street children of age 10-16 years who were found in 7 different kawad of Kathmandu 3.6 Sampling technique Quota sampling 3.7 Sample size In 7 different kawads, there were 42 street children who have sniffed glue last 6 months preceding the study. 3.7 Tolls of data collection Interview schedule

The structured and semi-structured questions were used to collect the data to explore the factors associated with the glue sniffing among street children. Case study Few case studies were done to explore the factors affecting glue sniffing among street children. 3.8Techniques Following data collection techniques were applied to collect primary data for the study: Interviews with street children who have sniffed glue last 6 months period preceding the study.

3.9 Eligibility Criteria 3.9.1 Inclusion Criteria All the street children (10-16 years) from selected 7 different kawads who have been sniffing glue during the past 6 months preceding the study were included the study. 3.9.2 Exclusion Criteria All the children other than selected kawads and children beyond 10-16 years. 3.10 data processing and Analysis •

Raw data were properly edited and coded in the same day of data collection with the view to simplify the data entry;

•

Data analysis was done in terms of percentage distribution;

•

Merging of responses was done, as necessary , for this responses for which frequency were found to be significantly smaller to derive necessary conclusions;

•

Sorting out of responses like not applicable , could not state/ not stated , not mentioned and no response from the general data were done to make the analysis effective; and

•

Triangulation and validation of the data between various findings was done as necessary.

3.11 Validity and Reliability Validity and reliability of the study was ensured by the following measures: •

Pre-testing of the tools was done prior to the study in a similar population and necessary arrangements and corrections were made, and as far as possible, the questions were set in the simple Nepali language to ensure reliable data , and time required was estimated by the process of pre-test;

•

Researcher himself was involved in the entire process of data collection;

•

Orientation and appropriate supervision to the enumerator by researcher ;

•

A thorough review of the complete questionnaire was done and the editing of the data will be done in the same time;

3.12 Limitation of the study •

Due to small study sample the outcome of the research may not generalize the entire target population and

•

The study was limited in time and resource.

3.13 Ethical Considerations •

The study was conducted strictly under the National Guidelines developed by the Nepal Health Research Council (NHRC);

•

Written letter of permission was obtained from the campus and related NGOs prior to the data collection;

•

Informed consent was obtained from the interviewees/ participants;

•

Confidentiality and privacy of the information provided by the interviewees/ participants was maintained as far as possible;

•

The collected data was used only for the objective of the study;

•

Refusal rights of the participants were rejected.

CHAPTER IV Findings of the Study 4.1 Profile of street children 4.1.1 Area In the study, the total numbers of respondents were 42 from 7 different area/kawad of Kathmandu valley. Among them 28.6 percent of respondents were from Mahaluxmisthan followed by Samakhushi (16.7 percent) and Gwarko (14.3 percent). Table 1: Area wise distribution of street children Kawad

Mahaluxmisthan Gwarko Kalo Pool Seto Pool Samakhushi Dilli bazar Thamel Total

Number 12 6 5 5 7 2 5 42

Percent 28.6 14.3 11.9 11.9 16.7 4.8 11.9 100.0

4.1.2 Age The study shows that highest percentage of respondents was in age group 13-14 years (59.5 percent) followed by 15-16 years (26.2 percent) and 10-12 years (14.3 percent). Table 2: Age wise distribution of respondent Age group

10-12 years

Number 6

Percent 14.3

13-14 years 15-16 years Total

25 11 42

59.5 26.2 100.0

4.1.3 Caste/ Ethnicity Most of the respondents (45.2 percent) were found to be from Brahmin/Chhetri followed by indigenous group (42.9 percent). The indigenous group includes Lama, Rai, Magar, Tamang, Gurung, and Limbu. The category Dalit (11.9 percent) includes Kami, Damai and Sarki.

