All Of Our Dignity

It would be impossible to forget Antonio. His abandonment and isolation had been so complete, nobody even knew how old he was. We guessed about 8 or 9. He lay in a cot, lifeless and listless in a dark corner. The lack of animation was the not the outcome of his severe disability and blindness but rather caused by extreme neglect. The institution “housed” around 150 adults and children. It reaked of human waste and human disregard.

My index finger gently brushed against his palm and he gripped it tightly as his face broke into semi-toothless smile. He had lived a life cut adrift from love, attention or even basic human acknowledgment .

Antonio’s story inspired a shared effort by the government of North Macedonia and the UN to end placement of children in large scale institutions. Children like him would be provided with family-based care, connection and stimulation in community settings.

The plan was knocked off script when locals in the town of Timjanik angrily refused a mayor’s request to accommodate some of the children . We went there with the minister to find out why. On arrival, we sustained a three hour volley of abuse and hostility from several hundred protesters. There was violence in the air. People watching this back in the capital on livestream were horrified. Pundits, influencers and activists began lambasting the protesters as primitive, callous and hillbilly.

We listened carefully. Their’s was a small town in decline. It could have been in Oklahoma or South Yorkshire.The townsfolk had previously been dependent on industry and agriculture. For generations their income and opportunities had been on a modest, upward trajectory. But they now feared their children would have a much more precarious future. They had lived with years of unfulfilled promises to fix their roads, improve their schools and provide a pre-school. They longed for someone to give a voice to them, alongside the regular campaigns they heard from human rights activists for migrants, sexual minorities and people with disability. Like Antonio, in their own way they felt abandoned.

But why did these two different forms of deprivation and abandonment compete with each other? Broadly speaking there are three catastrophic burdens in childhood that drive lifelong inequality:

Discrimination or Exclusion based on race, gender or disability for example. It creates barriers that exclude one from opportunities, justice and often the basic safety that others take for granted.
Income Poverty through a lack of the basic means to survive, thrive and access opportunities to reach one’s potential.
Emotional Poverty through the absence of the basic nurturing and protective parental relationships due to violence, neglect or other forms of dysfunctional parenting (also known as childhood adversity). This is often transmitted inter-generationally and unintentionally.

If you look at Black Lives Matter, Hillbilly Ellergy and Good Will Hunting through the lens of identity, they seem so different to each other. When we look at them through the lens of fairness and dignity for all, they seem the same. It sometimes feels like we have forgotten a sense of ourselves as a whole, we are looking for the differences and barriers. This fragmentation polarises us into differing sides in a counter-productive culture war.

People in places like Timjanik perceive human rights champions to be selective in the injustices they seek to address. Those living with rural and town poverty feel both politically and economically abandoned. They are at the fag end of a painful transition from an industrial to a knowledge economy. This transition has concentrated opportunity in large cities at the expense of almost everywhere else. Those same champions scratched their heads as populists have hoovered up support in poor and abandoned communities. Despite their best intentions, they must bear part of the responsibility for the growth in populism and polarisation.

I felt this recently back home when I took a group of young adult care leavers for lunch in London. They had each lived with all of the three catastrophic burdens described above. It is hard to think of a more deprived group in the UK. We walked past a protest march urging us to support the rights of an oppressed minority in a far flung country. The comparatively wealthy looking protesters obviously felt that from our position of privilege we should all support this vulnerable minority oversees and that this was the most important human rights issue of the moment. But whose privilege is it? One of the young people in our group said he could not imagine the same protesters marching for kids in care. To highlight injustice, without acknowledging it is not the only injustice is itself an injustice.

Coming back to the story of Timjanik. The following day at an unrelated press conference in the capital, we were asked by journalists about the events in the town. We were expected to join the public condemnation of the protesters behaviour. Instead we articulated the townsfolk’s grievances and their struggles and explained that we could understand them, though did not agree with them.

Within two hours our inboxes were flowing with warm messages from people in Timjanik. They had not expected that we would actually listen to them and tell their story. They had needed to be acknowledged and heard. To understand that we think they matter too. From a collective refusal to host the small group home just 24 hours prior, it was now back on.

From that moment on, we numerically balanced our public facing advocacy. We gave equal attention to the situation of the overall population and to those living with one or more of the three catastrophic burdens . If we did a public event on exclusion of Roma minority or children with disability one month, we made sure we also had an event on poverty or a population-wide issue like education or health the next. This struck us as fair, just and effective.

A few weeks after the protest, the government agreed a strategy to transfer all children out of large scale institutions through family re-unification, foster care and small group homes. The government named the strategy “Timjanik” in testimony to what we had all learnt from these events.

On October 15th last year, the last remaining children were removed from large scale institutions. The situation may have improved for children in state care in North Macedonia, but there is still so much to do to prevent exclusion, poverty and adversity in the lives of children the world over. We can only do this when everyone finds their place in a shared story of justice and fairness. We need to “re-universalize” our human rights story.

