A STUDY ON IMPACTS OF SUBATANCE ABUSE AMOUNG STREET

CHILDREN IN KATHMANDU

VALLEY

A Dissertation Submitted to:

Tribhuwan University

In the partial fulfillment of the requirement for the Bachelor of

Arts in Social Work

By

Mr. Jivan Bhujel

The Department of Social Work

Patan Multiple College

Patan Lalitpur

2018
 TRIBHUWAN UNIVERSITY
DEPARTMENT OF SOCIAL WORK,

PATAN MULTIPLE COLLEGE

PATAN LALITPUR
RECOMMENDATION LETTER

This dissertation” A Study on Impacts of Substance Abuse among Street Children In Kathmandu Valley”
submitted by Mr. JIVAN BHUJEL for the partial fulfillment of the course of Bachelors of Arts in Social Work is
prepared under my guidance and supervision. I recommend this dissertation for the final evaluation.

Date: Dissertation Supervision

Name of person
 TRIBHUWAN UNIVERSITY
DEPARTMENT OF SOCIAL WORK,

PATAN MULTIPLE COLLEGE

PATAN LALITPUR
LETTER OF ACCEPTANCE

This dissertation” A Study on Impacts of Substance Abuse among Street Children In Kathmandu Valley”
submitted by Mr. JIVAN BHUJEL has been accepted as the partial fulfillment of the requirement for the course of
Bachelor’s of arts in Social Work.

Evaluation Committee

External Examiner Supervisor

………………………… ………………………..

Mr.

Date:
 ACKNOWLEDGEMENTS

Being a part of Patan Multiple College as Bachelor’s of Arts in Social Work (BASW) faculty
and affiliated to Tribhuwan University is a great honor for me. First, I would like to thank
T.U for providing me for golden opportunity.

The research entitled” A Study on Impacts of Substance Abuse among Street Children In
Kathmandu Valley” has been prepared in partial fulfillment of requirement for the degree of
BASW 3rd year. This would not have been possible without the help and support of many people.
These people help me a great deal in developing my research skill such as writing proposal, doing
research methodology, reviewing literature, collecting data, analyzing data, coding and
communication skill.

I hope that this research will give greater opportunity in understanding of the impacts of
substance use among street children in Kathmandu valley to other interested researchers.

I would like to express my sincere gratitude to my respected teacher Mr…………… for her/his
valuable guidance and constructive suggestions during preparing questionnaire for the research
work. Also, I am thankful to Mr. ……..Dissertation Supervisor for providing research format
and direction to prepare research proposal and Mis/Mr. Binita Khatri ,field Supervisor for
her/his help in doing the coding of collected data in graph paper.

Likewise, I would like to thank the following agencies (NGOs) for their assistance with the
collection of data for my research. CWIN-Nepal,CWCN,VOC.

It is also important to remember and thank to the respondents who responded positively to any
questionnaire during data collection. Their genuine and sincere response to the questionnaire
has provided the dissertation with a good analysis.

Jivan Bhujel

2018
TABLE OF CONTENTS
Recommendation

Acceptance latter

Acknowledge

Chapter: 1 INTRODUCTION Page

1.1 Background of the study 1

1.2 Magnitude of the problem 3

1.3 Rational of the study 3

1.4 Objective of the study 4

1.5 Research Questions 4

Chapter: 2 LITERATURE REVIEW

2.1 Definition 5

2.2 Substance use among the street children in Nepal 8

2.3 Effects of substance use on the street children 10

2.4 Other substance that street children use 13

2.5 Method of using substances 13

2.6 Consequences of substance abuse for the individual street children 14

Chapter: 3 RESEARCH METHODS

3.1 Operational definition 16

3.2 Justification of the research area 16

3.3 Research Design 16

3.4 Nature and source of data 16

3.5 Universe and sample 17

3.6 Data collection and techniques 17

3.7 Data analysis 18

3.8 Limitation of the study 18

CHAPTER: 4

4.1 Basic Information of the Respondents 19

4.1.1 Gender composition 19

4.1.2 Age Composition 20

4.1.3 Place of the origin 21

4.2 Reason that involved respondents in Substance Abuse 22

4.3 Types of Substance used by Respondents 23

4.4 Impacts of Substance Abuse on Respondents 24

4.5 Preparation of the respondents on getting rid out of Addiction 25

CHAPTER: 5

5.1 Summery 26

5.2 Recommendation 27

5.3 Conclusion 27
 ABBREVIATION
 AIDS :Acquired Immunodeficiency Syndrome
 CBS :Central Bureau of Statistics
 CRC :Convention on the Right of the Child
 CWIN :Child Workers Concern in Nepal
 GN :Government of Nepal
 HIV :Human Immunodeficiency Virus
 i.e. :That is
 ILO :International Labor Organization
 LSD :Lysergic Acid Diethylamide
 INGO :International Non-Governmental Organization
 NGO :Non-Governmental Organization
 PCP :Phencyclidine
 THC :Tetrahydrocannabinol
 UN :United Nations
 UNCRC :United Nations Convention on the Right of the
Child
 UNICEF :United Nations International Children’s Emergency
Fund
 WHO :World Health Origination
 LIST OF FIGURES
Figure 1: Gender Composition

Figure 2: Age Composition

Figure 3: Original Place of Respondents

Figure 4: What Reasons to get Involve in Substance Abuse?

