Street Children and Medical issues.

CAS, in conjunction with the Salvation Army Church, Ghana, runs a clinic at the Refuge. All street children who are registered by CAS can have a free consultation by the nurse. CAS in partnership with Salvation Army have agreements with hospitals and institutions which means that a child with a severe health problem can be referred to any of their centers for treatment. Children who are sick but cannot afford the treatment receive help from CAS. CAS pays all hospital expenses for the children. An average of 60 children visit the clinic every month. Many children practice self-medication or delay in seeking medical advice, which can be very dangerous. The nurse at the clinic also educates the children on health related issues.


CAS has written special lessons on health issues which can be used in the streets by street workers, in the Refuge and Hopeland by social workers and also use in workshops where children receive skill training.

In addition, children are counseled regularly on health and other non-health topics such as:

1.Self-esteem 2. Planning for the future. 3. anger management. 4. money management. 5. Courtesy for boys and girls. 6. taking responsibility for actions. 7. Health issues on hygiene and emotions, Bilharzias, Birth control methods, intensive breast feeding and weaning.

After the hygiene lessons the children receive a piece of soap, a tooth brush and paste and are encouraged to wash their clothing.


The health statistics of CAS show many sicknesses and other problems. Fortunately it does not include HIV-AIDS. These statistics are from children who visit the House of Refuge at Lartebiokorshie and Hopeland. These are:

Hernia, attempted abortions, eye and tooth problems, pregnancy cases, malaria, bilharzias, skin rashes, cuts and wounds, STD's, diarrhea, cholera, ringworms, chickenpox, boils, measles, chest and other pains.

CAS also receives children with hard drug problems and mental cases. At times children with certain disabilities also visit CAS but the staff are not trained to take care of such cases.


CAS has made various attempts to insure children in the National Health insurance Scheme. Unfortunately, it has not been a success mainly because the street population is a fluid population and the children are not stationary.


CAS is preparing to work in the social welfare districts of the Greater Accra Region. As such, CAS will defend the right of the children who are in the streets. These rights are:

•The right to visit hospitals or clinics.

•The right to good sanitation.

•The right to clean water.

•The right to good and affordable health

•The right to a balanced diet.

•The right to shelter.

•The right to a safe environment.


CAS is a member of ARHR- The alliance for reproductive health rights. The nurse or other members of staff attend the meetings.


Children are introduced in literacy classes. The aim is to teach them reading and writing and simple English. An adapted Montessori system is used. Children also have a library and computer centre available. They do sports and drama and entertain themselves on Fridays.

Of late, we noticed that girls are reluctant to take part in sports. We have to encourage them to take part but before that, we have to find out why they stopped.

In order to give them ideas of what they can learn we show trades to them on videos or Masters of particular trades are invited to give talks. A good method of introducing children to trades was the excursions. Unfortunately, we had to stop them because of lack of fund.

Volunteers: CAS allows volunteers to work hand in hand with the workers. Several agreements have been signed with volunteer organisations and with universities. Many volunteers as well as students from Ghanaian universities benefited from this opportunity.


Coloring and drawing takes place at the House of Refuge. It allows the children to be creative as they draw and color. this exercise is very interesting as it creates competition among the children. Children are allowed to draw anything of their choice and then they color it in. Allowing street children to participate in this way is extremely interesting and helps to add to their confidence.










During the period May 2004 to May 2006, CAS conducted a research on children who needed special attention.

The report of this research highlights the difficulties some children experience in paying attention and interest in the programs that CAS offers.

There are several children who experience problems because they lack certain abilities. Our program does not include these children. They could follow the SAP program. (Special Attention Program).

The functional literacy program we designed is for children who did not have the opportunity to learn, as "an average street child" and to pick certain understanding to help him/her function positively as they become more engaged in the wider environment.

Functional literacy indicators.

Children have difficulties to communicate with others and with members of staff. They are often withdrawn and have not many friends to relate with.

We have to teach them to do things together with others.

The teacher must indicate the problem of the child.

Communication between the child and the staff has to improve.

Better communication through counseling, working with children to gain self esteem.

Ability to discern. 
The child has to learn to differentiate and make choices.

Child should be able to make choices. 

Give back. 
The children have to learn to be more active.

Some have difficulties to stay on one task for a long time without response and are easily distracted. for e.g. To maintain own clothes. To maintain personal hygiene are difficult for them.


It is important that the child learn to be responsible about personal hygiene, maintain themselves. Need to help them out.


Adjustment to environment and relationship.  
The child has to accept the place where s(he) is learning and learn to be with other children and other people irrespective of status.


Teachers should help the child to adjust and adapt to the change.

On relationship, it should be continuous to help the child to have more trust in the teacher.


Excluding the extremes (drug addiction, prostitution, etc), the child has to show at least an acceptable behavior in his or her environment.

The issue of behavior was considered within the context of traits.

