Health Services for Working Children in Turkey1

Tarih: 09. 08. 1998 | Kategori: Çocuk Emeği, Yazıları

The driving force and basic source of child labour, in Turkey, is family solidarity in agricultural small – holding families.Labour requirements necessitate the entry of child labour, into the work-force, at a very young age.

Our studies have revealed that children, in Turkey’s rural communities, start working before the age of 6. This is a recurring phenomenon in countries where social security systems are either non-existent, or inadequate.

In short, poverty and fear-for-the-future are the basic instigators of child labour.

How can child labour be eliminated ?

Obviously, the first step would be to develop a widespread social security system, within the framework of a rapidly expanding social state.

This, however, shall take a long time, and, in the meantime, steps should be taken to better the conditions surrounding working children.

Short-term measues should be implemented without delay.

For the past 16 years, our efforts in industrial regions, have contributed greatly to the expansion of the “Fişek Model”. The Model, aims at furthering all conditions surrounding child workers. The Model was tested in three major indusrial centres, i.e., Ankara, Ýstanbul and Denizli, and proved, both its success, and continuity.

The Fişek Model is multi-disiplinary.

Health professionals, engineers, and social scientists are working together to provide effective and continous health services to working children.

One of the most characteristic sides of the Model is our emphasis on the differences between male-female discrimination among child workers.

Employment of children is against all values and documents on human rights put forward in the second half of this century. However, there are other matters against those values, like poverty, unemployment, unavailability of health services and social insecurity.

Which one is in priority?

The expression “children shall not be employed” assumes that they should be looked after by their families. In this way, the “community” conveys the burden to the “family”. While the adult members of the family try to earn their living and worry about food, job and future, the children inevitably get involved in these activities. Children can not stay indifferent to these efforts as being a member of the family and because of future worries. They work initially to support the family, then to ensure their future life.

At this stage, it is a luxury for them to enjoy their childhood, to have a good education, and not to work in “extreme” or “intolerable” jobs.
Only after the family income and the public contribution to the “family burden” increases, their hopelessness diminish and they begin to make a choice.

***

It has been frequently told that children are the future of the society. To protect its future is a natural defense mechanism for the society. For this reason, the necessity of protecting working children by the community itself is a common consensus.

According to the studies of the State Institute of Statistics Prime Ministry Republic of Turkey (DIE), there are approximately 3 850 000 working children in our country (TABLE). Same statistics show that the number of working children increases with the number of siblings in the family (TABLE). A certain part of these children work and go to school at the same time. This may be an advantage in some aspects, but more likely to be a disadvantage when it is considered that protective measures against working life are limited.

A study of the Turkish Ministry of National Education reveal that a considerable number of occupational accidents occur among working children. According to our studies, a substantial number of occupational diseases also exist in working children and these are generally not reported .

2 970 000 of the working children (77%) can be reached to be protected at schools; as they attend primary schools, secondary schools and apprenticeship education centres of the Ministry of National Education. However, a health centre for students do not exist in any of the school. There are only advising teachers, but they are not interested in whether the children work or not.

In the context of problems of working children in our country, there are two main targets to reach the elimination of child labour.

The first group is the long term program objectives. Elimination of child labour requires sustained and forceful efforts. Poverty and unemployment are the primary reasons for child employment, and the children will continue working to meet their basic needs unless these reasons are abolished. Therefore, all individuals in the community should be covered by a comprehensive social security system, primary obligatory education, which is increased to 8 years in 1997 should be 12 years and occupational education should be improved. We consider these objectives as “long term program activities”.

In the meantime, we can not neglect children working today, who encounter the damaging effects of working life. As Fişek Institute, we are implementing our current studies in the framework of a “short term program”, with the aim of helping working children to ease their lives till the long term objectives are reached.

This program is called as Fişek Model and its objectives are to provide health and social services and to improve the working environment by preventive engineering measures. We are establishing health centres in regions of small industries for this purpose. These centres are open all year round and where routine check-ups are made and all children can benefit from first aid and other treatment facilities available.

Furthermore, we have “mobile units” offering the same service to small scale enterprises employing children. These vehicles are organized as examination rooms and provide a suitable environment for periodical health checks of all adult and child workers. Since we go to the enterprises, it is possible for our physicians to see and evaluate the working environment, thus taking the special health risks into account.

In addition; our industrial hygienists and occupational safety engineers visit the workplaces, interview the workers and employers, and eliminate hazardous environmental factors while training the workers.

