The health impact of adverse environmentand migration on children The German situation. ECPCP Spring Meeting, Rome 2015 Elke Jaeger-Roman, Berlin
Convention on the Rights of the Child • § 3....the best interests of the child shall be a primary consideration • § 22 States Parties shall take appropriate measures to ensure that a child who is seeking refugee ... receive appropriate protection and humanitarian assistance... • § 24 States Parties recognize the right of the child to the enjoyment of the highest attainable standard of health... • § 28 States Parties recognize the right of the child to education... on the basis of equal opportunity
Child (< 18 Years) Poverty Rate in Germany 19,4 % (1 in 5 ) of all children in Germany live in households with an income below 60% of the national median (2014): = 2,5 Millionen Children
Child health disparities are highly dependant on the socio-economic status of the parents
Poverty and educational background of parents are more important for child development than a migratory background 19 % of the German population have a migratory background Thereof > 30% are of Turkish and Kurdish decent (2./3.generation) Parents from a religiously rooted conservative migratory milieu* have difficulties to accept integration – their children are at risk of missing out on early childhood - and school education. *Most often islamic Rural background Patriarchal view of the world Rigid moral concepts Educational goal: hierarchical connectivity (vs. autonomy)
Development of Speech – German as Second Language. Mastery of language is one of the most important factors for good school achievement 40 % of children of Turkish or Arabic background do not speak German well at school enrolment. They are not able to follow normal lessons. 12,8 % of migrant children (vs. 6,5 % children of German descent) are school drop outs.
ThePresentRefugeeDisaster 65.000 refugee children live in Germany without secured residence status Eachyear, 40.000 refugee children come to Germany, of these 9.000 children and adolescents areunaccompanied (as young as 5 years). They only have the right for treatment of acuteillnesses, Schoolingisnotcompulsary.
What do we as primary care paediatricians do for advocacy? We paediatricians campaign heavily on all political and parliamentarian levels and in all media (TV, radio, newspapers, face book, twitter etc) for children's rights. These should be written into the German constitution. In March 2015 we launched a petition and collected over 111.000 signatures to appoint an ombudsman in parliament to monitor the rights of children in Germany. Some – but by far not enough - laws have been changed for the better of children due to our intervention.