Figure 5: Different type of Substance Use

Figure 6: Impacts on substance Abuse

Figure 7: Perception of Respondents

 1

CHAPTER

IN TRODUCTION

Background of the Study

The prevalence of drug and alcohol use among street children in Nepal has been a growing
concern during the 1990s. Several studies indicate that there are more than 5000 street
children in Nepal (CWCN 1998).
The phenomenon of street children is largely confined in large urban centers in Kathmandu
and Pokhara valley as well as in urban centers along Mahendra High way and in many
border towns. Several reasons among pull and push factors are associated with the lives of
a large number of street children. Temptation to earn more and live a better in the city are
the main push factors while lack of food at home , peer influence, maltreatment at home ,
abusive and alcohol parents are the main push factors (CWS 1996). In addition, flourishing
urban informal sector based on Primitive technology also attract children from the rural
area. Ultimately, however, they land on the street for survival strategy.
“The growing scale of poverty, rapid population growth, unemployment and shortage of
agricultural land and other social problems like family breakdown, parental negligence and
inappropriate family atmosphere have led the children to leave their home. Once they are
displaced from their home, they find themselves without shelter and means of survival.
Then they come on street and becomes street children “(Pradhan 1993)
“Street children are those who use the street as their permanent home. Spending their
major time in street, doing whatever necessary for their day-to-day survival as well as
support to their family. According to the study, all the children who stay in the street are
street children”
(CWIN 1990)
The term “Street children” in English is not new, George C. Needham in 1884 used the term
in passing to describe the children. According to him through the stress of circumstances,
they are force into a course of life which tends to the multiplication of criminals and
increase of the dangerous classes. But until 1980s term as “Street urchin waif” used in early
part of the century or “Run away on abandoned child” after 1980s the term has more
common as “Street children” (Jean 1995)
The national convention report on the street children held in1993 use the term like
“homeless, helpless, khate, sadak chhap,sadak balbalika” to the street children (National
Children Report 1993).
A study by World Health Organization (WHO) indicates that early onset and continues use of
illicit substances is more likely to occur among young people from communities with poor
social and economic indicators (Associated with low quality of life and low level of
education).
The proportion of the substance users among street children in Nepal varies greatly by
availability of substances, gender, age and background of the children. Studies have shown
that between 25 and 90 percent street children use substance of one kind or another.
There are very few studies that focus on alcohol and drugs use among the children at risk.
One of very few studies, (CWIN 1998) desires data from total sample size 1115 children at
risk in five CWIN centers. This study reported that one-fifth of the children age 4-17 years
had taken alcohol children taking tobacco continued 38 per cent. Gender difference in
alcohol use was much pronounced (21% for boys and 12% for girls).
Another study by CWIN-2000 indicates that 44 per cent of 303 children taken alcohol
followed by tobacco (23.7%) and drugs 3 %. Dhital(1999) indicated that children were
exposed violence in family, aggression, disgrace, self hurt, involvement in offensive action
and sickness.
All these street children either fight for their own survival by either begging or rack picking
in the street of our cities. They are also involved in criminal activities as transporting drugs,
gang fight, stealing, pick pocketing etc. The serious problem among them nowadays is
taking glue, sniffing from the plastic bags and substance called “DENDRIDE” (CWIN 1992).
Kathmandu valley is the most migrant area for the street children. In Kathmandu valley,
there are three districts i.e. Kathmandu, Lalitpur and Bhaktapur. Most of the street children
have migrated in Kathmandu from the adjoining district namely Nuwakot, Kavrepalanchok,
Sindhupalchok, Dhading, Makwanpur, Dolakha and Ramechhap (National Children Report
19193).
The consequences of substance abuse on street children’s life rang from acute and chronic
health and emotional problems to disruption in interpersonal relationships, school failure,
social marginalization and criminal behavior.
This study is a departure from other studies in Nepal in that is uncovers a wide range of
children at risk from different urban center. Second, it examines the behavior of street of
street children using various substances. It also examines children’s perception of using
such a substances and consequent effect on their lives.

1.1 Magnitude of the problem

Substance abuse is a complex disorder characterize by compulsive drug use. While is drug
produces different physical effects, all abuse substances share one thing in common:
repeated used can alter the way the brain looks and functions. The streets children addict
to the different kinds of substances are likely to face many problems.

 Taking a recreational drug causes or surge in level of dopamine in your brain, which
trigger feeling of pleasure? Your brain remembers these feelings and wants them
repeated.
 If you became addicted, the substance takes on the same significance as other
survival behavior, eating and drinking.
 Changes in your brain interfere with your ability to think clearly, exercise good
judgment, control your behavior, and feel normal without drugs.
 Whether your are addicted to inhalants, heroin, xanax, speed, or vicodin, the
uncontrollable carving to use growls more important anything else, including family,
friends, career and even your own health and happiness.
 The urge to use is so strong that your mind finds many ways to deny or rationalize
the addiction. You may drastically underestimate the quantity of drugs your are
taking, how much it impacts your life, and the level of control you have over your
drug use.

1.2 Rational of the study

The problem of the street children are consider as the most prominent but not new issue.
After having friends circle with street friends than they have used to substance abuse and
which as adverse impacts on their life. Street children always suffers from varies problems,
which further aggravated their worsening condition. So called civilized people always keep a
neglecting them and called them as “KHATE” but never try to help them. Various efforts
made by governmental as well as non-governmental organizations are negligible to
formulate and implement appropriate policies and programs.
This research was helpful in understanding the impact of substance abuse among street
children in Kathmandu valley. As a major concentrated area in KMC (Kathmandu
Metropolitan City), various studies regarding street children have been made just to
analysis the problem of street children but never try to identify the impact of substance
abuse among street children. So this research was helpful in understanding the situation of
street children due to to substance abuse and making suitable policies for street children so
that their problem can be reduce. Also the research will be applicable for those who work
street children.

1.3 Objective of the study

The objective of the study will be:

 To explore the reason behind substance abuse among street children.

 To examine the impact of substance abuse on street children’s lives.
 To identify age, sex, and permanent address of the street children.
 To know the types of the problems face by the street children during their street life.
 To know the perception of street children getting ride out of substance addiction.

1.4 Research Questions

 What are the impacts of substance abuse in their life?
 What are the reasons they involve in substance abuse?
 Which cast, age and sex back ground do street children represent in KTM valley?
 What are their surviving activities and daily food meal to spent life?
 What types of problems face by street children during their street life?
 What kind of perception to street children have regarding on getting out of
substance addictions?
 2

Chapter

Literature Review

2.1 Definition

Moreover, UNICEF has sub categorized and defined street children in to three types: 1.Street living,
2.Street working and 3.Street family .

According to the UNICEF, “Children from street families are children who live on the street with their
families.”

“Street working children are children who spent most of their time working in market of cities, but
return home on a regular basis”

“Street living children are children who may have lost the families through war or illness, or have been
abandoned because they have become too much of a burden, or else ran away from abusive,
dysfunctional, poverty-stricken families and now live along on the street.”

“They work, living and sleeping in the street, often lacking any contact with their families. These
children are at highest risk of murder, constant abuse and in humane treatment. They often resort to
pretty theft and prostitution for survival.” Reports UNICEF.