Members agreed that traits should be identified per child to help find alternatives in situation where a child finds it difficult to cope with the lessons.

Follow instructions.  

The child should be able to listen to instructions. Some show difficulties in following instructions (esp. when more than one instruction is given at the time)


  1. Instructions should be observed as demanded.
  2. Avoid loading the child with more orders or instructions to help monitor the progress of the instruction issued.
  3. Instruction should be explanatory to the child.


Interest in taking part,
The child should participate regularly and show interest to take part.

  1. Interest based on passion (positive or Negative)
  2. Interest based on purpose i.e. Participating based on needs.
  3. Not interested at all.

The child should be identified within the context of any one of the following above and assisted accordingly.

Can write and read simple texts.
Excluding children with learning difficulty, the child should be able to write his/her name and read simple text. 

The literacy classes take place in the House of Refuge, and at Hopeland.

During Literacy classes the children are taught the following;    Basic Mathematics which includes addition, subtraction and multiplication at the level one and in-depth at the level 2 and 3 respectively with the help of the teaching materials.

As part of learning  English, children at the level  one(1) are taught how to write their names before proceeding to the sounds and names of the alphabets whiles children at  the level two (2)  and three (3)  focus on forming of words with the alphabets, grammar , and  construction of short sentence etc.

In creating awareness of trade/careers, the children are introduced to and educated on other skills apart from the trades which are already familiar to the children.

The children are also taught the names of Africa animals, and items that can be found in their environment in English.

Lessons about money management and other group works are also organized for the children to encourage children to cooperate with each other.  

The aims are;

  1. To encourage the children to write and spell their own names wherever they finds themselves at any time.
  2. To help children gain confidence in themselves when speaking and writing the English language.
  3. To help children learn to do simple calculations by themselves.
  4. To assist and guide children to take the right decisions when they are ready to choose a trade rather than allowing their friends choice to influence their choice of trade which actually do not help them at the end.
  5. To demystify the thought or idea that certain trades belong to only males or only females. The teacher should help the child to understand that, everything is possible and achievable.

CAS assists the street children to be numerate and literate. They are taught at three different levels. These include; stack illiterates, Semi illiterates and JSS dropouts.

The lessons vary, attention is paid to Math, English, writing and reading. All children who show interest to be educated are sent to Hopeland training centre prior to sponsorship. At Hopeland the classes can be intensified because the children are accommodated and are stationary.

SUCCESS STORY                   AKUA

Akua was fifteen years when she hit the streets of Kaneshie in September 2010.  According to social survey reports compiled on her she is the third of six siblings born between her parents at Tarkwa Nsuaem in the Western Region of the Republic of Ghana. She had her basic education there but falls off the educational ladder in Basic four.  The report did mention that both parents were subsistence farmers and earned very meager income from the sale of their produce hence their inability to keep Akua and other siblings in school.  She was then assisting her parents on their farm.  The report further mentioned that the farm is about four kilometers from the town and had to work to and fro daily. Akua further said that, the distance coupled with the hazardous nature of the walk prompted her to travel to Accra to work and support herself.

Whiles in Accra, she transited to Kasoa a sprawling community in the central Region of Ghana but shares boundaries with the Greater Accra Region. Young Akua was working at the time as a “chop bar” assistance and occasionally doubles as an iced water seller.  Unfortunately, after barely two months of stay she moved to Kaneshie in Accra after a theft case was leveled against her by her mistress which according to her was an unsubstantiated allegation.

While in Kaneshie, she was selling sachet water to earn a living and using cold store popular place in Kaneshie where street children sleep.  Akua went further to say that there were times that she had to lean on the boys for support because she could not work.  The boys on the street took advantage and made series of love advances towards her.  She sometimes did not have any alternative than to succumb to their pressure thereby exposing her to a lot of health challenges.  It was during this period of her life that she met a follow-up worker on the street who introduced her to the project in 2011.  While with the project she endeared herself so much to all staff and instructors at the centre she put up a good behavior and participated in all the programmes at the centre.

She developed keen interest in cookery and pastries and went through an eighteen month training in the trade at the initial stages of her training, she was encountering a lot problems of adjusting well into his new environment (work) and also with her instructors.  Fortunately for her, her supervisors and other social workers played a key role in this and took her through counseling sessions and this went a long way to “fine tune” her to go through her programmes successfully.  On completion of her 18 months training on 2014 she had a three month attachment with a restaurant in Accra and whiles there she took NVTI Grade One proficiency test and passed.

She is currently being assisted by CAS Short Term department to look for a job and as a stop gap measure.  Akua is making meat pie and other pastries which she sells on a daily basis to support herself.

It is her hope that she will be able to raise money or get some support to buy items needed in her chosen field.


