Asian Social Work and Policy Review 5 (2011) 44–59

ORIGINAL ARTICLE

Violence, Negligence and Suicidal Tendency

among Physically Disabled Street Children
Amir Mohammad Sayem
Bangladesh Institute of Social Research (BISR), Dhaka, Bangladesh

This study was carried out among physically disabled street children (PDSC) in the city of Dhaka
in Bangladesh. The aim of the study was to explore violence, negligence and suicidal tendency
among PDSC. To do this, 30 PDSC (15 male and 15 female) were conveniently selected and inter-
viewed with an interview protocol developed by a step-by-step process. The results of this study
revealed that all the participants experienced physical violence but female children were more likely
to experience sexual violence than male children. Violence against disabled children came from
both family members or relatives and other people. As with violence, all the participants experi-
enced some sort of negligence, again both from family members or relatives and other people. More
importantly, this study found that more than half of the physically disabled children had suicidal
tendency to some extent, i.e. some thought of committing suicide at least once in their life, while
others attempted to commit suicide due to the sufferings that came with disability. This study con-
cludes with some policy implications, particularly: providing counseling to parents and the disabled
children; training of the service providers who provide services to disabled persons; and building
awareness through mass media.
Keywords negligence; physical disability; street children; suicidality; violence
doi:10.1111/j.1753-1411.2010.00048.x

Introduction
The maltreatment of children, including those with disabilities, is a critical public health
issue that must be addressed (American Academy of Pediatrics, 2001). Children with dis-
abilities are found to be at greater risk of becoming victims of abuse and neglect than

Correspondence concerning this article should be addressed to Amir Mohammad Sayem, Research Associate,
Bangladesh Institute of Social Research, 15 ⁄ H ⁄ 1, Zigatola, Dhanmondi, Dhaka-1209, Bangladesh. Email: say-
[email protected]
Acknowledgements: This study was funded by the Bangladesh Institute of Social Research, Dhaka, Bangladesh.
Appreciation goes to Dr. Khurshed Alam, Chief Executive of Bangladesh Institute of Social Research, and
Dr. Housne Ara Begum, Assistant Professor, Institute of Health Economics, University of Dhaka for their contribu-
tions to this study in terms of checklist preparation, cross-checking of translations and cross-checking of analysis.
The author of this paper also further acknowledges the contribution of Dr. Khurshed Alam who provided valuable
suggestions during the preparation of this manuscript.

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Amir Mohammad Sayem Violence, Negligence and Suicidal Tendency among PDSC

children without disabilities. Children with disabilities are 1.8 times more likely to be
neglected, 1.6 times more likely to be physically abused, and 2.2 times more likely to be
sexually abused than children without disabilities (Sullivan & Cork, 1996). The evidence
of sexual abuse involving individuals with disabilities was also found in another study
(Sobsey, 1994). The estimated incidence of maltreatment among children with disabilities
was 1.7 times greater than the estimated incidence in children without disabilities (Sulli-
van & Knutson, 1998). As it is well known that individuals other than family members
can commit harm to children, statistics limited to intra-familial cases would be likely to
underestimate the overall incidence of maltreatment among children with disabilities.
However, previous studies conducted on children with disabilities have not accurately
documented the extent or rate of abuse (Bonner, Crow, & Hensley, 1997). In fact, little
research on child abuse has focused specifically on children with disabilities (Westat Inc,
1994).
The causes of abuse and neglect of children with disabilities are the same as those for
all children. Several elements may increase the risk of abuse for children with disabilities.
Children with chronic illnesses or disabilities often place higher emotional, physical,
economic, and social demands on their families (Benedict, White, Wulff, & Hall, 1990).
Children with disabilities often have limited access to critical information pertaining to
personal safety and sexual abuse prevention. They may also be conditioned to comply
with authority, which could result in them failing to recognize abusive behaviors as mal-
treatment. In regard to sexual abuse, infrequent contact of a child with disabilities with
others may facilitate molestation, because there is decreased opportunity for the child to
develop a trusting relationship with an individual to whom he or she may disclose the
abuse (Ammerman & Baladerian, 1993). It is also likely that children who have increased
dependency on caregivers for their physical needs may be accustomed to having their
bodies touched by adults on a regular basis. Often, these children require multiple care-
givers or providers may have contact with numerous individuals, thereby increasing the
opportunity for abuse.
Parents with limited social and community support may be at especially high risk for
maltreating children with disabilities, because they may feel more overwhelmed and
unable to cope with the care and supervision responsibilities that are required (Ammer-
man & Baladerian, 1993). The requirement of special health and educational needs can
result in failure of the child to receive needed medications, adequate medical care, and
appropriate educational placements, resulting in child neglect (Ammerman & Baladerian,
1993). Societal response contributes just as much to the violence against disabled chil-
dren. Some researchers suggest that children with disabilities may have increased vulnera-
bility to abuse because of society’s response to the disability, rather than the disability
itself (Sobsey, 1994; Westcott, 1993). Other factors leading to abuse among children with
disabilities are the same as those found in the general population, i.e. single parents, teen
parents and various levels of stress (Kvam, 2000; Valenti-Hein & Schwartz, 1995). All of
these can result in increased vulnerability to abuse. Consequently, children with disabili-
ties may be perceived as less valuable than other children which may push them to
commit suicide.
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Amir Mohammad Sayem Violence, Negligence and Suicidal Tendency among PDSC

