Pay now or pay later?

Noreen Ramsden, who has a long history of involvement in the early childhood development sector, and is a member of the Children First Board, shared her passion for giving children a good start in life with delegates to the conference.

The benefit of giving young children the best we can is not just sentimentality. Even the World Bank has endorsed the economic value of investment in early childhood development programmes - and there are many long-term studies that bear this out.

All children need a good start and to have their needs met as they grow and develop. When we talk about raising children, we need to set our sights high. Our vision is that children are raised to be the best they can be - so that as adults they are capable, caring and responsible - an asset and not a loss to the nation.
The UN Convention on the Rights of the Child is the international standard on children's rights. This sets out the legal and justiciable rights of children - but not all the needs of children can be met within this narrow framework.

A wider declaration of basic human needs is set out by economist Manfred Max-Neef - nine of them for what he calls the sustainable self. Max-Neef is also very concerned about the sustainable environment and sustainable communities, but his analysis of human needs is most useful to us.
It is great that he does not set out a hierarchy of needs, except for starting with the basic need for subsistence, or survival. The other needs are of equal value, and all needs are inter-related and interactive. He sets out a system where satisfying needs can be synergistic. (This is well understood in early childhood education, where the need for play and the need for learning are harnessed together.)

It is interesting to see how the nine needs identified by Max-Neef relate to the more familiar UN Convention - or to Mazlow's Hierarchy of Human Needs. I am translating them from adult needs to children's, giving examples of actions that satisfy the need:

• SURVIVAL - satisfied by the action of eating, finding being given shelter and so on.
  
• PROTECTION - actions taken to keep children safe from abuse, neglect and preventable accidents
  
• AFFECTION - receiving and giving expressions of love and friendship
  
• UNDERSTANDING - studying, analysing, investigating and exploring
  
• PARTICIPATION - cooperating, accepting responsibilities and duties, expressing opinions
  
• LEISURE - playing, taking part in sport or cultural activities, reflecting
  
• CREATION - inventing, building, designing (art and music and drama …)
  
• IDENTITY - getting to know oneself, developing self esteem
  
• FREEDOM - making choices, agreeing or disagreeing

A tenth is added by some:
TRANSCENDENCE - the need to express wonder, and awe - to feel a unity with creation, with the universe.
I have spoken of the actions to be taken to satisfy the need, doing, but each need is also satisfied by
being or personal qualities
having (things)
interacting or settings
Max-Neef calls these "satisfiers" of needs.

For example let us take survival:

1. Having: providing for physical needs, the child having the physical things to satisfy the need. But these are not enough on their own, they will not help a child to survive if he or she has a death-wish, for example.
2. Being: the children will only thrive if they have the quality of wanting to survive - a zest for life. Research at the Great Ormond Street Hospital years ago showed that play activities for children in hospital reduced their stress and helped them to recover from illness and operations more rapidly.
   
3. Doing: the aspect of doing involves, for food, the actual eating of food. And for children often the actions of adults in feeding them - not plonking down a plate of porridge in the cot of a sickly two-year old and leaving it there - as is often done in hospitals. There is an art in coaxing a sick child to eat that needs to be learnt and applied by care-givers.
   
4. The setting and interaction with others is also important. For example: the baby in a grieving household is stressed and does not gain weight or thrive as he or she should (as we learnt at a UNICEF seminar a few years ago run by world-renowned therapist, Barbara Kolucki.)

The Max-Neef matrix on human needs emphasises that raising children involves every part of being human. He also includes a 'sense of humour' as a quality needed to satisfy AFFECTION within intimate relationships and also to satisfy the need for PARTICIPATION - where the actions might be working with people, expressing opinions, dissenting and so on. Are the children of Africa having human relationships that encourage laughter and fun? Can we have indicators of success - in our Logical Framework for instance - for care-givers to include how often the children laugh?

We tend to emphasis the role of having and doing, and the setting, in satisfying needs. These are more easily quantified! But we will not satisfy the human needs of children unless we also look at the intangible qualities that children need in order to learn.

They are not easily quantified and the impact of interventions to develop them is not easily measurable. But they are vitally important in the raising of Africa's children. We need to weave them into our workplans, even if these qualities and attributes and attitudes do not fit easily into a Logical Framework!

Meeting the needs of children as they grow and develop is dependent on relationships. A child needs at least one responsive and sensitive adult who loves and cares for him or her, and helps the child to feel safe, important and capable. And they need someone who is a role model for the qualities that they need … all the qualities a child must have for his or her Basic Needs to be satisfied.

