Wthn ths thess chldren wll be vewed as socal actors exercsng varous forms of agency. Theorsts of chld agency currently approach chldren as socal actors n ther own rght. It s also argued that chldhood s a socal and cultural constructon, and chldren can be socal actors wth ther own perceptons of the socal world (Alderson 1995; Chrstensen 1990; Chrstensen & James 2000; Hardman 1973; James & Prout 1995; James, Jenks & Prout 1998; Prout & Chrstensen 1996; Van der Geest & Gessler 2003). Summerfield (1998:8) argues that children are not just ‘innocent’ passive victims, but also active citizens whose values are connected to collective meanings and memories. Chldren are recognsed n the UN Conventon on the Rghts of the Chld (1989) as actors wth values and perspectves. For nstance, Artcle 12 of the Conventon s explct about the chld’s rght to freely express hs or her vewponts n matters of concern to the chld, and that, accordng to the chld’s age and maturty, those opnons must be taken nto account n decsons made about the chld35.
Recognizing chld agency s consstent wth the nternatonal move towards studyng chldren as socal actors wth the cogntve abltes to process ther own experences (James, Jenks & Prout 1998; Prout 2001; Prout & Chrstensen 1996). Scholars who vew chldren as socal actors therefore do ethnography wth chldren to elct ther emc vews, experences, perceptons, and actons n the socal and cultural world (Akello 2003; Alderson 1995; Chrstensen 1990; Hardman 1973:89-99; Van der Geest 1996:244).
35 Crtcally lookng at the Conventon, t s clear that for the age group represented n ths thess (8-16 years), there s an ultmate ambvalence concernng the rght to expresson and partcpaton. Chldren are ‘gven’ these rghts wth the rght hand, but the left hand takes them away by assertng that chldren are ‘mmature’ (cf. secton on chld vulnerablty above). Therefore, ths study wll largely rely on scholars of chld agency perspectves n studyng chldren n ther own rght.
Varous forms of chld agency – called replcatonal, transformatve, relatonal, and transactonal agency – have been coned for ths study. They descrbe dfferent ways n whch chldren construct and shape ther socal relatonshps. Wartme chldren wll also be vewed as actve socal actors exercsng ther power through ‘weapons of the weak’ strateges (Scott 1985: xv).
Concernng replcatonal agency, chldren’s dssemnaton and reframng of messages they receve from – among other sources – NGOs, wll be analysed. For nstance, the chldren n ths study were frequently heard tellng others about the mportance of recevng counsellng at Cartas and War Chld. These messages, as wll be explaned, had been reframed and renterpreted to sut ther own level of communcaton so that, for example, what chldren talked about concernng the mportance of counsellng dffered from what they practced when confrontng ther sufferng.
Relatonal agency wll be used as a tool to analyse how chldren construct socal networks, and n partcular networks whch are useful n dealng wth daly challenges. For example, a substantal proporton of chldren ndcated that chld-to-chld nteractons were more useful to them than adult-to-chld relatons.
In transactonal agency, chldren’s quests for professonal healthcare wll be vewed as medated by dfferental power relatons. For nstance, chldren’s nteractons n professonal and non-professonal healthcare contexts were n general shaped by ther occupaton of a lower socal echelon than the healthcare gvers.
Whereas transactonal agency s used to analytcally address chldren’s dsadvantaged poston n socal relatons, transformatve agency dscourses assess chldren’s perspectves n order to generate recommendatons for emergency healthcare nterventon, and school health re-programming for children above five years. In particular, such recommendations must be consstent wth chldren’s healthcare prortes and needs. Transformatve agency should further be vewed n connecton wth non-responses to projects n wartme desgned to promote chldren’s emotonal wellbeng. In short, chldren’s non-response to calls for counsellng wll be nterpreted as smlar to what James Scott, n hs book Weapons of the Weak: Everyday Forms of Resistance (1985: xv), calls ‘foot draggng, fegned ignorance and weapons of the weak strategies’; as attempts to influence the re-design and mplementaton of approprate and acceptable nterventons, thereby transforming project desgns. I use transformng here wth cauton snce, as I elucdate n subsequent chapters, the functonng of humantaran ad agences s, n the man, guded by preset guidelines and rarely by the beneficiaries’ perspectives, needs, and priorities.
Seekng to elct chldren’s ponts of vew n the arena of health and healthcare s consstent wth contemporary development dscourse and plannng whch uses mcro-to-macro level perspectves as opposed to macro-to-mcro ones (Chambers 1989:1-8; Katwikirize & Odong 2000; Leten 2003:10-18; Wess 1988:5-16, 2000; Wess et al. 2000). Central to the process of drawng from mcro-level perspectves n plannng s the dea that many key project planners in the past century had only hazy ideas about beneficiaries’ prortes, and were gulty of wastng resources on less successful ventures. The mcro-to- macro level approach in project planning aims to avoid this pitfall through beneficiaries’ partcpaton, dervng development prortes through consultaton, and usng ther vewponts n project desgn (Chambers 1989:6; Wess 1988:14). It has therefore been agreed that where donors’ ideas override the needs of the beneficiaries, their present and future wellbeing may be jeopardized. Literature in the field of development economics further suggests that macro-economc plannng has, n the past, allowed the ntroducton of projects whch turned out to be expensve falures. Evdence shows that n some cases, projects even had a negatve mpact, such as an ncrease n women’s workload, ncrease n wake-tme, and a lack of sustanablty (Chambers 1989; Oakley 1994; Wess 1988). The need to elct local level perspectves for project desgn became clear. Accordng to Chambers (1989:1), micro-level development involves modifying projects to fit local conditions through a decentralized analysis which encourages, permits, and acts on local concepts and priorities as defined by the poor people themselves.
Although the perspectves by Chambers (1994), Leten (2003) and Wess (2000) are donor communty based and adult centred, ther arguments are consstent wth ssues pertnent to ths study: nvestgatng wartme chldren’s perspectves and emc vews n order to generate recommendatons for polcy and plannng for nclusve healthcare for chldren. It s proposed n ths study that chldren can dentfy the ‘common’ llnesses that they experence, and I dscuss how they deal wth them themselves, accordng to ther prortes. Premsed on ths partcpatory approach, recommendatons wll be made to chld healthcare nsttutons, and a project wll be desgned whch s empowerng, and n whch chldren have ownershp (see Akello 2003; Chambers 1989:8; Kalnns et al. 2002:223; Leten 2003).
It s one of ths study’s goals to ntroduce mcro-level perspectves n plannng for the healthcare needs of wartme chldren n chld headed households. It s lkely that such a healthcare project wll be more effectve n drectng ncome and budget allocaton or expenditure towards priorities as identified by the children, and therefore it could be a successful and sustanable project. In a nutshell, by employng chld agency wthn the theoretical framework, this study facilitates the identification of children’s own perspectives and actions in health and healthcare, and the results can be utilized for the development of better healthcare for these chldren.