Disability: Bangladesh context

A major problem cited in the literature is the definition of disabilities. There is cur-
rently no universal agreed-upon definition of what constitutes a disability. Usually
the definition of disability includes all types of disabilities, including physical dis-
abilities, cognitive or learning disabilities, motor and sensory dysfunctions, mental
illness, and any other kind of physical, mental, or emotional impairment (Ammer-
man & Baladerian, 1993). The Bangladesh Persons with Disability Welfare Act
(Bangladesh Persons with Disability Welfare Act, 2001) lists the following categories
of disabilities: physically crippled, visual impairment, physically handicapped, hear-
ing impairment, speech impairment, mental disability, multiple disabilities, or any
other type of impairment that the government chooses. In a World Bank situational
analysis of disability in Bangladesh (Byskov, Khandaker, Bari, & Birgitte, 2004),
the authors mentioned the terms impairment, disability and handicap as words tra-
ditionally used to indicate disability types. Physical disability is considered as the
physical impairment that causes problems with mobility, coordination and muscular
control.
There is no accurate information on disabled children in Bangladesh; however,
using the WHO figures for 2004, and the 1991 BBS sample study, the total number
of disabled children falling between ages 3 and 10 is 2,559,222. This reflects an inci-
dence of 9.9% of all children between 3 and 10. The distribution of disabilities in
the population aged 3–10 is found from a study done at the Japan International
Cooperation Agency (JICA, 2002). However, in that study the total number of
disabled Bangladesh children aged 0–10 years was found to be 3,153,886, or 7.7% of
the population of that age. It is to be noted that two baseline studies conducted by
Action Aid Bangladesh offer different incidence figures, but probably give more accu-
rate groupings than do the Bureau of Statistics studies (Kabir & Rahman, 1996).
These studies, which were conducted in nine different locations in all parts of
Bangladesh, derived overall incidence figures between 7% and 15%. However, these
figures are criticized on the ground that the incidence figures of the Government of
Bangladesh (GOB) are conservative and, perhaps, under-representative (Kabir &
Rahman, 1996).
It is a well-known fact that many disabled children, including physically disabled
children, are already marginalized and stigmatized. However, previous studies con-
ducted on children with disabilities have not accurately documented the extent or
rate of abuse (Bonner et al., 1997). In fact, little research on child abuse has
focused specifically on children with disabilities (Westat Inc, 1994). The disabled
children who reside on the street are more vulnerable than disabled children in gen-
eral. However, there is no research available on physically disabled street children
in Bangladesh, although there are some studies conducted on disabled children
(Ackerman, Thornmann, & Huq, 2005) and disabled people in general (Byskov
et al., 2004) in this country context. The current study was an attempt to explore
violence, negligence and suicidal tendency among physically disabled children in
Bangladesh.
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Amir Mohammad Sayem Violence, Negligence and Suicidal Tendency among PDSC