Table 3: Caste wise distribution of respondent

Ethnicity

Brahmin/ Chhetri Indigenous group Dalit Total

Number 19 18 5 42

Percent 45.2 42.9 11.9 100.0

4.1.4 Education Concerning the education level, children having primary level education comprised 85.7 percent. Likewise children having secondary level education comprised 4.8 percent and illiterate accounted 9.5 percent. Table 4: Level of education of the respondent

Education level

Illiterate Primary education Secondary education Total

Number 4

Percent 9.5

36 2 42

85.7 4.8 100.0

4.1.5 Migration status Kathmandu is capital of Nepal where there is all facilities and opportunities, people of different district concentrated here for different purpose. Majority of street children found here from outside the Kathmandu valley. Among them 69 percent of the respondent has been living on the street more than 1 year followed by 6 months to 1 year (31 percent).

As already mentioned, most of the children came from outside the valley, the means how they came to street children came to street are different but most of them came due to ran away from home i.e. 52.4 percent followed by with friends ( 33.3 percent). Table 5: Reasons for coming to street Reasons

With family Run away from home Run away from work With friends With relative/villager Total

Number 2 22 2 14 2 42

Percent 4.8 52.4 4.8 33.3 4.8 100.0

Various push and pull factors are contributed to migration status of street children. Among them domestic violence (40.5 percent) and abuse & exploitation (19.0 percent) are major factors. The other factors include seeking employment, lack of food, deprivation from education etc. Table 6: Reasons for leaving home

Reasons

Domestic violence Lack of food Seeking employment Deprivation from education Peer pressure/influence Abuse& exploitation Just wondering Total

Number 17 7 7 1 1 8 1 42

Percent 40.5 16.7 16.7 2.4 2.4 19.0 2.4 100.0

4.2 Glue sniffing 4.2.1 Knowledge about glue sniffing Most of the children (90.5 percent) get knowledge about glue sniffing from their friends who are being on the street, followed by adults (7.1 percent). Table 7: Knowledge about glue sniffing

Friends from work Friends on the street From adults Total

Number 1 38 3 42

Percent 2.4 90.5 7.1 100.0

4.2.2 Initiation of glue sniffing Age of first experience with glue varies with age. Almost two third of total respondents reported their first experience before reaching the age of 10 years. And the medium age of first experience was also 10 years.

Table 8: Age of first experience of glue by single year Age

7 year 8 year 9 year 10 year 11 year 12 year 13 year 14 year Total

Number 2 4 8 13 8 4 2 1 42

Percent 4.7 9.5 19.1 30.9 19.1 9.5 4.7 2.4 100

4.2.3 Pattern of glue sniffing All the respondents were sniffed glue daily. Among them 71.4 percent respondents were sniffed glue more than 5 times daily followed by 2 to 5 times daily (28.6 percent).

Table 9: Daily pattern of glue sniffing Frequency

2-5 times > 5 times Total

Number 12 30 42

4.2.4 Why do children sniff glue and become addicted?

Percent 28.6 71.4 100.0

Street children reported to have sniffed glue due to various reasons. They are get heavenly pleasure (52.4 percent) followed by addiction (21.4 percent). Others are coping with hunger and belong to group.

Table 10: Reasons for glue sniffing

Reasons

Number

Percent

6 5 9 22 42

14.3 11.9 21.4 52.4 100.0

To cope with hunger To belong to group Addicted To get heavenly pleasure Total

Similarly, majority of the respondents started sniff glue for experimenting pleasure (71.4 percent) others started this habit from as a result of peer influence (21.4 percent) while some started this by peer pressure (7.1 percent).

Table 11: Reasons for addiction

Reasons

Peer influence Peer pressure For pleasure Total

Number 9 3 30 42

Percent 21.4 7.1 71.4 100.0

4.2.5 Knowledge about harmful effects of glue sniffing All the respondents known that glue sniffing is injurious to health. Among them two third respondents have satisfactory knowledge about harmful effects of glue sniffing followed by good knowledge (23.8 percent) and poor knowledge (9.5 percent).