Substance abuse refers to the harmful or hazardous use of psycho active substances, including alcohol
and illicit drugs. Psycho active substance use can lead to dependence syndrome-a cluster of behavioral,
cognitive, physiological phenomena that develop after repeated substance use and that typically
include a strong desire to take the drug, difficulties in controlling it used, persisting in its use despite
harmful consequences, a higher priority given to drug use than to other activities and obligations,
increased tolerance, and sometimes a physical withdrawal state.

Policies which influence the levels and patterns of substance use and related harm can significantly
reduce the public health problems attributable to substance use, and interventions at the health care
system level can work towards the restoration of health in affected individuals. (WHO)

Substance abuse can simply be defined as a pattern of harmful use of any substance for mood-altering
purposes. Medline’s medical encyclopedia defines drug abuse as “The use of illicit drugs or the abuse
of prescription or other the counter drugs for proposes other than those for which they are indicated
or in a manner or in quantities other than directed.” But recent research has shown that even
marijuana may have more harmful physical, mental and psychomotor effects than 1 st believed and
national institute on drug abuse reports that marijuana users can become psychologically dependent,
and therefore addicted.

People abuse substances such as drugs, alcohol and tobacco for varied and complicated reasons, but it
is clear that our society pays a significant cost. The toll for this abuse can be seen in our hospital and
emergency departments through direct damage to health by substance abuse and its link to physical
trauma. Jails and prisons tally daily the strong connection between crime and drug dependence and
abuse. Although use of some drugs such as cocaine as declined, use of other drugs such as heroin and
(Club drugs) has increase. (Dhital Rupa, 1999)

Studies have fond that between 25% and 90% of street children use psycho active substances of some
kinds. The word substance describes any psychoactive materials which when consumed affects the way
people feel, think, see, teste, smell, hear or behave. A psychoactive substance can be a medicine or an
industrial product such as glue. Some substances are legal such as approved medicine, alcohol and
cigarettes and others are illegal, such as heroin and cannabis. Each country has its own lays about
substances. The % of substance user among street children varies greatly depending on the region,
gender and age.

Psychoactive Substances street children may use

The types of psychoactive substance street children use can be many and varied and it may be difficult
to determine what substances they are using. Substances which are sold on the market can be
identified by their generic name. This is the standard name used throughout the world. However some
substances are marketed on under various names known as trade name and others have street name.
For example Diazepam is the generic name while valium is a trade name. Diacetylmorphine is a generic
name for Heroin and brown sugger or smack is some of the names it is called by the street. It is
important for the street educator to know the general categories of substances and the effects that
substances can have on a street child. The following example of substances in the general categories
may not be the ones use in your country, they are merely illustrative. (WHO-1997)

ALCOHOL

Alcohol is a depressant which inhibits or decreases some aspects of central nervous

system activities ( ie. Activity of the brain, spinal cord and some major nerves.)
Substance containing alcohol includes the following: wine, beer, spirits, home-brew,
some medicinal tonics and syrups (E.g. Cough syrups), Some toiletries and industrial
products.

NICOTINE
Nicotine is a stimulant; that is any substance which activates, enhances or increases central nervous
system activity. Nicotine is found in the following substances: cigarettes, cigars, pipe tobacco, and
chewed tobacco, snuff, nicotine gum, spray, skin patches. Most cigarettes have about 1-2 milligrams of
nicotine.

Hallucinogens
Hallucinogenic substances alter a person’s mood; the way the person perceives his other surroundings
and the way the person experiences he/her own body. There are much type of hallucinogens’ some of
which are chemically produce and the other which are naturally occurring. LSD (Lysergic acid
diethylamide) : In its pure state LSD is a white, odorless powder. It is usually mixed with a lot of other
ingredients. It is often put in to the capsules, liquids, tablets and as small spots on absorbent paper.
Mescaline: made from the pulp of the peyote cactus. Psilocybin mushrooms: Psilocybin is the
hallucinogen found in some mushrooms. It is usually made available as dried mushrooms. PCP
(Phencyclidine): this substance was use as an animal tranquilizer.

HYPNOSEDATIVES
The drugs in this group are made synthetically and do not occur naturally. There are a large number of
different drugs in these groups. All are slightly different, but all subdue the body’s nervous system.
Benzodiazepines: e.g. Alprazolam (XANAX), Diazepam (Valium), flunitrazipam (Rohypnol), Oxazepam
(Sere ax), Temazepam ( Normison), Barbituratus: Pentobarbital. Other sedatives, such as chloral hydate
and methaqualone (Mandrax).

CANNABIS
Cannabis plant grows in many parts of the world. Preparations containing different concentrations of
cannabis are consumed. Marijuana: the leaves and flowers of the marijuana or hem plant. HASHIS (oil
and resin): These forms of cannabis are made from the resin of the flowering heads of the plant, Tablet
containing THC (Tetrahydrocannabinol, the main active ingredient in cannabis).

STIMULANTS
This group of substance activates, enhance or increase centre nerves system activity. Caffeine: Caffeine
has been around thousands of years. It is found in different amounts in coffee, tea, cocoa and
chocolate. It is also in some soft drinks and in some medicines cocaprodructs: Coca leaves, coca paste.
Cocaine: cocaine is produce from coca leaves. AMPHETAMINES: AMPHETAMINES are fund in
prescription drugs an included in some diet pills, as well as in various forms on the street. On the street
in the Philippines they are called SHABU, A Japanese word for fast or quick, an in Australia speed or
goey. MDMA (Ecstasy): this substance is a type of amphetamine which has both stimulant and
hallucinogenic effects. It can be in the form of a tablets, capsule or oil which is usually mixed with other
substances. KHAT: The leaves and buds of a plant found in est Africa which are chewed or brewed as a
drink.

Inhalants include a wide range of easily available products including acrosols, volatile
solvents and gases. The following substances can all be inhaled: Acrosol sprays, butane
gass, petrol, and glue, paint thinners, solvents, amyl nitrate (poppers).

OTHER PSYCHOACTIVE SUBSTANCES

Some substances do not neatly belong in any of the categories above. KAVA: A drink made from the
roots of a shrub, which is used in the South Pacific for social and ceremonial purposes. BETELNUT: This
substance is the seed of an Asian Palm tree.