Methods
Study area
This study was carried out among physically disabled children who live on the streets in
Dhaka City. Dhaka City is centrally located in Bangladesh, in the southern part of the
district of Dhaka. It is the capital of Bangladesh, is located on the banks of the Buriganga
River, and has more than 15 million inhabitants, making it the largest city in Bangladesh
and one of the most populous in the world. It is the centre of political, cultural and
economic life in Bangladesh. It has both the highest literacy rate and the most diverse
economy amongst Bangladeshi cities. Although its urban infrastructure is the most devel-
oped in the country, it nonetheless faces challenges such as pollution, congestion, supply
shortages, poverty and crime. According to the adjusted population figures of the 2001
census the size of Dhaka’s population is 10,712,206 of whom 5,978,482 are male and
4,733,724 are female (BBS, 2003). The population growth of Dhaka stands at 56.5% in
the last decade, which is very high. This means that during the last decade the city’s popu-
lation has grown by 3,868,077. The sex ratio of the population is calculated as 123.4
based on the current population census (BBS, 2003). There are numerous streets in this
city. Many people who lack housing take shelter on the streets.
Participants
The current study was carried out with physically disabled street children in Dhaka city.
In this study, physically disabled street children were defined as children aged <17 years
who had slept or resided for at least the last year on the street in Dhaka City and who
had at least one of four types of physical disability, such as one leg cut off, one hand cut
off, both legs cut off and both hands cut off. The street-living physically disabled chil-
dren were chosen because they are often out of health coverage and are the most
neglected children in the city and extensive research is yet to be conducted, especially in
this city. Thirty participants took part into the study with a mean age of 14.16 years
(SD ¼ 1.62). Of the total, fifteen male and fifteen female children were interviewed whose
mean ages were respectively 14.13 (SD ¼ 1.68) and 14.2 (SD ¼ 1.61) years (Table 1).
The majority of the male and female children had formal education1 (male ¼ 9 and
female ¼ 8). Less than half of the male children (n ¼ 7) were engaged in income-generat-
ing activity (begging) whereas more than half of the male participants (n ¼ 8) reported
doing no work. In the case of the female participants, more than half were engaged in
income-generating activity (begging) while seven participants reported not doing any
work. The average monthly family income2 for the total sample population was found to
be 3670.00 BDT (SD ¼ 552.21) whereas the monthly family income for male participants

1
Most of the participants having formal education attended school for 1–2 years before coming to
the streets. It is to be noted that all the children acquired their physically disabilities after birth and
due to accidents.
2
The average monthly family income means the average monthly total income of all the members
of a family. Most of the street-living physically disabled children had earning family members.
Income from all the family members was added together to get a total monthly income.
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Amir Mohammad Sayem Violence, Negligence and Suicidal Tendency among PDSC

Table 1 Participants’ socio-demographic information (n ¼ 30)

Male children Female children

Family Family
Formal Work income Formal Work income
ID no. Age education status (BDT) ID no. Age education status (BDT)
MC01 13 No Begging 4000 FC01 12 Yes No work 3800
MC02 15 Yes No work 4000 FC02 14 Yes No work 3000
MC03 17 Yes Begging 3500 FC03 15 No Begging 3000
MC04 16 No Begging 4200 FC04 17 No Begging 3000
MC05 14 Yes No work 3500 FC05 15 No No work 3500
MC06 13 No Begging 3000 FC06 14 No Begging 3500
MC07 12 Yes No work 3000 FC07 13 Yes No work 3800
MC08 12 Yes No work 4000 FC08 13 Yes Begging 4000
MC09 14 No Begging 4000 FC09 12 Yes No work 4000
MC10 15 Yes No work 4000 FC10 14 No Begging 3500
MC11 17 Yes No work 3000 FC11 15 No Begging 3000
MC12 13 No Begging 4500 FC12 16 Yes No work 4500
MC13 12 Yes No work 3000 FC13 17 No Begging 4500
MC14 14 No Begging 5000 FC14 13 Yes No work 3500
MC15 15 Yes No work 3500 FC15 13 Yes Begging 3300

Mean age ¼ 14.13 years (SD ¼ 1.68) Mean age ¼ 14.2 years (SD ¼ 1.61)
Mean family income ¼ 3746. 67 BDT Mean family income ¼ 3593.33 BDT
(SD ¼ 602.22) (SD ¼ 506.34)
Mean age for total sample ¼ 14.16 years (SD ¼ 1.62)
Mean family income for total sample ¼ 3670.00 BDT (SD ¼ 552.21)

