Introduction

Child labour as defined by the International Labour Organization (ILO) refers to negative or undesirable forms of economic activity performed by children under the age of 15 years [₁]. Economic activity, in turn, as defined by the United Nations System of National Accounts is a broad concept that encompasses most productive activities by children, including unpaid and illegal work, work in the informal sector, and production of goods for own use. Not all children's work is equivalent to child labour. Forms of work that contribute to children's development and that help children to acquire skills and prepare to be productive members of society during their adult life are not considered child labour. After considerable debate, a consensus is gradually emerging that ‘child work' or ‘children's work' is seen as a general term covering the entire spectrum of work and related tasks performed by children, and ‘child labour' as a subset of children's work that is injurious to children and that should be targeted for elimination [₂]. There is also growing recognition that there are certain intolerable, or ‘unconditionally worst', forms of child labour that constitute especially serious violations of children's rights, and that should be targeted as a priority for immediate action [₂].

World-wide about 250 million children between the ages of 5 and 14 years work. Of these, 120 million work full-time and some 50-60 million work in hazardous circumstances, according to the International Labour Organization [₂]. Africa's 3.3 million refugees and its estimated 12.7 million internally displaced people are those most vulnerable to child labour [₃]. Cameroon is facing some of the worst human right issues with regards to child labour. According to ILO, there were about 602000 child labourers in Cameroon in 2000 [₄]. Of this number, 40% were females, 7% were less than 12 years and 60% dropped out of primary school [₅].

Little is documented about child labour in Cameroon and therefore many people are not aware of the ever increasing violations of children's rights. The aim of this study was to review existing literature about child labour in Cameroon in order to raise awareness and provide information for future interventions to combat child labour.

Method of literature review

Electronic search of the MEDLINE (1966 to March 2007) was conducted to identify published articles on child labour in Cameroon. The search used the search string, ‘(child labour OR child labor) AND (Cameroon)’, resulting in 14 hits. Relevant articles were identified by reading through the abstracts of the articles generated by the query string.

Additional reports (both published and unpublished) were obtained from child labour related conferences or meetings, consulting experts in the field and reports of important authorities like the United Nations Children's Fund (UNICEF), International Labour Organisation (ILO) and World Health Organisation (WHO).

Determinants of child labour in Cameroon

Household income: Children from poorer families are more likely to work and less likely to attend school than children from richer families. In Cameroon, 14.7% of children aged 5 to 14 years in the lowest income quintile carry out economic activity without any schooling compared to 1.5% of children from the highest income quintile [₂]. Similarly, 7.6% of children from the lowest income quintile work and go to school compared to 0.4% of children from the highest income quintile.

Parental educational attainment: The educational attainment of the parents may be a factor in determining whether a child will work, or go to school [₃]. In particular, there is a substantial literature claiming that the mother's education has a positive effect on the probability that a child will study, and generally on the share of family resources that is expended on children. There is also evidence, however, that the daughters of better educated women are more likely to stay at home to look after younger siblings, because their mothers are more likely to find outside employment.

Place of residence: Children who live in rural areas are more to drop out of school and carry out economic activity especially agriculture than children who live in urban areas. In Cameroon, 80% of children in urban areas are studying only compared to 67.6% in the rural areas [₂]. The rest of the children are either studying and working or only working.

HIV and AIDS: Since the discovery of Acquired Immune Deficiency Syndrome (AIDS) in 1981, it has claimed millions of lives. Cameroon is one of the hardest-hit countries with a prevalence of 5.5%. Overall, there are about 520 000 thousands people living with Human Immunodeficiency Virus (HIV) and 240 000 orphans [₆]. The orphans are very vulnerable to economic and sexual exploitation because they have no one to send them to school and no means of survival.

Migration: Both internal and external migrations are contributing heavily to child labour in Cameroon. Rural-urban migration is a major problem [₂]. People who migrate to cities tend to go back to their villages and take children of poor people to cities to work for them. The child initially is eager to go to town without any knowledge about what he/she will be doing. While in city, he/she is submitted to forced labour and sometimes female children are introduced to prostitution.

Flawed registration system: Children who are not registered at birth never formally acquire a nationality, they are easily moved between countries. This promotes child trafficking.