2.2 Substance Use Among The street children in Nepal

The term street children refer to the children who from the street more than their family have become
their real home. It includes children who might not necessarily be homeless or without families, but
who live in situations where there is no protection, supervision, or direction from responsible adults.
Human Rights watch dogs are often used to replace something missing in the children’s lives or to
“solve” problems, albeit temporarily. They often take drug to make up for an emptiness, a lacking
which rose in the form of suffering. These drugs allow the children to feel better; the relieve from their
everyday life, which hammers home its heavy truths and force them to put up with the present. When
they end up on the street, the children feel obliged to take drugs. (Child Protection Centers and
services 2012)

According to the Article 33 of United Nation Convention on the Right of the child (UNCRC), “ Children
most be protected from the illicit use of drug and prevent the use of children in their production and
trafficking. “ Each street child’s drug using experience is different though many start from a cigarette
then marijuana, alcohol, glues sniffing , tablets, and injecting drugs. By this naïve use of drugs, they are
facing different problems like HIV AIDS, Hepatitis B or C and sexually transmitted infection etc. The
different type of drugs taken very hugely. Most common are glue, alcohol,and marijuana ( Mainly in
the form of HASHIS0). Some of them even take one or more of these: VAT, FOCXO, NARFIN, DYJIPAM,
OPIDOL, BROWN SUGAR, CHARESH, NAITROSON, WHITE, CRONAJ and others with vat topping the list.
Some of statistics of substance use among street children:

Smoking 83% , Sniffing glue76%, Consuming alcohol And smoking Ganja 45% and other kinds of drugs
43 % , Intra venous drugs user (IDU) -4% force to take drugs 31%. (TOW VL,ul H, ZAFAR ST, Sherman
SG)
Drugs Risk Factors For Street Children
Personal Factors:

Psychological vulnerability and distress, emotional deprivation, low self-stem and little value attach to
one’s person or life social factors: Social Exclusion and stigmatization, peer group pressure family
factors: Proverty, Unstale, relationship of parents, domestic violence, broken relationship,
environmental factors: No proper parental figures or mentors, no pressure and control from parents,
free life the availability and accessibility to drugs, free circulation and used reasons why children take
drugs:

To resist and relieve the pain, cold and hunger. To reduce stress, anxiety and fear. To increase physical
strength, courage and stamina to escape from their existing problems. To adapt peer group practices.
To have fun and relax with friends. To experiment with new sensation. Exploitation from senior to
junior street children for transference and dependence of drugs.

Street children’s Vulnerability to HIV due to Substance use:

Of the 251 street children and youth aged (11-24), 19 Of them were positive for HIV, yielding and
overall prevalence of HIV infection of 7.6% in this sample. This is over 19 times higher than the
estimated HIV prevalence of the general population of Nepal at 0.39% this sample of street children
and youth of Kathmandu has a nearly 20- fold higher prevalence of HIV infection than the general
population of the Nepal (0.39%). There are approximately 71,250 people living with the HIV AIDS in
Nepal and estimated national HIV prevalence rate is 0.39%. The risk of HIV infection among children
and adolescents, especially those living on the street, may be especially high due to their marginalize
social and economic situations, as well as the existence of commercial sex and ex-change sex (for
food, shelter and other needs), Along with intravenous drug used and other high risk behaviors in this
population. True prevalence of HIV and other information on behavioral risks in this population is non-
existent. World Wide, IDU accounts for 30% of HIV infection. The street children are in number of high
rist behaviors, including intravenous drugs use, putting them at significant risk of contracting HIV and
other sexually transmitted infections. (Robbins CL, ZAPATA L, et al 2012)

Though The UN has estimated the population worldwide at 150 million, nobody knows there exact
number in Nepal- Street children are not easy to count they move around a lot, within an between
cities like Kathmandu, Patan and Bhaktapur. Kathmandu, The capital of Nepal, is among those cities
like Bombay, Manila, Rio de jenerio, Mexico city, Bangkoks, Nairobi, where the problems of street
children is very high due to rapid growth of urbanization and many other problems, such as economic
break down, Social distortion, Natural disasters and increasing family disintegration.

The life of Nepalese street children is so pathetic that with the little money they make by street based
jobs, such as rag picking, porting, flowers selling, newspapers selling, street vending and shoe shining,
they cannot afford one full meal a day, and most of the time they are hungry. It is hunger that its
forcing them into criminal activities, and the ultimate reward they get is mob beatings or a jail term.
Many ways

To survive, every street child has to work very hard and in many ways. They are threatened with
various forms of violence. Many such as children develop physical complication related to that
hazardous work and unhygienic living conditions. As a result, they become apathetic to social terms
and values. The horrible tale, sadly, doesn’t in here. According to CWIN, street children are often at
greatest risk of violence from those that are responsible to protect them- -the police and other
authorities.” Police often beat, harass, sexually assault and even torture street children. They may beat
children for their money or demand payment for protection to avoid fouls charges, for realize from
custody. They may seek out girls to demand sex. For many street children, assaults and thief by the
police are a routine part of their lives. Some are even killed by the police. Very rarely are those
responsible brought to justice,” Repots CWIN.

2.3 Effects of Substance use of the street children

Any substance can be harmful to a human body if taken in large enough doses, to frequently or in an
impure form. The health effects of substances can occur immediately or in the long term. The effects
are influenced by dose, the method of administration as well as whether the substance is use with
another drug. The long term effect often takes a long time to appear and is usually due to damage
body organs. We aware that some signs attributed to substance sue may be due to another conditions,
e.g. poor contiontraytion can be a sign of glue sniffing,, but it could also be cause by stress or a worry
about a life even, about pregnancy, or as a result of head injury. Effect of individual substances are
presented below: (Orlandia M A.Ed 1992)

Alcohol
The effect an alcohol will vary from person to person. Children, young and people are usually more
effected by alcohol than adult men because they tend to have lower body weight, smaller livers and
higher profession fat to muscle. This leads to fatter absorption of alcohol in the body

Immediate Effects:

This includes drowsiness, uninhabited action (A person is more likely to do things that normally
he/she would stop himself/herself from doing ), loss of physical coordination, unclear vision ,slurred
speech, making poor decision or impairment of memory. Excessive drinking over a short period of time
cause headache, nausea, vomiting, coma and death.