was 3746.67 BDT (SD ¼ 602.22) and for female participants it was 3593.33 BDT (SD ¼
506.34).
Interview protocol
The interview protocol consisted of four sections: (i) a socio-demographic section; (ii) a
section on experiencing violence; (iii) a section on negligence; and (iv) a section on suici-
dality. The protocol began with eight demographic questions including the participant’s
age, education, working status and family income. The section on violence had five ques-
tions, including: whether the participant had experienced violence during the last the last
year? If yes, from whom? The section on negligence had five questions, including: whether
the participant had experienced negligence during the last the last year? If yes, from
whom? The section on suicidality had five questions including: whether the participant
had thought of committing suicide during the last year? If yes, whether the participant
had attempted to commit suicide? The rest of the three questions in each of these investi-
gative sections were designed to determine the context and causes of violence, negligence
and suicidality among the street children. These three questions were open-ended in
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nature. The participants were given freedom to describe their context as well as the causes
of violence, negligence and suicidality.
Procedure
The participants were selected with a convenient sampling approach. In fact, there was
no available alternative option due to the lack of a list of physically disabled children. To
select the potential participants, the study team searched four places: Mirpur-1 crossing;
Mirpur-10 crossing; Mirpur-1 Majar; and Farmgate crossing, all of which are situated in
Dhaka city. Indeed, physically disabled children are available here because such children
are likely to beg in these places and hence it was easier to find them. All the physically
disabled children who were beggars as well as not working were found in these four
places. On the basis of eligibility criteria of physical disability (the abovementioned four
types of physical disability) and age (not more than 17 years), the study team interviewed
the physically disabled children who consented to the study. The interviews were carried
out in the evening and early night when the physically disabled children were usually
relaxed. The interviews were carried out separately. Each interview lasted for an average
of 30 min.
Data analysis
This study was an exploratory investigation in identifying the experiences of violence,
negligence and suicidal tendency among physically disabled street children. Thus, the pri-
mary goal of this study was to describe a phenomenon that has to date been under-
researched rather than to test any hypotheses. To this end, four primary steps were used
to analyze the qualitative information gleaned from the in-depth interviews. First, all the
transcripts were translated by the principal investigator and checked by an expert so as to
ensure that the translation was accurate. At this stage there was almost no difference
between the first translated version and that checked by the expert. At the second stage,
the principal investigator read all the transcripts to distinguish the narratives on the basis
of the themes derived from the transcripts. Three broad themes were identified which
included experiencing violence, experiencing negligence, and suicidality. At the third
stage, categories were identified based on the narrative descriptions of the participants
within each theme. In total the principal investigator identified six categories, two within
each theme (presented in Table 2). At the final stage, all the themes and categories were
cross-checked by an expert. However, at this stage, there was no notable difference in

Table 2 Themes and categories developed from the data

Derived themes Categories

Experience of violence Violence from family ⁄ relatives
Violence from other people
Experience of negligence Negligence from family ⁄ relatives
Negligence from other people
Suicidal tendency Attempting to commit suicide

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themes and categories between the two analysts. Although some minor controversies
arose regarding the narratives and categorization, after discussion with the expert the
principal investigator come to an agreed-upon solution. The final result of the themes
and categories is presented in Table 2. The overall data analysis was carried out manu-
ally. To maintain the anonymity of participants, the participant’s real names were
replaced with pseudonyms. For female participants, an identity number was assigned
ranging from FC01 to FC15 (where FC ¼ female child), whereas the numbers for male
participants ranged from MC01 to MC15 (where MC ¼ male child).

Results
Experiences of physically disabled street children
Physically disabled street children (PDSC) experienced different sorts of unexpected
events during their lives. They were neglected by people in the family as well as in society.
Within the family they were not treated well, while the same occurred in the extra-family
environment. Moreover, disabled children experienced physical and sexual violence both
inside and outside the family. Many such children thought of committing suicide and
attempted to commit suicide due to violence and negligence experienced in and out of the
family context. The present study explored different experiences during childhood which
participants experienced due to their disability. These included: (i) experience of violence
(by family members ⁄ relatives and other people); (ii) experience of negligence (by family
members ⁄ relatives and other people); and (iii) suicidality (thinking of committing suicide
and attempting to commit suicide. The summary of the results is presented in Table 2.
Experience of violence
Disabled children experienced different sorts of violence during their childhood. Violence
was both physical and sexual. Although both male and female children experience physi-
cal violence, female children were more likely to experience sexual violence than male
children. The violence against physically disabled street children came from both family
members ⁄ relatives and other people in society. MC01 said that he had experienced physi-
cal violence from his parents as well as a community member during the last year. One
female child (FC01) also mentioned the experience of physical violence from both family
members and people in the society. However, violence is often considered as inevitable
for disabled children. For example, on male child (MC02) reported:
I am physically disabled. I have only one leg. I cannot do other work except begging. Despite
my disability, I am often physically attacked by people. […] At the last month I was kicked
by my mother and fell down from the cot. Later I had to take medicine as I had bleeding on
my elbow. Besides, other people also physically hit me. Two months ago, I experienced slap
or push by other people in the street. It seems that it is a fate for the disabled child.

