Growing up in Adversity and its Impact
In early 2000, I met Rukmuna who was 10 years old. Rukmuna didn’t look any older than 5 or 6 years. She had a small, thin frame and wide toothy smile. I met her at an Outdoor Camp conducted by one of the NGOs in Mumbai where I volunteered. The memory I have of her was how she loved chatting away and how every second word in her sentence was an abuse or expletive. As a young 21-year-old, I was taken aback and confused about how such a young girl knew these words of abuse. She didn’t understand their meaning but knew that these words could trigger another human she wanted to hurt or fight with. Rukmuna was growing up in environments of abusive language at home and community which has become part of her daily vocabulary.
At another camp, I was asked to empty the pockets of all the boys who had come to camp, their items would to be returned post camp. While I didn’t appreciate the idea of this invasion of privacy, I soon understood why. As I began to empty their pockets (the boys were aged between 10–14 years), I saw knives, razors, scissors, blades, solution, glue and cigarettes fall out of their pockets. I was shocked and overwhelmed realizing that these boys came from spaces of violence and substance abuse and the impact this had on their notion of safety.
Later at the same camp, a bunch of boys got into a fight. I had to physically separate them. One of the boys threatened the other one in Hindi, “Aaj raat ko to tu gaya (Tonight you are dead)”. I slept in the boys’ dorm the whole night in fear of something happening. These boys were growing up with violence all around them and knowing that violence is a survival skill.
At another camp, 11-year old Sangeetha had probably stepped out of home for the first time. She was shocked in this unfamiliar environment with unfamiliar people. She didn’t speak a word all through camp but got tremendous acceptance, encouragement and validation from the facilitators and volunteers. On our way back from camp towards our bus stop, a 1-hour trek, Sangeetha quietly comes over and holds my hand. We walk the entire journey hand-in-hand in silence. On dropping her to her shelter, Sangeetha started howling and pleading that I take her home with me. Sangeetha is growing up in unloving relationships and seeking atleast one relationship of care, love and acceptance.
At a workshop that another NGO was hosting for a bunch of adolescent street boys, the facilitators were attempting to wean these boys off drugs. I was volunteering. The workshop started with the facilitators wanting to understand why the boys take drugs. After a prolonged silence, one of the older boys said with a smirk, ‘I don’t think you have the courage to listen to our answer.’
On further encouragement, he shared, ‘We live on the streets. We must pick up food from a garbage bin or food that’s thrown on the roadside. When we try to sleep on park benches, we get beaten with sticks by policemen. In dark alleys, we encounter older boys who beat us or abuse us. The only way to eat the smelly, rotten food and to not feel the pain of beatings and abuse is drugs. We lose awareness of our senses with drugs and it helps us get through another day of our miserable lives.’ The response was a lightening jolt and I came away deeply disturbed on realizing how complex their daily lives are.
Another time, I watched a group of kids, not looking older than 7–8 years begging on a Mumbai local train. One of the girls was carrying a large Harmonium on her shoulder and her slightly older brother was taking care of her. While I watched them get ready for the day, without adult supervision, I saw a deep gash on the girl’s tiny shoulders, possibly from carrying this big instrument through the day. These children have grown up a little too soon.
My early work with HIV+ children opened my eyes to the prominent role of stigma and prejudice in our society. They lived in a shelter home, having lost their parents to the dreaded condition and being rejected by relatives out of fear and stigma. Well-meaning people came to give food, clothes, and toys for the children, but none ever met them, out of fear of contagion. The children were refused admission in school because of the stigma and fear of people. They were not allowed to be part of an art workshop at a local community space out of fear that they might use the toilets and spread the disease. These are children growing up feeling unwanted.
Manoj, who I met in a slum community through a partner NGO, was 11 at the time. He dropped out of school because he got beaten every day for his shabby uniform and incomplete homework. He spent his days walking through the streets seeking adventure and food. For a 11-year old, he knew the city roads well and could travel by himself. He stole things from the neighbours, so he could sell them and buy food for himself and his little sister. His father had run away, and his mother was an alcoholic and spent time in and out of prison. Beatings from neighbours and older kids were common for Manoj and he had learnt to take them in his stride. He was caught once, stealing and sent to a children’s observation home. Two weeks there and Manoj was a different person. He had grown by years in those two weeks and it seemed like he was carrying the burden of life on himself. Soon back to stealing ways, Manoj stole a bike and not knowing how to ride, he got into an accident and was killed at the young age of 14. Manoj was growing up hungry, in neglect, abuse and abandonment.
Children like Rukmuna, Manoj, Sangeetha and others are growing in Adverse Childhood Experiences (ACE). Early on in life they are exposed to environments of neglect, abuse, violence, abandonment, hunger, extreme poverty amongst others. These adverse experiences impact their neurological development and results in failure to thrive.
Adversity, including malnutrition, has had irrefutable effects on child development and mental health resulting in challenges throughout life. The cost of damaged childhoods to a nation is immense. Correlational evidence between an adverse childhood and some of the most debilitating social problems that include unemployment, violence, crime, alcoholism, apathy, poor economic choices and a range of physical and mental health disabilities has been available for some time in the Public Health domain. In the 1990s the Center for Disease Control in the United States and Kaiser Permanente, a major insurance firm, initiated a large scale epidemiological study, that has since come to be referred to as the ACE (Adverse Childhood Experience) study, when it was noticed that a multitude of health and social problems that include chronic heart and lung disease, obesity, alcoholism, inability to benefit from schooling, imprisonment, depression, intimate partner violence, sexually transmitted disease, adolescent pregnancy and early death occurred in clusters. Digging deeper they found that what was a common childhood experience of abuse, neglect, and family dysfunction. Since then a large amount of data has been collected worldwide from several countries corroborating this finding. But why or how adverse childhood experiences lead so inevitably to a web of pathological and maladaptive behaviours later in life was not clearly understood and remained a scientific gap, long hampering the designing of effective interventions.
However, in recent years, because of a deeper understanding of the early stages of human brain development, this gap has been bridged and substantial evidence is emerging to support a causal relation between adverse early childhood experiences and negative life outcomes. Research findings from several disciplines are converging to reveal a story of how our early experiences shape the architecture of our brains and how in doing so largely determine our destiny. (Source : https://web.archive.org/web/20160116162134/http://www.cdc.gov/violenceprevention/acestudy/pyramid.html)
India, for example, has approximately 160 million children in poverty: The growth of up to 59% of rural and 48% of all children is stunted. The United Nations Children’s Fund (UNICEF, 2009) reported that 42% of India’s population was surviving on less than US$1.25 per day, and around 160 million of the 460 million young people in India under 18 years old were living below this international poverty line. The Hunger and Malnutrition (HUNGaMA) Survey Report (Naandi Foundation, 2012) estimated that 42% of children aged under five years in India were underweight, and the growth of up to 59% was stunted.
Adverse Childhood Experiences results in developmental delay, a phenomenon that has been observed for over a century, and is known as failure to thrive, which is associated with a range of mental health and developmental issues (Schwartz, 2000) caused due to ACE.
Unless we recognize and accept that these children have been impacted by adverse childhood experiences resulting in the various neurological and behavioural challenges that they demonstrate while growing up and as adults, we have already lost the battle.
So next time, you give up on a child because of their behaviour in the classroom, take a deep breath and remember the complexity of their life. Its time, we accept, understand and listen to them and respond to their silent pleas for help or else they will remain children of adversity perpetuating this cycle generation after generation.