Table 12: Levels of knowledge about harmful effects of glue sniffing Knowledge

Satisfactory knowledge Good knowledge Poor knowledge Total

Number 28 10 4 42

Percent 66.7 23.8 9.5 100.0

4.2.6 Perception about glue sniffing Most of the respondents reported that they want to stop glue sniffing (71.4 percent). Table 13: Children who want to rid the addiction No Yes Total

Number 12 30 42

Percent 28.6 71.4 100.0

All of the respondents were accepted that street children are easily addicted to glue sniffing due to various reasons. They are easy availability of glue (81.0 percent) followed by affordable and high desired (7.1 percent each) and others (4.8 percent). Table 14: Perception for addiction

Affordable Easily available Kind of high desired Others Total

Number 3 34 3 2 42

Percent 7.1 81.0 7.1 4.8 100.0

4.3 Case Studies Case: 1 “Drugs and alcohol are a major part of this life” I’m a 16-year-old boy. I have no family and have been living on the streets for the last 2 years. I ran from home because I could not tolerate physical abuse from my parents. I was suffering a lot and finally, one day, decided to go to Kathmandu and make my own living. I’m self-dependent

and do whatever I like to do with my own money. Here's there is no one to boss me around, telling me what to do and what not to do. In the beginning, I found it difficult to fit in with the street boys and the surroundings, but I gradually got adjusted to street life. Of course it takes a lot of determination to survive here. But what I like is the freedom. The rest of the time, I work as a Tempo conductor and I have to work really hard, shout a lot to alert the passengers. This untimely job is stressing me and my health is also deteriorating. After arriving on the street, I soon found out that drugs and alcohol are a major part of this life. I’ve tried everything that is available on streets, ranging from cigarettes and tobacco to alcohol and ganja. By now, I have become kind of an addict, so it is very hard for me to resist when everyone around me is taking some sort of drug. It’s been a year since I started sniffing glue (dendrite). I learned about it through a street friend. One trip is enough for me to last for a whole day but if the trip comes down sometime, I take it again. I know this sniffing habit is bad for my health even though I used to sniff glue for belong to group. I frequently suffer from chest pains and can’t stop my hands and body from shaking. I’ve also seen my friends suffering from abdominal pain. I want to quit this habit but have been failing to do so. Whenever I see someone sniffing, I get tempted. Case: 2 He frequently suffers from chest pains, abdominal pain as a result of glue sniffing A 13 years old boy living on street near Samakhushi says that he came to Kathmandu for the first time in search of work with some villagers. His family still lives in Kavreplanchowk (Panouti/Khopasi) but he left his home a year ago. He came to Kathmandu expecting a life of comfort and luxury. He had also heard that it is easy to earn money here. But when he came to Kathmandu he found that the situation was completely different from what he had heard earlier. The person who had promised him to provide with a good job left him alone on the street. Due to this reason he had to work as a rag picker to earn his living. After arriving on the streets, he faced a lot of trouble from bullies and policemen. He says he smokes cigarettes daily and drinks heavily whenever he has enough money. He is strongly into glue sniffing. He started this habit 1 year ago and says he usually sniffs with his friends in a group.

Even though he is well aware of the actual use as well as its adverse effect of the glue, he spends Rs.100 per day and sniffs 2-5 times a day and wishes to go on sniffing all day if possible. For him, one trip lasts only for 10 to 15 minutes. After sniffing he becomes very quiet and sober and starts hallucinating and feeling pleasure. He wants to give up this habit, but when sees someone sniffing he just cannot resist it and also becomes sick. According him, street children get into this habit easily because of wide accessibility and also due to a popular belief among street children that it gives a feeling of euphoria in their language psycho. He frequently suffers from chest pains, respiratory infection and has also seen his friends die as a result of addiction to glue sniffing. Case: 3 “I also started sniffing glue after seeing my friends doing it. I am boy of 14 years old living on Bhanu’s Kawad near Mahaluxmisthan, Lalitpur. I have a family in Hariwoun VDC of Sarlahi but I don’t live with them. It has been more than a year since I left home. Since then I’ve been living on the street. I had to leave my home with my friend because of domestic violence. After arriving on the streets, I started working in hotels and restaurants. Being on the street and coming to meet other friends from the streets, I started using substances like cigarettes and tobacco. Then I slowly got into other drugs. I came to know about “glue sniffing” from a friend two years ago. I used to see them sniffing from plastic bag. I also started sniffing glue after seeing my friend do it. I have been sniffing for more than 2 years. I use the Indian one with my friends. I earn money and buy from the shop where I spend more than Rs.100 per week. I sniff 2 – 5 times daily. The amount I use gives me a trip for an hour. Not only do I feel happy but also I get pleasure from it. I like the trip that it gives me. After getting the trip I enjoy myself. Sometimes I suffer from coughing but it gets cured by itself. I know its side effect and have seen the effect on my friend. By seeing the effects in my friend I want to give it up, but I can’t help it. I don’t see any good reason for giving up. I always see my problems in front of me. The problems of my life always haunt me, so to get away from them I have to sniff. There is no other alternative for me besides sniffing. Case: 4 “I am now addicted to glue.”