One female child aged 15 (FC07) said that she was hugged and kissed by one of her rela-
tives. When she was taking rest at night one of her relatives came to their home to visit
her mother, who was not there at the time. The relative came to her and forcefully hugged
and kissed her. Another female child aged 13 years (FC08) also reported about being

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sexually harassed by a relative. She said ‘‘I had a good relation with that uncle, he used
to buy me different things once. Nowadays, his behavior convinced me that he wants
different things from me. One day he came and unexpectedly took me into his lap. He
started to kiss me touching my breasts. When I started crying he stopped […].’’ More or
less similar experiences were expressed by some other female participants but none of
them expressed concerns about sexual abuse by family members, rather they mentioned
physical violence by family members. One female reported:
I have one leg and one hand only. On and off, I experience physical violence from my par-
ents. At 3 months ago, I came back from begging. My mother wanted me to give her the
money I earned during all the day long. Although I gave her it, she was not satisfied with the
amount I gave her. She asked me, ‘‘What did you do with the rest of the money?’’ I replied,
‘‘I have earned only the amount I gave you.’’ She did not believe it. Suddenly she became
angry and slapped me, and said ‘‘Give me the whole money.’’ Still I replied, ‘‘I do no have
more money with me.’’ […] At one point of our conversation, she kicked me and said that I
lost the money.

Some other children, both male and female, also mentioned the physical violence they
experienced from family members or relatives. Some of the participants reported that vio-
lence both physical and sexual is more commonly experienced at the hands of outsiders.
One male child (MC04) said that although he experienced physical violence at home, it
was more severe when it was committed by people other than family members or rela-
tives. One female child experiencing sexual harassment by a relative mentioned that she
experienced sexual harassment more from people other than relatives. Another female
participant reported:
I am disabled person. I have one leg cuts. My mother died when I was very young child. My
father remarried. Since then, I used beg to survive. But people both relatives and non-rela-
tives try to touch me and to have something bad. I try to avoid them. But due to my disabil-
ity, I can not always protect me […]. One of the rickshaw pullers during the last month
wanted to have sex with me. I refused. But he again came to me and asked me to do so. When
I refused again he forcefully did it […] (crying)’’ (FC11).

Sometimes the participants experienced physical and sexual violence at the hands of other
beggars. One male child mentioned that he experienced physical violence around
2 months ago from other non-disabled stronger child while one female participant said
that she experienced sexual violence by another older beggar. She said ‘‘I reside in a bus-
stand with my disabled mother. I was coming back earlier. On the way to home, I found
another disabled beggar with one hand aged around 35 years blocked the road and stood
before me and said that I am beautiful. He instantly hugged me and kissed me. When I
cried for help he disappeared very quickly.’’
Experience of negligence
Disabled children experienced negligence because they were disabled. They experience it
from from family members and relatives and others alike. Experience of negligence was a
common experience for all the disabled children. However, experience of negligence from

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other people was more common than that of family members ⁄ relatives. Those who expe-
rienced negligence from family members or relatives said that it was very painful. One
male child (MC05) said ‘‘My parents ignores my request even if they can do it for me.
Due to physical disability I can have food on my own hand because both hands of mine
are cut. Although my parents provide me food but sometimes they do not feed me when I
need to eat.’’ One female child (FC07) reported:
I have both the legs cut off. No one except me is disabled in our family. I can do little work
for me rather I have to look at the others to do something for me, be it, having shower, wash-
ing clothes, etc. […] Although my family members cared for me much once but nowadays I
realize that I am not equally treated by my parents. I can not wash my own clothes, my
clothes are washed lately compared to that of my brother and sister who are not disabled.
Besides, all the family members eat earlier keeping me alone to eat later. They are also getting
special care that I do not get. Relatively, my parents like them more than me.

Some of the participants mentioned the experience of negligence from relatives. They said
that relatives talk to the normal children more while avoiding the disabled children. One
male participant (MC07) said that he has one brother without disability. His relatives sat
down with that normal child but did not come close to him. Also at different occasions,
he was not invited to go to the relatives’ home. Another female child also mentioned that
she was not liked by her relatives. Relatives rather ignored her when she wanted to talk
to them. With a complaining tone one female child reported:
When I was a normal child, I used to get good care from my relatives. But the things have
been changed much after the accident that took my one leg. I rarely can talk to my relatives
although my brother frequently go and enjoy with them. Relatives come to us but often do
not talk to me even if I approach them they try to avoid me. It hurts me because when I was
not disabled they cared me equally. Also I cannot visit my relative’s home as often as my
brother can.