And the children in the story? Antonio is out of the cot, living in a small group home with adequate care and stimulation and for the first time in his life, he is enrolled in school. Today in Timjanik, the locals visit with cakes and play with the children at the small group home. Just ordinary people in an ordinary place with the extraordinary courage to reimagine a better tomorrow in a world that protects all of our dignity.

COVID-19, Violence & The Need To Act with Urgency

Amidst the fear and uncertainty of the Covid19 lockdown in China, 26 year old Lele experienced something more terrifying than the virus itself. Her husband fashioned a weapon from a kitchen stool and beat her semi-conscious as she held her 11 month old baby in her arms. There was nowhere to go, no services to support, no possibility to flee. She had to spend several more weeks with her abuser before she could reach safety.

On the other side of the world in Greenland, the capital city banned alcohol sales to prevent growing child abuse during lockdown. In India the were 92,000 calls to a child abuse helpline in the first 11 days of lockdown. France experienced a 34% increase in abuse helpline calls by children and an even bigger increase in the number of peers and school mates calling on behalf of friends. . As closed schools and stay at home orders spread, so did the risk of abuse.This pattern played out across the world, in three ways:

The first is the way that lockdown piles pressure on households . Even the calmest, securely attached and ‘child development-aware’ parents are being tested by ‘pandemic-parenting’. Often they are working in uncertain jobs while teaching ‘cabin fever kids’ while adapting to loss of space and privacy. But most will not suddenly become abusive or neglectful. In more volatile families however, this stress can spill over into violence or exacerbate existing abuse patterns. The biggest beneficiaries of #StayAtHome are the serial abusers who practice coercive control and other forms of psychological aggression. the lockdown increase the likelihood of adverse childhood experiences.

Secondly, the means of reporting severe child abuse or neglect have been dramatically reduced. According to the US Department of Health & Human Services child protection interventions are initiated by reports from teachers, social workers or nurses. Social distancing measures have reduced reporting. From the 1980s onwards increased reporting of family violence was a major mark of success and progress in protecting the rights of women and children. Momentarily, reporting is in decline.

The third issue, is complex but equally serious. In normal circumstances less than 1 or 2 % of children are subject to interventions by social workers. Yet Adverse Childhood Experience (ACE) research across populations suggests between 15 and 20% of children are affected by chronic, multiple forms of abuse, neglect or dysfunctional parenting at home. This 15 to 20% of children are now in a state of isolation. Children have a biological imperative to have protective, soothing relationships with an adult and are simply not built to be isolated. When a positive relationship at home is absent, the child interprets it at risk. It over-activates their stress response system which wreaks havoc on all aspects of healthy development. Unaddressed it can lead to catastrophic health and wellbeing outcomes throughout life. But when the stress is buffered and soothed by a healthy relationship with a teacher, grandparent or friend and the child is made to feel they matter on an individual level-then the recovery can begin. Right now around the world, hundreds of millions of children have been cut off from those relationships.

This is deeply distressing. Accounts of childhood maltreatment often recall a despairing loneliness and unbearable slowness. Loneliness when the parent who should soothe the pain, is actually the source of that pain. Slowness during long pauses of waiting for a violent outburst or scarce moments of maybe feeling loved. The isolation of the pandemic amplifies this pain exponentially. It is malleable with no end in sight. Relationships with teachers, grandparents and friends were cut off suddenly with no date for restoration.

We need to act with urgency on all three issues. Governments and communities could appoint ministers or local leaders to coordinate child wellbeing during lockdown. A priority must be engagement with parents on managing stress, home schooling and positive discipline, tailored to lockdown conditions. Online and media platforms could be adapted to facilitate a conversation with families and disseminate pandemic-specific parenting tips, similar to the global UNICEF parenting hub. Social protection and housing support must be adapted to reduce the stress on vulnerable families. Behavioural insights and technology innovations should be used to understand how we can best support parents and protect children.

Expanded helplines and channels that enable neighbours and friends to report maltreatment anonymously need to be provided . Equally we need to encourage extended family and friends to maintain regular communication with children in lockdown with abusive or neglectful parents. One of the most moving stories of the pandemic so far is the upsurge in calls by friends of victims reporting maltreatment in France.

Innovation and adaptation could help teachers and social workers restore normal levels of communication with children, despite lockdown. If they are not giving lessons, can they call each child for five minutes? These measures need to be population-wide and not just targeted to 1-2% of children who are child protection cases.

Decades ago, it became normal to ensure every child was immunised against deadly disease with a vaccine. In the future we could hope for a world were every child is buffeted from trauma by a calm and predictable adult connection. A world in which we improve prospects for parenting in every family at the earliest possible stage and maltreatment is managed and prevented as a part of routine public health . All we can do now is demand protection for Lele, her baby and millions of abused children and women locked down, unreported and isolated around the world as part of our immediate and shared struggle to defeat Covid19

A Children’s Pandemic

A month of Pandemic measures and I already wince at a handshake or touched face on Netflix. Just yesterday, New York was bustling, packed and confident. Now it is cautious, dispersed and masked. If our relationship with the world around us has been instantly transformed, what about the impact upon children in their formative years?