Long term effects:

 Drinking large amount of alcohol regularly over a long period of time can cause loss of appetite,
vitamin deficiency, skin problems, and depression, lose of sexual drive, liver damage, heart ailments,
nerve and brain damage or lose of memory.

Associated Health Risk:

This occurs when alcohol is taken with ether substance or drugs. Taking alcohol with drug that
depresses the bodies system, such a hypnosedatives or cannabis, can increase lose of judgment and
lose of physical coordination. Combination with hyn osedatives can lead to coma, respiratory
depression (person stop breathing) and death.

Nicotine:
Nicotine, the active substance found in tobacco is addictive in nature. Once a street child starts using
tobacco, they are likely to continue using it for a long time.

Immediate effects:
A person feels a lot immediately after using tobacco, and then feels more relaxed a few minute after.
There is also an increase I pulse rate, a temporary raise in blood pressure, dizziness, nausea and reduce
appetite.

Long Term Effects:

These affects may be due to the nicotine or the form in which it is taken. Heart and lung disease,
blockage of arteries (peripheral vascular diseases) , high blood pressure, breathing difficulties, cancer
of the lungs(with cigarettes smoking) and cancer of the mouth ( with pipe smoking and tobacco
chewing) may occurs.

Hallucinogens:
The substance can alter the person’s mood, the way the person perceive s his or her surrounding an
experience his or her own body. A user may also hallucinate (perceive that does not exist).

Immediate effects: the immediate effects are those of change in perception and in the awareness of
the things happening inside and outside one’s body. Things may look, smell, sound, test, or feel
different easy e:g seeing color, light, picture .”Bad trips “may also occur. The terms refers to
unpleasant and disturbing the feeling e:g panic, anxiety, confusion and alteration in the sense of
reality. The nature of the experience is partly determined by the sitting in which the hallucinogen
retaken. Unintentional injurious and suicide may happen under influence of hallucinogens.
Long terms effects:
In Long term effects may user report getting them experiences first obtained under influence of
substance, days or even months after they have stopped taking them substance. The substances are
called (flash back). Regular use of hallucinogens can decrease a user’s memory and concentration and
can resulting depression and other mental health problems.PCP each particularly likely to cause lasting
mental health problems.

Cannabis:
Cannabis may make a user euphoric at first, and then relaxed and calm. Large doses can change
perception in ways similar to that seen with hallucinogens.

Immediate Effects:
Feelings of well beings, relaxation, lost of inhibition, lost of motor coordination and lots of
concentration. There may be increased pulse and heart rate, redness of eyes, and increased appetite.
Large quantities can cause panic, hallucinations, restlessness and confusion.

Long term effects: there is no evidence that using cannabis occasionally in small quantities causes any
significant long lasting health problems. Regular use over a long time increase chances of dependency,
impairment of memory and concentration and may worsen mental problems such as schizophrenia.

Hypnos dative:
Those substances are depressants. They make the nervous system less active. Health workers often
prescribe them for treating sleep difficulty and anxiety because of their calming properties. There are
large numbers of different drugs in these groups.

Immediate Effects: All substance in this groups cause effect similar to alcohol. They slow down a
person’s thinking and movements and decrease the ability to concentrate. They cause ‘hang over’s’, or
problems such as slurred speech, sleepiness and lack of coordination after the intoxication has worn
off. Low doses reduce feeling of anxiety while higher doses cause sleep or unconsciousness. Alcohol
increases their effect. Reaped does cause other associate health risk because the substance is not
broken down (Metabolized) quickly. Unintentional injuries and suicide can occur.

Long term Effect: Regular use of these substances can lead to dependence, and continued heavy use
can result in problems with memory, ability to learn, and problems with coordination. Convulsions and
delirium (An acute confessional state) can occur the substance is withdrawn.
Stimulants:
Stimulants enhance or increase center nervous system activity. They are popular because they make
people feel energetic, self-confident and they decrease the feeling of hunger. They are often using to
reduce weight and help people stay awake for work. If too much of the stimulant is taken, the person
may become anxious, irritable, suspicious, panicky, and or threatening to others.

Immediate Effects:
Caffeine is in coffee and teas spirits quickly through the body and makes a person feel awake. To much
of caffeine can cause an increase in heart beat, anxiety and upset stomach. The effects of cocaine
amphetamines are similar except that the effects of cocaine last for less time. These are excitement,
decreased need foe sleep and food. High doses can cause anxiety, panic, high blood pressure,
convulsions and aggressions. With crack (Cocaine which is smoke) a person usually experiences brief
intense feelings of intoxication and an exaggerated feeling of confidence. The mood than quickly
changes to a low feeling and may prompt the person to repeat the dose. Over dose is commoner with
crack than with other forms of cocaine.

Long term Effects: Coffee and tea make cause anxiety, depression, stomach offset and difficulty in
sleeping. Long term use of amphetamine and cocaine cause depenances, inability to sleep, irritability
and mental heath problems such as feelings of suspiciousness and hallucinations. Similarly, heavy use
of KHAT can result independence and physical and mental problems.

Inhalants:
Like alcohol, they make a person uninhibited at first and drowsy later.

Immediate effects:
Immediate effects are feeling of happiness, relaxations, sleepless, poor muscles coordination, slurred
speech, irritability and anxiety. Hallucinations and fits can occur with heavy use. The most immediate
danger to the user is of “sudden sniffing death”. Death could also occur as a result suffocations.

Long term long effect:

Regular long-term use may lead to nose bleeds, rashes around the mouth and nose, lost of appetite
and lack of motivation. Some of the solvents are toxic to the liver, kidney, heart and brain.

Other Psychoactive substances:

Some substances do not belong in any of the above mentioned categories. Examples are:

Kava: It is use in the south Pacific for social and ceremony purposes. It causes mild sedation and feeling
of well being. Heavy use can cause dependence and medical problems

Betel Not:
It often chewed in parts of Asia and the Pacific. Regular use can cause dependence and diseases of the
mouth, including cancer.

2.4 Other substances that street children use:

It has been noted through the WHO project on substance sue among street children that street
children claim that inhaling through a weight carbon paper, inhaling vapor produce by a fixer of fiber
matting and boiling to pest, inhaling fumes from borning insects, and inhalation of sewerage can
produce desire effects (WHO-1973)

2.5 Method of using substances

Substance can be use in many different ways. They may be:

 Chewed, swallowed or dissolved slow in the mouth.