Beggars also talked about negligence from family members and relatives. One begging
child aged 16 years (MC12) mentioned that when he could not earn money, he was not
fed by his mother although other family members had food. Besides the negligence from
family members, some begging children also mentioned it from people other than family
or relatives. One male respondent (MC14) said ‘‘Although I complained to a police for
being assaulted by a shop keeper on the road, he (police) ignored my request and said
that I was Khora (my leg was disabled). I should have understood that I was not capable
to protest him (shop owner).’’ Experience of negligence by police was also reported by
another child. FC15 said ‘‘I was sexually harassed by a man here. I complained about it
to the police but he did not stand beside me rather he warned me not to say anything
about it.’’ Other people who neglected the disabled children include: other beggars; rick-
shaw pullers; walkers; cigarette sellers; tea-stall owners; students; and service holders.
Describing his experience of negligence, another male child stated:
I beg on foot path to earn my livelihood. One day, I was begging on footpath. I requested a
person to help me. He did not help me rather he asked me roughly ‘‘Why do you not die?’’

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I just looked at him. In the mean time, a cigarette seller also came and asked me ‘‘Why do
you not leave this place? You are cursed.’’ […] Since the conversation I thought of it for sev-
eral times. Every time I found that society does not look disabled person with goods eyes.

Suicidal tendency
Due to unbearable problems and suffering, the physically disabled street children often
thought of committing suicide so as to get rid of their suffering. Some of the children also
attempted to commit suicide but failed. Children who thought of committing suicide
mentioned that they thought that it would be better if they commited suicide not only
because of their present suffering but also because there is no hope for the future. One
male child said ‘‘Sometimes my mind wants to commit suicide. This is because I feel that
I am neglected from my family members, relative and from others.’’ One female child
(FC06) also reported:
This life I cannot live. Due to the frustration once I thought about committing suicide to
relieve myself from the cursed life. I thought this would save me from my sufferings of inhu-
man life. But I could not commit it finally. […] Later I changed my mind. Since then I tried
much to feel alright but very few time I can feel better. It seems that I am worthless person.

Some of the children thought about committing suicide due to the negligence of family
members or relatives and their consequent suffering. They said that committing suicide is
the only solution to the sufferings they are undergoing. One male child (MC10) said
‘‘Committing suicide may be considered as the highest solution to my sufferings but I am
living because every one wants to live.’’ Logic in favor of thinking of committing suicide
in order to be free from the difficult life they are living was also mentioned by some
begging disabled children. One of them stated:
My disability caused innumerable sufferings to me. No one loves me. Everyone considers me
as a burden in the family and society. I cannot lead my life like the other children who are
not disabled. […] More importantly my disability caused me to live my life within very
limited environment. Sometimes I feel the urge to commit suicide. However, as it is the act of
coward, I do not commit it. But I understand that there is no alternative to me to committing
suicide.

Although some disabled children only thought about committing suicide, some disabled
children even tried to commit suicide. They tried to commit suicide by taking sleeping
pills, jumping from high places and lying on the rail line. One male child (MC13) said
‘‘Once I tried to commit suicide lying on the rail line but one of my known people saw me
lying on the line and took me away from the line. After that I tried to commit suicide by
taking sleeping pills. However I could die at that time. Since then I never tried to do so.’’
One female child mentioned that she also wanted to commit suicide by taking sleeping
pills. She stated ‘‘I was very much neglected and decided to end my life by taking sleeping
pill. Although I took 15 pills, after some hours I found myself in a doctor’s chamber.’’
Some other children also mentioned that they had tried to end their lives. However, none
of them could successfully commit suicide. One female child (FC11) said that she tried to

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commit suicide four times but every time there was some one to save her. She ultimately
could not commit suicide. She reported:
If you are disabled, it seems that you do not have right to receive good care. People both
inside and outside the family do not consider disabled person positively. Every where you go
you would face rough behavior. It seems to me more logical to commit suicide so as to avoid
the societal demeaning attitude towards disabled people[…] I also tried to commit suicide.
During my last trying I hanged myself with a rope tied to the ceiling of my home. But as soon
as I removed the chair below, my mother saved me.

