Initiation to street life: a qualitative examination of the physical, social, and psychological practices in becoming an accepted member of the street youth community in Western Kenya

Abstract

Background: The objective of this study was to describe the physical, social, and psychological initiation practices of street connected children and youths, in Eldoret, western Kenya. Methods: This qualitative study was conducted from August 2013 to February 2014. A total of 65 SCCY aged 11 – 24 years were purposively sampled from the three referral points: 1) A dedicated study clinic for vulnerable children andyouthatMoiTeachingandReferralHospital(MTRH); 2) Primary locations in which street children reside “ bases/ barracks ” ; 3) Street youth community-based organizations. In-depth interviews and focus group discussions were used to collect data. All data were audio recorded, transcribed , translated to English, and a content analysis performed. Results: The overall median age was 18 years (IQR 14 – 20.5 years) and 69.2 % of participants were male. None had gone beyond primary level of education. The majority (81. 5%)reportedtobesexuallyactive.Thestreetcommunity had well-defined structures and rules that were protectiv e of members and ensured survival on the streets. To be fully accepted children had to go through an initiation ritual th at had important gender differences. Common rituals between males and females included interrogation, smearing of black soot, and payment of tax. Ritual practices unique to boys were physical abuse, theft of personal p ossessions, volatile substance use, b eing forced to eat garbage, and sodomy among the physically weak. Rituals unique to girls were being forced to ‘ become a wife or sexual partner ’ , rape, and gang rape. Physical and psychological abuse during initiation was normalized and there were no clear mechanisms of dealing with these forms of abuse. Conclusion: There were important gender differences in the initiation practices of SCCY. Normalization of physical and psychological abuse during initiation contributes to the high health risks faced by these SCCY. Appropriate interventions need to be developed in col laboration with SCCY.