Large family sizes: Deterioration of living conditions in rural areas and large family sizes are responsible for a large quota of child labour [₃]. When the parents cannot send their children to school, the only option is for the child to work at home or to be sent to town where he/she can work and send money back to the family.

Cheap labour: Child labour is cheap labour. People tend to exploit children in different economic activities because the child labour is cheap [₆]. Thus children work in plantations, factories and farms where they constitute a set of cheap and docile workers.

Socio-cultural factors: Cameroon is made up of 250 different tribes and each tribe has a slightly different culture. Child labour is engrained in certain cultural practices. Muslims for example send the female children to marriage at 12 to 15 years and women have a low social status [₉].

Government policy: The Cameroon Penal Code forbids the prostitution of children, the corruption of youth, child abuse, and forced marriages. In addition, it outlaws kidnapping of minors and kidnapping involving fraud and violence [₉]. However, in practice this is not implemented. Public health professionals tend to believe that child labour does not exist because it is outlawed. There is no effective Government policy to stop the practice of child labour in Cameroon.

Exposures: forms of child labour in Cameroon

About 12 to 20% of children aged 5 to 14 years in Cameroon work. Of this number, 1.0% is wage employment, 9.8% is self-employment and 89.3% is family employment. [₂]. These figures are however incomplete because there is a lot of underground child trafficking.

Wage employment: A good number of children work in plantations, industries and private firms where they are exposed to a lot of toxic chemicals, injuries, orthopedic problems and inadequate nutrition. The West Africa Cocoa/Agriculture Project (WACAP), a 3-year project launched in 2003, is aimed at removing some 284,000 children from exploitation on cocoa and other farms in West Africa and providing for their education. Representatives from Cameroon, Côte d'Ivoire, Ghana, Guinea, Nigeria, the European Union, and the United States set up the project [₇]. The project found that 5 500 children in Cameroon were applying pesticides and 16 192 were working with matchets in cocoa plantations. Worst abuses in child labour in Cameroon include shift work, long hours of work, heavy lifting, farm work, spraying, pickering, construction, and auto-repair.

Self-employment: As a result of wide spread poverty, some children take the initiative themselves and start an economic activity which can provide them wide the basic necessity such as food, shelter and clothing [₇]. Such children may even help the rest of the family especially in large families with many children. Such activities are include scavenging at garbage dumping, pottering, domestic work, commercial activities, fishing, hunting, food services and shaving in barbing saloons. Child labour co-exists with the use of tobacco, drugs and alcohol.

Family employment: Poverty is the main reason why children drop out of school. Either the family cannot support the school expenditures or the child is just asked to stop his/her education in order to help the younger ones at home. In the Northern part of Cameroon, where there are Muslims, female children are sent to marriage as early as 12 to 15 years. In the marriage home they carry out all household activities and cook for the husband. Such children are exploited both economically and sexually [₅].

Placement: A common tradition in Cameroon is the practice of placement [₇]. The practice provides a means for poor families to educate their children. Under its original form, poor family members would send their children to live with wealthy family members or with other families who lived in a city. The children were expected to provide various services to the host family in exchange for an education, vocational training, or money sent back to the family of origin. Gradually, traffickers began to exploit this intrafamily help system. Exploitation can range from withholding pay and refusing or failing to educate the child to abusing the child physically, sexually, and mentally.

Child trafficking and prostitution: In 2000, ILO conducted a study in Cameroon and found that trafficking was responsible for 84% or approximatly 530 000 out of 610 000 child labourers in three main cities (Yaounde, Douala and Bamenda) [₅]. Trafficked children are either forced to work for long hours or to serve as prostitutes in brothels. Trafficking is not only internal but also international. In September 2001 a boat capsised off the coast of Cameroon carrying an estimated 140-children slaves en route to Gabon [₅]. One Nigerian boy told of being trafficked to Cameroon by a fisherman. The trafficker would visit Oron Beach in Nigeria, acquainting himself with some of the children in the market square. The boy spent 3 years doing domestic work and working as a fisherman before he was returned to Nigeria [₈]. A ring trafficking Cameroonian girls and a boy to the United Kingdom was recently discovered when a Cameroonian girl escaped from a London brothel, where she had been forced into prostitution. Four years earlier she had been sold as a bride to a tribal chief, who sexually abused and mutilated her. She escaped from the marriage when a woman offered her a chance to work at a London restaurant; when she arrived in London, however, she was forced to work in a brothel [₉].

