PROVISION OF HEALTH SERVICES FOR WORKING CHILDREN: TURKISH EXPERIENCE

By Gurhan Fisek

Child labour is incongruous with any value developed through the second half of this century and every human rights convention. Yet, there are other things to be underlined presenting the same amount of incongruity: Poverty, unemployment, illiteracy, not being able to utilise from health services, social insecurity.

Which has a priority?

While saying that “children can not be worked”;, it is supposed that they should be “looked after by their family”;. In this way, “society”; imputes the responsibility to the shoulders of the “families”;; and the adults of these families find these children right beside, while struggling for “daily bread, job and future”;. As a member of this family, a child is not able to stay unconcerned, while s/he is also struggling for life. Consequently, a child starts to work first with the aim of supporting her/his family, then with the concern of guaranteeing her/his own future.

At that point, it is pretty luxurious for this child to enjoy her/hischildhood, have a quality education, not to work at “extreme”; or “intolerable”; jobs.

Nonetheless, the desperation of such a family will be reduced, as the level of income of a family increase and as the society take on the “responsibility of these families”;. It is at this time when such a family is able to make a choice.

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It is frequently stated that children are the future of societies. And it is the most natural defence mechanism that societies attend to their future. For this reason, it is broadly agreed upon that child labours should be protected and looked after.

The researches carried out by the State Statistics Institute demonstrate that there are approximately 3.850.000 child workers in Turkey. From these researches, it can also be deduced that increase in the number of brothers/sisters leads to an increase in the number of child labours as well. Among these labourers, some of them are both working and schooling children. This situation is advantageous for these children in some ways; yet, it has many disadvantages as well due to insufficient protection opportunities.

The studies carried out by the Ministry of Education show that the number of occupational accidents occurring among child workers is a striking fact that should not be underrated. In addition, they also ascertain that the studies realised by our Institution on occupational diseases have a noticeable quantity, even if they are not entered in a register in any way.

Among child labourers, 77 % -hence 2.970.000- of them can be accessed at schools. Because, these children do also attend to Elementary and High School Education Apprenticeship Education Centres which are affiliated with the Ministry of Education. However, in none of these schools, there are student health centres. Guidance counsellors, on the other hand, are not able to check whether these children study or not.

With respect to the studies on the solution suggestions for the problems of child workers, it is observed that two important objectives have come to the ground. Among these, the first one is related with the long-term program goals. Withdrawing child labourers totally from working life requires long and hard working process. Before all else, it is required that poverty and unemployment should be struggled with, and the vital requirements that force children to work should be abolished. In parallel to this, the society should be considered overall under the root of a comprehensive social security program. The period of compulsory education, that was determined as 8 years a year ago, should be 12 years; and vocational training programs should be nurtured.

All these studies cannot be achieved in a day; that is why we consider these as “long-term program activities”;.

But still, will we stay indifferent to the working children who will work and be harmed during this “long”; period? As Fisek Institute, we have assembled our studies on that matter under the title of “short term program”; and headed towards assisting these children for facilitating their lives.

The program that we call “Fisek Model”; aims to provide social and health services for the working children and to straighten out the working environments by means of engineering measures. For this reason, we establish health centres at the industrial regions. Being accessible throughout the year, these centres can be applied by people in need of a first-aid and child patients.

Besides, we have “mobile units”; in order to reach at small-scale enterprises employing child workers. Designed in the form of a doctor';s office, these units form a suitable environment for all employees and children to be provided with a periodic medical examinations. Since we go to the workplaces, our physicians are also able to observe the environment in which children works, and hence, able to take occupational dangers into account during their examinations.

On the other hand, our industrial hygienists and occupational safety engineers frequently visit these workplaces; and during these visits, employees and employers are conversed with. In regard to these conversations, it is endeavoured that negative working environments causing occupational diseases and accidents are straightened out and employers are trained.

