IRIN Web Special on World AIDS Day

Child labourers are particularly susceptible to sexual abuse

At the age of 14, Yasin Malik decided to go to school and leave the car workshop he was employed at for three years in the Gawal Mandi area of Rawalpindi in Pakistan's Punjab Province. He had discovered that he could be at risk of abuse from the older engineers and HIV/AIDS.

"I used to see them having sex with the boys in the workshop. They had no choice but to do it with them and they didn't use protection," he told IRIN. "I know you can die from AIDS and I'm so glad I have learned about this."

Malik is one of the more lucky boys. Other are forced to work because their families are just too poor and cannot support them. He made his decision after being educated on HIV/AIDS under the YES programme run in Rawalpindi by the Pakistani NGO, Amal.

Established in March, up to 3,000 children in Rawalpindi are educated under the programme every month by other boys in the area, who are trained to spread the word about the deadly disease. Working mostly with adolescent boys, the YES programme ensures that youngsters are better informed and can talk openly about sex. "There are so many difficulties faced by the boys. A lot of them are abused," the AMAL coordinator, Raza Hussnain, told IRIN in Rawalpindi.

Using 14 boys in the area as the key educators, the message was spread quickly and effectively, he said. Every educator taught five boys, who in turn passed the information on to others in Gawal Mandi. In addition to this, a project to educate youngsters on HIV was also being run in five schools in Rawalpindi alone, two of which are for girls. "Some boys had heard about AIDS and didn't know what it was or how to prevent catching it. So raising awareness is the only way forward," he said.

Hussnain said he had not yet come across any children who were HIV positive, as prevalence was low, but stressed that the potential for the disease to spread was incredibly high. According to government statistics 0.001 percent of the 1,710 AIDS patients in the country are children. However, health experts believe that statistics for the total number of HIV-positive people is unrealistic, estimating the number to be as high as 80,000, as many cases go unreported or are simply not diagnosed.

The aid worker maintained that raising awareness in preventing HIV/AIDS was crucial in a country where roughly 60 percent of the population was illiterate. "There are a lot of misconceptions in our society," Hussnain said. "Some boys are even scared to masturbate as they have been told by the men in the workshop that it was wrong and that they should be having sex instead."

Approaching children on this subject is not easy in this deeply Islamic country. "The children were very shy when we started educating them, as Pakistan is a very conservative society," he said, adding that they began to open up after a few sessions as they became more curious.

Usman Ali Butt, aged 17, is the leading educator in the workshop area, where some 500 boys are employed. "We tell children what HIV is and how they can protect themselves, by using cassettes and books," he told IRIN.

"When I inform other children, they are shy and wonder why I'm talking to them specifically, as many will not admit that they are having sex," he explained. He added that the first major hurdle was to get children to take him seriously in order for them to listen and absorb the information. "If we don't tell people about this disease it will spread very fast," he asserted.

In conjunction with the YES project, in 1984 AMAL also set up the Basic AIDS Information and Awareness Group, which focuses on educating children at school in major provinces across the country with the help of 400 child volunteers.

In a country where youth makes up 23 percent of the population, getting the message across to children has also become a priority for the government's national AIDS control programme. Under a new project due to start in 2003, the authorities plan to make a more concerted effort to reach out to millions of children in the country.

"We have a whole component on working with children in and out of schools on a provincial and federal level," the director of the national AIDS control programme, Asma Bokhari, told IRIN in the Pakistani capital, Islamabad.

Established in 1988, the programme was a new area for the ministry of health. "It was a new disease and not much was known about it. Most activities were lab orientated and very few were actually on the ground," the national programme officer for UNAIDS in Islamabad, Abid Atiq, told IRIN.

Since 1992, the direction of the programme has changed, with more involvement from NGOs and mass awareness through the electronic media in 1993. Prior to this there was only HIV testing and no focus on target groups, according to Atiq. "The government did hold back on tackling the issue due to the nature of the disease as this is an Islamic country," he explained.

Most of the funding for previous projects run by the authorities came from the government itself, and very little from donors. However, a renewed interest from the international aid community has given the green light for a more comprehensive five-year programme, with a budget of US $47 million to run as of 2003. "At least 40 percent of the implementation under the new project will be done by NGOs," Bokhari said. This is compared to the previous AIDS programme which had a meagre budget of $12 million over the same time frame.

With all of the cultural taboos surrounding the discussion of sexually transmitted diseases in Pakistan, NGOs are making a special effort to reach out to conservative areas, where children are at most risk of being infected by the HIV virus.

Working with children over the age of 14 in the North West Frontier Province (NWFP), the Orphan Refugees and Aid International (ORAI) NGO is spreading the word. "We warn children on the dangers of coming into contact with contaminated blood," the head of ORAI, Adrian McGee, told IRIN from Peshawar in the NWFP.

ORAI started a programme earlier this year in Dera Ismail Khan, one of the most conservative areas of the NWFP, targeting homosexuality with children in preventing the spread of HIV. "There is a park in the district where men take boys to have sex," he said.

According to McGee, children are very curious and happy to discuss sex openly once they know they will not be challenged about it. "We know that they are sexually active from the questions they ask us."

He also pointed out that barbers and dentists were using outdated and unsterilised instruments, which put people at risk. While disseminating information about the transmission of HIV, McGee said it was equally important to address misconceptions over how the virus was caught. Teams of male and female staff mobilised within schools have educated some 150,000 students since the project began in 1995.

Having spoken to teachers in schools in the NWFP, he said there were concerns over sexual practices between pupils and teachers. "They admit that there is homosexuality in this society. People also urged us to educate some of the teachers in schools."

Although there were no major problems with religious leaders in these conservative areas when tackling the subject, McGee said the youth in the NWFP were very badly informed about sexual diseases, as talking about sex was forbidden.

Similar projects focused on raising awareness are beginning to sprout across the country. The AIDS Awareness Group (AAG) in the Punjabi city of Lahore is educating children aged between 12 and 19 in schools.

Over the years, some 3,000 children have been informed under the programme. "Each time a session is held, children are chosen from the class so that they can talk to other children and spread the message about safer sex and the dangers of drug abuse," the head of AAG, Kushi Lal, told IRIN from Lahore.

The response from families when tackling such issues has not been too obstructive, according to AAG staff. "About 90 percent of the parents have agreed to our way of educating the children, so there has been only a small margin who have disagreed with this approach," he said.

Aid workers say the importance of giving children the choice to be informed is crucial in saving lives of innocent young victims who are forced to live and work in conditions which could put them at risk of being infected.

"I used to think that you could catch diseases if you didn't wash yourself properly. But now I know about AIDS and I know about protection," Akhtar Gul, aged 15, told IRIN at a car workshop in Gawal Mandi. "Some of my friends are being abused during the day and at night. Their parents know, but they don't do anything about it because they are too embarrassed," he added.

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