For the time being, our studies are accepted and supported by a group of employers. The attitude of some others is unsympathetic and selfish, they may not even allow us to enter their workplaces. However in these cases also we have two ways to communicate with the children : 1) The children attend our first aid+treatment centre 2) They go to apprenticeship education centres, to which they have to attend one day a week according to the regulations. We use both ways, and the number of children benefiting from our services is rapidly increasing.

Fişek Model is a dynamic model. We have achieved our current level step by step, which are:

  1. Health Centres in Industrial Areas
  2. “Mobile Health Units” for Small-Scale Enterprises
  3. School Health Services in Apprenticeship Education Centres
  4. Strengtheining equipment facilities
  5. Environmental and workplace monitoring
  6. Multi-disiplinary manpower employment
  7. “Friends of Health” programme forwarded to employers
  8. Exhibition Halls on “Environmental and Workplace Development”
  9. “Occupational Safety” practices
  10. Campaigns
    • Don’t Start Smoking
    • Improvement of Child Identity through recreation.
  11. Research on Child Labour
    • Medical and Social Problems of Child Workers
    • Dangerous Jobs and Workplace Conditions in Child Labour
    • Adverse Effects of Chemicals on Child Development
    • Demographic problems
    • Gender discriminition.
  12. “Science & Action Centre” Activities
  13. Joint Activities with the other organizations

Tomorrow, we will be in a better and more improved position than we are today.
There are some characteristics that distinguish our studies from others:

  1. Multidisciplinary and multisectoral approach,
  2. Fully-developed team work on occupational health and safety,
  3. Pursuing the community health philosophy,
  4. Targeting social risk groups and evaluating living conditions,
  5. Evaluating the problems of working girls within the socio-cultural infrastructure of the society, and developing programs with their participation,
  6. Dynamism and participating mechanisms of our system due to renewability and repeatability of it,
  7. Multiple branches organized around a focus,
  8. Independent and non-governmental nature,
  9. Carrying out practical and academical studies together in harmony and documentation of all findings and experiences,
  10. Self-sustainability.

There are two more significant factors that make our work a “model”:

  1. To our opinion, these kind of studies on working children carried out by the NGOs should produce “models” and guide the community. The expansion of these models is the duty, and the loyalty debt of the social state and the community.
  2. These studies constitute a model also for the other NGOs, so that they review themselvesand re-direct their public role. NGOs will play an important role in the transformation of a society and activation of people through concrete and productive action programs.

It was not easy to achieve this point both as an institute and as a program on working children. Currently we employ 24 professionals and we have over 100 voluntary labour force. We have 5 implementation & occupational safety exhibition centres and 4 mobile units in three industrialized provinces like Ankara, Istanbul and Denizli. We have been the leader of many initiatives in our country on occupational health and safety, child employment and sexual discrimination among child workers. We have been publishing the only periodical in the country in this field “Working Environment” for 6 years.

A total of 650 enterprises, 7000 workers and 2000 child workers are using the services in our occupational health and safety centres established among a number of small scale enterprises.

When we started our studies in 1982, we did not use any public or international funds. Our only resource was one-to-one correspondence with the individuals, the contributions of employers for the service provided to small enterprises and the sacrifice of our staff. These resources are the primary support to our studies today also. We charge the employers for our services for small scale industry, environmental and biological monitoring and physical examination of the workers. Our service for children under 15 is free of charge. We go to their workplaces and schools for interviewing and screening.

We have received support from two international organizations during this 16 years of endeavour. The Population Council / MEAWARDS have supported us in 1985 and International Labour Organization / IPEC between 1992-1998. These two international organizations provided the ground to surmount and encouraged us. Sustainability has been maintained following each project. I would like to thank both organizations and employers, workers and children of our country for their support and participation.

Currently our studies are directed to the living conditions of the child workers and sexual disrimination in working life. We intend to establish community centres in the residential areas. Our purpose is to connect these community centres with holiday camps, in which we can build a warmer environment for working children. Our contact with the European Union for financial support is ongoing. We are also expecting your support to reach our aim.

Lastly, I would like to thank all participants for listening and I wish that your sensitivity will continue on all social risk groups that should be safeguarded by the public.

İlk Yayın : “Health Services for Working Children in Turkey”, XXII.International Congress of Pediatrics (9-14 August 1998, Amsterdam-Netherland), International Pediatric Association.

 

1: Oral Presentation – 22th International Congress of Pediatrics
(8-15 August 1998, Amsterdam)