Investing in Children and Families
International Forum for Child
Welfare 2014
Thank you for the opportunity to present at this WorldForum. Along with climate change, the future of the
world’s children and their families remains the greatest challenge facing the
global community. While the recent
Millennium Development Goals report highlight some progress there is still much
left undone and the number of children in protective custody, prisons, and
mental health institutions are a constant reminder of the pain and suffering
still inflicted on children by people in authority. Day by day we hear regular horrendous stories
about the treatment of children and the seeming powerlessness of the world
community to prevent and to respond to their exploitation and abuse. There are
still enormous barriers to overcome and the solutions are not only the need for
more financial resources but also a change in attitudes as to how we treat
children. The welfare of children and
their families is our prime focus at this WorldForum and the challenge is to
raise the profile of children and to demand of governments, corporations,
institutions and the wider community that they invest in the health and
wellbeing of children, not only with rhetoric but in service provision, as
advocates and as a voice for their future. Healthy children need healthy
families. Nurture, protection and safety of children are the hallmarks of a
civilized society, and healthy communities and those institutions or organizations
committed to the care of children and families must ensure their wellbeing. We
know from bitter experience that this has not always been the case and still is
a challenge. An environment that
continues to punish the poorest, blame victims, allows tribal rivalries, hatred
and intolerance to continue, should be totally unacceptable in a civilized
community whether rich or poor and as a place in which to nurture and raise
children. As a global community we have the research and knowledge to protect
children and build stronger families, yet we fail at times even to use common
sense, and often rationalize why we do not more on the basis of ideological, free
market economics or political grounds and ideology, rather than human need. International
research unanimously affirming that investment in the first two years of life
will not only ensure the best possible chance for children in the future but
also makes economic sense. Disappointingly, in recent times the Australian
government has implemented policies that incarcerate children of asylum seekers
and refugees in detention and has reduced funding for health and education
services that impact disproportionately on the poor. Currently there are 4000 children held in
detention. I refuse to describe these children as illegals as the Australian
government encouraged and promoted. This
seems even more outrageous when only a few years ago the Australian government
with the then opposition apologized to Australia’s indigenous children and also
the Forgotten Australians.
In this presentation I would
like to begin with a few reflections and comments on the need for greater
investment of the world’s resources in children and the outcomes that can be
achieved, and then secondly, to speak about Australia’s challenges in meeting
and responding to the needs of our indigenous people.
A recent report in the British Medical Journal the Lancet noted that substantial reductions
in maternal child health deaths have been achieved worldwide over the past two
decades. This study demonstrated how
investment in women and children’s health can bring about significant health,
social, and economic change enabling greater participation and engagement in
community life. The report went on to speak about greater change if countries
invested more in the health needs of both children and their families, thereby
preventing the deaths of 147 million children, 32 million stillborn and 5 million
women by 2035.
The report in the Lancet noted that the global maternal
mortality rate was reduced over the period, 1990-2010 by 47%, and under 5
mortality by a similar percentage. However these improvements fall far short of
the Millennium Development Goals set by the United Nations in 2000:
·
Goal
4: reduce the under 5 child mortality rate by two- thirds between 1990 and 2015
·
Goal
5: reduce by three- quarters between 1990 and 2015 the maternal mortality rate
and to achieve universal access to reproductive health that aims to decrease
child and maternal deaths worldwide by 2015.
The most recent MCD reports indicate substantial challenges ahead. Six and half million children died in
2012. This is 19000 deaths each day. The leading causes of death in children under
5 are pneumonia, pre- term birth complications, diarrheoa and malaria. Nearly 45% of deaths are linked to
malnutrition. Children in the sub-Saharan Africa are 16 times more likely to
die before age 5 than in developing countries.
Nearly 300,000 women die from treatable complications of pregnancy and
childbirth. Alongside these figures sit 1 billion people who continue to live
in extreme poverty. Fifty-seven million children do not attend school and over
half the developing world lacks sanitation.
The report further highlights that despite economic growth in many
Asian countries, South Asia still accounts for one- third of child and maternal
mortality while sub- Saharan Africa accounts for 25% of deaths. While global
and regional efforts are being made to accelerate improvements, much more needs
to be done. The report highlights, as does both common sense and other research
, what is required if we are to successfully reduce the level of infant
mortality and improve the mother’s health. The simple answers are political
will and resources. The leading causes of maternal mortality are in many cases
preventable when well- equipped health services are present alongside
education, parenting services, sanitation and fresh water, housing and an
adequate income to ensure healthy eating, clean water and caring and nurturing
families.
Australia, while having a national health service accessible to all
Australians and supported by a robust and growing private health sector, is
experiencing a range of challenges including an ageing population, rising
obesity and high costs associated with advances in technology, longer waiting
periods for elective and non- life threatening surgery and a growing demand for
ante- natal and post- natal services. These challenges, alongside claims of
financial unsustainability by those who advocate choice and free markets, will
require a strong community and political will to ensure health care is
available to all in the future. In Australia today we are beginning to see
attempts at eroding a national and universal free health care system and
welfare for all, from vested interests and powerful elites. The voices of the
sick and the needy are shouted down by powerful lobby groups arguing for a free
market approach to service provision instead of community well--being and need.