Risks: effects of child labour in Cameroon

There is limited data documenting the risks associated with child labour in Cameroon. However, from exposures and limited literature available, we can identify the following risks to child labourers.

Growth and development: Child labour contributes to poor growth and development due to both physical and emotional trauma. Thus, a survey of households in Cameroon, found that child labourers had a lower body mass index than children who were studying without doing any economic activity [₂].

Education: Child labour contributes to low enrollment in schools and high drop out rates. In Cameroon, 11.9% of children in rural areas are engaged in economic activities without education, 67.6% are studying only and 6.1% are both studying and working [₂]. Children studying and working have a lower academic performance.

HIV and STIs: Children who are introduced to prostitutes, sexually abused and are working in brothel are highly vulnerable to Human Immunodeficiency Virus (HIV). This is especially true as they have no knowledge about sexually transmitted infections (STIs) and HIV. Children who are sexually abused have a higher prevalence of HIV in Cameroon [₁₀, ₁₁].

Teenage pregnancy: These children who have little or no knowledge about contraception often become pregnant and are forced to commit criminal abortion, since abortion is not legalized [₅]. The end result of unsafe abortion is bleeding leading to anemia, infection, infertility and sometimes septic shock and death.

Psychological/emotional trauma: These children who are physically, emotionally and sexually abused developed psychological problems such as depression and mental problems [₃]. This may have long lasting effects throughout their lives.

Juvenile delinquency: Child labour goes along with drug use, alcohol and smoking. These children are responsible for most of the crimes committed by all under 18 children [₃]. Children who revolt physical and sexual exploitation may end up as street children, armed robbers or drug abusers.

Adult unemployment: The employment of children in wage-paid jobs leaves adults unemployed. Child labour is cheap labour and children constitute a docile set of workers. Thus, children were being employed by the Cameroon Development Corporation (CDC) cocoa plantations until the West Africa Cocoa/Agriculture Project (WACAP) took the appropriate steps to liberate these children and provide jobs for adults [₇].

Poverty: Child labour leads to a cycle of poverty. Child labourers do not go to school and do not receive any vocational training [₃]. When they grow to adults, they are unemployed and their children are likely to follow their path.

Interventions to reduce child labour in Cameroon

Internationally, a step had been taken through the West Africa Cocoa/Agriculture Project (WACAP) to reduce child labour in five west african countries, namely Cameroon, Côte d'Ivoire, Ghana, Guinea and Nigeria. Nationally, the Cameroon Government ratified the United Nations Convention on the Rights of the Child along with other countries (all except Somalia and the United States) [₇]. This Convention is the only international human rights treaty that expressly gives non-governmental organizations (NGOs) a role in monitoring its implementation (under Article 45a of the UN Convention on the Rights of the Child, A/RES/44/25, dated 20 November 1989). Despite this ratification, the situation of child labour has not changed in Cameroon.

Nevertheless, Cameroon is in the process of developing country-specific strategies to combat child labour. The Director of the Central African Sub-regional Office of the International Labour Organisation (ILO), Alice Sorgho Ouedraogo invited the Cameroon Prime Minister, Ephraim Inoni to preside over the launching ceremony of the world report on child labour that took place on May 4, 2006 [₆]. The International Labour Organisation launched the world report on child labour in Brazilia, Brazil on May 4, 2006. The report was also launched in the capitals of 20 countries in the world at the same time, including Yaounde, the capital of Cameroon. According to the ILO Central African boss, the report contains information that will contribute greatly in the fight against child labour and trafficking in the world.

Assessment of the problem

Sentinel event: The discovery of 21 692 child labourers in CDC cocoa plantations should serve as a sentinel event [₇]. It is likely that children are employed in other plantations such as the banana, rubber, palm, tea etc. Other sectors such as commercial sector, industries, transport etc. are likely to be involved. The international project concentrated on cocoa because the United States threatened to stop purchasing cocoa if they did not remove of children from the cocoa plantation. It will be wise to complete the fifth question of sentinel event investigation by asking “are they other children involved in other plantations and other sectors?”