Every child needs someone who thinks he or she is the greatest!
These needs are of course best mediated through a loving and caring and competent family that has the human and material resources to raise children optimally, families that are part of a vibrant and nourishing community with health facilities, schools, leisure and cultural activities, safe places to play, neighbourhood groups … I could go on and on painting the vision of the ideal Child Friendly Society!

It is a vision that we need to hang onto but we also have to keep our feet on the ground and accept that the realities of children's lives are very harsh.
In the 1980s and 1990s we had a slogan 'children are on the frontline' (from the title of Dr Mamphela Ramphele's famous research). We need to transfer the passion of those days to these, where challenges as great face our land and the continent.

Poverty was a scourge in Africa long before the HIV/AIDS pandemic made it worse. Trade barriers and tariffs preventing the export of agricultural produce and minerals, loans with high repayment rates, globalisation causing the loss of a million jobs, World Bank and IMF insistence that on "cost recovery" for basic services such as water, the blatant indifference shown to the developing countries at the recent G8 World Summit - all these cannot be blamed on HIV and AIDS.

HIV/AIDS has deepened poverty - pushing poor families into destitution as they lose breadwinners and have to pay for medical care for the sick, and then for funerals, on top of their usual family expenses. The statistics are frightening - 60% of all families in SA are living below the breadline. In a cash economy the role of the employed family member is vital and the loss of a breadwinner catastrophic.

Instead of the old 'extended family' we are now getting a large proportion of 'contracted' families, such as granny and grandchildren, or adult sibling and young children, or variations of child-headed households. The effect of the decimation of the parent-generation on the way children are raised is of grave concern.

There is a breakdown in support services - clinics, schools, welfare offices … at the same time that the need for outside support for the family increases. There are problems throughout Africa with regard to staff shortages, low morale, lack of resources and lack of infrastructure such as good roads, clean water, sanitation, housing, telephones …

Matching resources to children's needs
I would like to offer some suggestions on how to help satisfy the basic human needs of children:

• Support ARV ROLLOUT programmes - so that there will be fewer orphaned children. Every year that a parent is kept alive and healthy is a year that a child is not orphaned. At the same time, encourage caregivers to bring children forward for testing and treatment, so that they do not die unnecessarily.
  
  
• ALLEVIATE POVERTY. We applaud the SA Government's extension of the Child Support Grant to 14 years - but this is the age when children should be at secondary school! Join the campaign to extend the grant to 18years. Ask for a review of the means test as this discriminates against families with large numbers of children - these families should immediately qualify for child care grants. Lobby for more money to be spent on the Welfare Sector, especially in support of NGOs offering essential services.… Demand comprehensive social security and social services for all children! Keep hammering away for a Basic Income Grant!
  
  
• Support ALL CHILDREN in need - from whatever cause - do not target and label 'AIDS Orphans'. There should be a safety-net in the community, without increasing stigma and causing resentment.
  
  
• Encourage COLLABORATION and not competition for funding and support. Strengthen communities and community-based responses so that there is a sharing of tasks around service delivery, information and skills development and advocacy.
  
  
• SUPPORT STIPENDS for community workers - unsupported voluntarism is not sustainable and experience and training may be wasted when volunteers are 'burnt out'.
  
  
• SYNERGY: Help service providers to work together in synergy in a community, forming circles of support - all those who come in contact with children should help them have their basic needs satisfied: educators and ECD practitioners, nurses at Primary Health clinics, TB centres, ante-natal care providers, social workers, police, as well as CBOs,
  NGOs, FBOs and so on.
  
  
• COORDINATION of all role-players who make policy decisions, decide budget allocations and devise implementation regulations and monitoring structures. Political will and commitment from all state departments is needed.

Conclusion
Children in Africa, like children everywhere else, have the right to have ALL their needs met. Not just 'basic needs' in the sense of survival and physical protection, but satisfying basic needs in the Max-Neef sense - what is needed for children to grow and develop as holistic human beings - to become caring, responsible and capable adults.

These human needs are the basic needs for all children. If they are not satisfied - if we do not 'pay' for these needs to be met now- we can be sure that we will all pay even more in the long run. The cost is likely to be that a large proportion of the new generation lack the qualities that make us fully human:

• not only physical health and safety, but emotional health and self-esteem and sense of identity;
  
• understanding and a critical capacity;
  
• the abilities and skills to work and create;
  
• opportunities for leisure, play and reflection;
  
• and perhaps most importantly, the ability to participate in society showing responsibility and a sense of duty with respect for others and themselves

Can we have indicators of success - in our Logical Framework for instance - for care-givers to include how often the children laugh?