Investing in children and families is a
political issue as much as a policy and best practice matter. And professionals
working in the field of children’s services need to be advocates and voices for
those who are unable to be heard in the market place. Research and common sense
tells us that global priorities need to change if the future of millions of
children are to be protected.
I want to now shift my focus in this presentation to how Australia has
sought in more recent times, to address the health and well-being needs of our
indigenous people, in particular children and families. The past is not one the
nation can be proud of and it is only in recent times that greater attention
has been given to their needs, partly driven by a stronger indigenous voice,
and by the nation’s guilt and moral failure in the area with a growing awareness
that more needs to be done, sooner rather than later. It has only been in the
last 8 years that the lives of the nation’s indigenous communities have been
recognised as an urgent priority and attention focused on addressing their
health and welfare needs. Since the arrival of the British in 1788, the past
230 years have seen indigenous Australians decimated and abused, and
annihilated would not be too strong a word, in some parts of the country. Today
there remains a crisis in the delivery and provision of health, education and
welfare services for our aboriginal and Torres Strait islander communities. Many
were massacred for their land. And had their health adversely affected by
European diseases, and the availability of alcohol, while thousands of children
were “stolen”, removed from their families on account of being mixed race
children . The decline of the indigenous population continued well into the
twentieth century. Today they represent about 3% of Australia’s population
numbering 600000. They were first recognised in the Australian constitution in
1967, although many fought alongside other Australians in the two World Wars, yet
they still remain in many places on the margins, struggling for identity and awaiting
full recognition. In February 2008 the then Prime Minister of Australia made a
formal apology on behalf of the people of Australia to the “StolenGenerations”
for the hurt and pain of the past inflicted on indigenous people by previous
governments and the general population vowing to do everything possible to
enable reconciliation and to ensure their future health and well-being. In 2009
a further apology was made to the Forgotten Australians, those children and
young people, many British children sent to Australia during and after the
Second World War and those of indigenous descent, who had experienced
institutional care. Both occasions have been recognised as significant steps in
the healing process and provided the background and motivation for greater
investment in services for children and families to improve health services,
schools, employment, housing and a voice in the formulation of public policy on
indigenous issues. Outcomes have been mixed and not always successful. Voices
have differed on needs and how they should be met even among Indigenous
communities themselves. When government
leaders across the country met in 2008 to agree to a set of policies and
objectives to be achieved, they set ambitious targets to address priority areas
for change. The initiative is called “Closing the Gap”, a strategy of the
Australian government in partnership with the States .The report outlines a
level of investment unprecedented in the area of indigenous well-being,
underpinned by a series of indigenous -specific and mainstream partnerships. The
“Closing the Gap” strategy aims to reduce disadvantage in respect of life
expectancy, access to education, employment, health matters and identity. How
well this is achieved will depend on implementation, skills, listening and
commitment not only by governments, but also by all Australians and the range
on non-government and faith- based agencies willing to assist. Listening to and
engaging the indigenous communities themselves will also be crucial. Perhaps
the greatest risk or fear in achieving outcomes that reflect resource
allocation is a belief that it is possible to move forward. The challenge is
great. Compared with non–aboriginal Australians, Australia’s indigenous child
population is:
·
More
likely to be stillborn, to be pre-term, to have low birth weight, or die in the
first month of life
·
Two
to three times more likely to die in the first 12 months of life.
·
Bear
a disproportionate 2.5 times the burden of disease, 5 times diabetes, 4.5 times
cardiovascular disease and 4 times intentional injuries, such as suicide or
harm from violence. They are more likely to have infection of the middle ear
leading to cognitive deafness and blindness with implications for education and
hospitalisation.
·
Many
live in communities that do not have sanitation or clean drinking water.
·
Disproportionally
represented in Out of Home and residential care programs
The impact of the removal of children from their families continues to
affect health outcomes. It is estimated that 38% of children 15 and over were
removed from their families and these children still suffer from a variety of
emotional issues including loss of family and identity. This prevents many
indigenous adolescents from participating fully in the community while
suffering depression and other related illness. Twenty years ago one in 20
suicides in Australia were of aboriginal descent. Given they make up only 3% of
Australia’s population that was far to high. Today half of deaths by suicide in
northern Australia are those of indigenous people. Figures from the Australian Bureau of Statistics
show, that indigenous men, die 4 times and women 5 times higher, from suicide, than
non-indigenous people. The group most at risk today is children mostly boys
between the age of 10-14. These young men account for 4 out of 5 of all
indigenous deaths,
“Closing the Gap” targets for Indigenous Australians are to:
1.