Discussion
This study was an attempt to explore the experience of violence, negligence and suicidal
tendency among physically disabled street children. The specific type and amount of vio-
lence against disabled children varies depending upon whether it occurs within the family,
in the community, in institutional settings or in the work place (UNICEF, 2003). As this
study reveals, disabled street children experience violence from family members, espe-
cially parents. In fact many parents are violent towards children where no disability
exists, but when a disabled child lives in a violent setting his or her disability often serves
to compound and intensify the nature and extent of the abuse (American Academy of
Pediatrics, 2001). For example, a mobility-impaired child may be less able to flee when
physically or sexually assaulted. It is likely that disabled children cause much suffering to
other family members or relatives that results in disgust among them which in turn causes
violence against disabled children. Family, neighbors, health-care professionals or social
service experts may be aware that a disabled child is being abused by parents or caretak-
ers in the home, but are unwilling to intervene, rationalizing such violence by citing stress
on parents or lack of alternative care arrangements. As with many aspects of violence
towards disabled children, at this point, much more research is needed to adequately
understand the factors that slow down or promote violence towards physically disabled
street children.
The findings of this study indicated that PDSC experienced physical violence from
other people. It should be mentioned that consistent with the expectation, only female
children experienced sexual violence whereas both male and female experience physical
violence. On the street, it is expected that disabled children are often victims of violence
because they can be easily harmed (UNICEF, 2005). In fact, disabled children are regu-
larly used to generate income through begging. Some are placed on the streets to beg by
their own families, some are sold by their families to others who keep stables of disabled
children in organized rings of beggars. Either way, reports and anecdotes from dozens of
countries indicate that such children are routinely subjected to violence both in order to
keep them on the streets and, once on the streets, by members of the general population
who see such children as easy prey. Disabled children used as beggars are often subjected
to physical abuse and torture in order to make them appear more pathetic and worthy of
charity (Wonacott, 2004). In fact this area is a special consideration from the societal
point of view that indicates that society still permits violence against disabled children.
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Amir Mohammad Sayem Violence, Negligence and Suicidal Tendency among PDSC

The findings of this study also revealed sexual violence against female disabled chil-
dren. It is expected that violence, including sexual violence, may take place without the
parent’s knowledge or while the parent is away (UNICEF, 2005). Sexual violence is also
common in other countries like the USA, where 5% of all disabled students report sexual
abuse by bus drivers on their way to or from their schools (Helander, 2004, cited in
UNICEF, 2005). A child born with a disability or a child who becomes disabled may be
directly subject to violence, including sexual violence, in the home or in the community
(UNICEF, 2005). In most societies, individuals with a disability are incorrectly believed
to be sexually inactive and hence virgins. Published reports indicate that in many
countries, HIV-positive people, desperate to rid themselves of the infection, are targeting
individuals with disability for rape. Disabled girls and young women are at particular
risk – as are disabled boys and young men (Groce & Trasi, 2004).
This study also found that disabled children were neglected by family members and
relatives. It should be noted that family is considered as a supportive mechanism of a
child’s development. If a child does not get support from family members it is likely that
their development will be abnormal. Similarly, relatives also provide a caring attitude
towards children that plays an important role, although less than that of family, in a
child’s mental as well as social development. When this supportive mechanism does not
work or works negatively, children perceive negligence, no matter whether the child is
disabled or not. This is clear from the statement of one participant: ‘‘I cannot wash my
own clothes, my clothes are washed lately compared to that of my brother and sister who
are not disabled.’’ It is to note that the disabled child in a household may receive less
food, medical care or other services. This can be subtle, for example, parents or caretak-
ers may wait a few additional days before spending scarce money for medicine or the
child may receive less food or less nutritious food than his or her siblings. The response
can also be direct: refusal to continue to feed, house or clothe a child after he or she has
been disabled (UNICEF, 1999). Neglect, in the form of a lack of adequate medical care,
less nutritious food or lack of access to related resources, is the apparent cause of many
deaths (Helander, 1999).
The findings of this study further revealed that disabled children were neglected by
people other than family members. This has been clear from the statement of one male
child (MC14). In fact, seeking protection from a law enforcing agency and receiving no
response is really neglect. It is important in the sense that police should protect people
from violence or illegal activities that cause harm. It is an important area for interven-
tion, because if the attitude of the police towards the people becomes equal, as it should
be, no doubt there would be less violence. The neglectful attitude of the police may also
cause a perception of negligence to develop among the disabled children. This is because
the police are perceived as the protector of the weak from the aggression of the strong.
No less important is the fact that negligence comes from other people like street beggars,
rickshaw pullers, walkers, cigarette sellers, tea-stall owners, students and service holders.
This is a very complex area in which to intervene because it is more a societal attitude
towards disabled children than a single group of people. Moreover, it is almost impossi-
ble to change the societal attitude towards disabled people suddenly. However, to
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Asian Social Work and Policy Review  2011 Blackwell Publishing Asia Pty Ltd 55
Amir Mohammad Sayem Violence, Negligence and Suicidal Tendency among PDSC