 Placed mucous membrane (Such as inside the anus or vegina, or noose,or under the eyelid).
 Rubbed in to the skin.
 Injected under the skin or vain or muscle with a needle.
 Smoke or inhaled though the mouth or nose, or inhaled by playing a bag over the head known
as bagging.

The way the substance is taken also influences how fast the substances reach the brain or
other organs. Injecting a substance is especially dangers because of the risks of infection that
are carried through the blood (Blood borne). In particular, sharing needle or other injecting
equipment and the way the substance is prepared spread HIV (The virus causes AIDS),
Hepatitis B and C, and other injection because of contamination infected blood.
2.6 Consequences of Substances abuse for the individual street children
Substance abuse on street children can have different consequence. Some of the
consequences are insignificant and some are extremely serious. Substance abuse has effects
on the body of the user as well as consequences on the life of the user and the whole
community.
Physical effects:
  Accidents
 Infection include HIV (Especially injecting drug use)
 Malnutrition
 Damage to body parts e.g. liver, lungs, nerves, etc.
 Cancer
 Death
Psychological Effects:
 Restriction of interest and life style.
 Depression
 Delirium (Confusion and hallucinations)
 Psychosis (Fixed false ideas, hallucination, grossly abnormal behaviors)

Social effects:

 Rejection by peer’s , family employers

 Exploitation and violence (including murder) by drugs indicate
 Inability of work and loss of income
 Legal problem due to: Behavior under the influence of substances and crimes
committed to obtain substances.
 3

CHAPTER

3.1 Operation Definition

The main propose of this study is not to identify the driving forces, which bring children into the street
and their social cultural and economic background, and preset problem and after entering into street
they involve in substance abuse which has adverse effects on their life. To achieve the aim of this
study, study site, research design, nature and sources of data, data collection procedure, sampling
procedure, analytical tools and presentation and interpretation techniques were applied and
presented here one by one as methodology of this research.

3.2 Justification of the study area

The study was carried out at 3 Kathmandu valley areas such as Boudha, Basantapur, and Lagankhel Bu-
spark. Boudha area was chosen being local of the researcher; Lagankhelbus park has chosen because of
availability of maximum numbers of respondents and Basantapur was chosen as one of the crowded Of
street children. The study is focused in the main tourist junkyards and bus park area of Kathmandu
valley where street children are roaming, begging, annoying walkers and vendors in the street.

10 respondents from Boudha, 5 respondents from Basantapur and 10 respondents from Lagankhel bus
park.

3.3 Research Design

The study will be taken by using descriptive research design. Descriptive research design is useful to
describe any existing knowledge, factor process in more detail an in death. In this method more
numbers of questions are asked to find out the details of the studied topic.

The study will follow descriptive research design as it attempts to clarify the impacts of substance
abuse among the street children in more detail. The study will also try to figure out the effect of
substance use in individual street child on his/her health, social and psychology sectors.

Moreover, the study will be taken through questionnaire, observation and interview method to find
out the more details about the study topic.

The samples for the study will be chosen through the convenience sampling design of snom-ball
sampling . Inconvenience sampling design, the researcher found othe rresdondents through help of
previous respondents.
Also the researcher use research base design “Nature of investigation i.e. non experiental design,
because the researcher 1st analyzed the effects of substance use and then cause of using substance.

3.4 Nature Source of Data

To fulfill the above mentioned objective of this study goes qualitative and quantitative data have been
collected and analyzed. Primary data i.e. 1st and qualitative as well as quantitative data obtain from the
field work-using questionnaire for interview. The secondary data were collected to get the authentic
and reliable information about economic, social as well as influencing factor to street to have the
habits of substance use.

3.5 Universe and Sample

For this study, the universe was Kathmandu valley where as the sample areas were Boudha,
Basantapur and Lagankhel Bus Park. Purposive sampling method was followed because samples to be
taken were already pre-planned and was taken for a purpose. The researcher talked with 30 street
children whereas 25 were boys and 5 were girls.

3.6 Data Collection Techniques

In this study both primary data and secondary data will be used

Primary Data:

Primary data are those 1st hand data collected be the investigator or the researcher himself/herself.
Primary data will be collected through questionnaire, interview and observation method. The
researcher will make the respondents to fill of the questionnaires, conduct an interview and observe
the expressions and gestures in order to find out the primary data.

Secondary Data:

Secondary Data are those which are collected from the other sources like related books, magazine,
internet, newspaper and etc. Therefore, the researcher will use books, magazins, internet and
newspapers in order to find out the secondary data.

3.7 Data Analysis Techniques:

It is done with the help of pie-charts, tables and statics. With the analysis of data in tables and pie-
charts, short description is also given so that it will be easy to understand. Sources and the topic of
table and pie-charts are also given along with table and pie-chart.

3.8 Limitation of the Study:

Because of the limited resources, manpower and time frame, the study will have limitations in area,
budget and time.

Area: The study will have limitation in area. Because of time limits the study will be taken in Boudha,
Basantapur and Lagankhel area only.

Respondents: The respondents will be limited up to 25 in the study.

Age: The respondents will be age between 7-18 Years.

Chapter
 PRESENTATION AND DATA ANALYSIS
4.1 Basic information of the respondents:

This chapter has analysis of data collected from primary source i.e. questionnaire. The basic
information of the respondents like gender, age and permanent address has been analyzed below.

4.1.1 Gender Composition

The gender composition of 25 street children is summarized in the following table and graph given
below:

Figure: 1 Gender Composition

20%

80%
Girls Boys

(Source: Field survey, 2015)

The figure one shows that out of 25 respondent 20 (80%) were male street children whereas few
number where female street children i.e. 5 (20%). Majority numbers were male and only few per cent
of females were seen in street of Kathmandu who is enjoying street life. The researcher found that
there were total 20 males and 5 females’ street children who participated in responding their kid of
using substance, its effects and perception on getting rid out of these substance addictions.

4.1.2 Age Composition

Figure: 2 Age composition

Age Compositin
12

10

0
7-10 Years 11-14 years 15-18 Years

Source: Field Survey, 2015

The researcher found that respondents were age of between 7-10 years, 11-14 years and 15-18 years.