I am a boy of 12 years old and I come from Gorkha district. I came to Kathmandu in search of work along with my family. I do have a family, but I don’t live with them. I have been on the streets for 6 months. When I first arrived on the streets, I worked as a 'khalasi’ tempo conductor. After some time working as a conductor, I could not continue with the late nights and hard work. I later worked in a teashop as a 'Kanchha' washing dishes and cleaning the place. I am tired of all this hard work, and right now I don’t work at all. While staying on the streets, I have known a lot of hardship, but the worst was when I had to go to sleep on an empty stomach and got beaten up by the ‘dadas’ bullies and policemen. I know about all kinds of drugs and alcohol but I just take cigarettes, alcohol, marijuana and dendrite. I first learnt about dendrite from a friend about a year ago. I prefer the Indian brand and I take it with my friends. Two to three of us share a tube of dendrite, which is about quantity of 20 ml. We spend about Rs 30 every day buying dendrite. I sniff dendrite everyday and it lasts for at least half an hour. The main reason I sniff dendrite is for a feeling of blissfulness. The other reason why I use glue is because when I sniff, I tend to forget all my sorrows, including my hunger. I know the real use of dendrite but I am not aware of its harmful effects. After sniffing dendrite, I get the urge to do many things I have always wanted to do. One thing I don't like is that I tend to fight with my friends when I am high. I don’t think I want to quit sniffing dendrite because I just love sniffing it, I am now addicted to it. I see no reason to quit. Even if I quit sniffing it, I know I will get into it again sooner or later because to survive on the streets you need some means of adjusting to the kind of life here.

CHAPTER V Discussion The chapter discusses the implication of the study findings; relate the findings with other relevant data published by other researchers and also compare the conclusions with the purpose of study i.e. factors which contribute street children to sniff glue. 1. General characteristics of sample population Highest percentage of respondents was in age group 13-14 years (59.5 percent) followed by 1516 years (26.2 percent) which is differ from CWIN study-2002, in which only 44.1 percent are in that age group. Most of the street children were found to be from Brahmin/Chhetri (45.2 percent) followed by indigenous group (42.9 percent). The indigenous group includes Lama, Rai, Magar, Tamang, Gurung, and Limbu. The reason might be poverty, family and social conflict and negligence by parents as most of the adolescent leaving home for domestic violence (40.5 percent) and abuse & exploitation (19 percent) but one of the study carried by CWIN-2002, found the reasons were domestic violence (36.4 percent) and peer pressure/ influence (14.4 percent). Concerning the education level, children having primary level education comprised 85.7 percent and illiterate accounted only 9.5 percent but different results were found by CWIN -2002 that 46 percent children were illiterate.

Most of the children came from outside the valley, the means how they came to street children came to street are different but most of them came due to ran away from home i.e. 52.4 percent followed by friends (33.3 percent) which is differ from CWIN study-2002, in which 28.8 percent were ran away from home and 22 percent were with friends. 2. Glue sniffing A strong influence of friends from the streets has pushed them into the habit of glue sniffing. A majority of street children said that it was friends on the street (90.5 percent) who are taught them and which were similar to the CWIN study 2002. About two third (64.2 percent) of the respondent reported their first experience before reaching ten years and used to sniff glue in