Catholic Action for Street Children first met Cynthia Dadzie when she was 14. She had come to the streets of Accra because her mother was ageing rapidly and was very ill. Her father had left her mother when Cynthia was 8 years old. Her mother had to care for Cynthia alone and had to work extremely hard to raise money for Cynthia’s schooling. Eventually, Cynthia’s mother became too ill to raise the money for her education. Cynthia felt that she was left with no choice, so she started to sell oranges to support herself and her ailing mother. She made enough to take care of herself, however she also had to extend the support to the younger siblings. This pressure forced her to do all sorts of other jobs on the streets to raise enough money.

Soon, Cynthia was spending more and more time on the streets, she started to make friends and would go home at night less and less often. When she recounts her story, she remembers the nights on the streets to be especially dangerous, and tells stories of fighting, arguing and abuse.


In September 2000, she met CAS street workers and visited the Refuge where she became a member of the centre. Cynthia soon became a regular attendant to the centre and its preparation classes, and she began to see other options for her life. She also introduced her friends to the centre, and they became regular attendees.

In 2002, CAS offered Cynthia the chance to enroll on a 3 year sewing and dress making apprenticeship in Accra. Now, Cynthia has graduated as a fully qualified dress maker and has returned to her mother’s home. She admitted once “my dream is to be able to go home one day and visit my mother, and see a look of pride and joy on her face at the sight of me”. This has certainly happened. She is now running her own workshop and is currently training three more ex street children to become dress makers. She is grateful for her new life. She says that she does not regret her time on the streets because of the many lessons she learnt there.


Ebenezer was among a few children who visited the refuge on his own as a result of interaction with CAS fieldworkers in February 2000. He was born in Ankaase in the Ashanti Region (about a 5 hour drive from Accra) of Ghana but lost his mother when he was four. His father left Ebenezer in the care of his grandfather, who disappeared shortly after this and could not be traced. Ebenezer's grandmother stood in and managed to support the small boy for a short time.

Ebenezer had the chance of starting school and managed to go up to the Junior Secondary School level but was unable to continue as his grandmother was ageing, weak and no longer able to support him. Life became very difficult in Ankaase and in August 1999, aged 15 he left for the streets of Accra. He had heard from his contemporaries that you could earn a living on the streets of Accra.

After living in the street for sometimes, he made friends with a group of shoe shine boys. He started coming to the CAS refuge regularly and was very respectful as he recognized the need he had to re-start his life and that CAS could help him to do so.

After a year with CAS, he was relocated to continue his preparation at Hopeland Farm. At the farm, he worked extremely hard and staff were impressed and recommended him for sponsorship. Unlike most of his peers, he spent less time at Hopeland because he was prepared and eager to start transforming his life.

In 2002, he was enrolled into the Aluminum fabrication works in Accra for three years. His seriousness and commitment to the training helped him do well and he did not need the full three years to complete his training. Three months after his graduation Ebenezer managed to establish his own private workshop at Pokuase in the Ga East district of Accra, and he took a lot of contracts in the city. He employed people to expand his business, including some ex street children who he had known at CAS. Within the space of one year, he married one of the CAS sponsored girls in a grand wedding in Accra.

A little after this, he was involved in a train accident, and the recovery affected his work and life for some time. However, although he is still weak, he is managing to work and has promised to recover fully. He is thankful to all his hopes to show kindness to his street peers when they need him.



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Gifty was born in Winneba (in Ghana's central region) and was bought up by her single mother who struggled daily to raise enough money to support her children. Gifty had the chance of starting school and completed JSS but was unable to continue as her mother simply could not afford to keep paying. Gifty became so depressed and distressed because she was missing out on her education and her mother simply could not help her. She started to work as an orange hawker in Accra and was introduced to CAS at the old refuge at Adedenkpo.

She was registered at the House of Refuge and was very keen with the program because she the benefits she stood to gain. Unlike most of her peers on the street, she was always careful in choosing her friends for fear of being abused. Every single day she visited the refuge, and unusually CAS did not send Gifty to Hopeland for a period of preparation. She was among the few girls who benefited from direct support because of her level of commitment. She helped CAS staff and was very disciplined and respectful, but she often looked withdrawn because she felt cheated by society. An erroneous impression which she always finds very hard to let go.

After two years of attending educational lessons at the refuge centre, Gifty was enrolled in the three year dress making sponsorship in the city. Gifty worked hard and struggled with her training, but at the end of the training she completed it with flying colors. Gifty graduated as a dress maker from Kaneshie Dressmakers Association. At the moment she is employed by CAS to handle the dressmaking activities in the demonstration department. She is currently in charge of the unit and is very happy working with children who are having the same street experiences that she had. She has been chosen as one of the CAS representatives for the partnership with the Right to Play project. She is engaged to be married.

Gifty is also grateful to CAS for her new life and is delighted that her dignity has been restored. She hopes to set up her own shop to train more street girls. She has not given up on her dream and we hope to see it happen.