Mali
In Mali, Sow Gouagna TRAORE presented the work of Samu Social with young women aged 10 to 25 living on the streets. Created in 2001, Mali’s Samu Social is a mobile service that has taken care of 6,000 young people. All these young people have similar life characteristics: a family break-up (violent to a greater or lesser extent) which is inevitably accompanied by desocialisation and gradual exclusion from society. These social constraints and vulnerabilities create a spiral to which new vulnerabilities can be added: sexual violence, drug abuse, health problems (including vulnerabilities linked to sexually transmitted diseases, AIDS or unwanted pregnancies). To overcome these cumulative difficulties, Samu Social opts for an integrated approach, combining mobility, the forming of trusting relationships, psychosocial support to maintain mental health and support resilience, work with families, sharing of tools with all the actors working with street children at local level, training of partners, mediation conciliation between children and parents, as well as strong advocacy with numerous partners and institutions (town halls, governments, regions, but also medical structures, detention and rehabilitation centres, child protection services, etc.)
Watch the video of Mme Sow Gouagna Traore (Mali)
Through a clinical vignette, we see that psychosocial support is transversal, adaptive and focused on reintegrating the individual into community and family focal points.
Benin
In Benin, King BANTIA introduced us to a second practice, guided by a very similar but different philosophy. The organisation Terres Rouges helps young people living on the streets. Unlike Samu Social in Mali, Terres Rouges does not always aim to reintegrate the young person into their family of origin. They note that for some young people who broke with their own environment "the street is also a community": very often, the young people have been able to surround themselves with people with whom they have been able to build bonds of trust and who function, in a way, as a substitute family. Through the clinical case of Cendra, the speaker showed that, as with Samu Social in Mali, the profiles are relatively identical (traumatic anamnesis or at least strongly adverse; loss of ties) and that the psychosocial support is wide-ranging and multifactorial (psychological interviews; support for requests for vocational training; support for IGAs; initiation of reception procedures in shelters; medical and health support and follow-up; and above all, building links with healthcare teams and support for community intermediaries). In this scheme, it is acknowledged that young people are successful when they experience certain encounters that build resilience. This is why Terres Rouges has set up a network of around sixty community intermediaries who carry out protection activities in identified places in the community. Thus, the approach is characterised by the provision of help and support within the community itself; it is even observed that, "On a case-by-case basis, it is preferable to support the child in his or her autonomy than to force a return to the family".
Watch the video of Mr Mouhamed Bantia (Benin)
The discussion
Adelin N'SITU (DRC) launched the discussion and spoke as a discussant. He emphasised the real difficulties of family reintegration and social reintegration encountered by these children, which very often result in them returning to the street after successive attempts to return to their families of origin have failed. He stressed the importance of preparing and accompanying the family and the community so that they accept that the young person returning to them will be different from the one they knew before. He also recalled the great psychological fragility of these children, underlining that exclusion is often only a consequence of the stigmatisation suffered by those with an untreated pathological condition. He invited the audience to consider (1) how to respond to the psychological needs of street children in order to facilitate their long-term reintegration; (2) what preventive measures could be envisaged to help children born in conditions that do not favour their inclusion in the intergenerational lineage; (3) and to propose ways of strengthening multi-sectoral care for children whose psychopathological state does not favour reintegration.
These presentations elicited many reactions from those following the discussion in the chat. The written comments on this workshop were in any case unanimous about the need to keep the child in the family environment as much as possible, whether it is the family of origin extended to the distant parents or an adoptive family. Alternative and temporary methods were mentioned (transitional reception centre before considering family integration) but the comments suggested that returning the child to the family rather than the street was by far the preferred option. A participant based in Kinshasa (DRC) cited the example of certain street children who were being used by political parties to unbalance opposing political camps during demonstrations, for example. These children are supervised and protected by the parties but no solution has been proposed to get them out of this street life, on the contrary: their potential to cause trouble continues to be useful for these same political parties. This discussion revealed the central place that the family of origin occupies in many African societies, particularly in terms of solidarity. However, Africa is vast, and its realities are extremely diverse. Some people's families are not the same as others', and in some contexts, the fundamental trends of urbanisation, rural exodus, job shortages and insecurity have weakened traditional forms of solidarity, confronting populations who are having to come up with new forms of belonging and solidarity to deal with the new situations they are facing.
"These traumatic experiences lock them into behaviours and attitudes of not asking for help. This is what Olivier Douville [...] has called a paradoxical adaptation style. This notion helps to understand why many children and young people build up an armour that prevents them from seeking help.”
This is a highly complex issue, as children and young people living on the streets have life trajectories which, according to the principle of paradoxical adaptation, make them vulnerable even when their situation tends to improve. Thus, the question of the effectiveness and accessibility of care can be added to those of the expansion and diversification of mental health activities, in order to proactively reach and anticipate the needs of young people.