It may be the single blessing of this ruthless pandemic that children are least vulnerable to the virus. But sadly not the potentially deadly ricochets and aftershocks it leaves in its wake. This week the UN Secretary General reported that health and food system impacts will increase other childhood diseases and malnutrition. The number of children living in extreme poverty is projected to increase from 386 to as much as 450 million as a direct result of a new Covid19-induced economic crisis. Extreme poverty is always a killer and likely to take more children than the virus itself. Perhaps reversing 2-3 years of global progress on preventable childhood deaths.

There is barely a child on the planet whose life has not been affected by the Pandemic in some way. 1.5 billion are at home and not school. At least tens of millions of children will be born into this crisis, mostly in conditions that would have been different if it weren’t for the pandemic. Children cannot see their friends and suffer major disruptions to learning, life and play. Sports tournaments, excursions and hackathons all shelved, teenage romance on hold. A recent study suggested that prolonged quarantine in general can make a person 4 times more likely to have poor mental health. The pandemic shocks touch all children .

Fortunately many children have the shock absorbers of a safe home, loving family and freedom from poverty, social exclusion or war. If just one from the set is missing, the impact of the pandemic is likely to be deeper and life-changing. There is now a new single thread of additional vulnerability tying together children in tightly packed slums in African cities with those in camps in Syria and Yemen. It extends to the low income children in rich countries like the UK and US and those at risk of severe acute malnutrition in the poorest countries. It also hits the approximately 5% of the world’s children with disability and the 15-20% in seriously dysfunctional, neglectful and violent homes. This pandemic has been merciless in piling more pressure on to those least able to absorb it.

The bottom billion have no means for social distancing or hand washing. Their health systems often have just a few ventilators and Intensive care beds. They are not thinking of flattening the curve, but rather a couple of dozen cases flattening their entire health system. Prevention of other childhood diseases is already disrupted, including vaccination programmes on hold in 23 countries. 30 million conflict affected children are dependent on humanitarian assistance which is likely to be battered as supply chains buckle and aid financing and fiscal space contract. 40% of the world’s children don’t even have hand washing facilities.

Remote learning is a great solution for most children, but even here in New York city it is estimated that 300,000 low income children don’t have the digital means to participate. School closures will widen the two main learning gaps. The first between countries with high performing education systems who have the agility and means to switch and those countries which cannot run their education system effectively at the best of times. The second gap is between the learning outcomes of wealthy and poor children within countries. 368.5 million of those poor children have also been cut off from essential school feeding programmes which are often the only source of nutrition. Children in need of special learning support at school or dependent on relationships with teachers and friends to mitigate the pain of violent and neglectful homes are suddenly adrift. All against a rising backdrop of increased reporting of intimate partner violence and child abuse from India to Greenland to Australia and all points in between.

If the Coronavirus was a pantomime villain waiting behind a curtain for an opportune moment to pounce, it did so with precision. Thus far, dwindling internationalism has made us too weak to address the Pandemic in the whole. But you cannot partially address a pandemic. Even during the Cold War, the USSR and the West realized this and joined forces to end smallpox. And thats what our polarised world needs to do now. If everyone is not safe, no-one is safe. The virus shows our interdependence and in the end, maybe thats its virtue.

This is not insurmountable. WHO, UNICEF, the Red Cross, scientists and artists have joined forces in the Solidarity Fund to mobilise resources for a vaccine and for prevention and response work in low and middle income countries. Scientists shared the genetic sequencing on the virus very early on and are collaborating across borders despite nationally-minded governments. There is also a global initiative to galvanise leaders into more collaborative and internationally-minded policy-making in response to the pandemic.

We have also seen national governments and societies prioritise children. 83 countries have adapted their social protection systems to help shield poor families and children from the crisis. Health, education and social work systems have often adapted to maintain basic services. Armies of school and health volunteers are helping minimise the impact of the pandemic upon children.

We should now see maintaining supply chains, aid flows and health systems in poor and humanitarian contexts as a first line response for us all, even though it seems far away. Look how far the virus has already travelled. We may also need to invest in social protection to help the bottom billion socially distance, particularly those in densely packed and poorly resourced urban slum and refugee/migrant camps.

In wealthy and poorer countries alike we should support adaptions for teachers and social workers to have exactly the same amount of contact with children as they had before the crisis and for school feeding programmes to be delivered to homes. When adapting education we need to prevent remote learning widening the gap between wealthy and poor.

Albert Camus may have appreciated the importance of teacher contact and continued learning. In 1957 he dedicated his Nobel Prize for literature to the teacher who was there for him in the midst of poverty and adversity. His masterpiece The Plague is once again a bestseller and remains a testimony to our interdependence and collective strength in the face of this crisis. In it, he wrote: “No longer were there individual destinies, only a collective destiny, made of the disease and emotions shared by all.” .