Respect for the dignity of children is a major denominator of their overall health. I would even say it is a guarantee that their rights are respected under international convention on their rights, which Canada ratified in 1991. In my practice of community social pediatrics however, I find that many children’s rights are not honoured, and that this has a serious and direct impact on their global development and well-being. Therefore, the treatment plan and actions we suggest are induced by the nature of the violation of their rights. Through my next three blogs, I will discuss the matter in a few clinical examples, hoping I might convince you to join the movement I initiated, incidentally just before the ratification of the Convention. My goal has always been the same: to contribute, together with others, to improving the lot of thousands of children living in a difficult environment.
№. 1 of 3: Restricted services to children in need and living in a migrant family
Two youngsters were attending the community social pediatric clinic with their mother, in great distress. We quickly learned they had been awaiting a decision on their refugee status for at least two years. This was the first time we were meeting them. The youngest was born in Quebec and must have had Canadian nationality and the rights associated with it. The family was completely isolated, forced to cut ties with other members who continued to live in their country of origin.
In their new community, the family knew no one, and like many, members were staying in their cramped three-and-a-half-room dwelling, waiting for the end of the pandemic. The mother told us that, in the early morning, she dares to take her little ones to the park, dodging all eye contact, with a certain guilty feeling. As for the father, he has fortunately found a small job. We felt that the family was discouraged, and for good reasons.
Both children had developmental problems, despite their obvious potential. The youngest had a delay in speech and in socialization associated with motor-level difficulties. The elder demonstrated a bit of socialization problems, but we believed it was most likely caused by a lack of contact with other children. Because of the pending administrative decision on their status, and despite the youngest having Canadian nationality, the family was all very limited in accessing proper care and services. Yet without such care and services, the right to dignity of these children and their right to global development were not being respected.
Penalized by policies that ignore the health of some children, these young people would remain stuck in their development, and the risk of serious consequences on their health would increase by the day. Their developmental problems would persist, their academic success would be jeopardized, while the impact on their physical, social and mental health would accumulate.
So, when I meet them with my team, the family has had no access to any real support services. No respite had been made available to allow them to get back on track. Children could not have access to the public childcare services and community support was slow to accompany the family, despite the best efforts of the CLSC worker to make a difference.
For this family awaiting an administrative decision that will seal its fate, at least three actions would promote respect for the dignity and rights of children. First, children need a stimulating childcare environment and the youngest must obtain speech therapy services like any child with the same needs. In welcoming this family to Quebec, the government should have an obligation not to discriminate against its children, regardless of their origin and status. As Parliament points out, children’s needs must be given a priority since timing makes a difference, particularly for those in need of ongoing specialized services. Second, these children should be able to access recreational activities in their neighbourhoods, even in times of a pandemic, because, once again, time matters in regard to their global development. And finally, the community should be able to offer respite to the family, which would allow the mother to breathe and continue to grow for the sake of her family and her welcoming community—she had just been waiting for that!
In one or two years, the picture would be completely changed for these children and their family, and at so little cost compared to the latent bill that we all would have to pay if nothing is done to respect the dignity and respect of these children and their parents.
After having established a trusting relationship with the family, we began to move at different levels right away to meet some of the children’s needs already listed, as to bring back a ray of sunshine in their lives. Children’s socialization, safety and language became a priority for the entire team. We also sought the engagement of our community partners to help us with these tasks.
Dr Julien 