Close
the life expectancy gap between indigenous and non-indigenous Australians within
a generation, currently approximately 10-12 years less for indigenous
Australians of both sexes
2.
Halve
mortality rates for children under 5 within a decade by 2018
3.
Ensure
all children in remote communities have access to early childhood learning by
2013
4.
Halve
the gap for students in reading, writing and numeracy within a decade;
5.
Halve
the gap for those in year 12, the final year in secondary schooling;
6.
Halve
the gap in employment outcomes.
The building blocks to achieve these goals are:
1.
Early
childhood services
2.
Schooling
3.
Health,
including sanitation and access to fresh drinking water
4.
Healthy
homes
5.
Economic
participation
6.
Safe
communities
7.
Governance
and leadership.
The process for the implementation of the “Closing the Gap” framework
involves financial investment in a range of partnerships to address lifestyles,
health issues, truancy, poor schools, inadequate housing and easy access to
alcohol. As well as government policies and agencies, non-government,
charitable and faith-based agencies are also engaged in service provision,
advocacy and research designed to enhance the well-being and opportunities for
indigenous children and families.
The key elements of the “Closing the Gap” initiative are :
1. Sexual health- sexual disease and
infections continue to be reported at alarming and much higher rates compared
to the non- indigenous population
2. Mental health-$2.2 billion is to be
spent over 5 years for suicide prevention, alcohol and drug addiction, preventative
care, addressing past abuse
3. Provision of culturally sensitive
services and accommodation for older people
4. Housing management and safe families
especially for children and women as violence resulting from alcohol and drug
abuse remains high
5. Road safety
6. Outlawing discrimination particularly in
the sporting arena.
Having outlined the policy directions and key components of the
program there is no cause for complacency. A great deal still needs to be done
and many mistakes have occurred. Undoing 200 years of mistreatment cannot be achieved
overnight or even in a single generation. It will require a continuing strong
political will, community support and advocacy, as well as a reordering of
priorities. Along the way respect for and the preservation of indigenous
culture must be a priority. Self- esteem and participation by indigenous people
must be taken seriously and accepted as a priority. Decisions cannot be left to
government bureaucrats no matter how well intentioned or motivated. On a recent
trip to a settlement in Arnhem Land in Northern Australia I saw new housing in
a remote and isolated community being built while young people sat around
smoking, drinking and bored. There were no jobs and schools. The complexity of
the challenge in investing in the future is not easy. While housing needs to be
addressed, the immediate goals remain to be addressed:
·
Getting
children to school
·
Getting
adults into work
·
Ensuring
safe communities .
Progress so far:
1.
Only
a small improvement in life expectancy has occurred since 2007
2.
The
target to halve the gap in child mortality is on track although no actual
figures seem to be available
3.
By 2012,
88% of indigenous children in remote communities were enrolled in pre-schools
4.
Progress
to halve gaps in writing, reading, and numeracy have been disappointing and
have not reached projected targets with only 2 regions out of 8 showing significant
improvement
5.
Little
progress has been made to halve the employment gap
6.
Improvements
have been achieved to increase participation rates a year 12 level.
Investing in children and families requires more than best practice.
It requires more than financial resources. It requires a full understanding of
what it means to be human in a world where 80% of the world’s wealth is in the
hands of 20% of the global population. Investing in children is a global
concern and requires a political solution where more than lip service is given
to the challenges. It requires a political will driven by a community belief
that all children and families have a right to education; freedom from abuse
and discrimination; access to clean water and sanitation, to shelter, and
employment. These principles are at the centre of the UN Declaration of Children’s
Rights and we all have a responsibility to speak with and on behalf of children
and their families to prevent or correct failure. Investing in children and families makes good
economic sense, as does the opportunity for ensuring that all children and families
are able to reach their potential.
The future of Australia’s indigenous children and their families is
Australia’s challenge in a rapidly
expanding urban context. This challenge sits alongside the high level of
service already achieved for the rest of the community. This shows that it can
be done . Respecting human dignity and promoting the rights of the child are
fundamental to any civilized society. Children are more at risk of poverty and less likely to succeed when
adults fail in their obligation to provide services and to protect young people
from exploitation.
Finally it does not matter who you are, or your status or experience.
The future of our children is the responsibility of each of us. It is not
someone else’s problem, and we in our attitudes and values may in fact be part
of the problem as we are the solution. As citizens of the world we need to
continue to challenge and expose hypocrisy and self-interest that prevents children
from reaching their potential and demand that international and national
priorities in spending be directed first
and foremost to the needs of the most vulnerable children and families in our
own communities thereby raising the
profile of political action as well as high quality service delivery.
References;
1.
Closing
the Gap, Prime Minister’s Report on progress on addressing indigenous
disadvantage, April 2014.
2.
Unnamed
paper presented by Associate Professor Jane Fremantle at an oral presentation
in St Paul’s Cathedral Melbourne April 2014.
Ray Cleary
8th June 2014.