Street girls and substance use

10 World Health • 48th Year, No. 4, July-August 1995 Street girls and substance use Kathia M. Butron Among slum children, the burden of poverty Falls heaviest on girls, who often have to care For their family at an abnormally young age. I n recent decades many Andean farming and mining families have abandoned the fields and mines and have moved into shanty towns, without water, electricity or basic services. There they remain trapped indefinitely, hoping to improve their income, an almost impossible hope in view of the country's economic situation. Thousands of women in Latin American cities are born into poverty and discrimination; their life histories are made up of thankless tasks which they must carry out in order to survive in a society which has no room for equity and solidar- ity. The girls in these slum areas have to assume responsibility for the family from the most tender age: they cook and care for the smaller children while the father, mother and brothers seek work; their only corn- pensation is the affection of their little brothers and sisters, whom they will visit occasionally after leaving the home so as to feel once again that special kind of love that goes with poverty. At night the father returns home drunk and very often the mother is in the same state; violence becomes a routine family drama. Adolescence complicates the position of these very young house- wives. This may mean that they are frequently harassed and raped by neighbours, family members and strangers who take advantage of their helplessness. These new humiliations and abuses often drive them into the streets where the hardships and dangers seem more bearable in a setting of freedom and adventure. Some may move to another town to "begin a new life". The street girls in Latin America resort to substance use as a refuge from pain and hunger. Today some are able to improve the quality of their lives - with a little help from the community. At an average age of 13 these girls take the decision to face life on their own, after having endured difficul- ties that are much less common in richer populations. In the streets there are three boys for every two girls; the boys are aged between 11 and 15, the girls between 13 and 18. The difference is accounted for by the fact that the girls are attached to their little brothers and sisters and stay at home longer. Life on the street Once in the street, the girl will join up with a boy younger than herself; this union requires absolute fidelity on her part but tolerates infidelity on the boy's part. She washes the clothes and looks after the belong- ings of both in return for being protected from harassment by policemen, pimps and other street boys. The street girls learn to defend themselves and occasionally take a knife to their attackers. They per- ceive the police as their main enemy. Despite their high levels of sexual activity, there are few preg- nancies that go to term; the girls World Health • 48th Year, No. 4, July-August 1995 11 Life is full of uncertointies for many young women in Latin America. At a shelter for street children set up under a WHO project in Cochabamba, Bolivia, girls can learn skills and prepare themselves to have a family of their own. believe that a pregnancy or a child guarantees the stability of the couple, although in reality this is not the case. Consequently, fertility is greatly valued and contraceptives are rejected. Abortions on the other hand are common, but they may often confuse menstruation with abortion. There are also clandestine abortions involving mixtures of coffee and oil , or latex, or getting someone to walk on the girl 's back, and so on. They have no one to advise them, but usually they have a girl-friend in whom they can confide. They survive by a combination of strategies, ranging from begging and selling sweets or fruit to robbery and employment as maids. They resort sporadically to prostitution to get over sentimental frustrations or to meet urgent financial needs. During leisure hours they meet in mixed groups to have fun , to steal, and to indulge in the only thing that society offers them to alleviate pain and hunger and to afford them a few moments of peace and euphoria: the cheapest possible psychoactive substances -glue, petrol, coca paste and a fermented beverage called chicha. Sometimes the boys get the girls drunk in order to rape them. Some of the girls smoke coca paste with their companion. Certain groups of smokers have initiation rituals for the girls, for example having sex with ten boys in succes- sion. In order to pass unnoticed, they all cultivate an unfeminine look: they wear trousers and T-shirts, keep their hair short and pay no attention to their appearance or hygiene. They only bother to make them- selves clean and tidy when they go to the shops to buy inhalants. An unknown future These girls become depressed and constantly reproach themselves for leading a life with few pleasures and from which so much else is missing; self-mutilation and suicide are common. At around 18 years of age they leave the streets to try and settle down to family life. These are women who, after all their misfor- tunes and diseases, still retain the ability to help and love others, and the decency to attempt a different lifestyle. For the moment there is no knowing what the future has in store for them. A WHO project for street chil- dren in Cochabamba, Bolivia, has given them the opportunity to express themselves and tell their stories. It also links them with the institutions which can respond to their needs. Our most outstanding success is that we can accompany them to the medical clinic and pre- natal clinic and thus solve many of their problems. They are also helped to obtain an identity document and to find work or a place at school. They take part in discussions about their sexuality and reproductive health, and have learned new skills which they used to think were be- yond their reach. In several cases, they have received support enabling them to lead a stable and indepen- dent life as a couple, and have been given guidance in the care and education of their children. With very few exceptions, it has been found that these young girls ' ability to recover is intact and that the "school of the street" has given them experiences that prove very useful for improving the quality of their lives -with a little help from the community. • Or Kathia M. Butr6n is a Psychiatrist and is Adviser to Chayanay Huasi, Cochabamba. Her address is Copre, Avenue Aniceto, Arce, N-0579, Casilla 2424, Cochabamba, Bolivia.