No need to say, these studies are welcomed and supported by only a group of employers. There are also others who behaves egoistically and mercilessly outside of themselves. These employers do not allow us to even to enter in their workplaces. There are two ways to get in touch with the child workers employed at that workplaces: 1. Their application to our first aid-treatment centres; 2. Our getting in touch with the Apprenticeship Education Centres to which child workers are legally required to go once a week. We appropriate both of the two ways. In this way, the number of child workers for which we provide health services increases rapidly.

Fisek Model is a dynamic model. We';ve come to this point not in moment, but gradually and step by step.

These are the major steps:

Tomorrow, we will not be at the point where you see us today.

There are basic characteristics which distinguish us from the others:

Multi-disciplinary and multi-sectorial approach;

Forming a mature team play in regard to occupational health and safety issues;

Adherence towards community medicine philosophy;

Aiming at social risk groups and evaluation of life conditions;

Putting forth the problems of girl child workers in line with the socio-cultural structure of the society; and developing programs in order to solve these problems accordingly;

Participant mechanisms and dynamism that are acquired together with the updateable and repeatable characteristic of the system we';ve formed;

Its being composed of more than one group organised around a same focus;

Independence from local power centres and government;

Carrying the practical studies in co-ordination with the academic ones; documenting all the findings and experiences through written publications.

There are two other factors that we name our studies as “model”; studies:

  1. We consider that such studies on child labour issues carried out by civil society organisation are only in order to guide society and to produce “models”;. Yet, wide-spreading all these studies is the society';s and social state';s debt of loyalty that should be paid back to these children.

  2. Another reason is the fact that they present a model character for the NGO';s as well. We consider that this model should be a mean for these NGO';s to question and conduct their social roles. In our opinion, NGO';s should and will play important roles for the transformation of society, activating people and with their concrete and productive action programs they will carry out.

Considering both the institute and the program that we have implemented for child workers, it has not been an easy task for us to arrive at this point. We are utilising from 24 professionals and more than 100 volunteers'; manpower. We have 5 implementation centres and occupational safety exhibition houses in 3 big industrial cities like Ankara, Istanbul and Denizli, in addition to 4 mobile units. In Turkey, we have put our signature on various firsts related with the issues like occupational health and safety, child labour, and gender discriminations among child labourers. We have been publishing our periodical, Working Environment Periodical, since 1992, that is unique and the most long-lasting periodical in its field.

The number of workplaces which are utilising from shared health units is around 650. There are approximately 7000 employees at that workplaces; 2000 of which are child labourers as well.

In 1982, when we started to our studies, the foundation did not receive any social fund or an international support. However, our one to one relations with society, financial contributions in return for the services provided for small scale industrial enterprises and the self-sacrifice of the Institute';s personnel helped us to achieve our sustainability. Today, they are still our strongest supporters. While the fees of the occupational health and safety services that we provide for the adult employees are paid by themselves; these services are free of charge for the children under fifteen. Additionally, the institute frequently visits the workplaces in which child labourers have a great majority in order to provide medical examination and consultation services. Since the establishment of our foundation, we';ve received additional supports from two international organisations. In 1985, we received support from the Population Council/MEAwards; and in 1992-99, from International Labour Organisation/International Programme on the Elimination of Child Labour (ILO/IPEC). These two institutions have encouraged us and provided a convenient working atmosphere for us to carry out our studies and to make a dash. Lastly, we would like to thank small-scale enterprises'; employers and employees and working children in Turkey once more.

Thistime, we have started to direct our studies towards the livingconditions of working children and gender inequalities. We have beenaiming at establishing societal centres at the living spheres as wellas in the case of the industrial regions. Considering the “holidaycamps”; that we provide for the working children, we have been trying to prove the fact that we would establish warmer relations at these centres. We would like to thank “European Youth Foundation- Turkish Women in Heilbornn and Environs, Keeping Culture Alive and Helping Each Other Association”; and our many volunteers for their financial contributions on that matter. This study has been going on since 2001. We look forward your contributions as well in order to ensure the continuation of Apprentices'; Holiday Joy.