minimize the negligent attitude towards disabled children, consideration should be given
to a mass-media campaign to build awareness among people regardless of age, sex, color
and status.
This study found suicidal tendency among disabled children caused by the experience
of violence and negligence. This is expected, because different studies identified that
abused children suffer from interpersonal maladjustment and socio-emotional deficits,
such as delayed playing skills, avoidance of adults, difficulty in making friends, insecure
attachment to a caregiver, low social competence and adjustment deficits in pro-social
behavior, hopelessness, depression, low self-esteem, and difficulties with peers (Egeland,
1991; Erickson & Egeland, 1996; Haj-Yahia, Musleh, & Haj-Yahia, 2002; Stockhammer,
Salzinger, Feldman, Mojica, & Primavera, 2001). It is indeed expected because reduced
care and a neglectful attitude towards disabled children might cause alienation from the
family, while unexpected neglectful behavior from near and dear ones may reduce self-
esteem and hence cause frustration that leads to thoughts of committing suicide. This has
been clear from the statement of one disabled child: ‘‘Due to the frustration once I
thought about committing suicide to relieve myself from the cursed life.’’ Thus the find-
ings of this study necessitate the provision of counseling services to disabled children so
that they can cope better with the adverse situation of being neglected, tortured and the
like.
The most regretful fact is that thinking of committing suicide may often turn into sui-
cidal attempts as this study revealed. In fact, it is likely because when disabled children
experience severe frustration or depression due to constant negligence and humiliation
from the family as well as society, they find no alternative option other than suicide,
which is made clear by one statement: ‘‘I understand that there is no alternative for me to
committing suicide.’’ The findings of this study further revealed that female children
attempt to commit suicide several times as often as male children. Different literature
generally suggested that suicidal attempts are higher among females than males in the
USA (Crosby, Cheltenham, & Sacks, 1999; Lewinsohn, Rohde, & Seeley, 1996; Roberts,
Chen, & Roberts, 1997) and in Norway (Dieserud, Loeb, & Ekeberg, 2000). It is likely
that gender roles dictate that men not fail at suicide, which leads them to choose highly
lethal methods of self-destruction. Conversely, gender roles for women encourage deli-
cacy and attention to appearance, even in death. This finding necessitates gender-sensitive
approaches considering the social, cultural, and power roles of men and women, rather
than inherent biological differences, for better understanding of sex differences in suicidal
behavior.
Despite the importance of this study in that it explored violence, negligence and sui-
cidal tendency among physically disabled children in Bangladesh, this study has several
limitations. This study used a conveniently selected sample population that is at risk of
sampling bias, a less representative sample of the population, and a limited generalizabil-
ity of the results (Polit & Beck, 2004). However, as this study was explorative in nature,
the generalizability may not be a problematic issue. Finally, the interview took
place where the children usually reside. It is expected that external factors like the pres-
ence of other people during the interview influence the responses of the participants
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56 Asian Social Work and Policy Review  2011 Blackwell Publishing Asia Pty Ltd
Amir Mohammad Sayem Violence, Negligence and Suicidal Tendency among PDSC

(Aquilino, 1993). However, another study suggests that the impact of third persons on
survey responses is fairly rare and mostly small (Smith, 1995). In this study, presence
may not be a serious issue as other people did not listen to the conversation of participant
and study team because of safe distance.
Although this study has several limitations, it has some applied implications. The
findings of this study indicate that disabled children experience violence from parents. In
this regard, intervention should be given including the parents so that they behave well
with the disabled children even if under pressure from other aspects. It is often not feasi-
ble to change the behavior of family members, relatives and other people towards physi-
cally disabled children very quickly. Often it requires a long-term approach to bring a
societal change. It seems more feasible to counsel the disabled children as well as their
parents so that they can change their view towards others’ behavior in a way that does
not leave disabled children in a state of feeling neglected or suicidal. Second, the findings
also imply that psychological counseling is necessary for the disabled children so as to
avert suicidality. In this regard, measures should be taken immediately but precisely in
the sense that not all the physically disabled children are beyond the coverage of the
counseling net.
Family, neighbors, health care professionals or social service experts may be aware
that a disabled child is being abused by parents, relatives or other people in the society,
but are unwilling to intervene, rationalizing such violence by citing stress on parents or
lack of alternative care arrangements. To change this attitude, a mass media campaign
can be the most effective way. Fourth, health-care providers should be trained to monitor
children with disabilities for signs of abuse and neglect and screen suspected victims of
child maltreatment for disabilities. Finally, intervention to stop violence against children
in the home is an issue in many societies; the neglect highlighted here is when a commu-
nity does not stop violence against a disabled child that would be considered intolerable
if perpetrated against a non-disabled child.

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