Out of 25 respondents, more respondents were 11-14 years and 15-18 years age i.e. 10 respectively
and while fewer respondents were age of 7-10 years age street children i.e. 5. According to CBS-Nepal,
the people below the age of 15 considered as children. Statics so that people of this age group
significant part of national population. However, due to various cause children in this age are
compelled to lead their home and begin to face street life within Kathmandu valley.

4.1.3 Place of Origin

Figure: 3
Original Place of the respondents

Districts of Origin Number of Respondents Percentage (%)

Chitwan 4 16
Dhading 4 16
Kathmandu 1 4
Kaski 2 8
Kavrepalanchok 2 8
Makwanpur 3 12
Nuwakot 4 16
Ramechhap 3 12
2 8
Total 25 100%

Sources: Field survey 2015

The table shows that most of the street children are from adjoining district of Kathnabdu valley, where
the direct transportation is available. The table shows the place of origin of the children from different
part. That means the street children are mainly from less develop and squatter settlement and coming
with the expectation of better life.

The street children number from Nuwakot, Dhading and Chitwon that is 4 (16%), second lead district
like Makwanpur ans Ramechhap has consist of 3 that is (12%) each respectively. Other districts such as
Kavrepalanchok, Sindhupalchok and Kaski also consist of 2 (8%) respondent each respectively. The
table also shows that 1 (4%) respondent each from even Kathmandu also.

4.2 Reasons that involved respondents in substance abuse

Figure: 4 what reasons to get involve in substance abuse?
 Reasons
30

25

20

15

10

0
ur
e ce er ar rs ts
ss ien ng fe he en
e r u nd ot on
d
rp
r pe ll h sa m sp
e ex ulfi es fro e
Pe w f str g of
r
ne To e in
d sc py rs
an du Co be
un r e m
rf To l nu
Fo ta
To

(Source field survey 2015)

The above figure shows that why street children are involving in substances abuse. Out of 25 street
children, it was found that 8 respondents were involving in substances abuse due to peer pressure, 6
respondents maintained that to fulfill their hunger they were involving in substance abuse, some
respondents were involving in substance abuse because of curiosity i.e. for fun and new experiment
and to reduce stress and fear. Few i.e. 3 respondents were involving in substance abuse in the name of
copying from senior street boys.

4.3 Types of Substances used by respondents

Figure: 5 Different types of substance used

Types of substance use

Smoking Tabbaco
24% 8%

Glu-sniffning
40%

Alcohol
16%
Marijuana
12%

(Sources: Field Survey 2015)

The figure shows that out of total 25 respondents, most of the respondents were using glue sniffing
and others were using smoking, alcohol, tobacco and marijuana as other major different substance use
by respondents respectively. Hence, these data shows that 10 (40%) of the respondents use glue
sniffing, secondly followed by smoking i.e. 6 (24%), than some respondents were using alcohol as
substance i.e. 4(16%) and some respondents were using marijuana as well as tobacco (betel nuts) 3
(12%) and 2 (8%) respectively.

4.4: Impacts of substance abuse on respondents

Figure: 6 Impacts of substance abuse
 Impacts
12

10

0
Physical provlem Mental problem Social problem Peer problem

(Source: Field survey 2015)

The above figure shows that the impacts of substance abuse in respondent’s life. Out of 25
respondents, after substance abuse 10 respondents maintained in their questionnaire that they were
having physical problem like; several headaches, problem while breathing and suffer from various
health problems. Similarly, 6 respondents were facing mental problem due to substance abuse like;
feeling lonely, depression, imagine death and even some time madness seen on them. 5 respondents
were having peer problem because of substance abuse such as; fight and quarrel with each other for
substance use. Some respondents maintained that after knowing that they are substance abuser than
they face social problems i.e. no acceptance in family and society.

4.5 Perceptions of respondents on getting ride out of addiction

Figure: 7 Perceptions of respondents

Perception
Not respondent
12%
Skill oriented jobs trsining for street children by Nepal government
20%

Care,support and acceptance from family and society

33%
NGOs and INGOs must care street children in shelter home
24%

Street children friendly constitution

10%

(Source: Field survey 2015)

The above figure shows that the perception of street children on getting rid out of substance abuse.
Out of 25 total respondents, 8(32%) respondents answered that if there is available of the proper care,
support and acceptance from family and society than they would be out of substance and struggling
street life. Some respondents i.e. 6 (24%) feel the questionnaire with the answer of if some NGOs and
INGOs freely care street children in their shelter home than they would be out of substance abuse
where as 5 (20%) respondents were expecting to have a scheme of skill oriented training or jobs from
GN (Government Of Nepal). Some respondents were giving pressure to GN to make a street children
friendly constitution where as 3 respondents didn’t give answer on this topic.

CHAPATER
 Summary, Recommendation and conclusion
5.1 Summary

Among street children living in shelters on the streets, substance abuse is even more wide spread than
was thought- Sometimes with tragic consequences. In a study of 24 street children in Boudha,
Basantapur and lagankhel, 40% had glue sniffing, 16% had alcohol and 24% had habit of smoking at the
time of the survey. For almost every substance used surveyed, youths living on the street had
markedly higher rates of substance abuse than either youths in shelters or a comparison groups of
youths living at home. Street youths were involved in more serious drug use than were youths living in
shelters or at home. For instance, substantially more street youths than shelter youth used heroin and
other injection drugs, methamphetamines and crack cocaine.

For both street and shelter youth and for almost every substance abuse surveyed, substance abuse
rates were higher among older than younger youths and among males than females. At the time of
survey, some 12% of street youth were using marijuana; around 1/3 were using hallucinogens,
stimulants, and analgesics; and 25% were using crack, other forms of cocaine, inhalants and sedatives.
At the time of the survey, 16% abused alcohol only.

Age was not significantly associated with substance abuse, for gender was, girls were far less likely to
take substance than boys. The longer young people remained homeless, the more likely they were to
have a substance abuse disorder.

Street children are pervasive problems in today’s Nepal, and the problem cannot be solved in isolation.
Schemes alone are not adequate.

Last, but not least, policymakers seeking to ends the street children syndrome in Nepal must address
the poverty i.e. most often the cause of the problem. Overcoming it required in-depth understanding
of the factors that force children in to streets, as well as effective interventions suited to each unique
socio-cultural and economic environment.

The problems of street children in Nepal is complex; So the policymakers most employee multiple
interventions that are integrated with one another. They should implement sustainable alternatives to
keep children from returning to the hazardous and exploitive situations on the cold streets.