order to survive in cold weather, remove tension and feel relax by sharing the glue ( dendrite) with friends. CWIN-2002, found that 60.7 percent street children used to sniff glue. And among daily users 54.1 percent respondents sniffed 2 to 5 times. In my study, all respondents were sniffed glue daily. And among daily users 71.4 percent were sniffed glue more than 5 times followed by 2 to 5 times (28.6 percent). CWIN-2002, found that to forget hardship and worries, to take challenge for survival and easy available were the main reasons for substance abuse. My study finding is also similar that is for pleasure (71.4 percent) followed by habit (21.4 percent) and coping hunger (14.3 percent). Similarly, which are differ from CWIN-2002 study findings that was peer influence (77 percent ) followed by pleasurable experience( 14.6 percent). All the respondents known that glue sniffing is injurious to health. Among them two third respondents have satisfactory knowledge (66.7 percent) about harmful effects of glue sniffing followed by good knowledge (23.8 percent) and poor knowledge (9.5 percent). Likewise, 71.4 percent street children are wanted to quit the addiction to become a good person in the society where as 28.6 percent children are wanted to continue this habit because of to belong to group member. All of the respondents were accepted that street children are easily addicted to glue sniffing due to various reasons. They are easy availability of glue (81.0 percent) followed by affordable and high desired (7.1 percent each).

CHAPTER VI Conclusion The main explorating fact of the study is that street children in Kathmandu are much vulnerable to substance use especially glue sniffing. Reason for children choosing to live on the street is associated with dysfunctional family. This population runs the risk of exposing not only to the substance use but also they run the risk of physical and psychology stress. They are deprived children, denied not only of their rights as children but also of their childhood. Without guidance, education and security they are heading towards an uncertain future. The risk is associated with negative impact on child socialization process as well as health and well being of such population. Therefore, combating substance use among such population appears to be challenging work, which requires understanding the socio-economic as well as cultural context of using such substance. In the sample population, most of the respondents run away from home due to poverty, family and social reason. Because they did not get care from their parents and suffered various forms of exploitation and abuse. Drug use has become phenomenon among street children since the early 1990s and currently glues sniffing (dendrite) is fast becoming an addiction among street children in Kathmandu. It has been seen as ‘debut’ drug for street children, often those who do not even smoke or drink alcohol, are into sniffing glue. Easy availability of glue in the shop is the main key factor of addiction. Glue sniffing among street children should be understood along with the phenomenon of existing unfair social and labour relations. Combating against such abuses requires ensuring fundamental rights of children and reducing exploitative forms of child labour in the long run. In short, there is urgent need to launch social action programme to generate awareness against glue sniffing among street children if we want to see a safe environment for the future of nation.

Recommendation

•

Awareness campaign should be conducted about the harmful effects of glue sniffing especially on children.

•

Anti-drugs programmes such as education campaign should be integrated with child development programme.

•

The shopkeepers should be made aware about ill effects of glue on children and should be punished for selling such substances to children.

•

The government should regulate the production, transportation and consumption of glue.

•

Peer educator programme should be launched by involving peer group in order to educate and inform harmful effects of glue.

References

1. Pradhan G, Young Survivor on the Street Working with Street Children in Nepal: An

experience of CWIN, CWIN; 2002. 2. Rai A, Ghimire KP, Shrestha P, et.al. Glue Sniffing Among Street Children in Kathmandu

Valley, CWIN; 2002.

3. Dictionary Labour Law talks (available at http:// encyclopedia.laborlawtalk.com/street

child.) Accessed on 14th April 2008. 4. CWIN, Fact Sheet on Glue Sniffing Among Street Children in Kathmandu, CWIN; 2001. 5. National Planning Commission, Constitution of Nepal;1990 6. Central Bureau of Statistics, National Planning Commission, Kathmandu, Nepal; 2001. 7. Pant , Nur Prasad, MPH 5th Batch, Institute of Medicine, Maharajgunj, Adolescent Health 8. Street Children: The Situation in East and Southern Africa and the Need For a Strategic

Global

Response

(

Availableat

www.