Walk through: A rapid assessment of the situation can be achieved by walking through plantations, industries, brothels etc. Just with the use of feet, nose, eyes and ears, we can define the exposures – where these children work, what they do in the work places, and what they are exposed to. We can also determine the outcomes – what symptoms they have, whether their symptoms get worse/better at work or at home.

A survey: By conducting a survey we can also gather some epidemiological data (W5H epidemiology – who, when, where, which, what, and how).

Types of Interventions

In order to be successful, any interventions should consider the Legge's axioms and the DPSEEA upstream model.

Legge's axioms: The three axioms described by Legge are: (a) stop exposure at the source. This means the best approach is to stop children from getting involved in economic activity rather than waiting until they are already engaged in such activities before struggling to remove them. (b) limited effectiveness and reliability of “education”. Education of parents is not enough to prevent child labour in Cameroon. The Government needs to design and implement stringent policies than are not under individual control. (c) obligation to inform, right to know. Everyone including children should be informed about the risk of spraying pesticides in plantations, using toxic chemicals, solvents, possible injuries, risk of sexual abuse in brothels etc.

DPSEEA model: If carefully applied, the DPSEEA (Driving force - Pressure – Stress – Exposures – Effects – Action) model can be more effective in controlling child labour than the classic exposure–effect model. It is not feasible to tell people to stop child labour without taking into consideration their culture and general socio-economic conditions such as poverty. In other words, acting upstream is better than acting downstream.

Compulsory schooling: This strategy ties with the second of the Legge's axioms described above, namely that individuals cannot be effective if left on their own to effect a change. Thus instituting mandatory free education up to at least class seven may curb down child labour.

Minimum age at work : The Cameroon Penal Code already states a minimum age of 14 years. What is necessary is the enforcement of this law.

Schooling and working: It may be difficult to eliminate child labour completely because poor families will tend to die of starvation and their children will go to streets. The solution to this problem is to define the minimum hours of schooling that each child should get and define the types of jobs that children are allowed to do and those that are reserved for adults only. In this case the employer should take responsibility. This will permit poor families to survive while the children go to school.

Complete banning of some abuses: Worst abuses to be banned include prostitution, shift work, long hours of work, heavy lifting, farm work, spraying, pickering, construction, and auto-repair.

Inter-sectoral collaboration: Because of the failure of medical model and the need to attack the problem upstream, we should ensure inter-sectoral collaboration. Poverty, culture and socio-economic conditions cannot be modified by one sector. Improving the vital registration system is important to control child trafficking. There is also need for collaboration with the HIV/AIDS programmes in order to reduce the number of AIDS orphans who are vulnerable to child labour.

Evaluation

In order to succeed in such interventions, there should be continuous monitoring of the implementation and outcomes. This will permit continuous feedback (either positive or negative) to the implementation team so that the necessary changes can be effected. At the same time there should be short-term evaluation which can be conducted every year and presented in an annual report as well as long-term evaluation every five years to see the overall outcomes of the intervention. Policies can be changed after the long-term evaluation. Evaluation should consider both the process and the outcomes. Evaluation should preferably be both internal evaluation (conducted by the Cameroonians themselves) and external conducted by international Non-Governmental Organizations.

Conclusion

Child labour is a major public health problem in Cameroon. The main determinants are poverty, parental level of education, migration, HIV infection, place of residence, socio-cultural factors, family size and the flawed registration system. The main forms of child labour include family work, self-employment, wage employment (in plantations, industries, farms, etc.), child placement, child trafficking and prostitution. The major effects are seen in the low school enrollment rates, high drop out from schools, poor growth and development, high adult unemployment and a persistent cycle of poverty. The worst forms of child labour in Cameroon which constitutes serious violations of human rights include child trafficking and prostitution, and should be targeted as priority for immediate action. It is not feasible to prescribe a single magic bullet to combat child labour in Cameroon. However, for any strategy to be successful, we strongly recommend that it should take into consideration the determinants of child labour identified in this review. Future research should seek to identify optimal interventions to reduce and in possible eliminate child labour in Cameroon.