An additional vital component of eradicating the problem is the insertion of community awareness
activities in project designs. For e.g. a public awareness campaign to educate parents, community
leaders, local organizations, teachers and civil society about the multifarious hazards associated with
street children and its long-term effects on future society would be beneficial.

Let us not forget that the fight against street children is to expand the frontiers of human dignity and
independence in the long run.
5.2 Recommendations
There is a dire need to develop some strategic to prevent from suffering, from drug abuse and often
untimely deaths.

1. Government should take immediate actions for there rehabilitation by establishing supports
systems.
2. Drop-In-center with all health facilities should be available for them.
3. Educational and vocational amenities should be provided to them.
4. Civil society and the families of these children should be involved in the remedial processes for
the children.
5. If anyone sales drugs to children they should be reported

5.3 Conclusion:
Within the limits generalizability, this study provides a glimpse of substance abuse problem among
street children. These all vary wildly depending on age, history of substance abuse among peers, family
pathology and currents living circumstances. Most of the studies on Adolescent Street boys were
conducted either in observation home via surveys; this is parts of our practical paper. This research
was done at evening time when these adolescent street boys from around city in large numbers.
During these periods they are relaxed and provide confidential information in privacy. Service
providers need to take these differences in two accounts when planning intervention. Especial efforts
are needed to connect these boys with night shelter, night schools, treatment services and other types
of help, such as life skills and jobs trainings. Some of they may need a pre-treatment stage, where
immediate crises are address through sheltering services and short term detoxication. However, the
study also suggests that those who need treatment most may be the hardest to reach, given their
more chronic pattern of homelessness. The study highlights the need for more aggressive outreach
strategies to make comprehensive health care treatment services more accessible to street children.
Without substantial intervention, this most elusive population will remain at extreme risk for substance
abuse and its adverse consequences.

REFERENCES
CWIN, 1998. State of the Right of the child (Kathmandu: CWIN).

CWS, 1996. Situation analysis of street children in Nepal (Kathmandu Child welfare Society)
Pradhan, Gauri ( May to Sep 1993). KHATE- the street survivor; Problem and prospect in Voice of Child
workers ( Kathmandu: CWIN)

Pierre veils-Gean, 1995. Blossoms in the dust street children in Africal.

WHO (1973). Youth and drugs. Geneva, WTO (Report of a WHO report series, no.516)

WHO (1997). Cannabis: A health perspective and research agenda Geneva, Substance abuse

Department, WHO , 1998, WHO/NSA/PSA/97.4

Orlandia M A.ed (1992). Cultural competence for evaluators: A guide for alcohol and other drugs abuse
prevention practitioners working with ethnic/racial communities, Washington, US

Department of health and human services, public health services, alcohol, drugs, abuse and mental
health administration (OASF) cultural competence series 1).

WHO (Retrieved on: 17th August 2015 from : http;www.who.int/topics/substance abuse/en/)

(Updeted july 21, 2015 from:http;//alcoholism.about.com/cs/drugs/a/aa030425a.htm)

Dhital,Rupa, 1999.“ Alcohola and children in Nepal”, Bal sarokar,Issue no. 35 (Kathmandu:CWIN)

A book on “ The street children of Nepal- anthrop sociological study of social, cultural and
communicational practices” (Child protections center and services, 2012)

Towe VL, ul H, Zafar ST, Sherman SG: Street life and drug risk behaviors associated with ex changing sex
among male street children in Lahore, Pakistan.J Adolescent health 2009, 44:222-228.

Robbins CL, Zapata L, et al.: multicity HIV sero-prevalence in street youth, Ukraine. Int. JSTD ADIS 2010,
21:489-496. ( Source 4 and 5 taken from the report on “ A study of the prevalence and risk factors
laeding to HIV infection among a sample of street children and youth of Kathmandu, 2012” )

Police head quarter, 1998. Statics of street children in Kathmandu.

Questionnaire

Basic information

Name:
Age:

Sex:

Father’s name:

Mother’s name:

Nationality:

Address:

Question: 1

How many members are there in your family?

………………………………………………………………………………………………………………………………………

Question: 2

What is the occupation of your family members?

………………………………………………………………………………………………………………………………………

Question: 3

Are you continuing your education?

……………………………………………………………………………………………………………………………………

Question: 4

What is the annual income of your family?

……………………………………………………………………………………………………………………………………

Question: 5

What is the educational level of your family member?

a. Below 8 b. SEE c. +2 level d. above +2

e. Illiterate
Question: 6

Where do you stay most of the time?

a. Home b. Street c. Others

Question: 7

If stay at street, how long have you been staying at the street?

……………………………………………………………………………………………………………………………

Question: 8

Why are you staying at the street?

a. Family problem b. Ignorance c. Expectation of better life

d. Influence of peers
e. Other reason

Question: 9

Have you faced any kind of problem in street?

a. Yes b. No
If yes, what kind of problems?
………………………………………………………………………………………………………………………..

Question: 10

From whom you face the problems most?

a. Police
b. General people
c. Businessman
 d. Others

Question: 11

Do you face problem to eat food?

Yes No

Question: 12

How many meals do you eat per day

a. One time
b. Two times
c. Three times
d. More than three times

Question: 13

Are you taking any types substance?

Yes No

If Yes, what kind of?

……………………………………………………………………………………………………………………………………………………

Question: 14

Are you been addict on substance that you use?

Yes No

Question: 15

How did you get involve in substance abuse? Elaborate.

………………………………………………………………………………………………………………………………………………..

Question: 16

Where did you get substance from?

……………………………………………………………………………………………………………………………………………………

Question: 17
Do you have to pay for the substance?

Yes No

If yes, how do you pay for it?

…………………………………………………………………………………………………………………………………………………….

Question: 18

What kinds of problems do you face from the substances?

……………………………………………………………………………………………………………………………………………………

Question: 19

How much money do you spend to buy substances per day?

…………………………………………………………………………………………………………………………………………………..

Question: 20

Is it because of substances abuse, you left your home and education?

…………………………………………………………………………………………………………………………………………………

Question: 21

Do you want to get ride out of addiction?

Yes No

If yes, what is you view on how can you get ride from this addiction?

…………………………………………………………………………………………………………………………………………….