House.gov/international

relations/109/sex091305.pdf. accessed on 13th April, 2008)

9. CWIN, Street Children in Nepal (available at http:// www.cwinnepal.org) accessed on

14th April 2008. 10. Eluvoyage production, web designer, Street children- Latin America. ( http:// street-

children.eduvoyage.com/ )

11. A Study on Street Children in Zimbabwe: Orphans and Other Vulnerable Children and

Adolescent in Zimbabwe( available at http:// www.unicef.org)accessed on 20 April 2008

12. Chen, Xiaojin, Taylor et.al. Early sexual abuse, street diversity and drug use among

female homeless and runaway in Midwest, Journal of Drug Issues; 2004

13. WHO, Working with the street children, a training package on substance use, sexual and reproductive health including HIV/AIDS and STD, WHO/MSD/MDP/00.14; 2000 14. Hindu online (in) 28/3/2005, Smoking, drinking rampant among street children study, the Articles- tobacco, ORG, Tobacco news and information. 15. Pagare D, Meena GS, Singh MM, et.al. Risk Factors of Substance Use Among Street

Children from Delhi , Department of Community Medicine, Maulana Azad Medical College, New Delhi;2003. 16. Benegal V, KulBhushan, SheshadriS, et.al. Drug Abuse among Street Children in

Bangalore Project in collaboration between the National Institute of Mental Health and Neurosciences, Bangalore and the Bangalore Forum for the Street and Working Children

17. Kasirye Rogers, Interface of Substance abuse and Child prostitution intervening the lives

of slums and street children in Kampala Uganda. 18. Xinhaunet, street children a big problem in Nepal, Kathmandu Post; 26/02/2002

Annexes Questionnaire Section A

Identification data: Respondent's ID No.: ………… …………

Date: ………………

Address of Kawad: …………………………..

Section B 1. Age of respondent a. 10-12 yrs (

)

b. 13-14 yrs

(

)

c. 15-16 yrs (

)

2. Ethnicity a. Brahmin/ Chhetri ( c. Dalit

) (

b. Indigenous group ( )

)

d. Others…………

3. Education of the respondent a. Illiterate ( c.

)

b.

Primary education (

Secondary education (

)

)

4. How long have you been on the street? a. 6 months-1 year (

)

b. >1 year (

)

5. How did you come to the streets? a. With family

(

)

b.

c. Run away from work (

)

e. With relatives / villages (

Run away from home ( d.

)

With friends ( f.

)

)

Others……………………

6. Why did you come to the street? a. Domestic violence

(

)

b. Lack of food

(

) c. Seeking employment education

(

(

)

)

e. Peer pressure/ influence exploitation

d. Deprivation from

(

(

)

f. Abuse &

)

g. Just wandering

(

)

h. Other………………

……….. 7. How did you know about glue sniffing? a. Friends from work

(

)

b. Friends on the street (

) c.

From adults

(

)

d. Others…………………….

8. Do you sniff glue daily? a. Yes

(

)

b. No

(

)

8.1If yes, how many times you sniff glue? a. 1 time (

(

)

b. 2-5 times

(

)

c. >5 times

)

9. At which age did you first experience glue? ………………year 10. Why did you sniff glue? a. To cope with tension ( c.

(

)

) To be strong

fight

(

(

)

d. To have enough strength to

)

e. To belong to group (

b. To cope with hunger

(

)

f. Addicted

)

g. To get heavenly pleasure (

)

h. Others………………….

11. How did you become addicted to it? a. Peer influence (

(

)

(

)

b. Peer pressure

)

c. For pleasure

d. Others…………..

12. Is glue sniffing harmful for health? a. Yes

(

)

b. No

(

)

12.1 If yes, what are the harmful effects? a. Good knowledge (

(

)

(

)

b. Some knowledge

) c. Poor Knowledge

13. Do you want to get rid of this addiction? a. Yes

(

)

b. No

(

)

13.1 If yes, why? ………………………………………………………………………………… ……………………………………………………………. ……………………………………… …………………………………………………………………………………………..……..… …........................................................................................................................ ...........................

13.2 If no, why? …………………………………………………………………………………… ……………………………………………………….. …………………………………………… ……………………………………………………………………………………………….. 14. In your opinion, do the street children get easily addicted to glue sniffing? a. Yes

(

)

b. No

(

)

14.1 If yes, why? a. Affordable c. Kind of high desired

( (

) )

b. Easilyavailable d. Enough money on hand

e. Others……………..

Thank You

( (

) )